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A Heart Pill to Swallow

Written by: Gregory Lafortune – DI Southern Regional Medical Center
Sunday February 14, 2021

It’s February! Love is in the air and nutrition is too! As a dietetic intern, I’ve enjoyed sharing best nutrition advice to people of many different conditions and backgrounds. As nutrition experts, our work is invaluable in this world. The love that we have for our profession and our heart to give people the best care possible should shine through any barrier that tries to stop people from living their healthiest lives. Yes, it is true that people look to us as experts of nutrition.

But here is a “Heart” Pill to Swallow:

We are not the experts. The people we serve are.

A patient dealing with a heart condition, type II diabetes mellitus, and alcoholism was admitted to the hospital with uncontrolled blood glucose levels. We received a physician consult for diet education for hyperglycemia. I prepared my education materials and prepared to do exactly what we were consulted for. I felt good about myself. I planned on approaching the patient with patience, kindness, and hopeful that my love for nutrition would get passed down to him. As I entered the patient’s room, I began my assessment. My preceptor observed me, but I felt ready. I proceeded along with the diet education. My patient listened and seemed to take everything in. I felt more confident as I spoke. To me, it was going very well. As I wrapped my diet education, I asked my patient if he had any questions. I was taken aback at his response. He appreciated the education and told me that it is more of a reinforcement to him. He told me that he normally takes care of his self very well. The ONLY reason why he was in the hospital and couldn’t control his blood sugars was because he recently became homeless, which stopped him from eating the way he was supposed to. I froze. I thought I was prepared. Now I realize that I wasn’t ready. Thankfully, my preceptor took over and proceeded to ask the patient if he wanted help from case management. He responded, “Yes, that would be helpful.”

In my head, I began to question my approach. At first, I felt like the expert. But at that moment, I realized that I wasn’t. I didn’t even ask my patient what was important from his point of view. I just started talking from my “expert” point of view. This was a heart pill for me to swallow. My client knows exactly what he needed. Being homeless stopped him from being able to take care of himself properly. Nutrition education is important, but for him, the most important thing for him was finding a place to live after leaving the hospital. Because once that happens, he will be able to go back to taking care of himself as he was used to. Looking back at it now, I would’ve approached the education differently. At the end of the day, I learned that being relevant and timely is important. What is relevant to me may not be relevant to my patient. This is a heart pill to swallow. I have to choose the right time for my words when my patient is ready to receive them. This is another heart pill to swallow. Here are some questions I now ask myself when approaching a patient:

Relevant. 
What matters to them? 
What is their point of view?
How do they receive information best?
What are they interested in?

Timely. 
What do they care about now? 
How can we meet them where they are at?
What barriers are they experiencing?
What are they ready to hear/do?

Yes, I love nutrition. But my love for nutrition should come second to my love for people. And in my love for people, I should pay attention to their specific situations and needs.  That’s why I believe that our patients are the experts. They know exactly what they are going through. It is our job to make sure our nutrition expertise is relevant to and timely in their lives.