Return-Path: <nifl-health@literacy.nifl.gov> Received: from literacy (localhost [127.0.0.1]) by literacy.nifl.gov (8.10.2/8.10.2) with SMTP id e791dOP11311; Tue, 8 Aug 2000 21:39:24 -0400 (EDT) Date: Tue, 8 Aug 2000 21:39:24 -0400 (EDT) Message-Id: <46.904be74.26c20fb1@aol.com> Errors-To: listowner@literacy.nifl.gov Reply-To: nifl-health@literacy.nifl.gov Originator: nifl-health@literacy.nifl.gov Sender: nifl-health@literacy.nifl.gov Precedence: bulk From: Dwyoho@aol.com To: Multiple recipients of list <nifl-health@literacy.nifl.gov> Subject: [NIFL-HEALTH:2506] Re: The role of non-professionals X-Listprocessor-Version: 6.0c -- ListProcessor by Anastasios Kotsikonas X-Mailer: AOL 5.0 for Windows sub 119 Content-Transfer-Encoding: 7bit Content-Type: text/plain; charset="US-ASCII" Status: OR In a message dated 08/08/2000 11:15:35 AM Eastern Daylight Time, Helen@healthliteracy.com writes: << While I know that our health care system is woefully understaffed and overworked, I personally am not comfortable asking non-professionals, regardless of their training, to assess whether a patient has the knowledge to be safely discharged to home. >> This opens an entirely new line of discussion, one which I think lies at the heart of the problem of understandable health information for all. It seems to me that a very small group of people--health professionals-- have very important, very valuable information which is needed by a very large group of people--all the rest of us, and especially low literacy individuals. What are some ideas to address this problem? Currently, we have uninformed people in need. If it is unwise to bring non-health professionals into the equation, what are the alternatives? Or does Helen mean other professionals are okay, as long as they are "professional", even if not schooled in health care--or even health education (although she does say "regardless of training)? Of course, we all agree that no one should be delivering health information without training. I guess the issue settles on what prerequisite education is necessary. Or are we talking here of an especially sensitive problem, i.e. discharge, and other situations might be more amenable to the use of "non-professionals"? Many years ago, fresh out of college, I worked for Planned Parenthood. I had no background whatsoever in health, only a master's in education. After I was trained to do so, I conducted "exit" interviews/counseling/education sessions with family planning patients about what family planning methods were available, which ones suit which patients, and exactly how to use their chosen method of contraception. I also delievered all the informed consent information. Now perhaps this information was less critical than discharge info from a hospital, although I doubt it. These women would get pregnant if I didn't connect with them to establish a thorough understanding of what to do, and the agency could have been sued if the consent I obtained wasn't properly "informed". I sense an underlying problem that may need the light of day. I'll put it this way with another example from those days in the clinic: When the agency, in 1975, decided to invest in training one of the RNs as a nurse practitioner, all kinds of issues were raised about whether it was "safe" to use a person with this level of training to do what nurse practitioners do--practically everything, in this setting, that a doctor does, working under a protocol of course, and with a doctor near at hand. The same issue of "non-professionals", i.e. less trained people, has been fought for years by nurse-midwives and by organizations such as La Leche League, which utilizes volunteers to deliver medical advice about breastfeeding. In education, we fight over teacher certification. Those who are certified are not comfortable, often, with working side by side with individuals who are not--and there are many instances where this is necessary. The strength of teachers' unions lies in safeguarding their own perceived importance of having the "professionals" in control. Obviously, if a person with less training (than that of a teacher who has four years invested in a college education and specialized background in a given subject area) can do the job, the certified person is threatened. What would we need them for? How much of professional hesitation in trusting and equipping "non-professionals" is based NOT on a belief that non--professionals will do a poor job, but actually on the fear that they might do very well?
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