Tuesday, March 23, 2010

Angelique's Afterthoughts: Monday 3/15

Sharon Watkins is a nurse and director of the Wellness Center at N Street Village. In addition to her nursing background, she also has a master's degree in counseling and has worked with drug and alcohol addiction clients. We were at the Wellness Center to conduct a blood pressure clinic with women from N Street Village. Before beginning our clinic, Sharon wanted to meet with us to find out a little more about us, as well as share a little about herself and the Wellness Center. Sharon was absolutely full of wisdom. She offered perspectives based upon her experiences and education that I can only imagine I am years away from discovering for myself. She told it like it is, so to speak. She didn't sugar coat anything, but yet at the same time she used her therapeutic communication abilities to make us all feel comfortable and at ease.

So what did I learn from my time with Sharon? The number one thing that sticks out in my mind is her discussion on how, as health care providers, we tend to get too focused on results. She reminded us that the patients/clients/etc that we work with have their right to autonomy. By focusing on results as our measure of success, we are taking away the role of their right to self determination. We should base our success more on the efforts we put into the situation. At the end of the day, what our patients decide is out of our hands. It does not make us a bad health care provider if our patient makes what we consider to be a "wrong" decision. As simple and common-sense as this may all seem, it is so completely different from the way I've always looked at my patients and the care I provide. Perhaps it's the hospital setting in which I've always practiced that has me so focused on outcomes. Perhaps it's simply that I don't have enough years of experience to have come to these conclusions myself. But up until now, the outcome has been my focus. For example, if I have a patient who had a heart attack and ends up back in the hospital a month later because he stopped taking his Plavix, there's always that element of "did I say enough?" These kind of thoughts are taking away the patient's autonomy. As long as I know I provided the information in the best manner I could, in the end it's the patient's right and responsibility to decide what to do with the information. The choice he made in no way reflects how successful of a nurse I am.

This all makes so much sense, but we couldn't help but question how she keeps from getting hung up on results? I can only imagine how frustrating it must get at times with the clients she works with; if she and the rest of N Street Village have worked so hard to help a woman succeed, but in the end the woman ends up back on the streets and/or back on drugs, how would you NOT feel like somehow you had failed her? Sharon just reiterated the woman's right to self determination, as well as the stages of change (precontemplation, contemplation, etc). Perhaps this time didn't work out, but if what you did even just planted the seed for future change, then your efforts were a success.

Needless to say, I've got more than a little developing ahead of me before I get to this mentality in my practice...We all left the Wellness Center that day feeling like we could have spent an entire day (if not entire week) listening to what Sharon had to say. She has the wisdom and experience that we all aspire to have ourselves someday, and we are all better for the time we did get to spend with her.

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