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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.
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'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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