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

Remembering Debbie

I worked with "Nurse Debbie" for several years at a facility for developmentally and emotionally challenged clients and then again in the hospital setting but on separate shifts and floors. Debbie had just started working with me for a couple of days and took me by surprise when she grabbed both of my hands and began twirling me in the hallway and singing Ring-a-Round-The-Rosie. I knew from that day forward, I would never have an ordinary predictable workday if Debbie was on.

We became friends and I invited her for a walk in Tyler Park in Bucks County one afternoon and she seemed to be in awe of how clean and peaceful it was, something that I admit I took for granted.

Soon after that our work schedules and lives caused our paths to diverge.

I read the obituaries daily (a nurse thing) and remember clearly the lump in my throat when I opened the page to see that Debbie had died suddenly. She was 51 years old. In lieu of flowers, friends and family were asked to donate to Today, Inc., a rehab facility for drug and alcohol addiction. I recall an increase in absenteeism, but I never predicted this. I miss Debbie and think of her often. I planted a willow tree in her memory. Although it is still young, it is magnificent and I am not able to walk by it without being in awe of its "presence." I wrote this poem two years later.

Backyard Delusions

I planted this willow tree
after May 23rd,
seeking shelter
from a frozen ache.
Its roots
weave and huddle,                                                             
weathering
red-eyed storms.
Each spring blooms
a presence,                                                   
every day,
I recall.

We walked carefully
across slender twigs
and idle banter,
a surface of concentric rings.                                            
You insisted I not be bothered:
I had my own battles,
my own walks in the park.

Now I survey this court yard alone,
seeing long flexible legs
whirling down on the lawn,
tearing up the terrain,
making my chin drop,                                                         
and blink to                                                                        
find you
gracefully
sitting there,
breathtaking and
beautiful,
so quiet,
and so quiet.

Certificate in Complementary and Integrative Therapies

Drexel On-Line: Certificate in Complementary and Integrative Therapies
This will be my next new adventure. Will be studying herbs, aroma therapy, holistic living, and natural remedies for womens health issues in the fall. I am hoping that medicine meets the reality of how much our mind and spirit effect the body. It is hard to ignore the gravity of this when you spend 12 hours a day at a patient's bedside. We must branch out to include a more holistic, natural treatment of our patients. They deserve it.

What Do You Do to Relieve Stress?

I tend to get my camera ready when I approach bridges because sometimes there is a spectacular view. I saw this sign several times approaching the Tappanzee Bridge on the way home from my vacation. I immediately felt guilty about having such a wonderful and relaxing week and wondered what it would be like to have so much stress that you felt compelled to jump off a bridge.

Sometimes I feel inept with helping patients whose stress has gone beyond what their body can handle. I recently had an alcoholic patient who was 49, jaundiced, bloated, ventilated and sedated. So young, so sad. She's what we call a frequent flyer (multiple admissions to the hospital due to chronic illness that is not well controlled). I will be surprised if she celebrates her 50th birthday. My other patient was admitted with palpitations and was put on a medication to prevent withdraw from alcohol because he drinks daily. There was some speculation that his racing heart was due to "holiday heart" (sometimes increased alcohol use can trigger rapid atrial fibrillation, which is an irregular fast heart rate).

I got to thinking how our habits are so entrenched that we don't care if we are killing ourselves as long as we get quick temporary relief from our stress. Alcoholics in particular, have it tough because their method of stress relief is more damaging to the body than any other. We all have habits that are automatic when we encounter stress, many that are harmful to the body, mind, and/or soul. I think we all could use help when trying to change habits. I found a free web-site called goalforit.com. It helps you to set goals and make positive changes. I struggle with simple things like drinking enough water and eating enough fruit (and grabbing junk food and coffee). I have a daily reminder set to my email and cell phone. I have been successful in uping my fruit intake and tackled being consistent with my daily vitamin. I have yet to incorporate a daily stress relief plan that includes consistent exercise, yoga, walking, biking or meditation. If you struggle with similar goals, sign up for goalforit.com and become friends with me there. We'll cheer eachother on!

Like the 12 step programs of AA or NA or GA or OA, etc., I think we need each other to help us not only achieve goals, but deal with everyday stress. If you are struggling with addiction, check out AA (or google whatever your addiction is) and find a meeting near you. There are even on-line meetings to get you started. Reach out and help yourself. Life is precious!

Mental Health Checklist: #1 Look at the Beauty in Front of You

This past week I spent some quality time with my hubby in Wellfleet, MA. I relish not only our time together, but the beauty of our great country as well. When we conversed with other couples who stayed at the same B&B, they all commented on where we live (Bucks County, PA) and how beautiful it is. Sometimes we forget to appreciate the beauty that is right in front of us. Looking up at the sky, I asked my husband, "Are the clouds always this beautiful ?" I had my answer when I took the time to look up at the sky today.