Every Patient Should Ask Questions!

What Questions Do You Have?
As I full-time diabetes educator, I spend all my time teaching patients in the hospital. At the beginning of my teaching sessions, I often ask if the patient has any burning questions.  I would estimate that 99.9% of the time patients say, "No, not really." Their answer is not based on the fact that they already know everything about diabetes. I often teach patients who have had diabetes for 5, 10, 15, and even 20 years or more who are lacking in a knowledge of the basics of diabetes physiology and management. I believe the reason why patients don't have any questions, is because they don't know what they don't know, and they simply don't know what to ask.
Questions to Ask About a New Diagnosis

Let's pretend that you have a new diagnosis of diabetes, for example. Wouldn't you like answers to the following questions? (Note: Most of the questions below are appropriate for almost any new diagnosis.)

1. What type diabetes do I have?
2. What caused this?
3. How is this going to change my life?
4. Can you help me understand what is happening with my body and why my blood sugar goes up when I eat the same thing that has no impact on someone who doesn't have diabetes?
5. Is diabetes inherited?  Are my children at greater risk for getting it?
6. Is there something that can be done to prevent other family members from getting it?
7. What complications can there be from diabetes, and how can I prevent them?
8. What lifestyle changes can help me manage diabetes as well as possible?
9. When should I call the doctor?
10. What side effects are possible from the medication I'm going to be taking?
11. When should I take my medication?
12. Will I be going home on insulin?  If so, can I practice giving it with you watching me?
13. Are there some classes available or good books or other resources to help me?
14. Can a dietician come and talk to me about my diet?
15. What is the expected course of diabetes?  Will it shorten my life?
16. Is diabetes curable?
17. How often should I check my blood sugar, and when should I check it?
18. What numbers should I be aiming for?

It's Never Safe to Assume
As I mentioned before, I have often found that patients who have had diabetes for literally decades have never been properly educated. The same is likely true of many diseases and conditions.  Busy nurses and physicians often assume that patients who have had diabetes for years have received at least basic diabetes self-management education, for example.  It isn't wise for caregivers to make that assumption.  It is also not wise for patients to assume their nurses are going to teach them everything they need to know!  That's why questions are so important. 
A Case in Point - Mrs. A
Mrs. A was admitted to the hospital with cellulitis of her right foot.  She was diagnosed with diabetes 9 years earlier, and she had been checking her blood sugar three times a day faithfully, just as her physician had advised so long ago when she was first diagnosed.  I was asked to see Mrs. A., and one of the things I asked her was What are your blood sugar targets?  In other words, when you check your blood sugar, what numbers do you hope to see?  Mrs. A. hesitated just a moment before she answered I don't know! 
The purpose of checking one's blood sugar is to get feedback.  The numbers on the glucose meter let patients know if their diet and activity choices and their medication are having a positive impact on their blood sugar.  Unless patients knows their targets and whether the numbers they are seeing are acceptable or not, checking blood sugar is a waste of time. Of course, patients should write down the numbers they see and take their log with them to their doctor visits, but they should not rely completely on their doctor for feedback every few months.  They have a tool in their hand that can give them feedback every day!  So what question didn't get asked or answered?  What numbers should I be looking for when I check my blood sugar? 
Nurses Love Questions!
I'll tell you why nurses love questions.  It helps them educate you, the patient!  Also, when you ask questions, it hints that you are motivated to take good care of yourself, and nurses love it when patients are fully engaged in that way.  Finally, nurses truly want to make a difference in their patients' lives, and giving answers that help patients is very rewarding for the nurse.
When You Really Aren't Sure What Questions to Ask
If you are absolutely stumped and just don't know what to ask, because you have no idea what you need to know, then I suggest two things: 1) ask some friends or family members what questions they think you should ask. 2) Tell the nurse, At this point, I don't know what questions to ask. Can you please tell me everything you would want to know if you were in my place?
Be Persistent
If a nurse or physician tells you that someone is going to come and teach you about your new diagnosis, make sure there is follow through.  In some hospitals, certain specialists, such as the diabetes educator, do not work on weekends.  If you are going to be discharged on the weekend, and the person who is supposed to come to your room to teach you about your diagnosis is not available, make sure the nurses provide you with education.  There should be videos available and printed material.  And speaking of printed material, it is highly unlikely that you will remember everything you are taught, so please ask for printed material that you can refer back to when needed.
A Smart Patient is a Patient Who Asks Questions
Not only do your caregivers want you to be safe in the hospital, they also want you to be safe once you go home.  So please be sure to ask lots of questions so you know exactly what to do at home to prevent a readmission.  And if you have more questions once you get home, call your own primary care physician and ask even more questions!  The more questions you ask, the more knowledge you acquire.  SMART!