What the nursing process can teach you…A FIVE PART SERIES (continued)

healthy living waterfallI often wondered if the nursing process–assessment, diagnosis, planning, implementation, and evaluation– could be applied to anything requiring a practical format for change.  If you have been following this series, I hope the answer is YES.  In my opinion, nursing contributes more to society than credited or realized.  My point in writing this series, is not only to illustrate how this process can help those outside the field, but to indelibly reflect the contribution nurses make in many ways–unsung and unnoticed.  Ok I’m done.

Prevention has always been a passion for me.  Witnessing first-hand the “afterthought” when it comes to illness, I now choose to utilize my skills in prevention.  Specifically–this means healthy living and fitness.

IMPLEMENTATION–the last stage before evaluation, and the “let’s get to it” after PLANNING, is my favorite part.  It all starts to take shape here and now.  Was my assessment correct?  What about my diagnosis of the situation?  Will my plan work?  Time to find out.

IMPLEMENTATION is indeed the “let’s get it done” phase.  It is also where plans can fall apart.

You PLAN to work out 3 times a week, for at least an hour.  You’ve made up your mind you will get up at 5:30am, go to the gym–or do that almost impossible looking DVD.  This is the commitment.   BUT–you over sleep on Monday; Tuesday you have an early commute, and Wednesday you awaken to a flat tire.  Thursday the baby sitter cancels, and Friday you are just too tired to think.  The weekend is here at last–maybe now, well maybe not.  Sound familiar? I know it does to me.  My intentions were good, but my follow-through was anything but.

I had the best excuses too.  I’m on my feet all day(that’s my workout), I have a young son, I don’t have mom or mom-in-law around to help, I’M JUST TOO TIRED.  These reasons were great–25lbs later, not so much.  What did I learn from all of this?  A PLAN IS JUST A PLAN, UNTIL IT BECOMES AN ACTIVITY.  Only then is it IMPLEMENTATION.

My solution?  For starters, I got a treadmill.  If I didn’t wake up early enough for the trail, there it was–staring me in the face.  Kind of like a neglected lover.   That impossible DVD?  Who said I had to do every minute of it?  Those on the DVD certainly took breaks.  Also, who said my workout had to be in the morning?  Yes, I was tired; some shifts were so hectic, there wasn’t time to go to the bathroom.  Yet I found if I went to the trail–even for a walk/run, it re-energized, yet calmed me down from a stressful day.  Paradoxical as it may sound–it’s true.  I was more patient with my son, and still had energy for the rest of my evening.

At first, the extra effort produced marginal returns.  However, I found a large part of IMPLEMENTATION, IS DETERMINATION.  That determination meant redesigning my plan.  It also may meant forfeiting one thing, in hopes of gaining (or losing) another.  How did this translate for me?  No workout equaled less food; and no sweet after dinner (this WAS a CHALLENGE).

What happened?  I saw results–some I expected, others I didn’t.  Yes, I lost the weight I wanted.  Yes, I had more energy, as well as patience at the end of the day.  So what were the unexpected consequences of this journey?  My son now 16, runs cross-country and track.  Once infatuated with White Castle cheeseburgers (he ate several at a sitting) he now refuses to eat any burger, more than twice a month.  He has exchanged doughnuts in the morning for yogurt or cereal bars.  He runs/works out 5 days a week.

For every action, there is an equal and opposite reaction.  I’m not a chemistry or physics major, but I don’t have to be to know this.  I’m just a nurse, implementing her plan.

All for now.  Keep up and keep at it.

Questions? Comments?  Contact me at serrenity.c@gmail.com


What the nursing process can teach you–A FIVE PART SERIES (continued)

healthy living waterfall

Live life unscripted–we’ve heard this in ballads, and touted throughout pop culture.  Most of us realize life is unscripted; especially when our best laid plans go awry.  Yet that’s just it, somewhere along the way–there was a plan.

PLANNING is a pivotal stage in the nursing process.  Why?  It paves the way for IMPLEMENTATION & EVALUATION.

PLANNING usually isn’t a complicated task; it’s sticking to it that gets in the way.  Sound a bit ridiculous?  It should.  However, it’s a reality we all face; in one way or another, at one time or another.

From a health and fitness perspective, PLANNING is KEY.  However, it’s the IMPLEMENTATION or follow-through which leads to lifestyle change.

For the moment let’s stick to PLANNING.  As stated earlier, planning isn’t usually complicated.  We’re going to keep it that way.  Yet, our plan should include these vital elements when thinking fitness–nutrition adjustment, move modification, and education.  I have coined the term NAME.

Everyone has a name-a proper noun to which we respond, when we hear it.  Unless something traumatic occurs, most of us will not forget our name.

Nutrition adjustment is the make or break element here.  You may have been told it is exercise.  Exercise is a must; but your weight loss battle is won or lost at the table.   You can actually gain weight, even if exercise is part of your daily routine.  You must expend or put out, more calories than you take in.  It really is that simple; and that complex.  For specifics on caloric expenditure, see my post under Nutrition.  Furthermore, recent theory suggests that unless you are moving throughout your day, an hour at the gym if the rest of your life is sedentary, may not be beneficial.  Will keep you posted, as some of these clinical trials are very new.

Move modification may mean walking throughout your day, running, resistance training, home workouts, or any combination thereof.  The point is this–do something.  If you have not engaged in regular exercise, have mobility issues, or restricted because of cardio-pulmonary compromise–this doesn’t spell the end or let you off the hook.  Every workout is not for every body.  Your responsibility is to find one that is right for you.  Proper consult with your physician, as well as thorough ASSESSMENT, are essential to your PLANNING.  ACSM (AMERICAN COLLEGE OF SPORTS MEDICINE) prescription principles suggest the following:

Cardiovascular exercise–should be 3-5 times a week, for 20-90 minutes.  The routine should be continuous and rhythmic in nature

Resistance training–should work major muscle groups to their full range of motion (ROM), with control of speed.  Eight to ten exercises of 2-4 sets each

Flexibility–In order for your muscles to “trust you,” you should hold your stretches for at least 15 seconds.  Flexibility training should be 2-3 days per week, to mild discomfort (Mild discomfort is difficult to define for everyone.  When in doubt, consult your MD; and especially your own body).  Flexibility training can be static or accomplished with help–15-60 seconds for each; working towards 3-4 repetitions

EDUCATION–or continuing education, is tantamount.  How many of us have returned to school either to “brush up” on a subject or acquire new knowledge?  From floral arranging to learning to speak a different language, most of us desire to know more.  Even if the desire isn’t always there, the requirement may be.  Modifying your lifestyle to reflect your weight loss/fitness goals require education; continuing education.  This doesn’t just mean looking up new exercises or diet trends.  More notably to you, it means interpreting your own data.  Understand what your body is telling you AND document it.  In this way, you have a written record of your successes, failures, and everything in between.  It can also be a useful tool when discussing progress with your trainer or medical professional.  The point is you are educating yourself, about yourself.  This is essential for your nutritional as well as exercise component.

As a nursing student, I was constantly reminded “if it’s not documented, it’s not done.”  That mantra has seen me successfully through false allegations of neglectful care, to assessing new employee skills in the field.  With this in mind, I cannot stress enough, the importance of documenting your progress; even if its regress.

NAME is just a reminder I use.  However, it can be useful to remember and reconcile your PLANNING stage.  There are countless ways and means to see you through.  Regardless of what you choose–have a plan.  Even if needs revamping, rethinking, or rebooting, HAVE A PLAN.

All for now.  Keep up and keep at it.

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Questions?  Contact me at serrenity.c@gmail.com