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In the Internet Age, rumors and misinformation have taken a quantum leap, but a growing number of patients are turning to the Web as a medical resource. The goal for health practitioners is not to smother a patient's desire to gather information, but to direct him or her to reliable resources.

'Ephedra can be used to effectively treat asthma, hay fever and nasal or chest congestion."

"If you have hypertensive epistaxis, you can consume as much salt as you want, as long as you drink enough vinegar to 'cancel it out.' "

"It's all right to take in great quantities of pork fat, even if you've just had your second heart attack-assuming you balance it with cholesterol-cutting cabbage."

An experienced nurse would find these statements ludicrous, but patients have uttered them all in the Internet Age.

Computer programmers didn't invent bad advice, of course. Overbearing dads and next-door neighbors have dispensed their own versions for centuries. But rumors and misinformation have taken a quantum leap in recent years. Practically everyone in America has access to a computer terminal and a modem. And seeing something in print-even if that print is on an electronic screen-tends to legitimize the information.

"A female patient came in. She was having stomach pains," recalled Penelope Vickers, RN, who works in outpatient surgery and endoscopy for Battle Creek Health System in Michigan. "She had done some reading, and was under the impression that stomach pains most often led to stomach cancer. I had to sort through that, to let her know it was a good thing she did all that reading, but it didn't necessarily mean she had stomach cancer."

Unfortunately, the response can't always be so cut-and-dried. Sometimes, a patient's research produces a mix of accepted and questionable information. Or a proposed alternative can reside in a gray area.

"One patient hoped she would regain control of her bladder function if she had the acupuncture treatment she read about on the Internet," said Sandi Disher, RN, who works at a urology clinic in Ontario, Canada. "We told her that we do not see sufficient research to support this treatment, and we do not offer it in our clinic. However, since the treatment was offered by a qualified professional, we did not see any harm in her trying it.

"She did a course of acupuncture, but unfortunately did not achieve bladder recovery."

Rosanne Gephart, MSN, RN, CNM, a nurse practitioner who runs the Women's Health & Birth Center in Santa Rosa, Calif., gets plenty of expectant mothers armed with well-intentioned literature. The most common issues they raise are immunizations and vitamin K supplements, which either can be injected, as in all U.S. hospitals, or given orally, as in Canada and England. Gephart is open to some alternative procedures; however, that doesn't reduce the need to evaluate information and tailor suggestions to each patient.

Gephart recalls one client who was tested as Rh negative and therefore scheduled for a dose of RhoGAM. However, the woman had researched the subject thoroughly and was worried about a preservative often used in the globulin. "She wanted to know what dye lots we had," Gephart said. "I thought, 'Oh my gosh, I'm overwhelmed.' It probably took me two hours to find the company, talk to the right person and find out which batch of RhoGAM we had. But it's a legitimate concern."

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