Uncovering the 'hidden heart' of your patient

22 January 2016

ROSEMARY MINTO believes the key to making a difference to patients is finding the self-belief system driving their health behaviours. Read on to find out how out the primary health care nurse practitioner has chosen New Year's resolutions to help her to do just that.

New Year always spawns new resolutions, old regrets and dire predictions about the future of the human race. The media seems to target those of us who are too fat, too lazy, too dedicated to smoking or drinking (or any other vices) and too environmentally challenged.

This makes me wonder how we humans have managed to survive at all for so many centuries. My conclusion is that core to all our life choices – be it who we connect with (or who we don’t), who we partner with, what we eat and how we live – are the relationships that sustain us (or not). I believe that our relationships with the other people in our lives, created by choice or circumstances (including being born into our families), ultimately influence who we are and who we become.

I look at some of the people I am privileged to care for and I see not only a mother struggling with five kids, battling alcohol addiction and poverty, but also the small child within who was abandoned by her own mother, left adrift from her whānau with no sense of self worth and no positive role model. And that obese man with no job, because his leg ulcers won't heal, is still an 18-year-old boy with an abusive father who tells him he is a worthless waste of space, which has moulded the core of his self-belief system into a destructive pattern of self-harm. Death by overeating is the external mechanism of choice. 

The tricky component to changing behaviour is embedded in that complex system that houses our self-beliefs. Evidence has shown that if this belief system (our understanding of our world as it relates to our identity) is threatened, we are much less likely to want to make changes. So to lead a horse to water, or to facilitate a person to make better lifestyle choices, requires not only knowledge, but also uncovering that 'hidden heart' or the self-belief system that drives a person’s behaviours.

Once that hidden heart is revealed, we can use our unique relationships and connectedness with the wider health system to facilitate change for that person. Only by understanding – and then in a therapeutic way persistently challenging the values that underpin people's choices and attitudes – will we address health issues like obesity and family violence that are so damaging to our wellbeing.

I believe the training you have had or how theoretically well you have achieved as a health professional matters little if you are unable to connect, to communicate, to care, and to uncover the hidden heart of the person you seek to help. Listening, giving your time, and being willing to wait until the time is right for change, are all skills every health professional needs to have in abundance to win this war on illness.

The more I see of the social ills – poverty and family violence, the diseases of our modern society – the more I feel that my role should be more than a 'technician of health', who monitors and treats blood pressure and the like, and should place more emphasis on being a 'caring connector' who assists people to move positively to wherever they need to be to help them get well and stay well.

So this year my resolutions are to listen better, hear more and care constructively. 

 

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