I always ask patients why they're here, what they view as the problem, and what they would like to get out of the visit. If there are things they can do to feel better, I explain them thoroughly in ways that they understand. I tailor recommendations to the patient, and they frequently respond, “How come nobody ever explained it to me that way?” Change is hard, and patients have to know why you want them to change so they can act on it. If a patient’s quality of life is better, in the way they describe it, that’s a success. I might have my own little successes that don't excite them, maybe an improvement in a lab result, but that's not going to really improve their life. The real successes are when patients determine the success. I’ve always liked helping people. I was a bedside nurse for many years and saw so many changes in the field over that time. I felt like I could do more, so I became a nurse practitioner much later in life, and now I can be a much more direct help to patients. The most rewarding thing is when I don't realize what I've done, but patients come back later and they say that I really changed their life. That makes it all worth it.
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