smartblnde

I have to get it from the provider.

The client isn't requesting the results, our diabetes self management education program is. Also, the doc has not shared his rationale for not sharing. Frustrating, because we offer this service for FREE in the community, and people benefit from DSME (on average, DSME lowers A1c comparable to introducing one oral med). I guess he must be intimidated that his client could be empowered to care for his own diabetes without additional meds if taking DSME seriously and making changes. We send our participants right back to their own doctor. We are not stealing them, but educating them so their PCP actually looks BETTER in the numbers, and, if paid for performance (BP, A1c, lipids, cholesterol to target), they will make more money. Just cannot get my head around this one.

Hello! Rn/BSN, CDE (cert diabetes educator) here. We offer a diabetes self management education program (for FREE) in our community. Part of our program requires us to have a signed release in order to request labs from our class participants' providers. We send this request immediately after the class completion and again at 6 months to allow another A1c to be run after changes suggested in class have been implemented. This helps to encourage and empower the person with diabetes who made these changes, or, if the A1c shows no change, a little motivational interviewing by phone can guide them to something else to try that they feel empowere and motivated to do. I have one doctor who refuses to send the labs. Letters (with the signed release enclosed) twice, phone calls, etc, with no success to acquiring the results. How would you work around this? I do not want to call the client/participant to put them in the middle of this. Is there a clause or section/paragraph/line of the HIPAA law that addresses this? After a few hours of searching, I ask those who probably know. Joan

Hey, everyone... I know this original post was posted in July, but just saw it. After 43 years of T1DM, I kinda know what I'm doing. Additionally, I'm a Certified Diabetes Educator (I did not know about the oral meds very well before training for the CDE). There are MANY PCPs and other docs who are clueless. As someone said, it is up to US to advocate for our patients. However, when the doc just won't listen, we need to get our patients to ask specific questions. I give my patients the questions to ask and the answers they should hear when it comes to meds. If they don't hear the right ones, they should see an endocrinologist. I have also seen some 'internists' give totally wrong info. go figure. "My fasting/pre meal sugars are all just fine, but my A1c is 8.1. Well, now. There are great clues here to narrow the field of optimal medications. Maybe an alpha glucosidase inhibitor would be a good option? Or, maybe, prandin or starlix? You are so right that knowing about the diabetes meds can help our people so much more. EVERY doc should have to attend DSME/T (Diabetes Self-Management Training) before treating people. 8 hours could help everyone so much more. OFF my soapbox now! Thank you for your post. Joan

Oh, my Goodness. Totally nevermind. I found it. No more teaching 8.5 hours of classes on one day anymore. At present, it only says "submitted." What does THAT mean? I fear another year of applying. (tears.) I can just make all the number of what I owe bigger! LOL smart

Can you share if there is a link to the page on which to log on? I have gone to the NELRP site, but there isn't a place there..... Will try to see if there is a link in the reminder that was sent last year, but, that may take some time, and a link may be a quicker route. I SO don't want to do the whole application process again! Mind boggling and discouraging to see how much I owe! Best wishes for everyone to hear postive news soon.

Hi! I have just checked the site, and there isn't even a place on which to log on..... Year 4. So far, no luck. If the loan to ratio really means anything, I am 100% yearly income:loan. If I could allocate all my income to my loans for a year, I could pay them off. But, alas, the bank wants me to pay for my house, car, food, clothes, gas, electric, water, and all those other trrivialities. : ) Good luck to all. I think we could all use a bit of help with this. Anyone else in government where there have been no raises for years, yet the cost of everything continues to increase? Regards! smart

The nurse, the family and, most importantly, the patient, knew that increasing the O2 to 6L would drop the CO2 level to such a low (for this patient), the patient would lose the drive to breathe. His/her body would think they were breathing just fine, if not better, than a typical day. Therefore, the patient ends up on a respirator. More than one answer would be appropriate for this situation.

Good morning, I, too, am wanting to be a CDE. I have 38 years of experience with diabetes... Have been one myself for that long. That, however, does not count as experience, and that is weird, because I do a LOT of teaching to all kinds of people about all aspects of the disease. Go figure. Joan

Hi, I live in Kentucky, but work in Ohio. At our hospital (Christ), we make $18 an hour to start, plus a $4 an hour shift differential for night. There are bonuses available for working on your off days if you are called and they are desperate. Local Northern Kentucky hospitals are similar in their approach. I had heard when I was near Browning, MT last year, you can earn up to $80,000 working for Indian Health Services. From what I understand, there is not a lot to do in/near Browning itself, so there is no place to spend that $80,000! For me, that is very appealing, since I can't keep a dime in my pocket! I do realize this was verbal info, given from a 'friend of a nurse' there, so I take it with a grain of salt. Best wishes to everyone!