My personal experience as a diabetes educator
IN JUNE 2006, I was assigned to attend a seminar for nurses at the University Hospital of West Indies (UHWI). This was facilitated by Nurse Andrea Hunt, the diabetes educator at the hospital. Little did I know that, 14 years later, I would be consistently providing diabetes education for the paediatric patients and their parents/ caregivers.
That initial exposure laid the foundation for building my knowledge and skill level, thus providing a much-needed service for the paediatric patients at the hospital. Occasionally, I am asked to see patients from other facilities but my focus has primarily been on the acutely ill inpatient population. This requires some degree of manoeuvring since I am the Charge Nurse for the Paediatric Surgical Ward and the children with diabetes are admitted to the medical wards; however, it has been doable so far.
My responsibilities include teaching the parents/caregivers as well as the children whose participation is dependent on their age and developmental stage. Basic concepts of diabetes, monitoring, medications, diet, exercise, complications, and coping with diabetes; demonstrations of glucose monitoring and insulin administration are addressed. Return demonstrations of the basic skills that are required for their home care are facilitated.
These sessions vary in length, depending on the participants’ levels of receptivity, attention span and emotions. I try not to exceed two hours, the requirement for the initial session with the newly diagnosed.
Parents often blame themselves expressing feelings of guilt for their child’s condition. Some children display anger or sadness and resent the changes to their lifestyle. One non-compliant teenager’s response was “oonu must go find a cure”. Perseverance is needed at such times as the issues must be managed to move on.
Where necessary, referrals are made to support services. We are fortunate at the UHWI as we have a child psychologist on-site and an active Social Work Department. Life for A Child Programme and the National Health Fund are also utilised. With the parent’s permission, printed material is given to the school to assist with the child’s care at school. Dialogue is held with school nurses where necessary.
Most often, education of the extended family is needed to maintain support at home.
Due to the COVID19 pandemic, it is more challenging as we now have to limit the time spent in faceto-face sessions and work with one family at a time. For the mute patient who relies on lip reading, I had to be creative and rely on the sign language skills of the caregivers, use gestures, printed materials and pictures.
The experience so far, though sometimes exhausting, has been very rewarding. Especially more so when I get children who surpass their parents/ caregivers in confidently learning how to safely and comfortably self-care as the ultimate goal is to make them self-reliant to achieve blood glucose control in order to meet their growth and development needs.
Special thanks to Mrs Hunt who consistently provided support and printed material to give to the patients and their families long after she left the organisation. The task was made that much easier due to her efforts.