I was recently admitted to hospital with acute chest pain. This was my first time in hospital as a patient since I was 14. It was eye opening to be on the receiving end – and I had many expectations that were not met by nurses or doctors.
Prior to this admission I had already started addressing my lifestyle risk factors – over the last four months I have been focussing on my health – I have cleaned up what I eat, lost 20 kgs, increased my physical activity by walking and swimming every day, stopped drinking alcohol and worked on decreasing my stress levels.
While in hospital, no-one addressed any lifestyle risk factors with me at all – despite the fact that I had had what they called a “cardiac incident” with rising troponin levels! During my three day stay, not one person talked to me about what I ate, how much alcohol I drank, whether I did any exercise or how stressed I was (on admission the form asked me whether I smoked and the answer was “no” and so I can understand why that was not raised as an issue).
This lack of talking about risky lifestyle factors is scary and a real issue within the health system. I am appalled that not one person ever asked me about the known lifestyle risk factors associated with cardiac disease. I saw my Cardiologist when I was about to be discharged and he told me that my cholesterol was “in the normal range but should be decreased by the taking statins”. He did not suggest any dietary changes and did not ask me what I normally ate or suggest that I look at decreasing my cholesterol intake by changing my diet! He has absolutely no idea of what I eat and whether my cholesterol level could be decreased by eating a healthier diet.
There are many potential reasons why no-one brought up lifestyle risk factors with me;
1. Lack of knowledge by nurses and doctors of the risk factors associated with cardiac disease – this is probably NOT the reason because I assume that health professionals do know this but for some reason are not talking to their patients about it!
2. Lack of time – “yes” the ward was busy but there were many opportunities to raise the topic, especially when giving me my medications or even during the discharge conversation. The ONLY thing addressed in the discharge planning conversation was how to look after my arm after the cardiac catheter!
3. Embarrassment – many of the nurses and doctors were overweight and some even commented that they “were out of shape” and “should get fitter because they were out of breath at work”. From my previous research where I surveyed over 6000 Australian nurses, some nurses commented that they were reluctant to talk to patients about lifestyle risk factors because they themselves were “overweight, smoked, did not exercise or drank too much alcohol and so they felt hypocritical about raising the subject with their patients”.
Things have to change. We are not serving our patients if we do not address lifestyle factors with all patients, but especially with those who have a “cardiac incident”. Luckily, I do know what to do and I am already addressing my lifestyle risk factors! But what about all of those other patients? They’ve been sent home with absolutely NO support for decreasing their risk of having another cardiac episode – and let’s face it, their risk of dying from cardiac disease is already increased. Our job is to decrease their risk, and at the moment, we are failing miserably in doing that!
If you are interested in learning how to address risk factors with patients, using health coaching, then click this link for our new, updated course (and earn CPD hours as well)!