Celebrating diversity in patient needs during the holidays

The winter holidays are a time for family and friends to gather to eat, drink, and celebrate. The weeks leading up to the holidays are a hectic time for many, with little time for rest and self-care. During the festive days, no one wants to be ill, and anyone who is feeling ill may delay seeking medical treatment to avoid disrupting holiday plans, missing out on the togetherness and joy, and possibly spending long waits in the ED or, worse, being admitted to the hospital. Thus, individuals may ignore signs and symptoms of illness; they may deny, minimize, or attribute these signs to harmless causes that they can investigate later. They may try to will the symptoms away or at least delay their intensification, believing that once the excitement and emotional and physical stress of the holidays have passed, their symptoms will also disappear. Too often, however, a delay results in adverse outcomes, including death. HEALTHY HEARTS The findings of a 2004 study are still cited today by the American Heart Association (AHA)—more cardiac deaths occur in the US on December 25 than on any other day of the year, followed by December 26 and January 1.1 Findings indicated an increased risk during the winter holidays not only for cardiac mortality but also noncardiac mortality. Reasons are multifactorial. As the holidays approach, NPs can help their patients and themselves enjoy this time more safely by following several heart-healthy tips from the AHA: 1) know symptoms and take action, 2) celebrate in moderation, 3) plan for peace on earth and goodwill toward yourself, 4) keep moving, and 5) stick to your meds.2 Routinely educate patients about the signs and symptoms of heart attack and stroke. Make sure your patients know the steps for the emergency response system in their community. Advise patients to consume food, alcohol, salt, and sugar in moderation and also to avoid harmful substances. Share tips to reduce stress leading up to and during the holidays. Encourage patients to maintain physical activity. And lastly, remind patients to take their medications as prescribed and keep a sufficient supply so they do not run out, particularly if they have plans to travel. NPs can partner with their patients to decrease certain risks during the holidays. Practice respect and cultural humility in providing heart-healthy guidance. CULTURAL DIVERSITY We live in a rich and culturally diverse society, which is reflected in the winter holidays. For example, Kwanzaa, Christmas, and Hanukkah are all representative of strong cultural and/or religious traditions of different groups. If you are not familiar with the special foods and practices customary during a celebration, ask your patients to educate you. Be open to accepting modifications in your recommendations for the season; following tradition may have more meaning to your patients than following your guidance at this time. Evidence-based practice encompasses holistic care that considers the best available evidence, the NP's knowledge and skills, patient preferences, and culture to guide decision-making. Remember, you are the patient's partner in realizing health. We know that health disparities exist among groups, but we can all give patients the same message this holiday season by emphasizing the importance of seeking medical care immediately if they have any signs and/or symptoms of illness different from normal. It is time to change the 2004 finding that has persisted. HAPPY NEW YEAR This year has been an eventful one across the globe. May you find peace during the holiday season. May we bring peace in the world. Jamesetta A. Newland, PhD, FNP-BC, FAANP, DPNAP, FAAN Editor-in-Chief [email protected]