By Janet Howard-Ducsay, BSN, RN, CDE
As an RN for 29 years in critical care and ED, I have welcomed every opportunity to educate patients and family members. In 2006, I expanded my role and became a certified diabetes educator.
Initially, I felt like quite the novice, but over the past few years, I have been able to exercise my passion for patient care, while at the same time, providing them with crucial information. I am proud to say that most of my encounters with diabetes patients result in their being open to something I have shared with them about self-management.
I take time to read my patients’ histories and physicals so I don’t have to ask the same questions they have been asked so many times. I approach them openly, without judgment, asking “What obstacles are you having with your diabetes?” It isn’t always about food. Perhaps they have lost their insurance or are recently divorced or have not had their condition explained to them. I ask open-ended questions to find out where they are at the moment.
Many times I talk with patients about accepting that they have diabetes. In any given week I can meet with a young adult who chose to just stop taking his or her medication. I can have multiple sessions with a dialysis nurse who had severe complications from diabetes because she felt, as a caretaker, she needed to care for others and not herself. Then there’s the patient who, at 87, developed diabetes and questioned “Why now?”
Another patient was a 30-something man whose tough exterior melted in the quiet solitude of his hospital room. His tears spoke simply, “I’m scared.” In our third meeting, he revealed his concerns — a fear of needles because of all the drug-related issues in his immediate family, feeling sad that his children don’t want to trick or treat with him and not knowing how to stop his binge drinking. As he spoke about these issues, it might have been the first big breath he took in a long time.
I take my patients on a journey starting from wherever they are and teaching them the basics that will fit into their daily lives without disruption. I help them lean into the process, showing them that it’s not about deprivation but, rather, it’s about doing things differently. They learn that self-management allows them to make decisions and plans they can see themselves doing now and five years down the road.
I miss caring for patients in the ICU and ED, but my new role as a diabetes educator has fulfilled my purpose and passion beyond my expectations. As you follow your career paths, always keep an eye open for an unexpected opportunity to follow a new road that may be a wonderful, fulfilling chapter in your career.
Janet Howard-Ducsay, BSN, RN, CDE, is a diabetes educator at Redlands Community Hospital, Redlands, Calif.
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