- How do we help him manage the insidious effects of the disease and treatment – constipation, fatigue, bloating, sensitivity to heat, melancholy, etc.?
- How likely will the surgery, chemo, radiation, steroids affect his prognosis and quality of life? What if he doesn’t want them?
- When and for what should we contact you and if not you, who? When should we go to the Emergency Department?
And where care lodges, sleep will never lie.”
― William Shakespeare, Romeo and Juliet
My grandson, age 4: Opa (that’s me) go get your cane, let’s play in the yard.
Individual best health depends on organizational best health. I spent a valuable portion of my professional career working in behavioral health. Organizations and individuals all suffer tragedies from time to time. Many similarities exist between organizational improvement and personal recovery. For example, an addicted person follows a longstanding behavior without question. The behavior affects the addict negatively, even tragically, but definitely results in poor performance. Resistance to change is fierce. The addict will not be forced to change. When the addict perceives the hopeless of the addiction, usually in a heightened state of collapse and despair, he or she becomes open to exploring new behavior patterns and significant belief systems become rearranged, thus creating positive change and subsequent improvement. Paradoxically, hope evolves from despair or surrender. Healing occurs first in the spirit, then in the mind and last in the body.
- Bounce back
- Take on difficult challenges and still find meaning in life
- Respond positively to difficult situations
- Rise above adversity
- Cope when things look bleak
- Tap into hope
- Transform unfavorable situations into wisdom, insight, and compassion
- The capacity to make and carry out realistic plans
- Communication and problem-solving skills
- A positive or optimistic view of life
- Confidence in personal strengths and abilities
- The capacity to manage strong feelings, emotions, and impulses
A best health goal is a milestone in a health journey. These goals can be set individually or collaboratively with a health team. Goals can run the continuum from lose 10 pounds in the next 3 months to make an appointment with a dermatologist to stay alive until my grandson’s wedding. The goal can be one of several, such as walk 50 feet with assistance, manage pain without IV’s or injections, and have meals brought to my home so I can be discharged. Goals need to be specific, measurable, possible, and explicitly stated. One of the characteristics of valued members of my health team is that they help me set goals and attain goals. If they can’t do this, they aren’t part of my team. The goals that I have set with my team this past year include lose 35 pounds in 9 months, walk at last 5 miles per week, do eye exercises 10 minutes every day until the double vision decreases, and stretch my quads twice a day. I have been able to meet all but the last one. Factors for success for me have been that the goals were stated and written; I kept a log of my activity and progress; and these goals were discussed at every opportunity when I met with members of my team, including my wife and my family. As a nurse it’s inexplicable to me how disconnected goal setting can be from the patient. While every profession has a treatment, care, discharge plan, often the patient and family don’t explicitly collaborate in setting the goals and mapping progress happens in the patient record or between professionals and not consistently with the patient and family. How can we get better at setting explicit measurable goals with our health team?