Success Strategy: Environmental Scan
Happy Nursing Week!
This year’s theme from the Canadian Nurses Association is Health for All.
This means “not just the availability of health services, but a complete state of physical and mental health that enables a person to lead a productive life.”
What is this elusive concept and why does it fall on nurses to advocate for it?
Health is in contrast to illness.
In general, the medical system works from an illness paradigm. Hospitals and physicians support those who are ill so they can recover and become productive. You as a patient are encouraged to only visit your physician when you are unwell or for routine visits that look at only a few indicators after which you are told whether you are healthy or unhealthy.
On the other hand, Nurses work from a health paradigm. Nurses work to support not only the individual, but their family, communities and society at large to prevent illness and support health. Nurses build a partnership and walk alongside the patient to coach them into health.
As a Nurse Practitioner I could just spend 5 minutes with my patient to diagnose and prescribe, but instead I also take the opportunity to connect, explore and prevent. I know that an extra 10 or 20 minutes up front to educate, explore family and financial dynamics, and discuss prevention will lead to better health in the long haul.
As per the old wisdom, instead of feeding my patients, I teach my patients to fish.
I have seen the revolving door health system in Ontario. Patients are supported a just enough to get them stable and out of the door and then, when they are unable to replicate their hospital lifestyle at home, they return to hospital as sick as when they left.
For example, in a patient with heart failure the hospital provides daily medication adjustments, vital signs monitoring, and structured daily activities including highly skilled nursing, physiotherapy, and a tailored low salt, heart healthy diet (however unappealing).
When a patient leaves the hospital to return to their home environment they are advised to continue the same and follow-up with their primary care provider. Even if they have changed, their home environment has not. Their primary care provider sees the patient and advises them again to take their blood pressure, monitor their weight, exercise and eat a heart healthy diet. Inevitably, with an unchanged home environment, the patient stops monitoring their weight and blood pressure, dietary salt increases, and daily exercise falls off. The patient returns to hospital in heart failure. The cycle repeats
Nightingale was famous for her attention to the environment.
The power of natural light and a hygienic environment were game changers to improve outcomes in her patients!
In modern times, the environment is more complicated. We recognize even more factors affect mental and physical health.
There is both tremendous opportunity in new technologies and tremendous risk in ignoring them.
We are both more connected and more isolated than ever.
You have the power to create physical and mental health in your life through personal change, but not without also changing your environment!
Gain awareness and take action!
Environmental Scan
Scan your environment to assess how healthy it is.
Ask yourself the following:
Home
Does your physical environment give you shelter?
Does your physical environment give you safety?
Does your physical environment give you joy?
Family
How are your relationships with your family?
Do you make time for connecting with family members?
Are your family members a good influence in your life?
Do you set healthy boundaries with family members?
Friends
How are your relationships with your friends?
Do you make time for connecting with old friends or making new friends?
Are your friends a good influence in your life?
Do you set healthy boundaries with your friends?
Nutrition
Are you set up for good nutrition?
Do you know how to access and prepare nutritious foods?
Do you need assistance to maintain a healthy diet?
Where in your community can you get assistance (ie. financial support or nutrition education) in improving your diet?
Physical Activity
Do you get 30 minutes of physical activity most days of the week?
Is your environment, including your schedule, set up to support physical activity?
Where in your community can you get assistance in improving your physical activity?
Work
Do you have a secure employment?
Do you feel safe in your work environment?
Do you feel like a valued team member?
Does your work bring you joy?
Finances
Are your finances secure?
Do you have rainy day or retirement savings?
Are you being financially taken advantage of?
Do you have the financial knowledge you need and where in your community could you access assistance for learning?
Screen Time and Online Activities
Are you spending time in front of a television, computer, tablet or cellphone? How much?
Are you consuming or creating content?
Are you consuming content that is having negative impact on your mental health?
What content would improve your mental health?
Are you creating content that is damaging to the mental health of others?
Could you create content that supports the health of others?
Offline Activities
How do you spend your time offline?
Are you spending any time in nature?
Do you spend time working on your mental health through meditation, mindfulness or counselling?
Are you participating in physical activity most days of the week?
Are you spending time on mind stimulating activities offline most days of the week like reading, in conversation, doing puzzles, or getting active?
Are you participating in the health of your community or society at large?
If you have scanned your environment and found areas for improvement take action in honour of Nursing Week!
Change Your Environment, Change Your Health!
