Posts by GillianGivens:

    Improving Yourself for Your Patients

    April 14th, 2013

    By Gillian Givens.

    mexico

     

    Health care professionals have an unprecedented ability to prompt change in the patients and families with which they interact. Professionals within the healthcare realm are extremely influential in critical life changing experiences. It is crucial to understand that you, as a health care professional, are many times viewed as a source of hope and positivity by many individuals that are affected by a single, sometimes devastating, event. A certain diagnosis carries with it a multi-factorial series of implications in both the experience of the individual patient and the lives the patient will effect in the present and future.You have the ability to empower healthy change in your patients and all of the people that they will touch in their lifespan. Imagine being able to affect at least double the number of individuals that you interact with simply by acting as a catalyst for healthy change in your patients.

    While the patient has been mentioned many times, the core of proper holistic care takes root in the attitudes and biases of the professionals that they interact with. The root of the issue with subpar health care lies in the nurse or physical therapist treating the patient, NOT the response of the patient themselves. While this idea may seem strange, I would like you to consider a realistic scenario that I have personally experienced many times while on clinical rotations: a health care professional with a negative attitude that always seems to be complaining,  yet becomes frustrated with a patient because they are not “compliant” with treatment and considered to be difficult. From an observational standpoint, how can we as health care professionals expect our patients to demonstrate the commitment and enthusiasm that is necessary for them to evoke positive change and healing, while we ourselves are being negative and critical? The basis of that interaction is completely unfair to the patient and does not uphold excellent patient care. However, it is not to say that some patients are more difficult to reach because of barriers like dementia and Alzheimer’s, but it is critical to radiate healing energy regardless of the medical diagnosis. Health care professionals are healers. We must work hard to first heal ourselves before we expect our patients to heal themselves. I would like to outline some areas of focus to begin this journey of self discovery, to better heal yourself and those that you are helping to heal.

    1.) Self-awareness

    To begin this process, the practice of self-awareness must be at the forefront of initiating the process of self-healing. By becoming more self-aware, you are able to share these tools with your patients, and promote their internal healing processes. Self-awareness is oftentimes linked to awareness of the corporal self, how we move through space and get into our car and drive to work. However, it is imperative to realize that while the physical body is an element of our self definition, the energy and words/actions that we choose to release into our environment are extremely important. With every word and action you articulate and execute, you have the ability to either create negative or positive change.

    While to some a few words may not seem to make a huge difference, I beg to differ. Imagine saying a few words to a critically ill patient such as “you will never get better”. Imagine the impact that those five words have just imposed on a patient that has been struggling with depression and anxiety while in the hospital. You alone, have now become a central  stimulant to begin a process that feeds into the negativity that is already taking place. Choose your words and actions wisely, your patients and their families are looking to you as a source of support and positive change.

    Working in a health care environment can oftentimes be daunting and stressful, there are no illusions with this truth. Practicing self-awareness in an environment like this takes practice and effort which is sometimes difficult, especially when exhausted. Taking an internal scan of how you are feeling and reacting to your environment is especially critical during times like these. If you feel that you’re absorbing negativity from the environment, change your thinking. YOU alone have the perspective and self-awareness to dictate how you respond to situations, not your environment or your patients. Self-awareness requires commitment and discipline, but I can guarantee that once you become aware of the effect you have on others, you will be better able to truly listen and connect with patients in a way that allows a deeper, more meaningful healing interaction.

    Tips:

    • Quick meditation to center yourself.

    • Awareness of your breath to refocus yourself.

    • Focus on the goal, not the distractions.

    • Journal

    • Learn from your patients: learn something from them that stimulates positive change in you.

     

    2.) Healthy Empathy

    The complexity and range of emotions that occur with patient care is inevitable. There will always be complications, tragedies and human suffering no matter the environment. This also is an universal truth, and is a shared human experience that comes in many forms but share a common basis. Being able to provide the empathy that patients require, while not internally storing it, is crucial to ensure excellent patient care and to avoid becoming “burned out”. I learned this lesson very quickly while rotating in the Intensive Care Unit. In the beginning of this rotation, it was extremely difficult for me to interact with patients/families that were experiencing so much loss and not “take it home with me”, so to speak. I found myself leaving the hospital drained and sad, and in the process demoralized to a point where I was sure that my patient care was suffering. I felt emotionally exhausted and though I was grateful for these experiences putting my life into perspective, I had to develop coping mechanisms that were respectful to myself and to my patients. Witnessing the balance of life and death every day, pushed me to approach empathy in a way that was healthy and productive instead of being a source of depletion.

    Empathy involves the ability to “feel” for another human experience and to also recognize it as being legitimate. There are ways to perform both of these actions while being able to preserve the core emotional homeostasis that you require for your own well-being. I learned very quickly to differentiate between peripheral and core empathy: peripheral empathy acknowledges and participates in the shared human experience of loss and joy without necessarily internalizing it. Core empathy is choosing to internally store components of an experience in a way that helps to promote self growth. There is choice with empathy; make choices that create internal change in a healthy way, and avoid choices that cause emotional instability. Imagine the peaks and valleys of human experiences that occur in one standard day in a hospital setting: a baby being born, a beloved matriarch passing; to personally absorb each and every one of these experiences completely disrupts your emotional center. Lacking emotional resiliency results in unreliable patient care. Maintaining a perspective of emotional balance is integral for yourself and your patients.

    Tips:

    • Realize that suffering/grief is a natural part of the human experience and choose when to internalize it.

    • Journal difficult experiences and think about what can be gained from them- internalize if it creates positive change.

    • Encourage your patients to be grateful, remind them of blessings.

    • Participate in an activity after work that can be enjoyed separately from the stressful environment: create your own oasis.

     

    3.) Welcoming Change with a Compassionate focus

    Change is another reality of health care that will always be constant. The evolution of a patient’s journey from sickness to healing involves a long chain of remodeling. From my experience, change is not always welcomed because it is mysterious and presents an element of the unknown. Both therapist and patient experience this element of mystery; whether it be dealing with a new diagnosis, a tricky family situation, or a sudden change in the patient’s medical experience. Rather than being intimidated by this dilemma, use this experience as a platform to focus change within a patient-oriented, compassionate scope. Encourage family members and friends to participate in welcoming this change. Ask your colleagues and other members of the patient’s medical team to accept situations that may seem like drawbacks, as being a necessary and positive transformational step in the journey of the patient.

    As a student in physical therapy, I have often been at the forefront of trying to instill positive, healthy changes in my patients. This role in care makes me an agent of change. The fact that we as healthcare providers, encourage change in our patients’ lives, also means that we ourselves need to be willing to accept change. I believe that most individuals would consider themselves to be dynamic beings; if this is true, then why would we limit ourselves to static experiences that don’t allow us to reinvent ourselves? Change should be viewed as a chance to grow and explore. Always be thankful for it, and realize that it seldom presents itself in the form that you desire but facilitates the growth that you require. If you communicate that willingness and acceptance of change with your patients, they will be more willing to accept and hopefully encourage others to view change the same way. We live in a society that values instant gratification. Realize that change is a process that takes time, patience, and commitment. I often find myself hoping to create dramatic change instantly both in myself and my patients, and not respecting the beauty of the process that it encourages. In Deepak Chopra’s book Reinventing the Body, Resurrecting the Soul,  he outlines a concept known as subtle action which involves the healthy approach to change that is necessary:

    1.) You go inside and make your intention known.

    2.) You believe in getting results.

    3.) You don’t resist the process of change.

    4.) Your body shifts effortlessly at the physical level.

    5.) You repeat your subtle action until you have mastered the change you desire.

    The beauty of this process is its’ simplicity; it doesn’t involve processes that exhaust and overextend you, thereby making change seem impossible. Adopt this attitude and follow these steps to encourage this behavior in your patients. Teach them the skills of self-awareness and compassionate thinking that you have mastered, so that they may master a healthy approach to their experiences and encourage this growth in others.

    Tips:

    • Use the process of subtle action.

    • Emphasize change in a compassionate spectrum by involving everyone you can. Gain fresh perspectives.

    • Accept that change is natural and should be welcomed as part of the human experience.

    • Re-assess your inner motivation and believe that the opportunities/experiences you need will be present to you without struggle.

    • Encourage change as a positive concept in patient care.

    • Get rid of your comfort zone; reinvent yourself.

    • Rid yourself of your own biases: engage the patient, not your perception of them.

    • Consider yourself and your patient as dynamic beings; share all elements of human experience.

    • Stop thinking about yourself, Give!

    I hope that the steps outlined above have challenged and renewed your perception of excellent patient care. Take steps to promote your self healing and you will master this potential in your patients. Think on a big spectrum, you can never be sure of the amount of healthy change you alone can cause!

    Resource: Chopra, Deepak. Reinventing the Body, Resurrecting the Soul. New York: Three Rivers, 2009.

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    Healthcare And Women Violence Problem

    April 4th, 2013

    By Gillian Givens.

    Healthcare improvements in the comprehensive management of victims of sexual violence: The Violence Against Women Reauthorization Act of 2013

    In 2009, 52.3 out of every 100,000 women were victims of attempted or forced rape in the United States; this statistic does not include statutory rape or other types of sex crimes3. According to the Rape, Abuse and National Incest Network (RAINN), a new victim of sexual violence occurs approximately every two minutes.

    In 2013, the range of crimes involving sexual violence is vast, affecting both men and women of various ages in a vast number of forums (technological and physical). The prevalence of rape has decreased 60% since 1993, saving thousands upon thousands of possible victims of sexual violence2.

    This decline is significant and reflects ongoing policy to maintain this current rate and to further decrease it. Continued legislation and advocacy efforts to prevent and protect victims are imperative. The role of health care in this process is also fundamental. Health care professionals are usually some of the first resources to deal with victims of sexual violence and its implications.

    The aim of this paper is to provide a brief summary and raise awareness of the House of Representatives Bill H.R.11: Violence Against Women Reauthorization Act of 2013 that was recently referred to the committee on January 22, 2013.

    This bill, which aims to alleviate and hinder violence committed against women, is a vital piece of legislature in current affairs and the greater scope of domestic violence policy.

    To begin, the basic premise of this bill is to reauthorize and amend the Violence Against Women Act of 1994. The Violence Against Women Act of 1994 addressed several important facets of violence against women including policies regarding rape, accessing appropriate resources to report cases of domestic violence, and passing legislature to enforce accountability of sex offenders.

    This new bill hopes to further expand and define practice and approaches to handling various aspects of the vast spectrum of issues affecting victims of domestic violence currently. This bill provides a comprehensive view of the many issues plaguing victims of domestic violence including economic and housing provisions for victims of violence, protection for battered immigrants, safety for Indian women, sex offender management, stalking and preventative measures to reduce tragedies.

    Though these issues are vast and equally important, title V of this bill: Strengthening the healthcare system’s response to domestic violence, dating violence, sexual assault, and stalking, will be further explored and delineated as an effort to advocate for a comprehensive and healing approach within health care management of victims of sexual violence.

    Title V of this bill addresses several facets of the role of health care in this issue including the implementation of education, training and nationwide strategies dedicated to the comprehensive and respectful treatment of women who are victims of sexual abuse.

    This title targets a large female population ranging from children to elders, thereby making it applicable to a diversity of patients. In addition, this act also targets a large scope of health professionals including those in the “medical, dental, nursing, social work, allied health services and mental/behavioral health” fields to provide effective strategies and the necessary academic background in health care to provide a multi-factorial and holistic approach to treating women.

    Patient confidentiality, professional licensure, accurate documentation, forensic examination/collection and access to on-site resources and professionals are additional health care efforts 1.

    It is critical that health care professionals are well versed in understanding and receiving the proper training to act as advocates for victims of sexual violence and to more effectively deal with the plethora of issues that these atrocious acts imply.

    The prevalence of sexual violence is significant, and it is very likely that health care professionals will interact with patients that have suffered these crimes.

    As a student within the health care community soon to be working with the professional healthcare sector, I realize how important it is to fully grasp the needs of patients that have experienced these crimes.

    Victims of these offenses are faced with obstacles effecting every aspect of their being. This being said, health care is not strictly limited to treat the physical effects of these crimes, but can be used as a platform to advocate for the effective and comprehensive use of resources in the treatment of patients to address all of the implications.

    Physical therapists have the unique ability to treat, advocate and initiate healing in their patients in a variety of ways through active listening and understanding the complexity of their human experiences.

    Health professionals are critical in the constellation of services that this bill hopes to engage and improve upon. Supporting this bill helps to raise the advocacy and implementation of services, professionals and programs that victims of sexual violence explicitly require.

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