Disclaimer: This podcast is for informational purposes only and is not intended to be used as personalized medical advice. 

Cheryl Martin (Host): A key challenge for some patients these days is how to successfully balance the demands of health, work and family. Here to provide some answers is nurse practitioner, Courtney Robbins. She practices family medicine at Skagit Regional Health.

This is Be Well with Skagit Regional Health. I'm Cheryl Martin. Courtney, delighted to have you on.

Courtney Robbins, ARNP: Yeah. Cheryl, thanks so much for having me today. 

Cheryl Martin (Host): So, Courtney, what trends are you noticing with patients related to balancing their health, work and family demands?

Courtney Robbins, ARNP: I think it's helpful to first define the term health. And according to the World Health Organization, it can encompass the physical, social and mental health of a person. And one trend that I've noticed is when patients are having a hard time finding a balance, it's usually their health that's put on the back burner.

Cheryl Martin (Host): That's interesting, health as opposed to work and family. Why do you think that is?

Courtney Robbins, ARNP: I think it's easier to prioritize other things around us rather than taking the time to exercise and make the healthy meals. And there's some behavior changes that need to be had to make those changes.

Cheryl Martin (Host): Like what, for instance?

Courtney Robbins, ARNP: So, for example, some behavior changes that we're going to talk about a little bit later could include emphasizing foods that make your body feel good and properly energized. And I'll have some resources from myplate.gov to help learn how to prepare simple healthy meals, meal prepping, balanced nutrition and more.

Cheryl Martin (Host): Great. So, Courtney, what symptoms are patients describing as being out of balance?

Courtney Robbins, ARNP: Some patients report feeling fatigued, having trouble sleeping, racing thoughts, increased anxiety, kind of feeling down or depressed, struggling with weight imbalances, low libido, headaches and more.

Cheryl Martin (Host): So, what then does a healthy balance of health, work and family look like?

Courtney Robbins, ARNP: I think it's important to acknowledge that each person is impacted by different social determinants of health, which can involve a person's access to healthcare, educational level, living environment, social community and financial resources. As an example, 6.4% of Skagit County's population were without health insurance, which impacts their access to healthcare. So, in an ideal world, a healthy balance would first ensure that basic human needs are being met by having access to healthcare, safe housing and food. And then, after that, it can be kind of dependent on each person's expectations and life goals. An ideal balance would consist of a routine that helps a person prioritize their health and help them feel accomplished.

Cheryl Martin (Host): So, what are the top strategies that you recommend, Courtney, to your patients to help them achieve a healthy, balanced life navigating their health, work and family?

Courtney Robbins, ARNP: I think this starts with prioritizing self-care. People cannot pour from an empty cup. And a tip that I would recommend for my patients is to communicate their needs with their partner that they'd like to exercise on these certain days of the week and then work out the logistics of how that works for their family schedule and then offer the same opportunity for their partner to do something that they enjoy. So, they can also refill their cup. 

Another idea would be to prioritize both fitness and family by going for a hike, a bike ride, or go play pickleball together. The American Heart Association recommends 150 minutes of moderate to high-intensity exercise spread out over the course of the week. It's a great opportunity to lead by example and instill healthy habits in your children as well. And then, also emphasizing foods like we talked about earlier. Myplate.gov would be a great resource for patients to look into. And then, depending on the situation, I refer my patients to our registered dietitians for them to have further insight into healthy eating habits. And then for myself personally, I find that meal prepping for the week helps me stick to my health goals and makes my day less stressful as I head out the door for work. 

Another important topic is for patients to maintain a routine and schedule for their family. The American Pediatrics has a lot of resources on the importance of family routines on healthychildren.org. It's beneficial for the whole family if parents prioritize consistency with a schedule and routine. When we're juggling so many different things, we may not get the quantity of time we want with our family. So, capitalizing our opportunities for quality time at dinner time would be a good opportunity to see how the new routine is working out for everyone in the family. 

Personally, my husband and I utilize a digital calendar so we can keep track of our upcoming events, appointments and work schedules. It makes our week a little less chaotic. And then, of course, good sleep hygiene is a must for optimal health and functionality. The recommendation is for adults to get at least seven hours of sleep each night.

Cheryl Martin (Host): I'm glad that you are sharing these strategies because those who are listening who don't have health insurance can fully implement these.

Courtney Robbins, ARNP: That's a good point.

Cheryl Martin (Host): Now, what services do you recommend for patients who are feeling, let's say, out of balance?

Courtney Robbins, ARNP: So, as I mentioned previously when things are out of balance, it's usually the health of a person that takes a hit first. So. I always recommend checking in with your primary care provider. This allows the opportunity to assess your overall health, which includes both physical and mental health. And then, another great resource would be a licensed mental health counselor. Counselors can help patients develop stress management techniques to help prevent stress proliferation, which is when stress becomes so unmanageable and trickles into all aspects of our lives. It can have a negative impact. So, it's a great opportunity to start to manifest an optimistic attitude and outlook and develop a game plan looking ahead.

A great resource to locate a therapist is psychologytoday.com. There's a filter button that allows patients to select their insurance coverage and helps patients identify local counselors. Another option would be to contact their insurance coverage and see which counselors are covered. Patients do not need a referral to be seen by a licensed mental health counselor. 

And then, thirdly, if a patient has religious or spiritual beliefs, sometimes checking in with a religious community and resources could be beneficial.

Cheryl Martin (Host): How often would you say should adults plan to visit their primary care provider?

Courtney Robbins, ARNP: I recommend at least an annual check-in with your provider. It allows an opportunity to identify any concerns and health goals that we need to prioritize in the upcoming year and allows for more of an upstream approach to a person's healthcare. And then, of course, if a patient has chronic diseases or new concerns, they may need to be seen more frequently.

Cheryl Martin (Host): So, once they schedule that wellness visit, what do you recommend the patient discuss at an annual visit with his or her healthcare provider?

Courtney Robbins, ARNP: At an annual visit, patients can expect to discuss a multitude of things, checking in on medical family history, current medications, eating habits, exercise routine, their mental health, how well they're sleeping, any concerns regarding substance use, making sure that you're getting up to date on any vaccines and cancer screenings, advanced care planning, and then health goals and concerns looking ahead.

Cheryl Martin (Host): So, do you recommend that a person have a list of things they definitely want to cover, even asking about getting certain blood tests? How important is it for the patient to be proactive instead of just waiting for the doctor to suggest these things?

Courtney Robbins, ARNP: Oh, it's absolutely important to be proactive and voice those concerns and things that you'd like to address with the healthcare provider. If you are just sitting at home one day and you have questions, just write them down and bring them to that appointment. That way, your healthcare provider can kind of triage and say, "Yes, let's address this today," or "Let's get some labs and look into that a little bit further." And then, follow up next week and talk about next steps.

Cheryl Martin (Host): Courtney, any final words of wisdom on this topic that you want to share?

Courtney Robbins, ARNP: Some final words of wisdom that I have is, most importantly, to make sure that you're giving yourself grace. It's okay not to be perfect in all aspects of your life. If things are not working well, it's okay to switch things up. A lot of what we talked about today involves behavior changes, and behavior change is very difficult. But with consistency and support, the changes can become lifelong. So, if someone is feeling overwhelmed, I recommend leaning into family, friends and their healthcare team for support and guidance.

Cheryl Martin (Host): I really like the fact that you stressed the importance of routines and how having those routines could greatly assist with the family, health and work balance.

Courtney Robbins, ARNP: It's been shown in multiple different professional organizations, that just having that routine helps you feel a little less chaotic when you're juggling everything.

Cheryl Martin (Host): Courtney Robbins, thanks for sharing some great tips for helping us to provide life balance when it comes to health, work and family. Thank you so much.

Courtney Robbins, ARNP: Yes. Thanks for having me. I appreciate it.

Cheryl Martin (Host): For more information, visit kagitregionalhealth.org. If you found this podcast helpful, please share it on your social channels and check out our entire podcast library for other topics of interest to you. This is Be Well with Skagit Regional Health. Thanks for listening. 

References

American Academy of Pediatrics. (2024). The importance of family routines. 

https://www.healthychildren.org/English/family-life/family-dynamics/Pages/The-Importance-of-Family-Routines.aspx

Centers for Disease Control and Prevention. (2024). About sleep. 

https://www.cdc.gov/sleep/about/index.html

Centers for Disease Control and Prevention. (2024). Social determinants of health. 

https://www.cdc.gov/public-health-gateway/php/about/social-determinants-of-health.html

Psychology Today. (2024). Therapists in Washington. 

https://www.psychologytoday.com/us/therapists/washington?utm_content=2QSQODsZ-dc_pcrid_81157722480881_pkw_psychology+today_pmt_be_slid__pgrid_5565528051_ptaid_kwd-134277007577:loc-4132_&msclkid=26eea62d4664135ca13dc0445b15734b&utm_source=bing&utm_medium=cpc&utm_campaign=[US]+-+Washington+-+Brand&utm_term=psychology+today

U.S. Census Bureau. (n.d.). Skagit County. U.S. Department of Commerce. Retrieved June 20, 

2024, from https://data.census.gov/profile/Skagit_County,_Washington?g=050XX00US53057#populations-and-people

U.S. Department of Agriculture. (2024).  Prepare healthy meals. https://www.myplate.gov/eat-

healthy/healthy-eating-budget/prepare-healthy-meals

Ward, B.W. (2014). Stress proliferation. Wiley Blackwell Encyclopedia of Health, Illness, Behavior, and Society. https://doi.org/10.1002/9781118410868.wbehibs108

World Health Organization. (1946).  Constitution of the World Health Organization. 

https://www.who.int/about/accountability/governance/constitution

Zimmerman, G., Olsen, C., Bosworth, M. (2000). A ‘stages of change’ approach to helping 

patients change behavior. American Family Physician. 2000;61(5):1409-1416https://www.aafp.org/pubs/afp/issues/2000/0301/p1409.html