Nurses in Prevention: Natural Change in a Healthier Direction
I decided to post this here, even though it is my new page information about “Preventative Nursing”. That it is immediately current when you click on the blog site this week.
“People don’t decide their futures, they decide their habits and their habits decide their futures”
I remember when I signed up to take a month long “stress management” class offered by a hospital. My immediate thinking was, “I know I can teach this better than the instructor”, for the simple fact that stress can’t be “managed”- only avoided and/or build a resistance to it. (Like time management you can’t manage the rotation of the earth, you can only manage yourself), but I digress, I was a lot more arrogant then than I am now. My objective was to find out “how” I could do this type of work for this department.
After being the “teacher’s pet” and staying after class to help put up supplies and walk her to her car, etc. We actually started to ‘hit it off’. Soon the question came that I had hoped for? “Lori, have you ever spoke on fitness to the public before?” Without hesitation, I said “Yes!” See, the instructor of this class was also the manager of the Health Resources dept. of the hospital.
I eventually was hired on staff…my title, an “RN Health Educator”. I was finally in a role as a nurse in PREVENTION! For almost 14 years and it was great, but I always had side jobs and ventures going… good thing… because in that 14th year… we were all laid off. Replaced by “wet behind-the-ears” marketing grads and physicians all speaking on new procedures, treatments and surgeries. Why did this happen? Simply, our department didn’t make any money.
We (RN Health Educators) spoke to packed rooms anywhere and everywhere. But most of our “prevention” programs were FREE or nominal costs (and offered food/snacks). The hospital paid for the event supplies, staffing and all the marketing (often thousands of dollars for each event) and they finally had enough. No more “We’re doing this for the good of the community”, our department became expendable. Prevention (education in health and disease avoidance) wasn’t worth it.
We also kept stats on who visited physicians and the hospital(s) after attending or because of a health promotion event we gave.
Turns out people only visit doctors or hospitals when they have a problem or think they have a problem
- either way -
the key word is problem. And usually they are having signs/symptoms.
It’s not surprising, because according to research, it’s human nature. It’s called, “hyperbolic discounting”.
The farther away a reward is in the future, the smaller the immediate motivation to achieve it.
And it’s immediate motivation that’s needed to get someone started in changing their habits. Especially when you are in business to help people make that change, (like prevention in a fitness nursing practice?) and you need motivated buyers.
If not – this is what happens when you’ve just delivered your wonderful, no fluff, benefits driven program and then hear the excuses like:
- “I have to check with my spouse” or even
I’ve had people tell me they can’t afford it, and forgot that I was offering the session for free. HA!
Most of the time, it’s NOT money. People are overwhelmed today – and BALANCE is NOT going to happen. So “can’t afford” can mean their precious time and energy.
There is no urgency in prevention, there’s only “It would be nice to have or do” and the only people who buy into that are those 3%, who are competitive athletes or very health conscious and consider themselves ‘in training’ already.
If you want to “train athletes”, then – go into that highly competitive market. I’m done with that. Be careful because they really can and do know as much (or more) as you do. They are walking the talk.
Fortunately, this is not the majority of the public.
So what’s a nurse interested in prevention to do?
First, recognize this point in human nature that exists.
Second, think about all the people who are already sick (aware of it or not) and offer a natural solution that will immediately work (within a short time), easy to implement and access.
Third, help them get started and give credit to them for things that they are already doing right (I know what you’re thinking… but find something!)
Research also shows that when people feel that they are already doing some of the things necessary to reap the reward, they will be more motivated to “continue” instead of start cold.
Before I get to what we do here about prevention at Fix It Fitness Nurse Consulting™, I have some more bad news about prevention and our healthcare system.
According to Jack Challem’s book, “Stop Prediabetes Now”, in a study done with 4 prominent NYC hospitals, they established programs to help diabetics manage their disease through diet, exercise and blood sugar monitoring. The program was a great success and had a high rate of patients participating. But the 3 of the 4 hospitals shut down the program before the study was completed. Why? The hospitals made more money from treating the complications of diabetes than by preventing the disease. The hospitals actually LOST money when it came to prevention. Should I go on?
…Like I’ve always said, in part, to nurses who tell me they want to work in the preventative side of nursing or healthcare, I’ll write here:
“I know that you’ve had enough of what you are doing and want to help people avoid getting into the situation that you are now caring for them – but answer this – with all that we hear about how better nutrition, increased exercise and vitamin supplements could save the U.S. billions of dollars in health care costs, have you ever wondered why couldn’t they make money? It’s simple.
To save 15 billion dollars in healthcare costs, someone would lose 15 billion in revenues. This includes, but not limited to, food companies, drug companies, surgical instrument companies, labs, hospitals and physicians. Yes physicians. Most know that they are in the “sick care” business because that’s why people go to see them. They’re sick or hurt. Don’t be upset with that. That’s just what MOST doctors do, it’s how they are trained and they are good at it.
Let’s look at surgery, it helps and cures many people. In the case of a bariatric type of surgery, it can earn a hospital $50,000; but there’s little financial incentive to pay a nutritionist $100 an hour to provide regular nutritional counseling.
Please don’t be fooled by the “non-profit” in your hospitals tag line. They are still very interested in earning a profit instead of taking a loss. Success in healthcare is based on revenues, profits and large numbers of patients.
Let’s not forget insurance companies either – They may hesitate to pay $150 for a visit to podiatrist, who can detect early signs of a diabetes-related foot problem; but pay $30,000 for an amputation without question.*
So I’ll stop there. After saying all that, you can see why I just smile to myself when I hear a well-intention nurse say to me, “I want to be in the preventative side of healthcare”… it really doesn’t exist, not within the hospital or the ‘system’.”
What’s the answer?
You have to decide you will not stand for what is currently going on in “sickcare” and be prepared to stick with your decision to improve people’s health, regardless of how hard it gets – you have to step out on your own.
Do what you have to to pay your bills, but also create a plan to do what really wakes you up inside, keeps you alive and drives you to really help people get healthier; you can make a living doing it. It will be hard, you know the saying, if it was easy every nurse would be not just talking prevention, but would be making money doing it. You MUST learn marketing and sales and influence. You will likely give up your free time.
Is it worth is to you?
Yes! You know why?
Because you are already familiar with the “art of persuasion” and how to influence people to do things that need to be done for their best results and to get well. All the talk of sales and marketing may make you anxious and nervous; you just need someone to bring out what you already know how to do. We use proven scientific ways to influence people… your nursing training and experience fits right into this.
You’re here on this site. You’re not alone. You can be part of a movement of nurses who feel like you do and want to intervene earlier, when people are on the pathway to sickness through their lifestyle choices.
Since no one has yet registered the domain PreventativeNursing.com – I decided to do so. To get attention! If you don’t get attention, you have nothing when trying to grow a movement! As a group, grassroots, we can develop our own criteria and present to interested healthcare people who see our vision. We take our programs to our community and talk to healthcare people in those communities.
To me many nurses are all talk. No action. They have an opinion about what you may do or not do, but say the same old standard stuff that I heard back in the 1990′s about balance, stress reduction, finding your power and boneless, skinless grilled chicken breast, brown rice and broccoli.(Oh, don’t forget to eat it 6 times a day to ‘be stable’ or to ‘boost your metabolism’… really? Who ever thought of that wasn’t stable.)
We are sicker and fatter than ever!
That’s not working, say something else already!
Nurses are still miserable. The ones that aren’t… I won’t chastise you – good for you and I mean that. But if you’re so happy in your work; you wouldn’t be on this blog post, right?
No wonder these nurses are not happy or getting results in their “business or work”, no one cares about those things in the mundane way they present them mixed in with how wonderful they are. They’re afraid to step out; worry about what people will think. I’ve ask nurses in the past, “If you believe so much in prevention, why don’t you register the name and start a business promoting all prevention?” One said “maybe, I will”. Do I have to tell you what happened in that story. Nothing happened. She stayed safe and would rather complain about me and my political incorrectness.
I least I stand for something. You don’t have to agree and I just want you to make a decision.
Don’t you admire people who have an opinion; even if it’s different than your own? I have business friends who are vegans; but I don’t promote veganism – We do things together except eat (limited things to do).
I respect them, they have a tribe of followers who love them. I’m happy for them; but I’m not part of their tribe.
So, if you want to be a nurse in prevention, like a majority of nurses who want change do, we challenge you to get real, accept the facts and do something about it and “get dirty” in your community. We can do something in prevention, but in a way to help people who feel they have a current problem; that problem can be reversed with exercise and nutrition/diet.
And here’s what I do when working as a nurse in prevention and and many other nurses who have signed up for this movement, who think in similar ways, who can see the vision and want to be part of something that will have a positive impact in improving health:
We work with 2 specific lifestyle health problems.
Not all health problems on earth.
We PREVENT them from getting worse.
We use the word HEALTHIER instead of health and we meet people where they are.
And we do it as naturally as possible (not always standard conventional, politically correct stuff) using lifestyle habit change and measure outcomes using reliable biomarkers.
We (nurses) usually work with people who are sick, yes that’s what the public perceives that nurses do. We use this in our favor – just because someone is sick doesn’t mean that they can’t exercise or even exercise hard (volitionally)- they can and they should.
We help them do it safely. We don’t take insurance. Yes this is an challenge; but when targeted properly and presented very juicy and obtainable – people will pay for your service.
We are a cash-based business.
We find certain (not all) physicians and advanced practice nurses and physician assistants who want to do more to prevent their patients from getting sicker, naturally first, but don’t have the time and/or resources to do so. We can, legally, help them do so. Lower their liability.
How? You have to get on the list (sign up top right box) a become part of the “real” prevention movement – where we actually take it to the people who we value and they really value us and the health care professionals who want to lower their liability while increasing their cash flow.
Certified Fix It! Fitness Nurses™ only work with targeted clients. For more about our certification program please CLICK HERE
*Challem, J; Stop Prediabetes Now; 2007, pp. 72-73.