Can any nurses answer my questions? Please!

SHGR, MSN, RN, CNS · Jul 20, 2012

Your Name and Title I'll have to PM my name, but title is RN, BSN, CDE

The specialty area you work in Family Medicine clinic

Which category you belong to: (Educator, Administrator, Clinical Specialist, Staff Nurse,

Nurse Researcher) staff nurse/diabetes educator/chronic conditions case manager

Questions are:

1. How would you describe your role in your current position and your educational preparation for this role? I did a BSN right from high school and then stopped learning for awhile, sadly. When I started working more with our patients with diabetes, a couple of the docs took me under their wings, so to speak, and taught me some new stuff...I got excited about it, and then studied on my own for the CDE exam. So I think you have to find your own niche and then keep learning. It could be something you never would have expected.

2. How would you explain the unique contributions you as a nurse bring to an interdisciplinary team? I work closely with the docs. We have a social worker on our team. As has been probably been reinforced to you throughout your nursing education, docs deal with conditions, nurses with the human response to conditions. I think I bring the ability to translate "doc speak" and more complex patho to whatever level of understanding the patient is at. I wrote out diabetes instructions that I would have been able to understand at age 6 today...the patient and her family needed it that simple. A doc would have overcomplicated it.

3. How would you describe the unique role of your specialty in promoting quality outcomes for patients? Well, I work mainly with patients with diabetes and hypertension. So we have the guidelines, you know for hemoglobin a1c levels, for blood pressures, for smoking cessation, exercise, etc...the short-term outcomes. We also look toward long-term outcomes of stroke prevention, CAD prevention, fewer MI's, reducing kidney disease, reducing unnecessary ED visits, and also reducing longer-term costs associated with these things.

4. How has nursing research improved or changed a particular aspect of patient care in your specialty area? I've been reading a lot about self-management in chronic conditions. There is a surprising amount of research done by nurses on the subject.

5. How do you facilitate patient-centered care in your practice? As I mentioned in my answer to the second question above, I try to really get a handle on the education level and the level of understanding the patients have, to pace teaching, and really tailor it to the individual. This is something I seek to continually improve on. I use motivational interviewing techniques to facilitate behavior change, and this is completely patient-centered. We have PCMH accreditation as well, and are looking toward the next application next year- that is guiding us toward patient-centered care as well (I hope not only on paper but...)

6. How is cost containment techniques of addressed in your specialty area? See my answer to #3. I communicate with the case managers in the ED, for one thing we've initiated, so that the frequent flyers' needs are addressed better in our clinic; because I've developed a relationship with many people, I can try to better address the barriers they might have (can't afford a copay, finding a workaround, that kind of thing)

7. How has your specialty area addressed the needs of underserved patients and populations? Almost all of our patients are underserved. Providing education is the biggest thing. Another big thing is, using resources, making phone calls or using the internet to find a less-expensive workaround. Empowering is huge. A lot of our patients have depression and helping them feel more in control is a big deal.

8. How does information technology apply to your specialty area?

One of the things our clinic was "early adopter" on was chronic condition registries. We got an electronic medical record system in 2003, earlier than a lot of facilities in our area. So we pull registries on a regular basis to monitor how we are doing with diabetes care and other chronic conditions, with mammograms, with immunizations. We're doing more with it all the time.