Determinants of Health - A Humbling Learning Experience

During my time as a front-line nurse, I was able to meet some incredible people. I was also able to meet some who seem to have the odds stacked against them. Those “frequent flyers” who would repeatedly visit ER for one reason or another. I used to become frustrated with this cycle of patients who seemed totally unable to cope with life and the challenges that come along the way.

One of my biggest learning curves while transitioning to Home Care from the hospital setting, was the challenge of providing care on “their turf” rather than in the hospital setting.

Resources are available to you but are most often at a distance. And above all, the patient had the control and the to refuse your care. It is a humble experience, to be invited into a person’s home to do your job.

You get that opportunity to assess the living environment and meet the family and friends who may offer them social support. You may learn that your diabetic patient simply is not able to afford to buy the appropriate foods to maintain the diabetic diet. They may not have running water in their home in order to clean their body, not to mention the dirty socks they use to hold the dressing applied in the ER. They may only have a junior high level of education which could limit their ability to work, or even know how to secure employment. They may also be the patient whose grandmother “swore by” Dettol as an antiseptic for open sores and it is unlikely you are convincing them otherwise.

Having these relationships in the community is key, however even this approach is too late. It’s time to have the tough conversations, offer increasing support in the community, and hold people accountable.