Heath education has always been a vital part of nursing practice, but it has become increasingly more difficult to accomplish as numerous factors beyond our control threaten its quality and value. Margaret Comerford Freda, writing in the Journal of Midwifery & Women's Health (2004), cites the influx of clients of varying cultures into an overburdened health care system, the lack of time for patient education, the amount of patient educational materials, and the lack of reimbursement for time spent on patient education as significant barriers to effective patient education.