Originally Posted by rn/writer
I think one of the biggest obstacles to "compliance" (geez, I hate that word), is that you can use all the scare tactics in the world, show pictures of gangrenous feet about to be lopped off and post-mortem shots of shriveled kidneys, tell horror stories about blindness and heart attacks and neuropathy, cite statistics about early death, and all the rest, and it JUST DOESN'T GET IN.
Why? Because it's theoretical. It's out there somewhere applying to all those other people.
We need to find ways to show people what is happening to them, inside their own bodies, to mark the wicked progression in ways that make it real that this isn't something out of a textbook or a government pamphlet, but changes that are taking place right now to them.
With gentle but thorough questioning we need to help patients evaluate their energy level, changes in sensation, and even their sexual function. If they can begin to see the micro-alterations occurring to THEM the rest of it may finally seem real.
Then, once they have this personalized awareness, we need to ASK them what they want for their own future. Some patients are willing to combine constant vigilance and vigorous efforts in pursuit of nearly perfect numbers. Others are less so. It isn't for us to decide which route they will take. They are the ones who have to live with the work and the consequences.
Too much of diabetic education and monitoring is adversarial. All that attitude does is build opposition and defensiveness. Patients end up not only insulin-resistant but help-resistant as well. There is an all-too-pervasive lack of respect for diabetic patients that often starts out being patronizing and ends up with both sides exasperated.
Two things are necessary to overcome this exercise in frustration. First, teaching methods that supercede denial and help each patient evaluate the very personal course the disease is taking inside them, and second, the recognition that the battle belongs to the patient, not the doc or the nurse or the educator. Even an effectively informed patient may still make the "wrong" choices. We need to be okay with that, even as we communicate sadness because they matter to us.
Awesome post !!! Thank you for this, I couldn't agree more! I have spent nearly ten years in dialysis, and there, too, have had to deal with "the battle is THEIRS", not mine. I can so relate to what you are saying above.
I have leanred SOME about diabetes, but now I am in Home Health with more time available to do some sound but gentle teaching... and I am hungry for good advice and guidelines in both HOW as well as WHAT to teach. I'm finding that while I know the very limited "basics", I really know very LITTLE.. far
too little about this disease.
Oh, I have seen ALL the
consequences of the disease... you bet I have!
But I want more education on the disease itself.. the physiology aspects of it, and the whole insulin deal... it gets VERY confusing.
And above all, I want to be informed so I can help guide my patients to make informed decisions for themselves.
Please let's keep this wonderful thread going !
I for one, am ready for "Diabetes 101"... and then keep going to Diabetes 102.. and on.. and then on some more.
THANK YOU!
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