The role of the nurse in diabetes self-management education
THE 2020 World Diabetes Day campaign focuses on promoting the role of nurses i n the prevention and management of diabetes. The testimonials below from patients working with Mrs Andrea Hunt, a certified diabetes nurse educator, tell the story of the critical role the nurse can play in supporting patients and their families through varied experiences with diabetes. The shortage of nurses with these skills in Jamaica, and the wider Caribbean, is a challenge we must meet by recognising diabetes selfmanagement education as an area of specialisation and providing additional training opportunities for our nurses.
Beverly**, 45-year-old woman with pre-diabetes, weighing 260 lbs
“Hi, Nurse. I’m sure this comes as a complete surprise – you save[d] my life! What you taught me at the diabetes class was ... eye-opening. I started an eating programme. I lost 60 lbs and my medications … were cut in half. I try my best to make the right choices every day. Admittedly I have fallen off the wagon … but the next morning ... [I am] back on track. I’m working on the next 60 lbs!”
Rhona**, 32-year-old physician with diabetes in pregnancy
“I have been a doctor for 10 years and this year in the midst of the pandemic, I became a patient. At 11 weeks’ gestation, I was told I was diabetic and unlikely gestational. I honestly panicked, and all my medical knowledge went out the door. Everything sounded foreign to me. I wondered how I would manage since I needed to start insulin, change my diet, and exercise. I was to start a new type of insulin and make some additional dietary changes. My hands were held virtually by Nurse Hunt through the process of insulin administration and how to manage low or high blood sugars. Along the entire pregnancy I had constant support, and all my questions were answered. On the days when I felt I couldn’t manage anymore and I wasn’t doing a good job, I was reassured. I’ve come to realise that managing diabetes is more than prescribing meds, and I’m happy I got that 360-degree support! It’s a service I think all Jamaicans should access. It’s worth it.”
Trudy**, 40-year-old patient with uncontrolled type 2 diabetes on insulin
“I went in to see my GP for the flu and came out being diagnosed with type 2 diabetes … . I was told to lose weight, cut my portions, and cut out certain foods [and started on insulin]. Yet my blood sugar level readings were still high. And so the medication doses were increased. I was struggling. An endocrinologist suggested as part of [my] treatment ... that I work with a diabetes nurse [educator]. What a God send. Within a week of working with her, my dosages were lowered, and in another week was lowered again. What nurse was able to provide was a clear understanding of how my body reacted to the food and how my medication was working in conjunction with that. That changed the game for me, and I have her continued guidance to better understand and make the right choices to manage my diabetes effectively for the long term.”
Cas**, mother of a nine-yearold with type 1 diabetes
“My seven-year-old daughter was diagnosed with type 1 diabetes in 2018; it was a very frightening experience. I was able to get the assistance of the diabetes nurse educator, who explained how to take care of her … . Over numerous sessions, I also learned about my own health, too. My daughter is now nine years old; she has never been hospitalised, nor had any extreme[ly] low blood sugar
Rose**, 38-year-old mother with type 2 diabetes
“Having had type 2 diabetes before the pregnancy, and losing one child due to the disease, I was very anxious ... . My thanks to the nurse ... [who] explained how to manage diabetes in pregnancy and taught me how to take my insulin and adjust as needed, and follow the specific meal plan. It was a rough journey, but I successfully delivered a healthy baby boy, who is now two years old; in addition, I continued to work with the nurse and with her support, I have successfully lost and kept off 40 lbs. Thank you.
“Education is key and you are unlocking that for me. Thank you [Nurse].”
**Actual patient names are not being used.