Patient Navigation: A Humbling Learning Experience

I greeted the tall, middle-aged male patient with a warm “Good morning” as he entered my office for his precolonoscopy visit. It was my first day in my new role as a patient navigator at a gastroenterology office, and I was eager to assist him. As I introduced myself and extended my hand for a handshake, I asked him to confirm his full name and date of birth while glancing at his chart label to verify the information. Despite my cheerful demeanor, I noticed he did not reciprocate the smile.

Inviting the patient to sit, I began the visit by asking, “Do you understand why you are here today?” He nervously replied, “All I know is that the doctor told me it was time for me to have a colonoscopy and said I should come in to talk with the patient navigator to go over the instructions. Do I really need this test?” It became evident from the patient’s body language and his question that he was hesitant about the procedure. I took the opportunity to explain the importance of colorectal cancer screening and the benefits of early detection. To aid my explanation, I brought out a well-prepared binder labeled “precolonoscopy class,” anticipating the potential questions and topics to cover during the visit. Sitting alongside the patient, I used visual aids to illustrate the large intestine, a polyp, and even a colonoscope, which seemed to alleviate the patient’s anxiety and increase his engagement. Following this, I asked the patient, “Do you have any questions about the importance of colorectal cancer screening or anything we have discussed?” The patient responded, “I have no questions right now.”

I then reviewed the step-by-step colonoscopy preparation instructions using a detailed blue pamphlet with accompanying visuals. I explained each step, from the low-fiber diet to the clear liquid diet and the bowel preparation process. After reviewing the instructions, I handed the patient the pamphlet and asked, “Do you have any questions?” I quickly noticed his perplexed expression. At this moment, I realized the patient struggled to comprehend the extensive information and steps involved in the preparation process.

This realization was a turning point for me, leading me to understand that effective patient education required more than just covering the necessary steps; I needed to identify the needs of each patient at a deeper level, understanding that each patient has unique needs. As a registered nurse in the patient navigator role, I found this encounter to be a humbling experience and a significant professional growth opportunity.

It inspired me to seek effective teaching techniques to better educate patients on preparing them for colonoscopies and ensuring successful outcomes. One approach that I found particularly helpful is the teach-back method. This simple yet powerful tool allows me to gauge a patient’s understanding by having them restate the information in their own words.¹

Ultimately, the patient had a successful colonoscopy procedure, and I walked away reaffirming that I should meet the patients where they are and provide individualized care, as every patient has unique learning styles and needs.

Reference

1. Anderson KM, Leister S, De Rego R. The 5Ts for teach back: an operational definition for teach-back training. Health Lit Res Pract. 2020;4:e94-e103.