One Size Does Not Fit All

Recently I had the opportunity to observe as our nurse Maria worked her health education magic with a patient. Rogelio* was a Spanish-speaking middle-aged man struggling to cope with his comorbid conditions of obesity, prediabetes, high cholesterol, and hypertension. Maria used her patience, in-depth medical and cultural knowledge, and creativity to turn his difficult situation into a more manageable one by tailoring her lessons to his needs.

Her first step was to ask him about his current level of understanding of his own health, using open-ended questions. By gaining a sense of our patient’s knowledge, Maria was better able to adapt her explanations to fit his understanding. Then, with the utmost patience and diligence, she proceeded to go through each of his health conditions, one by one, and every medication he was prescribed. I was most impressed by the creative analogies and comparisons she used to help Rogelio understand complicated medical information. For example, she used an analogy of a balloon to explain how ACE-inhibitors work to relieve blood pressure. To describe how insulin helps shuttle blood glucose to areas of the body that need energy, she compared it to putting away groceries after grocery shopping. With each explanation, I could see the understanding grow in Rogelio’s eyes. His sense of helplessness decreased and he felt less overwhelmed by terms such as “lisinopril” and “hypertension.”

She also helped him understand how his conditions were related and how obesity can lead to his other problems of high blood sugar, blood pressure, and cholesterol. Using references from their shared Mexican culture, she explained how these conditions can be caused, as well as treated, by lifestyle changes. As she spoke about Mexico’s active lifestyle compared to the inactivity of the United States, Rogelio agreed wholeheartedly. Her effort to relate to his cultural background was much more effective than simply telling him to exercise more and eat healthy.

Through creativity, understanding, and education tailored to him, Maria helped Rogelio leave our clinic with a new sense of autonomy and confidence, ready to lead a healthier lifestyle. Watching her work and learning from her example has been the best training I’ve received thus far. Maria demonstrated how being a successful health educator requires so much more than simply having the knowledge; you must also know how to deliver the information effectively to each unique patient. Our patients come from diverse cultural and socioeconomic backgrounds and have a variety of education levels. One size does not fit all. With Maria’s help and example, I have learned to be creative in my health education sessions. I strive to meet each patient where they’re at in their understanding and ensure they leave our session feeling empowered to take charge of their health.

*name has been changed

This blog post was written by NHC Chicago 2017-18 member Lena Law.

Lena is a health eduacator at Heartland Health Center - Albany Park and Roosevelt.