Making Diabetes Self-Management Education (DSME) Classes Fun

I taught my first DSME class last month. I loved it. Part of being a nurse is being an educator---to patients, families, and colleagues. I hadn't had the opportunity to teach this class before because I had two nurses who were committed to teaching it as their role within a primary care clinic. But one nurse went to Iraq and the other transferred to Washington state. That left me to teach until I can get another cadre of experts trained. I went ahead and joined the American Academy of Diabetes Educators so I can learn and add to my credibility. I don't want to pass the wrong information to these patients who are relying on me.

I am in the process of trying to establish a DSME committee that would have physician oversight with a multi-disciplinary membership. My hope is that the training would continue to be evidence-based and provide a pool of qualified and respected instructors.

A wonderful resource for teaching is found on the University of Michigan web site. While I was waiting for everyone to show for class, I had them fill out this questionnaire on concerns that might interfere with learning about or managing their diabetes. I was amazed at the responses and so gratified that these individuals would trust me with this private information.

One of my colleagues in the Health Promotions Department is more jaded and cynical. I had two no-shows for this class and I contacted them afterwards to discover what barriers or obstacles prevented them from coming. My colleague said, "If you offered bingo along with the class, a $100 pay-out and free cards, you wouldn't have anyone making excuses for not attending. In fact, they would call in sick to work in order to attend!"

I don't want to believe that of my patients. I would prefer to believe that they have other needs more pressing that prevent them from making their healthcare a priority in their lives: grandchildren who must be reared, power bills that must be paid (and no money to pay), fears and worries that so overwhelm them that no action is preferable to making the wrong decision. And so, I am entering this contest to win a book, "The Big Book of Diabetic Desserts, written by Jackie Mills MS, RD. My hope is to have a prize to offer one of my patients. Our Health Promotions Department has funds for purchasing patient education materials, but they cannot fund giveaways or incentives. Consequently, I buy trinkets out of my own pocket. I currently have about 950 Unite for Diabetes pins to distribute to my patients (I started with 1,000 pins). Of course, they're not purchased from the Diabetes web site; I had them made by a Chinese company in Shenzhen, just across from Hong Kong, because a 10-pack of pins cost 30 Euros.

Director for Nursing Services Billet Still Vacant...

Last week the senior nursing leadership posted an email regarding the selections for Senior Nurse Executive/Director for Nursing Services assignments for Fiscal-Year 2008. Glaringly vacant was the spot for DNS - Naval Hospital Guam.

The spouse envisioned the following dialogue:

Detailer: I have a great duty station for you. How does Guam sound?
Prospective SNE/DNS: Thanks, but I think I'll resign my commission.
Detailer: But you only have 19 years in. You'll lose millions!
Prospective SNE/DNS: Let's see, what is that address again? Oh yeah, jobsearch.com. Be seeing ya.

Recognition Crucial for Recruitment and Retention Efforts

The department head meeting yesterday was very interesting. Apparently, NO ONE from the command has gotten any formal recognition (NAM, COMM, even LOA) for the part they played in the Frank Cable mass casualty. The Commanding Officer (CO) said, "Well, there were over 200 people at Naval Hospital involved in the incident. We can't give everyone an award."

When one of the department heads said, "Well, the Frank Cable managed to give 113 awards to sailors for THEIR role in the incident," the CO said, "That never happened." Then the Public Affairs Officer cleared his throat and said he could provide the article from the Pacific Navigator.

Rumor has it that the command was submitted for a UNIT award and it was turned down...even though we were lauded throughout the Navy for our medical care.

And they wonder why there is a recruiting and retention problem for Naval Hospital Guam.

In the CO's call yesterday, he showed us two books that were passed out at the Surgeon General's conference: "Made to Stick" and "The Second Rule." I read the first and would like to read the second (I think it's on my wish list….just haven't had justification to pay for it because I have so many other books in the queue). I would recommend the CO read a few other books. My suggestions? "The Carrot Principle," "It's Okay to be the Boss," "It's Your Ship: Management Techniques from the Best Damn Ship in the Navy," and "First, Break all the Rules: What the World's Best Managers Do Differently."

All of these books state definitively that recruitment and retention efforts fail or succeed at the supervisor level and that recognition is what people crave most.

The CO can say, "Naval Hospital Guam gets kudos from all over the Navy," but until he puts his money where his mouth is and we see awards for people other than those who donated "multiple off-duty hours" to coordinating the Navy Ball (give me a break), he has no credibility for me.