Creating a Win/Win Through Teaching Patient Responsibility

There is a condition that runs rampant among healthcare providers, particularly within the nursing profession. The root cause is that providers as a group attach high value to caring for others and being of service. The symptoms include major bouts of empathy and concern, a willingness to do as much as possible for the patient, and a tendency for patient care to go far beyond one’s job description. The resulting side effects include stress, fatigue, burnout, and lack of time for self-care.

While patients and their families often appreciate your efforts, taking on the role of “healthcare provider as problem solver” may not actually be the best approach or produce the most sustainable outcomes.

For example, ask yourself how often you have taken the time to research resources and solutions for patients, only to find that they rarely take action based on your recommendations or use them consistently? How often do printouts, brochures, and phone numbers connecting patients with valuable services land, unused, in a patient’s file folder or, worse, in the trash? How often have you anticipated your patient’s next visit, eager to find out how he or she liked the yoga class or the cancer survivor support group that you suggested, only to learn that the patient didn’t attend?

Time and energy are both limited resources for everyone these days, and for most people, stress levels are at an all-time high. When your efforts result in no action by the patient, it can be deflating. In turn, patients can experience feelings of guilt or shame for not following through on the supportive suggestions we may make in an effort to improve their quality of life. Yet there is an easy, no-cost tool in plain sight that can turn the situation around for you and your patients; it’s called responsibility.

You help your patients the most when you support them in being personally responsible for finding solutions that will work best for them. When we do too much for patients, we can unintentionally reinforce their sense of not being able to address their own needs. Telling patients how to remember to take their medications is not as effective as helping them create their own strategy for doing this-an approach that requires much less effort on your part.

Here are some quick tips for helping your patients to be more responsible:

Tip 1 - Help patients assess what they need.
Consider the example of a new medication that must be taken with food and may have a side effect such as constipation. Here’s a sample proactive discussion between the healthcare provider and patient that supports patient responsibility:

• Based on the information I’ve provided, what do you feel is the best way for you to remember to take your medication daily in the morning with food?
• What tool or tools do you normally use to remind yourself of a scheduled event?
• What kind of support, if any, do you need to make sure you follow your plan for remembering?

Tip 2 - Help patients assess what they already know.
This approach builds confidence and plants the “seed” in the patient’s mind that the patient has successfully managed his or her personal affairs in the past and, therefore, can most likely succeed in doing so now.

• With regard to the potential side effect of constipation, what has helped you in the past to either prevent it in advance or to resolve it when you experienced it?
• What, if anything, would you need to have on hand when you start taking your medication, should you become constipated?

Tip 3 - Remind patients that support is just a phone call away.
Some healthcare providers are concerned that they are “passing the buck” to the patient and don’t want to appear to be doing so. Reminding patients about how and when to reach out for medical assistance helps them to feel supported and reassures them that they are not being left to their own devices. For example, let your patient know what to do and whom to call if a side effect persists beyond a certain point in time.

Putting patients in charge of certain aspects of their care-particularly in regard to things they can do to improve their quality of life-creates a win for them and a win for you. Dealing with a medical challenge can quickly disrupt patients’ self-confidence and self-trust. When facing a major illness, patients often feel that their body has betrayed them. Learning that they can improve certain conditions related to their disease helps them to feel more in control. When patients take charge of care areas that they are capable of managing, this frees your time as a healthcare provider, allowing you to shift your focus to tasks that require significant medical expertise.

Clearly, there are times when putting the patient in charge is not an option. You will know when only you have the expertise to jump in and find the solution to a particular problem. Trust your instincts, but if you follow the tips that I have outlined, you will most likely find yourself with more energy and more time. Importantly, you will probably also witness your patients become better self-advocates, more resilient, and more confident about being a partner in approaches aimed at enhancing their own wellbeing.