Anyone who read my former blogs knows good diabetes care has been challenging in my long term care homes. I have written about “Ethel”, the long term resident who thinks pork rinds are healthy and about the nurses who were upset because a resident with good blood glucose control refused to follow a “diabetic diet”. I also wrote about “Lola”, the resident who convinced her nurse she did not have diabetes despite having a fasting blood sugar of 180mg/dl. After many of these experiences, I realized the licensed nurses in my long term facilities needed to be educated about diabetes. I am happy to say the Director of Nurses in my buildings agreed with me and I have started training workshops on this subject. So far, I have conducted the training in one building with more workshops scheduled in the next few weeks. In my first workshop, the nurses were provided a test at the beginning so I could find out what they needed to learn and I gave them a test at the end to see if they understood the new information. Here are the results:
1. The Good News.
The pre-test revealed all the nurses knew the main causes of high blood sugar. They knew high blood sugar was caused not only by too many carbohydrates but also dehydration, infection, stress and the wrong dose or blood glucose medication. They were also able to name at least two signs and symptoms of low blood sugar. They also realized there was currently no cure for diabetes and that they need to monitor residents’ blood sugar even if they are following a “diabetic diet.”
2. The Bad News.
Most of the nurses did not know the difference between basal and bolus insulin. Plus, they did not know the differences between short acting insulin such as Novolin RU100 and rapid acting Novolog insulin. In addition, they were unaware of the possible side effects of common oral diabetes agents (pills) and could not tell me the recommended Hemoglobin A1C value from the American Diabetes Association (ADA) or the American Academy of Endocrinologists (AACE). They did not realize insulin was adjusted based on varying factors such as weight and the progression of the resident’s disease.
After reading this blog, you probably think I am picking on nurses. This is not true. Nursing is a tough profession and I admire them for choosing such a challenging career. When it comes to the overall care of the residents, these nurses know more in their little fingers than I know in my whole body. However, I feel the general medical community needs to take more interest in diabetes care, especially given the high rate of people developing this disease. Overall, they were positive about the workshop. They answered all the post-test questions correctly. One nurse told me she felt “relieved” to learn the information. I know they care about their residents. I look forward to conducting more diabetes workshops in the future and empowering our nurses.
If you have any comments or questions regarding this blog, please email me at askard@stablebloodsugar.com Allison
