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Small steps consistently applied

By Irish Pharmacist - 05th Jan 2021

puzzle jigsaw heart on brain, mental health concept, world autism awareness day

Séamus Ruane, community pharmacist and certified positive psychology practitioner, looks at the importance of what may seem like small choices

A defining moment that shaped my attitude to health and wellbeing happened very early on in my career as a pharmacist. On one particular day, two patients, both of whom I knew socially but who were unconnected to each other, presented in the pharmacy with a prescription for a statin; same drug, same dose. Patient A dropped in his prescription, and after a brief chat said he’d call back in five minutes to collect it.

Right on cue five minutes later, the pharmacy door swung open and the entire shop was immediately filled with the tempting aroma of fresh fish and chips from the chip-shop next door. The prescription was collected and off he went, prescription under one arm, fish and chips under the other.

Within the next hour, Patient B presents with an identical prescription, accompanied by, “could I speak to you for a moment please, Séamus?” Off we went to a quiet corner of the pharmacy (pre-consultation room days) and discussed the steps he could take to reduce his elevated cholesterol levels. We talked dietary interventions, the important role of exercise, how stress was a contributing factor, which supplements could help, and the effects of quality sleep. Patient B listened intently and left with his prescription, lots of determination, and some appropriate literature.


What happened with these two patients over the course of the following number of months really grabbed my attention and shaped my attitude to health, wellbeing and lifestyle. Twelve months later, Patient A had continued to visit the chip-shop on a regular basis, coupled with many other poor lifestyle choices. Over time, he experienced a dose increase of his statins and the introduction of a plethora of other meds to treat his raised blood pressure, increased weight, and oncoming diabetes.

Whereas Patient B successfully made the necessary lifestyle interventions, and within 12 months discontinued his statin therapy, never to be seen again in the pharmacy, presumably off to lead a long and healthy life.

The obvious lesson for me was this: When it comes to our health and wellbeing, what we do on a daily basis really does matter. All day, every day, we make small choices that appear to be inconsequential, and indeed when looked at in isolation, many of them are.

However, daily habits, either positive or negative, when applied on a regular and consistent basis and stacked one on top of each other, end up being hugely powerful. In his highly recommended book Atomic Habits, James Clear calls this “the power of 1 per cent gains”. The effect is comparable to compound interest, or exponential growth. Small daily habits that benefit our health, over time bring us to a completely different destination compared to negative habits, or indeed no action at all. And so it is, ‘how we live our days is how we live our lives’.

It turns out that this of course is good news for us. When it comes to making changes that affect our health or wellbeing, many of us feel paralysed. Mistakenly, we often think that we will only get results if we succeed in making drastic lifestyle changes. As a result, we put off trying until ‘some day’ when the time is ‘right’. We excuse ourselves with, ‘it’s just too busy at work’, ‘I haven’t time, the kids are too young’, ‘the weather is bad and the days are too short’ or whatever the excuse is today to make us feel justified in our choice, or lack thereof.

The truth of course is that change is rarely achieved by one giant drastic step, or by acquiring some astounding new ‘secret’, but by showing up every day and constantly and consistently making the right choices.

Trusted professionals

We are healthcare professionals. The public seeks us out as a valued source of advice on health, wellbeing and lifestyle issues. Survey after survey shows our opinion is widely respected and trusted. We know the science, research, and reasoning behind simple daily interventions to safeguard our health and wellbeing. We counsel patients on the what, the how, and the why of healthy living each and every day of our working lives. Surely this only makes sense if we apply the same advice to our own lives.

So how does this apply to you and your busy life in the frontline of healthcare? If you were your own patient, what advice would you give yourself? What habits would you encourage yourself to adopt?

So for a start, how about taking a look at the really obvious and simple stuff? What’s for lunch today, and could you make a healthier choice? What could you do to get a little bit more physical activity and fresh air into your day today?

Can you punctuate your day with a few moments of mindful, deep breathing? And remember: Small steps, consistently applied.

If you would like to work with Séamus to boost your level of wellbeing or that of your team, he can be contacted at Tel: 087-2274108 or email






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