Sara Balster, R.N., Project HealthDesign M.S.N. Student, Walden University
I joined the Project HealthDesign National Program Office (NPO) team in September to fulfill the final practicum for my M.S.N. in Nursing Informatics program. Outside of school, I serve as an IT project manager for an electronic medical record (EMR) implementation in the UW Hospital and Clinics Transplant Program. My work with the Project HealthDesign NPO introduced me to the concept of observations of daily living (ODLs). I found ODLs intriguing and decided to focus my project on discovering whether transplant recipients recognize ODLs in addition to clinical indicators such as lab results, spirometry levels and blood pressures, which they are instructed to monitor post-transplant.
The transplant recipients I interviewed said they were feeling well. When asked how they defined their health, each recipient considered his or her current activity level and what he or she could do after transplant, as opposed to the limitations he or she had experienced prior to transplant.
“Travel has been another thing … going to places I never would have been … because what if I didn’t have a ready source of glucose or sugar, or what if I didn’t have my insulin or didn’t have refrigeration available, you know now I really have no restrictions that way. So as far as how I define my health … activities are definitely a big part of that,” said one patient.
“So I feel very fortunate that … not only do I lead a what I consider a normal life … I’ve been able to finish school and high school when I had my first one and finish college when I had my second one, and … I was working actually when I had my third and fourth, so I feel very fortunate, you know. It really didn’t stop [my] career, it didn’t stop … a lot of things that I think would have been things that could stop people … That’s kind of what I consider normal,” said another patient.
Interestingly, recipients said they relied on intuition to determine their level of health.
For example, one recipient said: “… If you think something’s not quite right ... I was having a little chest pain and I thought ‘Well, I’m too young to have a heart attack,’ this was a few years back … so it was kind of one of those ‘I’m not feeling good, and I think I should just go in’ [moments] and it was a pulmonary embolus.”
Additionally, clinicians seem to report similar thoughts:
“I remember one of the transplant surgeons … saying … that you know your body better than anyone else … there’s just certain things you get in tune to.”
What do you think? Is personal intuition an indicator of an ODL? If so, how would it be documented, qualified and/or quantified?