Motivation and the Magic Bullet

A nurse is faced with not only teaching his/her patients about healthy lifestyles, but is left with the monumental task of motivating people to change.  Sometimes I think, if only I had a motivational pill....I'd first take it myself........and then give it to my patients....ahh, yes...the magic bullet.

                                                                            

Unfortunately, most people think the same way-they want the quick fix, but even when left with medicinal treatment options, I find some people are still not motivated.  I recently had a patient who admitted she has bad behavior when her blood sugar is high and she proceeded to use profanity and cursed at me, called me a liar, and told me she wasn't going to do anything I said.  She began crying and I asked her what was wrong and she said that the kitchen would only send her diet syrup.  Her behavior was outrageous- she started tearing everything off and rocking back and forth on the bed, pulling her hair and crying.  Her blood sugar was over 300.  When I asked her if she checked her blood sugar at home, she said no.  When I asked her if she needed a blood sugar machine, she said she has one but just doesn't use it.  I'm sure there were many underlying issues in this situation, but there was at least one obvious solution.

I was left wondering why anyone would know a solution to a painful situation and still not be motivated to change.  Then I looked in the mirror.  I know that being overweight is unhealthy and it causes strain on my joints and a multitude of other health issues.  I have plantar facitis which is aggravated by being overweight, if not the cause.  This condition causes severe pain in my foot when I wake up and take my first steps of the day...outrageous pain and a wake-up call!....  yet how motivated am I to change?

I saw my daughters college Psych 101 text sitting on the table and decided to refresh on Motivation 101. 

The old self-fulfilling prophecy.  Definition:  An expectation that is fulfilled because of the tendancy of the person holding it to act in ways that bring it about.

Ok, so I do expect that I will probably never reach the goal weight that is acceptable for a 5 ft 4.5 in. female.  How do I change that expectation?  Well, that depends on my

self-efficacy.  Definition:  A person's belief that he or she is capable of producing desired results, such as mastering new skills and reaching goals. 

Am I able to handle challenges-what is my level of confidence?  Well, I have lost weight before, but the nagging devil on the other shoulder says, "yeah but you gained most of it back."  So I need help on my self-efficacy.  Ok how do I do that?

By having successful role models who teach you that your ambitions are possible and from having people around to give you constructive feedback and encouragement. 

So why do we in the health care system tell people to do this and that and send them on their way without a clue as to what their expectations are, their beliefs are, or their self confidence to achieve is?  Who gives them constructive feedback and encouragement?  The Psych book really caught my eye when I read that self-efficacy has an effect on just about every aspect of  people's lives and went on to list the aspects and included:

                             even their chances of recovery from a heart attack.

We do have cardiac-rehab after a person has a heart attack, which is definitely a step in the right direction.  But if there is one thing that I feel our system needs it would be encouragement and continued support after discharge.  I give patients scripts for new medications, but can sense that they are not confident at times because they haven't even accepted what has happened to them yet, let alone what the solutions are and how the medications will help them.  I wrote this poem in an effort to share my frustration of our "system" and how we treat patients-mostly with pills (which by the way is what most people want).  Please do not misinterpret my intentions-I think medications are an important part of medicine and therapies towards health, and I do not wish to make light of any of these serious conditions, but I do believe that we have to start introducing alternative and complementary therapies more often in conjunction with traditional therapies (meds). 


Pill Therapy

What record are you playing in your head?
Has life left you feeling tired, tired, tired?
Don’t worry… just take a pill instead.

These pounds you have to shed, shed, shed?
Take this med- you’ll be kill-appetite inspired.
What record are you playing in your head?

Bills, bills, bills have you in the red, red, red,
and your last two jobs? Fired and fired.
Don’t worry… just take a pill instead.

Can’t doze-si- doze when you climb into bed?
A capsule each night will get you unwired.
What record are you playing in your head?

Spider and speech fill your head with dread.
Mind’s a flash, flash, flash, of memory transired.
Don’t worry… just take a pill instead.

If you would’ve jumped, you’d be dead, dead, dead.
This tablet, twice a day, is all that’s required.
What record are you playing in your head?
Don’t worry… just take a pill instead.

So, what IS the solution?  My take:  Avoid isolation and reach out into the vast sea of humanity BUT on the other hand I think if you hang with monkeys then your gonna eat bananas.  So off to the gym I go where people are encouraging and working towards being fit.  Weight Watchers?  Why not?  I'll keep you posted!  Please share any of your success stories or solutions you found to motivate yourself.

Invitation to Psychology, Fourth Edition, Carole Wade and Carol Tavris