Deb Bershad: How Motivational Interviewing Helps My Health And Well-being
In the fall of 2014, I took a local university course in Health Navigation. The most valuable aspect of that course was an introduction to Motivational Interviewing (MI). By learning and practicing MI, I discovered how to positively impact my health and well-being, as well as that of the patients I work with.
MI is a highly researched, evidence-based style of collaborative communication that strengthens a person’s own motivation and commitment to change. MI offers the nurse the opportunity to engage with and better understand the patient’s point of reference and barriers to achieving healthier behaviors, provide focus and support for the patients’ personal change process, and reinforce the patients’ personal motivation for change. The process was originally developed in work with Substance Use Disorder, specifically those dealing with alcohol addiction. Its use has expanded to applications in promoting healthier behaviors in patients with chronic disease, providing patient centered care and facilitating patient engagement.
Initially, I had absolutely no intention of using the process personally. I did, however, make a commitment to using it in my day-day interaction with patients. The professional results I have observed have been significant. I have received feedback along the lines of, “I have never felt so listened to and respected.” I have seen patients make positive changes in their personal health behaviors in terms of managing their chronic disease and their ability to more effectively engage with team members. Another unexpected result is that as I have seen these positive changes, I feel more rewarded and satisfied in my impact and role as a nurse.
I believe that as a result of these outcomes, I began to take a closer, introspective look at my own health behaviors. Over the years, I had developed some personal UNHEALTHY behaviors. I had gained weight, was continuing to struggle with sugar addiction, found myself falling into the old habit of emotional eating in response to stress, lacking in regular physical exercise, as well as found myself consuming more alcohol than I was willing to admit to when asked at my annual physical exam. The three to four servings of alcohol a week that I was reporting, was closer to 15-20 servings a week. CDC guidelines recommend that if alcohol is consumed, it should be in moderation—up to 1 drink per day for women and up to 2 drinks per day for men. The sugar addiction is significant, since I am a Type 2 diabetic and have significant family history of diabetes, hypercholesteremia, and cardiac disease.
Have I reached perfection? That would be a resounding NO! Have I made improvements? That would be a resounding YES! For the past two – three years: I have consistently been able to keep my hgbA1c at 6.5 or below. For the past five years, I have maintained a healthy weight, improved labs, and am doing better at achieving my goal of regular, moderate exercise 4-5 days a week. I don’t have to be perfect in reaching my health goals, being better provides the motivation I need to maintain my healthier changes.
If the concept of Motivational Interviewing is new to you, I hope you will consider reading the article in the September 2019 issue of American Nurse Today, for a basic introduction.
Deb Bershad, BS, RN, HCPN, is a nurse whose career choice has been to work at the bedside with patients. As a frontline nurse, she has spent approximately 30 years working in the acute care setting and in the past five years worked as a surveyor for the CA Department of Health & Centers for Medicare Services, and as a Resource Nurse for a community based Hospice and Palliative organization in the North Bay area of San Francisco.
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