When patients are diagnosed with diabetes, they often can feel scared, lost, and/or confused. So when part of your job as a nurse is to educate diabetic patients about the condition and the changes they need to make in their lives, it’s important to know how to handle it.
Not a Death Sentence
When patients panic, they can’t take in any information. That can be a problem when trying to educate them.
Vashti Johnson, RN, at BrightStar Care in Cary, North Carolina says that when she needs to educate newly diagnosed diabetics, the first thing she stresses is that it’s not a death sentence. “If managed properly, a diabetic patient can live a long and productive life,” explains Johnson. “They simply need to change some habits and to focus on a healthier lifestyle.”
“It’s important to remember that being diagnosed with any disease can be very overwhelming and almost always leaves the patient with many questions and concerns,” says Brittany Dudley, RN, director of nursing at the Health Care Center at Friendship Village in Tempe, Arizona. “Newly diagnosed patients are often fearful of the facts of their disease and will withdraw from engaging with education. I always assess my patients to the best of my ability on their ability to learn and what technique of teaching best fits their needs prior to initiating any education.”
Which brings us to our next step—figuring out what to tell them and how. Patients with Type II diabetes are often asked to make life changes, and, for many, this can be difficult.
Commonly, explains Dudley, they will be put on a diet, exercise, and medication regime. And some of them may not like it.
“The more you understand a patient’s lifestyle, the better you can educate them,” says Dudley. “I often tell my patients and their families that we have to make a ‘plan.’ In making a plan, we can understand what will and won’t work for this patient during his or her lifestyle change. For instance, if ‘Joe’ tells me that he eats a chocolate chip cookie every night before bed, and he is not willing to change that, I will not insist that he does. I can educate him to make better choices, but will most likely look for other areas in his diet where we can compensate for his daily cookie. This is a plan that works for Joe, and therefore, he is more likely to be successful overall.”
Johnson says that patients need to know to take things one day at a time. She admits that, for many patients, some days won’t go as well as others. “Also, compromise when it comes to eating. For example, if someone wants a piece of cake at a party, avoid bread or pasta during that meal,” she says.
She tells patients to set short goals because each time they meet one of their goals, it will energize them. “Smaller victories feel just as good as a long, drawn-out battle,” Johnson says.
Timing is Everything
Dudley recommends that nurses educate their diabetic patients throughout their entire hospital stay—not just right before discharge. You can certainly review everything with them, but teach them what they need to know over time, when possible. “Patients who are going home are focused on getting home, not learning what you are telling them. You will have better engagement if you educate every time you go in the room during their stay,” she says.
In addition, patients need to realize that it will take some time for them to implement the necessary changes in their lives. “Life changes never happen overnight,” says Johnson.
“I encourage starting slow,” says Dudley. She tells patients not to expect their bodies to do things that they can’t do. For example, she may recommend that, in terms of exercise, they begin by going for walks for 15 minutes daily, and then gradually increase the time. “Your body will respond as your blood sugars become controlled, and you will naturally feel like doing more,” she tells them. “I also teach that it takes 21 days to break a habit. I tell them to choose one bad habit and see if they can make it to the three-week mark. Setting goals helps change come faster and easier.”
Using Educational Tools
People learn better in various ways. Some learn better by listening to information, by reading materials, by watching videos, or a combination of all. As a nurse, you’ll need to figure out how your patients learn best and try to provide them with resources they can use. “I always assess my patients’ learning type or preference for optimal outcomes,” says Dudley.
She does, however, prefer using printed materials when appropriate. “All of the written forms give the patients some information to refer back to, and also allow me to reference while teaching so I don’t forget important points,” Dudley says. “You can never over-educate! I also advise using diet journals, exercise, blood sugar logs, and medication sets. These simple tools help us hold ourselves accountable for making progress. Nutritional counseling and the American Diabetes Association are great resources.”
Johnson says that the most effective resources will depend on each patient. “Some patients respond better to speaking to someone who also lives with diabetes, and some will feel more prepared by reading and researching for themselves,” she says. Johnson will also suggest they consult with an endocrinologist, a dietitian, and to look into diabetic support groups. She also always shares tips on how to live with diabetes.
“It is important to remember that diabetic patients will need a lot of encouragement to change their lifestyles,” says Johnson. “It could be challenging to understand their disease process, so they may need more mental support and coaching above anything else.”