Windows of Opportunity: Practical Applications in Self-Care
Author: Bonnie L. Albert, DNP, ACNP-BC, CCRN

We recognize that cardiovascular disease is the leading cause of death and disability in the world, and we realize this impact is largely due to the presence of modifiable risk factors and the absence of needed behavior change.(2) We are rightly shocked by the worldwide estimates of heart failure that reflect a patient population nearing 26 million. (3)

As heart failure nurses and providers in the care of adults and children with heart failure, we also are presented with “windows of opportunity” in our practice. Excellent formal processes are in place for heart failure education where high quality information on self care, medication adherence, diet and novel interventions is presented. The didactic instruction equips us and gives our patients a reservoir from which to drink. Still, it is the personal application of this information in daily life that is the goal.

Human Capital Theory (HCT) reveals that the social and economic success of individuals hinges on the “knowledge, skills, competences, and attributes that … contribute …. to personal and so-cial well-being.”(2). HCT suggests that education cultivates health because it provides the means and ability to be an “effective agent” by increasing personal control which enables an individual to establish a health lifestyle. (2) 

During moments of patient self reflection and self disclosure, we can optimize sustainability through observation which includes listening to the cries of our patients and responding with practical applications. We can encourage small changes over time which make a difference and elevate attitudes. We can practically educate our patients: perhaps we can share recipes which utilize the facets of the Mediterranean diet, a plant based diet known to reduce heart failure. (4).  Maybe we suggest a diuretic schedule that will work with the patient’s walking program and social commitments, or we discuss the benefits of standing over a predominantly sedentary life-style.(5).  Possibly we create a way to add that enjoyable piece of sliced cheese in the daily or weekly diet by allowing the sodium milligrams first while demonstrating how to calculate and recorded sodium content on a diet chart. 

In whatever way, we are alert to and seize  the “windows of opportunity” of practical application,  we take a step toward preventing Stage A progression and the downward spiral of heart failure. I leave you with the words of the great mentor of us all, Florence Nightingale, who exhorted us to “never lose an opportunity of urging a practical beginning, however small, for it is wonderful how often in such matters the mustard seed germinates and roots itself.”(6)