Clarifying the role of the diabetes educator in Europe

Clarifying the role of the diabetes educator in Europe

287 Patient Education and Counseling, 16 (1990) 287-288 Elsevier Scientific Publishers Ireland Ltd. Letter to the Editor Clarifying the role of the...

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287

Patient Education and Counseling, 16 (1990) 287-288 Elsevier Scientific Publishers Ireland Ltd.

Letter to the Editor

Clarifying the role of the diabetes educator in Europe Dear Editor,

(1) Basic knowledge of the illness, physiol-

In 1928 Dr. Joslin in the United States hired the first diabetes educator and paid her himself. The lack of knowledge by doctors and nurses was already recognized by the well-known diabetologist Dr. Etzwiler in 1967 and still is known and measurable almost daily by talking to patients and health professionals. Although fortunately one can sense a change of attitude towards the need of sufficient care and education for the patients suffering from this disease, education is part of the treatment and therefore should be given by the whole medical team. But what about the educator, what should we expect from him or her?

(2) Teaching injection techniques

ogy and patho-physiology (3) (4) (5) (6) (7) (8)

(9)

Teaching how to measure and interpret the blood glucose levels Instructing self-regulation by means of the blood glucose levels Instructing users of the insulin pump Giving advice on foot care Instruction by the family in using glucagon Instruction of foreigners which brings different problems, language, cultural differences, nutritional habits and even illiteracy Instruction of the visual and otherwise handicapped

What are the requirements for the job?

(1) Clinical background (2) Didactic skills Used to work independently Being able to function well in the medical team (5) Affinity for working with patients suffering from diabetes mellitus Lots of patience (6) (7) Must be willing to offer continuity in care (shared on duty for 24 hours) (8) The ability of putting oneself in someone else’s place

(3) (4)

What exactly does the educator do? In short, the medical-technical and psychosocial guidance. Medical-technical guidance includes:

Psvcho-social guidance includes:

(1) The first reception of the patient after hearing the diagnosis

(2) Helping the patient pull his life back (3)

(4)

(5) (6)

(7)

together Giving the patient a back up while solving his problems at home, at work, in his social life, problems related to having to cope with the disease Organizing talk groups, possible in cooperation with peers, patient associations Involving relatives in the whole process Advising in insurance matters or day to day things, like getting a drivers license, how to deal with job interviews Being an intermediary between the several health care personnel

288

Should all patient education be accomplished by the diabetologist? First is the problem of lack of time. Education is very time consuming. As education is part of the treatment, the doctor is responsible, but perhaps nurses can do it better because

for instance, the Hbal’ does not match the patient’s own blood glucose measurements (6) The educator observes and calls attention sooner when there are problems of any kind

(1) The patient talks and expresses his feel-

Individual adjustments to the wishes and needs of those involved are essential in diabetes care. That is the role I envision for the diabetes educator, to assist the patient in achieving quality of life.

ings easier to a nurse, there is a lower threshold (2) More contacts with relatives are possible because there is more flexibility in time (3) House calls/visits can be made, which can give a different outlook on some situations (4) More possibilities for external contacts with health visitors, insurance companies, pharmaceutical companies and the patient association 0) When there is a good understanding relationship, one finds out easier why,

A4. Wayenberg, SRN, CDE Chairman, European Association of Diabetes Educators Postbus 3023 2301 DA Leiden Germany