Show them how it’s done

Healthcare professionals should exemplify the healthy lifestyles they preach. 

It’s almost as if chronic diseases have become more infectious than the plague, and we are beginning to find out that they are just as deadly. The outlook is rather bleak.

As healthcare professionals we are in the position to encourage patients to start implementing lifestyle changes. The question is, should we be telling our patients to change or should we be making those changes first ourselves?

The ultimate acid test

I was at a conference recently and after one lecture on the therapeutic effects of a particular herb on cognition, one member of the audience asked the presenter whether or not he took he herb himself. There was no problem that I could see in someone genuinely wanting to know whether a fellow healthcare professional acted upon what they’d learnt from their research, considering the proclaimed effects were so positive. In one sense this could be seen as the ultimate acid test! Here was someone who had researched a herbal medication and had intricate knowledge of its therapeutic benefits, in fact, you would expect that he did use the drug, considering the evidence for its use was so strong. The presenter answered in the affirmative that, yes, he did like to use the herb for improved mental pep occasionally. The audience sat back and nodded, somewhat satisfied and perhaps comforted by this assertion. This was the answer they had been expecting.

But before that lecture, there had been one on dementia prevention. It was an exciting and highly informative lecture and ultimately, I thought, inspiring: How we can start preventing dementia right now, in our children and throughout our own lives. One of the key strategies, proven to help prevent the onset of dementia is...can you guess?

Exercise.

Exercise, the wonder cure for everything, cropped up in almost every lecture on health and well-being that day. It was impossible to miss the message: exercise is crucial for the maintenance of health and well-being and illness prevention, both physical and mental.

Now, when a medical professional so strongly advocates a practice that will help to prevent a serious illness that could hit anyone one of us, a practice that is applicable to everyone at every point in their lives, my question is: Why didn’t anyone raise their hand and ask, ‘Do you exercise?’

OK, perhaps some there would have felt it rude to question a colleague on such a thing, considering that it would allude to his own self-discipline and self-motivation. But apart from that, is there any difference between the herb question above and this one?

This leads me to my point: If doctors and nurses are advocating particular practices to their patients, practices that are evidence based, proven to help members of the community and their patients stay healthy and well, should they, or, should we, be role models and modify our own health behaviours as a means of demonstration? We study and are examined on how to motivate our patients, via conversation, to modify and change their lifestyle so that better health may ensue. But is it study that is needed, or would role-modeling be more effective? (Now that would make an interesting study!).

Scenarios

Imagine I was a mother worried about vaccinating my children after having read a load of anti-vaccine rubbish online. Imagine I go to my GP or practice nurse and he says that I should vaccinate my children, but what if I find out that he chooses not to vaccinate his own children. How might I feel then? Or perhaps I am a smoker, keen to quit. Yet my ward nurse for the day reeks of stale cigarette smoke whilst counseling me, nicotine stained fingers checking off the most effective ways to quit.

Imagine I am in my mid 40s, I go to my practice nurse for a check-up. He finds I am overweight and mildly hypertensive. He advises me to change my diet and lifestyle and encourages me to exercise every day for one hour at a time. What if my GP is heavily overweight and doesn’t look as if he has done a day of exercise in his life? How might I feel then? I should be able to separate my GP’s health issues from my own and undertake his advice and go about making dietary and lifestyle changes. But would the potency of his motivational interviewing be affected by the appearance of his own lifestyle habits and choices?

But what about if my practice nurse was in his mid 50s, competed in weekend sporting activities, trained every day and ate a wholesome diet. Perhaps he stands out as especially trim and muscular and has a desk decorated with a couple of sporting medals (great motivational conversation opener!) and racing shots. The waiting room may be full of magazines focused on sport or healthy cooking. I think that in this scenario, I personally would be much more encouraged to undertake a lifestyle change. I believe I would be inspired by this older man or woman who managed to achieve what I may feel is impossible.

How do you think you would feel?

Do as I say, not as I do?

Why, in the first place, do we encourage patients to change their lifestyle to improve their overall health and fitness? The truth is, we are not ultimately advocating dietary changes and exercise regimes to give our patients the best bikini body on Bondi Beach!  No, it’s much more mercenary than that.

Healthier patients reduce the burden of disease on society. Unhealthy bodies are expensive. So you tell me whether there is an element of hypocrisy involved when a healthcare professional urges a patient to stop smoking, drink less, loose weight, eat better, exercise more, when they themselves are not doing their ‘bit’ to reduce the disease burden.

It’s not fair

The down side to admitting this, believing this and acting on this means that being a nurse or a doctor becomes even harder than it already is. It also feels totally unfair.

We work jolly hard, saving, changing and supporting life. Surely it is an injustice to expect us to conform to an ideal ‘healthy’ picture in addition to the physically and mentally strenuous workload we deal with each and every day?

After nine hours on your feet running up and down a busy ward, who feels like running 21km then filling up on a salad?

Start thinking about you

There’s no way anyone could insist that nurses, and doctors become the perfect healthy role model to their patients, in the same way a car mechanic shouldn’t necessarily be scorned for driving a shoddy car.

But the fact remains we humans, as a race, are getting heavier, more sedentary and chronically sicker. Motivating patients to change is a frustrating business so I wonder whether it’s time we temporarily shifted our energies away from our carefully scripted motivational interviews and spent some time thinking about our own bodies. Perhaps by implementing healthy changes into our own lives, we will naturally become role models patients will want to emulate; and you’ve got to admit, that would be pretty cool, don’t you think?

Naomi Cook is an RN and children’s author. nursenaomi.wordpress.com

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