Change_Paper

Change Part I I will exercise three days a week for a minimum of thirty minutes. To some this may seem like a very simple change that would take little effort. Time is a very important and scarce commodity at this stage in my life, so as small as it may be it is a substantial change for me. Exercising regularly will help to improve stress, sleep, and my overall health. “There is a continuum of meanings underlying statements of intended changes…from consideration, through aspiration, to a commitment” (Overton, McCalister, Kelly, & Macvicar, 1999). Implementing this change for me is not only important for the benefits of exercise but for me have a small look into the change process I will be helping my patients plan and implement. Implementing a regular exercise routine is important for many reasons, the most important being health. The great thing about the effects of exercise on health is that it does not discriminate. Once tailored to an individual, exercise can have a positive effect on all ages and genders. Exercise helps to maintain muscle strength, heart health, cardiovascular health, bone health, and many other aspects of healthy living. Another important health benefit of exercise is its effect on stress. Exercise decreases stress by increasing ones overall health and sense of well-being. This happens when exercise causes the release of extra endorphins or the “feel-good neurotransmitters.” In reducing stress exercise can improve sleep which can be affected by stress. Being able to control your stress yourself with exercise can give you a sense of control over your own body and your life. I know how important exercise is and used to love going to the gym. Life has just gotten so busy that exercise has taken a back seat to school and family. I began contemplating this change after having my thyroid removed and gaining fifty pounds in a year I realize how important exercise will be in trying to maintain a healthy lifestyle. I have decided that I need to implement this change for my own self-esteem and to set a good example for my children. One other motivating factor is the hope to work as a flight nurse one day. I will have to maintain my weight much better to accomplish this goal and exercise will be a large part of doing this. My plan to implement this change was to walk for thirty minutes three days a week. I knew I needed to find time in my schedule and leave room for the unexpected. I blocked out four times during the week to walk. I found my least busy days and planned on walking after dinner. Implementation of my plan was not as easy as I thought it may be. I went for a walk first by myself after dinner. I found this boring and it starting getting dark earlier than I thought it would. Then I went for a walk with my family, I found myself enjoying it more but was at a much slower pace. Then I went for a two hour hike with my family, this I enjoyed and felt like it was beneficial exercise. My barriers have become more evident this week. I know that I will have to contend with the cold, the dark, my family and boredom. With this in mind I have decided I need to vary my exercise choices. If I am bored I will not continue with this change and with winter arriving soon I will need some indoor options as well. I also noticed that if I knew I was going to exercise after dinner I prepared better foods and ate less. I have improved my plan by preparing a list of activities that I can do with my family, indoors, outdoors, and at a gym. I have also bought a video game exercise program to try with my kids. This way I can portray to them the importance of exercise and make it fun at the same time. After this change I realize that I cannot expect my patients to implement changes without some hesitation and barriers. Change is not easy no matter how simple the change in itself may appear. I will have to allow for my patients to struggle and realize what may or may not work for them as an individual. I can then help them reevaluate and implement changes as needed. A large part of this is going to be encouragement and reinforcement of motivating factors. Implementing this change has broadened my outlook on the teaching of patients. I know now that when preparing for a change I need to go through the scenario and look for any possible barriers and address them from the beginning. I also need to look for alternate methods or approaches. An effective method for one may not work for another. One other important teaching idea is to continually reinforce motivating factors; they can be forgotten easily. Change Part II Week one of my change helped me see the importance of varying my routine to avoid boredom and to enjoy the change. Week two I realized that I needed to find something to make exercising more enjoyable. I wish I was one of the people that love to exercise but to me it is just a chore. Week three I found a friend to walk with. This helped tremendously with the boredom because I had someone to visit with. It worked well that she has young children also so on the days I needed to bring the kids along she did also. Week four was a little chilly and getting darker much earlier. I varied my exercises this week and went for a bike ride with the kids. I still feel as if exercising is a chore but I feel as if I am teaching my kids the importance of it which makes me feel good about it. Week five got really cold. This week I resorted back to my video game work outs. It was a nice change but I’m not sure I want to do this all winter. Week six I decided I should try a gym. I am going to try out the YMCA next week since I am able to go free of charge and they have very inexpensive childcare. I do not enjoy the gym as much as exercising outdoors, and I hate that I have to drive to a gym, but this may be the best answer to the winter weather. My plan has been working out well in the aspect that I have been able to stick with it. I do not feel like I have been able to alleviate any stress which was one of my goals. Trying to stick to my plan causes stress of its own when I am trying to find the time to exercise. I may be able to change this by exercising on both Saturday and Sunday as not to compete with my school schedule. One other way I am going to try to alleviate stress through exercise is to try the Yoga class at the YMCA during the winter break. This will give me an opportunity to try something new without having to worry about my school schedule. To maintain my goal I will continue to add exercise into my schedule at least three times a week. I will vary it as much as possible and think of new things to do that I can incorporate my family into. I have not begun the maintenance stage yet and may need some more adjustments but I am well on my way to having exercise be a part of my weekly routine. A reward of this change that is the most important to me is weight loss. So far I have lost five pounds; it is not nearly close to what I need to lose but feels good just the same. Continued weight loss will motivate me to continue this change. It will help me maintain my health, gain self confidence, and realize my goal of someday becoming a flight nurse. After implementing my change for six weeks I realize that my patients may need to adjust their plans many times before they ever reach the maintenance stage, and this is ok. During these adjustments they are going to need constant reinforcement of goals, motivating factors, and best of all the rewards. I have also learned that my patients will likely be ashamed of setbacks. This is why it will be important to set very realistic goals and to reinforce every achievement along the way. I have learned that it will not be best practice to set definite dates for some goals. If a patient is expecting to be in the maintenance stage at six weeks this can be disappointing if this does not happen. Every patient is going to have their own setbacks and adjustments to be made. It will be important for me as a nurse to make the stages clear but make it understood that every person will have their own timeline that may need adjusting many times, and that is ok. As a nurse I will help my patients keep their eye on the “prize” and keep them moving forward towards their ultimate goal. References Landers, D.M. The Influence of Exercise on Mental Health. The President’s Council on Physical Fitness and Sports (PCPFS) Research Digest, Series II (XII). Mayo Clinic. (2010) Exercise and stress: Get moving to combat stress. Retrieved from www.MayoClinic.com/health/exercise-and-stress/SR00036. Overton, G.K., McCalister, P., Kelly, D. & Macvicar, R. (2009) Practice-based Small Group Learning: How health professionals view their intention to change and the process of implementing change in practice. Medical Teacher. 31(11), 514-520. Retrieved from http://informahealthcare.com/doi/abs/10.3109/01421590902842425.