The Growing Importance of Diabetes Prevention
With nearly 26 million children and adults in the United States living with diabetes, and an additional 79 million Americans at risk, it is more important than ever for nurses and other healthcare providers to educate the public about diabetes risk factors and preventative behaviors. In fact, according to the American Diabetes Association (ADA), diabetes is no longer just a condition – it is an epidemic that requires greater focus and awareness on ways to prevent and manage the disease.
“The ADA is taking action against diabetes with several different initiatives to ensure that every person is properly educated on how to lower their risk for type 2 diabetes,” said Marjorie Cypress, Ph.D., RN, CNP, CDE, President-Elect of the ADA, and independent consultant and adult nurse practitioner with Albuquerque Health Partners in Albuquerque, N.M. “Nurses in particular have an opportunity to help in this fight against the disease by counseling their patients on how to live a healthier lifestyle.”
Early assessment and intervention to treat risk factors associated with diabetes can help patients prevent this potentially dangerous disease. Patient adherence is critical to the success of treatment, and ongoing education can help patients understand how to manage risk factors. Nurses can seek opportunities within professional organizations to not only expand their critical knowledge about diabetes, but to also gain access to valuable resources that can help create more public awareness.
“When given the proper educational tools, nurses can help patients facilitate appropriate lifestyle strategies to prevent diabetes including weight loss, altering diet and increasing activity level. The ADA offers a variety of professional tools to help diabetes nurses facilitate those lifestyle changes, and can be a great resource for nurses looking to positively impact their patients’ risks of developing the disease,” said Cypress.
Stop Diabetes® is a national initiative that was launched by the ADA in November 2009 to help end the devastating toll that diabetes takes on the lives of millions of individuals and families in the U.S. Those who pledge their support can contribute in a number of ways – supporters can become advocates or event volunteers, participate in walking or bike riding events, or provide financial support. This comprehensive program offers the tools supporters need to get started in the fight against diabetes.
Additionally, the ADA worked with the American College of Cardiology and the Preventative Cardiovascular Nurses Association to develop the “Reducing Cardiometabolic Risk: Patient Education Toolkit,” a bilingual toolkit designed to help nurses educate patients on steps towards diabetes prevention. The toolkit contains 29 different patient education topics for patients with and at risk for pre-diabetes and type 2 diabetes. Nurses can download topics in English and Spanish, and customize educational packets to meet patients’ individual needs.
According to Cypress, assessing cardiometabolic risk factors such as obesity, high blood glucose and hypertension, gives clinicians a more comprehensive understanding of a patient’s health, including the patient’s potential risk of diabetes and complications from the disease. Each of these risk factors poses a danger to good health, which is why it is important for nurses to educate patients about their individual risk factors and how to take action to lower those risks.
“Nurses have an opportunity to help diabetes patients not just at the bed side, but in a more holistic way by acting as a counselor. It’s a nurse’s job to learn about a patient’s daily lifestyle and find ways to promote physical activity and healthy eating habits. While it can certainly be a challenging job, helping patients in this way is an important part of being a nurse.”
To learn more about the ADA, visit www.diabetes.org.
Nurses Defining Diabetes Education and Care
According to the World Health Organization (WHO), diabetes is one of the leading causes of mortality in the world. It is a condition that affects the body’s ability to produce or absorb enough insulin, and can often become a deadly disease if not treated properly. Because of this, it is imperative for patients with diabetes to seek expert professional care from nurses and other healthcare providers to help monitor the condition.
The Diabetes Control and Complications Trial (DCCT), a landmark medical study conducted from 1983 to 1993 by the United States National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), showed that keeping blood glucose levels as close to normal as possible slows the onset and progression of the eye, kidney and nerve damage caused by diabetes. This study has significant implications for healthcare providers and their patients, indicating that a primary treatment goal in diabetes should be blood glucose control.
“Prior to the 1990s, we really didn’t know if there was a way to prevent or delay complications from diabetes. The results of the DCCT study really changed that mindset and the way we treat diabetes,” said Cynthia Watson, MSN, FNP, ADM-NP, nursing instructor at the University of Louisiana at Lafayette in Lafayette, La. “Since then, there has been a lot of research into the various ways to maintain glucose levels, and how to manage all aspects of the pathophysiology of the disease – things we didn’t know a decade ago.”
Today, the role of a diabetes nurse includes both the care and education of a patient to ensure the disease is managed properly. Nurses who specialize in diabetes provide routine examinations, monitor their patients’ glucose levels, administer medication and explain treatment options. Additionally, they educate their patients on how to manage their disease, including diet choices and activity levels suitable for their condition. They also observe their patients for complications that are commonly associated with diabetes, including circulatory disorders, heart complications, and skin and eye disorders.
“Any nurse who is interested in diabetes nursing should be well-versed in the pathophysiology of the disease and the entire disease process. It’s important to know how lifestyle choices – such as nutrition, exercise and stress – can impact the condition, and to have a good understanding of the medications that are used to manage diabetes,” said Watson. “Those interested in the specialty should attend as many lectures and conferences specific to diabetes as they can, and subscribe to journals to keep current on some of the rapid changes that are taking place.”
The first step to becoming a Certified Diabetes Educator (CDE) is to earn an associate degree in nursing (ADN) or a bachelor’s degree in the science of nursing (BSN). It requires experience in diabetes education, as well as a satisfactory score on the CDE certification exam provided by the National Certification Board for Diabetes Educators. Nurses interested in becoming an Advanced Diabetes Management Nurse Practitioner must earn a Master of Science in nursing (MSN) and have a minimum of 500 clinical practice hours in diabetes management, plus a satisfactory score on the BC-ADM certification exam.
“Diabetes nursing is a great career path for anyone who desires to help patients manage their diabetes and prevent the complications of the disease. However, all nurses have the potential to encounter diabetes in any setting and any specialty, so even if someone is not interested in pursuing diabetes nursing specifically, it’s extremely valuable for nurses to have the background and education on how to properly care for a patient with diabetes,” said Watson.
For more information about the career of a diabetes nurse, visit www.discovernursing.com.
Get to Know
Lynda Stallwood, Ph.D., CPNP-PC, Assistant Professor at Chamberlain College of Nursing in Detroit, Mich.
Q. When did you decide to pursue a career in nursing and why?
A. As far back as I can remember my sister and I always wore matching nurse outfits. It is something I knew I wanted to do even as a young child, and as it turns out, my sister and brother also became nurses! I believe we did this partly because our mother’s dream was always to become a nurse, but she never had the opportunity to go to school. I related very well to how she cared for us when we were sick – she had a natural gift for care giving – and I always enjoyed doing the same for others.
Q. What do you enjoy most about nursing?
A. On many levels there tends to be a gap between the healthcare provider and the patient, and I believe nurses help to bridge that gap in terms of providing personalized care. While healthcare providers are dealing with issues like diagnosis and treatment options, we can work more closely with patients to determine what educational materials and support resources they may need not only while they are in the hospital, but also once they return home. Helping to establish a care plan, teaching and advocating for patients – those are the things that really get me excited about being a nurse!
Developing these kinds of plans is especially important when dealing with type I diabetes, as deliberate home care becomes more important for my patients than those with acute illnesses. I truly enjoy anticipating what their needs might be and simply being there for them as they in turn care for their own families.
Q. Why did you choose diabetes nursing as a specialty?
A. About 25 years ago, I received a new patient – a 14-year-old girl with type 1 diabetes. This sweet, young girl came into the office very calmly with her family. They gave me the impression that they were very much in control of the situation and could handle any outcomes of the diagnosis. They were an absolute delight to work with, but I could tell that they knew deep down that this was a game-changing diagnosis that would infiltrate every aspect of their lives.
While working with the family for a few days, they continued to be very understanding and seemed prepared to deal with this chronic condition with a positive attitude. Towards the end of my shift one evening, I noticed that the patient was crying. This was very different from my previous encounters with her, so I stopped in to check on her. She looked up at me, tears swelling her eyes, and asked, “Can I sit on your lap for a while?” Being only 5’2” myself, she was as tall as – if not taller than – I was at the time. Nevertheless, I sat in the rocking chair by her bed, held her and let her cry.
I didn’t have to say much; this young girl was finally able to express what was really going through her mind. She told me, “I have to be strong for my parents’ sake. I can’t let them know that I’m sad, or that I’m scared. I don’t want to have diabetes.” So I continued to sit with her until she felt a little relieved and could get a little bit of sleep.
The next time I spoke with her parents, I mentioned my experience with their daughter. I was amazed when they began crying on the phone, declaring that they felt just as afraid as she did, but that they needed to handle it with strength for her sake. This was a great time of relief for both the parents and the patient. It became a turning point for them in how they responded and dealt with the condition from that point forward, and the next time they came in together they were much more relaxed and ready to move forward together as a family.
This experience 25 years ago is still fresh in my mind and in my heart, and it is why I dedicated myself to caring for young patients with diabetes. I’ve had a lot of great experiences being a nurse, but that by far was the greatest and most life-changing one of my career.
Ask a Nurse
Learn from Industry Leaders How to Kick-Start Your Nursing Career
Attention all student nurses and new nurses – are you interested in learning how to expand your network, prep for interviews or gain valuable experience in nursing? Or maybe you want to know what to expect during your first year as a nurse. We are inviting student nurses and nurses with less than five years of nursing experience to share your fundamental questions with us on the Nursing Notes by Johnson & Johnson Facebook Page and on Twitter @JNJNursingNotes. Each month, we will pick a few questions to highlight in this section with responses provided by seasoned nurses!
Q. What can a recent graduate with little work experience do to stand out in a job interview?
A. During an interview, recent grads should talk about their education, as well the part of their education they found to be most useful as it relates to the job they are applying for. They should know what the duties are going to be if they get the job and look back to their education and clinical experience so they can pick out specific experiences that show they are qualified for the job.
They also need to be willing to be flexible and understand that not too many employers will hire a new graduate into high acuity positions, such as those in the Intensive Care Unit, because they want nurses with a little more experience. Recent graduates should to be willing to accept a more generalist type of job for a year or so with the goal of applying for a position with higher acuity later on.
-Cynthia Watson, MSN, FNP, ADM-NP, nursing instructor at University of Louisiana at Lafayette in Lafayette, La. Watson has been a nurse for more than 30 years and a nurse practitioner for nearly 13 years.
Q. What’s something you wish you had known as a student nurse that you know now?
A. Looking back, I wish I hadn’t been as timid when it came to speaking up about my patients’ needs to other healthcare staff. Nurses are able to counsel their patients and relay that information back to the team they are working with – it’s important that everyone, from the nurses to the physicians, know what the patient is going through to ensure that they are providing the best care possible.
-Marjorie Cypress, Ph.D., RN, CNP, CDE, President-Elect of the American Diabetes Association, and independent consultant and adult nurse practitioner with Albuquerque Health Partners in Albuquerque, N.M. Cypress has been a nurse for 32 years.
Q. What advice would you offer a recent graduate searching for the “right” specialty?
A. Many nursing students are lucky enough to find their passions going through clinical rotations in nursing school. For example, I decided that I wanted to work with children well before I graduated. For others, finding a specialty can be more challenging. For those students who aren’t quite sure, I always suggest going into a medical-surgical unit to gain strong clinical skills. Medical-surgical work can introduce young nurses to a variety of specialties they might have not previously considered, and the skills gained will be invaluable in the long run.
-Lynda Stallwood, Ph.D., CPNP-PC, Assistant Professor at Chamberlain College of Nursing in Detroit, Mich. Stallwood has been a nurse for more than 26 years and a nurse educator for 10 years.
Small Lifestyle Changes Can Have Big Impact for Type 2 Diabetes Patients
A new, national study conducted by GfK, an independent market research firm, on behalf of the Johnson & Johnson Diabetes Institute, revealed that physicians feel type 2 diabetes patients could better manage their disease by appreciating the benefits of “small successes” – such as walking instead of driving short distances – rather than focusing on drastic changes. In fact, 97 percent of physicians said type 2 diabetes patients would have more success in managing their disease if they understood that even a small five- to 10-pound weight loss could improve outcomes.
The survey also found that physicians and the general public strongly agree a significant challenge in the treatment of type 2 diabetes is the fact that patients often don’t realize that the disease impacts their entire body – less than one in three physicians felt patients are very aware of negative effects the disease has on the body beyond blood glucose, including impacts on the heart, kidneys, and pancreas. Because of this, it is evident that there is a need for nurses and other healthcare providers to help patients focus beyond just the reduction of blood sugar to address other related medical issues.
The Johnson & Johnson Diabetes Institute is a global initiative that was established to address the growing epidemic of diabetes and to help transform diabetes care. Through this institute, diabetes specialists receive the latest information about innovative practice models, as well as ways to use existing diabetes tools and technologies to meet the needs of patients and providers in their region. The Institute offers free membership for healthcare professionals and provides webinars on current topics, articles written by experts and the opportunity to interact with thought leaders.
To learn more about the Johnson & Johnson Diabetes Institute, visit www.jjdi.com.
NLN Leadership Institute Expands Faculty Development Offerings
The National League for Nursing (NLN) recently announced increased support for several of its faculty development initiatives. Made possible through funding from the Johnson & Johnson Campaign for Nursing’s Future, this will facilitate an expansion in the coming year or two of the NLN’s signature leadership programs, and make possible the creation of a third program within the NLN Leadership Institute.
The two existing Leadership Institute programs to be expanded are LEAD, aimed at faculty aspiring to leadership roles or nurse educators who have been rapidly transitioned to a position of leadership within their academic institutes, and the Leadership Development Program for Simulation Educators, designed for experienced simulation nurse educators eager to become leaders in this specialized field. Each accommodates an annual cohort of 20 nurse educators, selected through competitive application.
“We value the longstanding relationship we have with the NLN and are pleased to expand our support of critical nurse educator training programs and initiatives,” said Andrea Higham, Director of the Campaign. “One of the pillars of our campaign is nurse retention – high-caliber, leadership-focused program experiences such as these help propel existing nurses and nurse educators to the next level of their careers. This shared commitment to excellence in nursing education helps us move closer to a day when we will have enough nurse leaders to meet the healthcare needs of our patients and communities.”
For more information about the Leadership Institute, visit the NLN website at www.nln.org.
“Nursing Notes Live” Podcast Series
Nurses and student nurses – be sure to tune in to the most recent episodes of “Nursing Notes Live,” the Campaign’s podcast series! The series features 20-minute episodes which deliver exclusive interviews and news segments on topics featured in the monthly e-newsletter. Last month’s episodes highlighted the importance of philanthropy in nursing and featured nurses who give their time to others by volunteering.
Each month there will be two all-new episodes of the podcast. This month’s episodes will feature interviews and discussions with diabetes nurse industry leaders including Marjorie Cypress, Ph.D., RN, CNP, CDE, President-Elect of the American Diabetes Association (ADA), and independent consultant and adult nurse practitioner with Albuquerque Health Partners in Albuquerque, N.M.; Lynda Stallwood, Ph.D., CPNP-PC, Assistant Professor at Chamberlain College of Nursing in Detroit, Mich.; and Cynthia Watson, MSN, FNP, ADM-NP, nursing instructor at University of Louisiana at Lafayette in Lafayette, La.
NSNA 61st Annual Convention
The 61st Annual National Student Nurses’ Association (NSNA) Convention will take place April 3-7 in Charlotte, N.C. This annual meeting attracts nearly 3,000 nursing students from across the United States, and this year’s theme is “HEALTHY Campaign: Healing, Enlightening, and Loving the Healthy You.”
Meeting attendees are invited to join the Johnson & Johnson Campaign for Nursing’s Future in our “Healthy Haven” (located in Room 219) to reset, refocus and revive. Learn tips and techniques on how to live a healthier lifestyle and maintain energy at school and in life, presented by a coach from the Human Performance Institute, a Johnson & Johnson company. In addition, view the interactive Portrait of Thanks Mosaic revealed last fall, a digital photo mosaic of nearly 10,000 individual photos of nurses and student nurses, designed to thank nurses for their hard work and dedication, and to commemorate the Campaign’s 10th Anniversary.
For more information about the NSNA 61st Annual Convention, visit www.nsna.org. And be sure to follow the Campaign on Twitter @JNJNursingNotes for updates about activities in the Campaign’s Healthy Haven room – join the conversation by using hashtags: #NSNA, #DiscoverNursing, #StudentNurse, #NursingCareer or #HealthyNurse.
Nurse Practitioner Scholarship Program
The Johnson & Johnson Family of Consumer Companies has partnered with the CVS Pharmacy MinuteClinic® to sponsor the 2013-2014 Together We Care™ Nurse Practitioner Scholarship Program, a program that offers up to $100,000 in scholarships for students enrolled in a Nurse Practitioner program.
Applicants must meet all of the following criteria to be eligible for this scholarship:
- Must be a legal U.S. resident
- Must be enrolled in either a Nurse Practitioner program with a nationally accredited master’s degree leading to licensure as an APRN with Family Nurse Practitioner specialty OR with a special interest in community or public health
- A Doctor of Nursing Practice in a nationally accredited DNP program leading to licensure as an APRN with Family Nurse Practitioner specialty or with other specialty
- High academic performance, with a GPA of 3.2 or higher
- Must have strong community involvement/leadership activities
Applications will be accepted until May 1, 2013. For more information and to apply online, visit www.minuteclinic.com.
Celebrate World Health Day
World Health Day is an annual event celebrated on April 7 to mark the anniversary of the founding of the World Health Organization (WHO) in 1948. The purpose of World Health Day is to draw attention to particular priorities in global health, and this year’s focus is hypertension, also known as high blood pressure.
According to the Centers for Disease Control and Prevention (CDC), one in three adults worldwide – an estimated 68 million people – has high blood pressure. High blood pressure increases the risk of heart attacks, strokes and kidney failure, and if left uncontrolled, can also cause blindness, irregularities of the heartbeat and heart failure. The risk of developing these complications is higher in the presence of other cardiovascular risk factors such as diabetes.
To help reduce the risk of high blood pressure, adults should consume less than 2,000 mg of sodium, or 5 grams of salt, and at least 3,510 mg of potassium per day, according to guidelines issued by WHO in January. These guidelines are an important tool for nurses as they work to address non-communicable diseases such as heart disease, stroke, diabetes, cancer and chronic respiratory diseases.
For more information about World Health Day, visit www.who.int.
Tweets of the Month
Highlights from The Campaign's Twitter Conversation
If you haven’t already, follow the Campaign on Twitter @JNJNursingNotes for news and information about Campaign initiatives, nursing resources and other nursing-related updates. We’ll be tweeting live from the upcoming National Student Nurses’ Association (NSNA) 61st Annual Convention about happenings in the Campaign’s Healthy Haven room at the convention.
Here are a few highlights from the conversation this month:
- @JNJNursingNotes: The Campaign is proud to support the national Minority Nurse Faculty Scholars Program with @AACNursing! Learn more at http://ow.ly/ioJjT
@neoslip: @JNJNursingNotes @aacnursing This is a wonderful project!
- @JNJNursingNotes: What are some things #nurses can do to stay energetic and avoid burnout after long shifts on the job?
@Laclemdelacle: @JNJNursingNotes drink lots of fluids!
- @katQ25: The GBCN 2013 Image of Nursing Award submission for NSNA has 172 views & 7 likes! Like & share? http://youtu.be/SNslwTkrMrg @JNJNursingNotes
- @KyrieMentoring: When days get long and the nights get rough, remember this... pic.twitter.com/XcFgaj2fhW via @JNJNursingNotes
Coming to Nursing Notes in April
The April issue of Nursing Notes will feature articles about how nursing and the healthcare setting have evolved in the past 30 years to become more environmentally focused. If you are a nurse who is passionate about sustainable practices and would like to be considered for an interview for our April issue, please send your statement of interest and contact information to firstname.lastname@example.org by Friday, April 5.