« Dancing on the Beach. | Main | Late Night Post: Grazie!! »

Guest Post: Nursing and Diabetes.

I'm working on some recaps of the CWD Marco Island conference, but the kiddo has caught a cold and is requiring lots of snuggles and hugs these past few days.  Thankfully, Abby (the Person) has offered to guest post about her experiences managing diabetes (and the gummed compliments of ancient grandmas) while in her third year of nursing school. 

Thanks, Abby!!

*   *   *

Abby (the Person)As I finish up my 3rd semester of nursing school, and prepare for my final few months as a student, I can’t help but reflect on what worked, what didn’t and what still remains a mystery.  Diabetes is no exception.  Nursing school is not like “regular college”, (which I can confidently say “been there done that” to) and there are a few things that really stick out to me as "DiaNursingSchoolFails" (CBC term shout out).
 
We talk about diabetes in class a lot, because a large part of the hospitalized population are there either with diabetes, or because of complications (usually type 2, but that’s never mentioned in my classes).  This is where my first issue arises.  How do I tactfully explain to my teacher, who has been a nurse for umpteen years, that she is totally dead wrong on her facts?  

Example:

Teacher: “Atkins was developed for over weight people. A lot of people lost weight on it when it first came out, and most of them their diabetes went away.  Type 1 and Type 2 diabetes went away when they cut out carbs and lost a lot of weight, it’s great for that purpose.”
Me: “I’m sorry, did you say Type 1 and Type 2 diabetes just goes away when you lose weight?”
Teacher: “Yes, these people lost so much weight it made their diabetes not an issue.”
Me: Offhanded comment to the girl next to me “Well, I’m officially not paying attention in this class anymore.”

This is definitely a sticky situation, however, not an uncommon one.  My teachers are usually very accepting of me being a diabetes know-it-all.  This semester when learning about endocrine disorders, my teacher let me bring in my pump and a few random insulin pens I had and pass them around to let people get hands on experience with these commonplace devices they’ll probably never see again.  It was really fun!

Then there’s clinical.  I love going with my patients to see procedures being done.  I’ll spare you the gory details of what I get to see, but they all have one thing in common: they’re in different parts of the hospital entirely.  To a PWD, this means leaving my diabetes supplies four floors up at opposite ends of the building.  No thanks. I know it’s not the most responsible thing to do, but I’ve resorted to stashing a tube of glucose tabs in my scrubs and scurrying on my eager-student way. If only there were BGM stations at every corner like at diabetes camp.

What about those postprandial breakfast highs that I CANNOT seem to get rid of no matter what I do?  I’ve been battling this issue for almost a year now, and have yet to discover something that works 100%. As in: Exams are 8-10am. Therefore, I take most of my exams with a spacey brain, a sticky mouth, and blood glucose over 200 mg/dl. It’s amazing that I’m passing these classes.

The final issues I run into frequently are my cute-as-a-button 89 year old patients with questions like “Oh dear, how did you do that to yourself?” when they discover I have diabetes. I keep my cool, but that stigma really gets me sometimes. (If only I had known about the “case of the stupids” response…)

But on a positive note, I’ll never get sick of this one: "Sweetie, there’s no reason to be 23 and unmarried.  You’re pretty and nice (or some grandma variation of a ridiculous list of compliments).  Go find yourself a husband and make some babies!"

*   *   *

My college degree didn't require as much time and attention as Abby's (English major here), but I do remember the delicate dance of diabetes and college a few years ago.  How do you, or your kid, deal with diabetes in the college environment?  And for another perspective "from the medical trenches," revisit this guest post from Dr. Adam Kaye!

Comments

I could have written this. Word for word. I'm in nursing school and am also trying to balance nursing and diabetes.

This semester my pediatric nursing instructor started spouting off incorrect information about Type 1. She's been a peds nurse for about 30 years. She was saying things like glucagon is given orally and Type 1's can't have a full piece of cake. After class I met her in her office and respectfully told her her information was antiquated and deadly inaccurate. She was pretty receptive.

Every semester I let my instructors know the first day that I'm Type 1. They're all pretty great about it and I've never had a problem with any of them. I think, especially in college, it's important to let people around you know that you're diabetic. Before going college I had my family and friends who all knew I'd been diabetic since I was three. They were familiar with what I did. But when I started college only a handful of people knew about it. It was important to let everyone who spent lots of time with me know the basics about what I needed to do.

Thanks for guest posting, Abby! All of these things have happened to me in the past three years. Including questions about why I'm not married yet. :)

Thankfully, I was diagnosed towards the end of my undergrad degree going into grad school. I scored an awesome assistantship where I got to work in research and get paid to go to grad school. So, it was almost like having a "real job" in an office, but just for 4 hours/day.

The only time I really considered diabetes was before I defended my master's thesis. I was going to be up in front of a huge group of people, talking for about 45 minutes, then getting grilled by my committee for 15 minutes. I always get low when I'm anxious, so I bought a huge bottled water to keep my throat moist during my talk and a bottle of apple juice to sip if I started feeling the nerves. Needless to say, by the end of the hour I really had to PEE!

I don't remember having a lot of issues in-class in college, but I sure have issues as a professor! I teach in the morning, and tend to plummet during my morning classes. I've found that eggs for breakfast helps keep the sugars stable...and in between classes I dash to my office for a banana. I've had a few bad lows during teaching. Usually I just gulp juice and keep talking. Once in a while I have to disclose: "Class, I'm really, really low. Take what I say with a grain of salt." My students have been really good about it, and sometimes I get the opportunity to educate about diabetes in the process.

Thanks for sharing this perspective, Abby! Certaintly a valuable and much-needed one, especially within the nursing school ranks! I like the above-commenter who mentioned talking to the profs in their offices outside of class, to go over any "misinformation." Maybe then they will have the chance to see how and why they're wrong, and help spread the message that they were in fact mistaken. If not, then the myths and misinformation is only perpetuated to future generations of nurses who don't know any better except what they learn in class and from textbooks.

ABBY!!! The Abby that baby-sat Joe while attending St. Michael's college in VERMONT?! I cannot believe that is you.

Glad to hear you are in nursing school and it must be difficult balancing all that you do. Keep up the terrific job. I think Dave and I have been out twice since you last babysat - LOL.

Hello,

I am 24, so not that far off. I was a Dental Hygiene major in college, so at times we dealt with similar issues. I chose to tell as few people about the diabetes as I thought was safe in-case of emergency. I did this because college was my first chance at not having to tell everyone (Diabetes was the first thing my parents mentioned in any situation while growing up). I wore my pump mostly on my pocket then, and sometimes people would ask. I always tried to take the time to politely answer any questions, as most were T1/T1 parents who had never seen a T1 in the wild with one on before.

My professors were always sorely wrong about T1, and they were the type that didn't take well to correction...I learned to get over this. They new I had T1, but rarely referred to me. I would step out as needed.

Once, while in the clinic (a no-cell phone zone), I was outside of a station administering insulin when one of the clinic teachers mistook my pump for a cellphone and pulled it out of my hand and me. It was amazingly embarrassing for us both. She was extremely apologetic though, and I replaced it immediately.

My college offered a T1 support group just for students, and it was a great place to learn. There were several pump types/infusion set/ lifestyle chats that really helped us all to get through college easier. There was also an endo in our student clinic that saw all of us regardless of our health issue (cold or major insulin adjustments, which at times coincide), and I think I miss this the most.

Geez...long winded today, I guess. Sorry!

Thank you for posting this! I'm a nursing
Student just about to start my first work placement next week, and i don't know any nurses that have diabetes. It's great to hear your story. Thanks!

Answer: College + Diabetes + Sarah = Fail. Freshman year I canceled all my endo appointments, only rescheduled when I realized my doctor wouldn't refill my scripts unless I made an appointment, and found myself with a 9.6 A1c. I didn't want to carry my insulin to the caf, I didn't want to take time out to test, I didn't want to skip the mac and cheese or biscuits and gravy because they were the only decent tasting things in the caf. And I definitely didn't want to exercise. It was not fun at all! I felt sick a lot. Senior year was a whole lot better! I actually grew up and started testing. From testing alone, no change in diet or exercise, my A1C dropped from 8.6 to 7.9!

Actually, diabetes was no biggie for me in college or university. If I was low, I pulled out a juice box (I learned how to make the hole bigger with the straw so I wouldn't make slurpy-suck noises when I drank it), and no one ever said anything. I guess I must have been high at some points....but I never really felt it made a difference for me. Maybe it did, and I just didn't know it. Either way, I had no problems that I can think of...like a poster above though, I do have occasional probs when teaching (I am an elementary school teacher) and always tell my kids I am diabetic and what to do if I start acting weird. My fellow teachers also know and know where my sugar stash is kept. Maybe I have been lucky...

Thanks for posting this I too am in nursing school and it is def. a interesting turn in my life. I love it but it has its moments! you hit most of the nails on the head. I have a teacher who seems to be the diabetes police so it is extra special in that class!! ohh and BTW. I take my morning exams low and afternoon exams high lol with some normals in between. Good Luck next semester!

Pretty much all health-related classes (in college) will be pegged with diabetes mis-information.(at least, in my experience,hopefully not in yours) I go into it expecting it,& unless the teacher in question HAS diabetes/family member with it (remarkably,1 did have type 1)my brain just filters out the junk & lets the real facts in.

And I cannot wait to join the Nursing Student Ranks.(8 days,ready or not!)

We're all advocates (for the patients,and for the community as a whole)whether we like it or not.By virtue of having diabetes,we're (frequently)placed in situations where being silent is just not an option.

Hey Abby!
I am a student of nutrition, so in my diet therapy classes the professors constantly get this stuff incorrect. Ugh. They're usually spouting to my classmates that "if a T1 has ANY high BG, then they are out of control."
My method of control is to retrain my classmates :D I have tried to correct the professor (generally outside of class) but have found that the easiest way is to talk to my classmates about what was wrong and what is actually the truth.

Congrats on almost being done!!

Hello Abby and Kerry!
I found that simply explaining to my professors that I may need to check or eat during classes does the trick. This is my third year in college and, although I attend a culinary school, we aren't allowed to eat or drink anything but water in our classes. Ironic, yes? I've had to deal with lows in the middle of baking, mixing things, exams, you name it. I've also had to leave classes because of ridiculous highs. Those were not fun days, but I've been getting through them.
Hope you had a good break from school Abby!

I really enjoyed this! I'm planning on going back to school to become a registered dietitian, so it was right up my ally. :)

About the old folks that make comments about how you did it to yourself. Just remember they are OLD, and they grew up in a time when people (even docs) really DIDN'T know the difference between Type 1 and Type 2 (not that they do now, either!) -- and then just smile and go on. People make inappropriate remarks all the time, but especially those who are old, ill, and/or possibly demented. Don't even try to correct them -- they are not the future!

I'm a non-diabetic RN who graduated from nursing school two years ago. I was honestly always in awe of a classmate of mine who was balancing type 1 and school- she was always battling lows and did so with grace. I learned more about diabetes from her than from all of my professors combined. Unfortunately, even though we discussed diabetes a lot in nursing school, not all of my professors were up to date on their information, either. I'm sure that many of my classmates (now RNs) are out practicing in the real world with some serious misinformation about diabetes. I hope that you continue to educate your professors, fellow students/future colleagues, and friends about diabetes... please don't get too discouraged about all of the misinformation out there!

Good luck with your studies!

I felt so lousy my first semester of college that I knew I couldn't continue like that and I checked myself into the Joslin Clinic. I needed a much better education in managing my diabetes than I'd had thus far. It was a smart move.

Hi Abby,
I am glad you are in nursing school. I still think it sucks that you can't always carry your testing equipment with you. At least you are able to carry glucose tabs so I guess that is better than nothing.
I don't understand why people who work in the medical profession think diabetes goes away. Once one has diabetes whether type 1 or type 2 it is there for life. Yes, type 2 can appear to have disappeared but it is still there just hiding. It is a sad fact that most doctors and nurses don't know about type 1 diabetes but it is also a sad fact they don't know about type 2 diabetes. I am glad you are there to educate the truth about type 1,

I clicked on this title thinking it would be about breastfeeding and managing diabetes;) The topic of your post is an equally important topic and encourages patients to be well-informed from a variety of sources. Thanks for a great post! Best of luck with the rest of your studies.

Hey Abby,
Nursing school and diabetes is definitely hard to manage (I've been a nurse for 5 years and a diabetic for 17). A lot of the instructors and floor nurses definitely have antiquated information but most of them were really receptive to new information (and the opportunity to see my pump in action). That being said, start planning for your NCLEX in advance and make sure they know about your diabetes and need for sugar. Working on a floor is particularly grueling but do-able depending on the patient load. I did floor nursing for a while before I got my CDE - now I am constantly surrounded by fellow diabetics and endos so it's a little easier to deal with the diabetes on the job! Good luck - it's a great career!

My story is almost identical to yours! I love camp! I have been T1 for 16 years and I'm also finishing up my last semester of nursing school(will graduate in MAY!!).It's always a great reminder to hear that I'm not the only one dealing with teachers who have no clue about the difference between type 1 and 2, Or the struggle of leaving your supply stash floors away on a clinical day, or wrangling BG's while taking exams and trying to study! Good luck with the next semester! And thanks for sharing your story : )

I LOVE this post, because I am also 23 and a nursing student with diabetes. I can totally relate! Especially all the misconceptions being taught about type 1's. I do love that my fellow students are very interested in my pump and CGM and are always willing to learn about my experience with diabetes. Thanks abby and Kerri for hosting this post. :)

I was diagnosed with type 1 diabetes last summer, during my junior year of undergrad at university of michigan. I can completely relate to Abby! I'm majoring in biomedical engineering (how ironic) and have taken so many exams with blood sugars of 300 and above, even prior to my diagnosis. It's amazing that I can even pass! Whenever diabetes is mentioned in my classes, I am always anxious to see if they know the right information. But I definitely have had plenty of stupid responses from strangers, and even friends. I'm on a pump now, but when I was on pens, I let my friends in the nursing school give me a shot..they were so interested!

Thanks Abby and Kerri for posting! It's great to know there's other diabetics out there who are going through the same things. :)

I graduated from a University Nursing course in 1993... went thru the SAME stuff!

Type 1's can't have babies, etc. I encourage you to email or print out some info for your instuctor... you will be doing an unknown amt of people a favor as all these RN students graduate & forward mis-information!

Thanks Abby for the post...well am also a type 1 and in medical school...well even here the doctors are soooo misinformed and i have to stop getting pissed everytime they make some off handed and often backhanded comment about diabetes...most of my class mates know so whenever diabetes comes up (which is so often it ridiculous why no one takes it more seriously) I have found that after the class i have to go correct the lecturer (who is a medical proffesional) on some thing he or she said...most of the time they are cool about it and stuff but my close friemds are cool and they always carry fanta (my low fighting bullet)and all sorts of stuff to fight my lows...hopefully I have inspired atleast one or two of my classmates to get into endo or to be more aware...

It's so funny how many of us there are who decided to become nurses!! I totally agree with the frustrations about how many misconceptions there are about Type 1, even among health care professionals. (I even wrote a whole post about it: http://laynenp.blogspot.com/2009/11/brittle-really.html)

I remember how hard undergrad in nursing was. One of the hardest thins for me was seeing all the diabetic patients with horrible complications. Almost all of them were Type 2, except for one transplant patient who recieved new kidneys and a pancreas at 33 years old. I remember asking my professor where all the Type 1's were and he told me that the reason you don't see any older Type 1s in the hospital is basically because they are all dead. Nice! Turns out it's because our control tends to be better and we have fewer complications. But that scared the SNOT out of me.

I think nursing school is particularly tough. Not only is the job tough on the diabetes routine (long hours, always on your feet, hard to carry around supplies) but it also sucks to see diabetic patients with complications all day long and have to deal with health care folks who don't know what they are talking about.

It is great to hear your story. Just awesome how something like diabetes does not make person weaker, but instead make them stronger. Good luck to you!

Post a comment

(All comments are moderated. Thanks for your patience!)