I entered the nurse practitioner profession in the primary care setting. As idealistic as they come, at least in regards to my profession, I was ready to jump in and make changes in my patient’s lives. I approached health coaching with enthusiasm, helping patients see where their diets were off track, sharing smoking cessation techniques, and recommending regular exercise. I applauded reported lifestyle improvements. In the face of pressures to see more patients and generate higher revenues, health coaching wasn’t always easy to fit into appointments, but I put a lot of time and energy into the effort. Until I began to lose steam, that is.
It seemed that regardless of my efforts, patients failed to heed my advice. They returned home from appointments only to forget completely about our conversation where the patient had agreed to a daily 30-minute walk. In some cases the patient was so unhealthy, that incremental lifestyle change seemed hopeless. A loss of 5 lbs. in a 400 lb. individual was an improvement, but hardly one that would have a significant impact on health status. Slowly, I became disillusioned, discouraged by the task of encouraging healthy lifestyles. It seemed that most patients wanted a quick fix through medication, anyway.
Many nurse practitioners I talk with experience similar feelings of disillusionment. Charged with inspiring healthy behaviors, they enter the profession ready to stamp out obesity, sedentary lifestyles, and chronic disease. Their efforts, however, seem to yield few results causing them to lose professional inspiration and motivation. The other day I had an experience that gave me a glimmer of hope that my efforts have not been in vain.
Out for my daily jog, a black suburban stopped in the parking lot adjacent to my running path. A middle aged man stepped out of the car and flagged me down. Thinking he wanted directions, I paused to address him. “I promised myself I would stop you the next time I saw you”, he told me.
The man, fit and wearing athletic clothing, let me know that he had weighed an additional 40 pounds more 18 months ago. He had once been athletic but had let himself go over time. Overweight, he was chronically tired and felt he couldn’t exercise, even if he had wanted to. On his way to work in the morning, he would notice myself and my running group jogging. One snowy, dark morning he was surprised to see that the ice and brisk temperatures hadn’t hindered our routine. Then, that summer, he noticed me running despite 90 degree heat. “If she can get out of bed regardless of the weather and run everyday, I can too.”, he told himself. So, he did.
At first, he let me know he could only muster a slow jog with walking breaks. As he lost weight and gained stamina, he was able to increase his speed and run comfortably. He resumed playing tennis, a sport he had formerly enjoyed. He felt fit and confident. “You really changed my life, so I wanted to thank you” he said.
I appreciated the encounter with the stranger. I never would have known that my commitment to take care of myself was being so closely watched. It was encouraging to know that I had unknowingly inspired someone else to get healthy.
I tell this story not to get a pat on the back for my own habits, but to say that as nurse practitioners, we likely experience similar scenarios with our patients. Changes in behavior may not occur with a single nudge. You may feel like a broken record, but repeated encouragement is often required in health coaching. And, you never know to what kind of action or words could cause your advice to click. Some patients respond to verbal cues, others are motivated by observing you and others set healthy examples.
Growing frustrated in our roles as healthcare providers is natural. We can’t force people to change. But, we can keep trying, knowing that our efforts are having unacknowledged, positive effects.
Have you grown frustrated with trying to inspire your patients to live healthy lifestyles?
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