“Diabetes is so prevalent in our society, and I feel as though I have a better understanding of my own patients with diabetes,” said Heather Weber, RN, who works in a busy outpatient GI department. She has type 1 diabetes, and has experienced what it is like working as a nurse with diabetes. “I recently had a GI sickness at work, and as a result, my blood sugar dropped rather quickly after lunch,” she said. “My coworkers noticed that I was diaphoretic and quickly sat me down, giving me some apple juice to drink. I ended up going home since I was sick with a GI bug, but only once my blood sugar was stable enough to drive. I was grateful for my coworkers’ assistance.”
According to the American Diabetes Association, approximately 30.3 million people in the U.S. have diabetes, and about 1.25 million adults and children have type 1 diabetes. How can nurses with diabetes manage their condition? Nurses have a difficult time eating a balanced diet due to skipping meals. They are also on their feet most of the time, putting them at risk for complications of the foot, such as ulcers.
Fortunately, many nurses want to share their experiences to help others navigate the challenge of balancing diabetes and providing excellent patient care. Diabetes educators strive to help all people who have diabetes, and they are an excellent resource for nurses who want to manage their diabetes.
Nurses generally know how to handle their condition. They know diabetes front and back through their job, and they are intelligent professionals who know how to adapt those ideas for themselves.
“I can usually slip away for a few minutes or have a coworker cover for me so that I can test and/or eat a snack,” Weber said. “When I worked as an ICU nurse doing 12-hour shifts, I would typically eat snacks to prevent low blood sugar as I did my charting at the nurses’ station.”
Tips like this are invaluable because they are grounded in the actual experiences from nurses with diabetes.
Fran Damian, MS, RN, NEA-BC, who works at Boston Children’s Hospital, has her own tricks as well: “Managing well with diabetes requires good planning and being well prepared with extra supplies all the time,” she said. “I live a healthy lifestyle as much as possible. That includes regular exercise and a well-balanced diet. I feel best when I eat a lot of fruits, vegetables, and lean protein, and I drink a lot of water … I always have glucose tablets on me in case I start feeling low.”
“Our unit was pretty good if we were slammed and did not get lunch,” said Danielle Kreais, MSN, RN, CPNP-PC, a nurse practitioner in Ohio. She got her diagnosis and learned to cope, all while working a busy OB unit on nights. “The manager ordered lunch meat sandwiches and chips for us. There was another diabetic I worked with, and the advice she gave me was to make sure I always had one of those Nature Valley bars in my work bag, in the glove box of my car, and in my locker. The peanut butter ones have protein and they are a carb, so it was a great combo if lunch was missed.”
Kreais added: “She told me for lows to keep those peppermint-striped candies [in my pocket], which are soft, and you can chew them. They are enough to bring your sugars up, plus they don’t melt.”
Nurses newly diagnosed with diabetes would do well to carry glucose tablets at all times to prevent low blood sugar. Be sure to tell your manager and your coworkers what’s going on so that they can help you when needed. Snacks and water are essential to good blood sugar control. Don’t forget to use your resources, such as endocrinologists, dietitians, and diabetes educators to help you plan the right meals and strategies to use on the job.
Although tips from nurses can be invaluable, they are nothing like the kind of focused information that can come from a certified diabetes educator (CDE). These medical professionals are responsible for teaching all people with diabetes in all situations how to manage their lives and prevent complications.
Lucille Hughes, DNP, MSN/Ed, CDE, BC-ADM, FAADE, director of diabetes education at South Nassau Communities Hospital in Oceanside, New York, described some of the challenges nurses can face when dealing with diabetes on the job, and noted the following tips for handling some common ones.
Nurses often don’t get the chance to eat during a shift, and this can severely impact blood sugar levels. “When nurses with diabetes find themselves in this situation, planning and being prepared is the best medicine,” said Hughes. “Keeping snacks on hand that are a blend of carbohydrates, protein, and fats can be a tremendous help in these situations.”
“Meal planning is the secret to living with diabetes and being a healthy person,” Hughes continued. “Investing in a good lunch bag — or two — will allow you to plan and pack all the essentials to eating and snacking healthy. Being unprepared and finding yourself at the mercy of a vending machine is not a good situation to be in. It is very unlikely you are going to find a ‘healthy’ lunch or snack option.”
In addition to poor nutrition, nurses also face significant impact to their feet, and this can cause foot-related complications for nurses who have diabetes. “First and foremost, investing in a good pair of comfortable shoes is essential for anyone who spends most of their day on their feet,” said Hughes. “Calluses and skin evulsions due to rubbing of a shoe on a toe, heel, or ankle area can be dangerous and yet avoidable.”
Here are six tips that Hughes has on how to find shoes that fit and how to determine if they are a healthy choice:
- When trying on a shoe in the store, make sure it feels comfortable; if it isn’t, don’t buy it
- Many people think that new shoes require a bit of “breaking in” and that you must endure the associated pain; this is not true — if new shoes start to hurt, immediately remove them and don’t use them again
- Don’t think that the only shoes you can wear as a nurse with diabetes are unfashionable ones; there are many options for shoes that fit, so do your due diligence and find shoes that will protect your feet
- In addition to finding the right shoes, foot inspection is vital to protect your feet; check them every day, and use a mirror to see the bottoms and sides of your feet. If you notice any redness, cuts, or blisters, see your podiatrist immediately. Take care of small changes immediately before they expand into something unmanageable
- See a podiatrist yearly — no exceptions, and more often if necessary
- Finally, any time you see a medical professional, ask if they will take a look at your feet at your office visit. This could be your primary care doctor, your endocrinologist, or any other specialist you may see — within reason, of course; many dentists would have trouble with this request. Seriously, though, any professional who looks at your feet could possibly see a problem early enough to stop it. Use these resources
Nurses spend so much time taking care of others that they often forget about caring for themselves. Unfortunately, this is unhealthy for any nurse, but particularly troublesome for a nurse with diabetes. Yet, these challenges are not insurmountable, although they may take a little work. Planning your diet and meals are key to ensuring that you will have food on hand for sudden lows. Meal planning can also help you keep your high blood sugar under control. For your feet, planning is again essential. You must find shoes that are comfortable — no questions asked.
Following these steps, nurses with diabetes should be able to function well as nurses — and many are! If you find yourself troubled by mixing diabetes and nursing, let your doctor know. They may be able to refer you to any number of professionals who can help. The most important item, though, is to catch things early and always plan how to confront any challenges.
Lynda Lampert, RN, has worked medical-surgical, telemetry, and intensive care units in her career. This story was originally published by Minority Nurse, a trusted source for nursing news and information and a portal for the latest jobs, scholarships, and books from Springer Publishing Company.