When I was a freshman in high school in Connecticut, I was really small. I stood at 4'8" and weighed 80 pounds. One of my good friends was on our school's crew team and convinced me to be a coxswain.
A coxswain is the small person who sits at the stern of the boat, looks forward, and directs the rowers while they race. Their demeanor is different depending on the team, but for the most part, they are aggressive motivators. They scream "GIVE ME A POWER 10!" - 10 hard rows counted down, and encourage the rowers to row hard through a stretch of the course.
I did not know anything about being a coxswain going into the sport. I was meek but kind, and wanted to make friends. I barely knew what the stern and bow of the boat were - I definitely had difficulty distinguishing between port and starboard.
During the first mock race, I was a coxswain for a boat of 8 junior and senior guys. I used words of encouragement - "you're doing great!", "keep going!", "I know you can do it, just row, row, row!".
These didn't work - the rower closest to me yelled and cursed at me for being too nice. They needed more powerful encouragement. We almost hit a bridge piling during the race and came in dead last. When a boat wins a race, they tip the boat and coxswain into the water in celebration. I stayed bone dry that day.
I stuck it out for the rest of the season, but I was by far the worst coxswain the team had ever seen.
How does this relate to dietetics? This morning I read an article in the Journal of the Academy of Nutrition and Dietetics related to health outcomes with people who undergo interventions for diabetes (Franz et al, 2015). If the participants didn't lose more than 5% of their body weight, they didn't see significant health improvements for their cholesterol or blood sugar.
Losing 5% of one's body weight requires intensive instruction, dedication, and perseverance. Its instruction cannot be taken lightly and proper nutrition counseling is a major factor in success. Being meek and kind may not result in better health outcomes; assertion and dealing with difficult topics are necessary for success of the patient.
Moving forward, I will keep my kindness, but I'll be less meek. If a patient expresses that they are disappointed in their progress, I will not shy away from this statement. Rather, I'll explore why they are disappointed and ask them what they think they can do better in the future. I'll focus on their big-picture goals and how health outcomes play a role in their quality of life.
I'll avoid scare tactics (like what kidney disease is like due to diabetes, or what cholesterol can do to blood vessel health) - rather, I will support clients in their health goals and inform them of what they need to know and how to achieve that.
With a fresh perspective, I can help each of my clients row the boat that crosses the finish line in first place.
Kate Fossman, RDN, LD
October 21, 2015
No comments:
Post a Comment