Lifestyle Nursing – An Exciting New Field for Ambulatory Care Nurses

The US is an outlier when it comes to healthcare spending. According to the Commonwealth Fund, the US ranks 11th out of 11 industrialized countries studied in global healthcare system performance for four of the top five indicators, ranking in the top 2 for only one indicator care process. The US ranked last in access to care, equity, healthcare outcomes, and administrative efficiency. The US ranks highest in healthcare spending (17.9% GDP) and lowest in health system performance. Of the 11 countries reviewed, the US has the highest number of people with chronic disease; 60% of US adults has one chronic disease and 40% have two or more chronic diseases and spends on average over $12,500 per capita. The global average is $6,414 per capita. Clearly, the US approach to patient chronic disease management can be improved. For the last 20 years a new, evidence-based science has been taking root. This science, know as l00ifestyle medicine, takes a root cause approach to chronic disease instead of a symptom-based treatment approach. It is particularly effective in stabilizing or reversing heart disease and diabetes. A large-scale study revealed 58% of people with prediabetes did not progress to diabetes after a 16-week program of education on lifestyle factors impacting diabetes.

Lifestyle medicine is a holistic approach to improving health and reducing the impacts of chronic diseases such as diabetes, heart disease, and hypertension. Lifestyle medicine uses simple but very powerful lifestyle changes to prevent many of the most common chronic diseases and has been observed to halt or reverse their progression. The tenets of lifestyle medicine are focused on six pillars: eating whole, mostly plant-based foods; increasing physical activity; achieving restorative sleep; managing stress; maintaining social connections; and avoiding risky substances such as tobacco and alcohol. Lifestyle medicine relies on a partnership between the healthcare team and the patient. In this partnership, the lifestyle nurse guides the patient, provides expert knowledge, and encourages self-decision making. The patient is viewed as an expert in their life experiences and when health goals are based on the patient’s beliefs, preferences, and values, the patient is more likely to achieve those goals. Patient engagement is a nurse-sensitive indicator and nurses are adept at using patient engagement techniques such as motivational interviewing to elicit patient-determined goals for health. Using coaching methods nurses can engage patients in their healthcare goals and can monitor and support them in achieving these goals over time.

Lifestyle nursing uses a back-to-basics approach and evidence-based science to move patients from a state of illness to a state of wellness. Lifestyle nursing relies on top-of-license critical thinking and nursing modalities to improve patient outcomes. As a result of nursing collaboration with the patient and the primary care provider, many patients are able to reduce or discontinue medication. Lifestyle nursing is consistent with Pender’s theory of health promotion, which focuses on increasing a person’s well-being consistent with health as a positive, dynamic state and not merely the absence of disease.