Health promotion: whose responsibility is it?

Oncology nurses often educate patients and encourage them to adopt a healthy lifestyle. Where does this responsibility begin and end? Another new year is upon us. Human nature encourages people to strive to do better. Consequently, each new year, millions of people resolve to make changes in their lives. This year I will . . . stop smoking, eat better, walk more, get a mammogram, reduce stress, be a better parent, keep the house cleaner, get more organized, be more patient, get more sleep, schedule a colonoscopy, be a better nurse . . . the list goes on. On the surface, few would argue that these things are bad. In fact, most of these resolutions have a positive domino effect. If I get more sleep, I may be less frustrated, more tolerant, and, ultimately, a better parent. If I get more organized, the house may be cleaner and I will be calmer, have less stress, and, yes, maybe even be a better parent. If an individual gets a colonoscopy and has a polyp, it can be treated easily and toxic cancer therapies can be avoided, resulting in a less-stressed individual and family. If a woman has regular mammograms, any positive fi ndings are likely to be caught early and treatment will be effective, resulting in minimal toxicity and a better quality of life. These are often major reasons cited for recommending cancer screening services. However, some look further and say that healthful behaviors are important because they save money. Although we cannot put a price on human life that is spared suffering, one can measure the healthcare dollars spent and productivity lost when a tumor is detected later and expensive therapies are required. My nursing career has centered largely on the practice of prevention and early detection. To show how long, when I was taking extensive continuing education Suzanne M. Mahon, RN, DNSc, AOCN®, APNG, is a clinical professor in the Division of Hematology and Oncology, Department of Internal Medicine, and in the Adult/Older Adult Nursing Program in the School of Nursing at Saint Louis University in Missouri.