I have been thinking lifestyle risk factors this since I was recently admitted to hospital with acute chest pain. Once I realised that I wasn’t having a heart attack and that my life wasn’t in immediate danger, I was very thankful for my nursing background because, during my hospital stay, no-one talked to me about lifestyle risk factors!
Prior to this admission had been focussing on my health – I was eating lots of fresh fruit and vegetables, had cut out sugar and fatty foods, lost 20 kgs, increased my physical activity by walking and swimming every day, stopped drinking alcohol and worked on decreasing my stress levels.
This lack of talking about risky lifestyle factors is scary and a real issue within the health system. I am appalled that not one person ever asked me about the known lifestyle risk factors associated with cardiac disease. I saw my Cardiologist when I was about to be discharged and he told me that my cholesterol was “in the normal range but should be decreased by the taking statins”. He did not ask about my diet and did not suggest any dietary changes or suggest that I look at decreasing my cholesterol by changing my diet! He has absolutely no idea of what I eat and whether my cholesterol level could be decreased by eating a healthier diet.
There are many potential reasons why no-one brought up lifestyle risk factors with me;
- Lack of knowledge by nurses and doctors of the risk factors associated with cardiac disease – this is probably NOT the reason because I assume that health professionals do know this but for some reason are not talking to their patients about it!
- Lack of time – “yes” the ward was busy but there were many opportunities to raise the topic, especially when giving me my medications or even during the discharge conversation. The ONLY thing addressed in the discharge planning conversation was how to look after the puncture site on my wrist following the cardiac catheter!
- Embarrassment – many of the nurses and doctors were overweight and stressed and some commented that they “were out of shape” and “should get fitter because they were out of breath at work”. From my previous research where I surveyed over 6000 Australian nurses, some nurses commented that they were reluctant to talk to patients about lifestyle risk factors because they themselves were “overweight, smoked, did not exercise or drank too much alcohol and so they felt hypocritical about raising the subject with their patients”.
Things have to change. We are not serving our clients if we do not address lifestyle factors. Luckily, I do know what to do and I am already addressing my lifestyle risk factors! But what about all of those other patients? They’ve been sent home with absolutely NO support for decreasing their risk of having another cardiac episode – and let’s face it, their risk of dying from cardiac disease is already increased. Our job is to decrease their risk, and at the moment, we are failing miserably in doing that!