CHAPTER 27

The Nurse as Client

LEARNING OUTCOMES

Upon completion of this chapter, the nurse will:

PERSONAL CARE

The title of this chapter was selected to get your attention. This chapter is for you—the telephonic nurse. It is very easy to fall into patterns that are harmful to your health, particularly when moving from a position of direct care provider to one of telephonic nurse. Probably, one of the major issues is that of weight management.

Weight Management

Most everyone has heard of the “freshman 15”: a first-year college student gains 15 pounds because of late-night eating and other indulgences. Well, there is a similar phenomenon in telephonic care. It is called the “telephonic 20.” Yes, you read it correctly. There is the potential to gain 20 pounds just from changing jobs.

How can this happen? It is really quite simple. As a direct care provider, you were moving constantly. The only time you might have been seated was to document and even that was interrupted by answering call lights, taking phone calls, or rushing to provide a pain medication before going into report. You were expending a great deal of physical energy and might not always had a chance to have a meal. Your caloric expenditure was equal to or possibly even less than what you were taking in.

Then you applied and were accepted for a position as a telephonic nurse. In your new job, you drive (or use some other method of transportation) and park in a lot next to the main office. You might have to walk a few hundred steps to the elevator. Then you walk to your desk (or cubicle), hang up your coat, put away your personal items, get a cup of coffee (or something similar), and sit down at your desk to begin your workday.

Calls are presenting to your desktop and you are on a roll. Before you know it 2 hours have passed, and you put yourself on “break” through the dialer. You walk to the break room (or staff kitchen) and chat with a few colleagues, read through a new posting on the bulletin board, and pour another cup of coffee before going back to your desk.

You resume working until your lunch break. You tell the dialer you are on lunch, and you talk with other team members and share a pizza that was delivered a few minutes ago. The time flies, and you get back to your desk and resume your workday.

During an afternoon break, you walk to the photocopy machine to make a copy of a cheat sheet for a new employee and then return to your desk for a few more hours of care calls before the end of the day.

You log out of the dialer, collect your personal items, saunter past a few colleagues’ cubicles, and chat as you work your way to the elevator and walk the few hundred steps back to your car, where you proceed to sit, again, for the drive home.

The amount of exercise you receive as a telephonic nurse is equivalent to less than an hour as a direct care provider. And, if you do not adjust your physical activity when you are not at work or alter your eating plan, the telephonic 20 will occur in record time.

This situation leads to the next issue that telephonic nurses experience: the hazards of immobility.

Hazards of Immobility

Every nurse knows what can occur to a client who has been placed on bed rest while hospitalized:

As a telephonic nurse, you now are at risk for these same hazards. However, do not be hasty and hand in your letter of resignation. There are a few lifestyle changes that you can make to combat these hazards. And you might just recognize these approaches because they are very similar (if not identical) to the ones you use to encourage your clients to perform.

Exercise/Activity

Telephonic nurses have to plan or schedule activity. Because you will be sitting for most, if not all, of the workday, you will need to get exercise or activity some other way. Some suggestions include:

For those telephonic nurses who work at home, the challenge is even more acute. Additional physical activity losses for these nurses include:

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