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The Toughest Part of Patient Care

These broad strokes don't adequately detail the sorts of obstacles—large and small—clinicians face every day. Sometimes it can feel like everybody's working against their mission to help, even the patients.

DOC News asked:

What is the biggest challenge you face in the care of people with diabetes, obesity, and cardiovascular disease?

Finding the time to do it all. I work in an outpatient clinic, and I'm the only diabetes educator. I have approximately 20 doctors, and my patient load is more than 1,000. So my biggest challenge is just trying to get everything done.

Shirley Pinkney, RN, CDE Diabetes Educator Williamsburg, Va.

THOMAS NORTHCUT/GETTY IMAGES

The biggest challenge in my practice is changing the home environment—trying to prevent the younger generation from growing up with the same health issues as their parents and grandparents. We're trying to target the seniors, the parents, and the kids, and to bring that collectively into the home. We can give the message in schools, but then kids go home to the same environment. If the parents and grandparents aren't all working together, you can't facilitate change.

Suzanne Jaeger, PA, CDE Diabetes Educator Miami, Fla.

Getting people motivated to make changes is the biggest challenge. You have to figure out what their goals are, what they really want, and work with that, rather than telling them what to do and making their goals for them.

Kimberly Packard, RD Dietitian Leesburg, Va.

There's lots of new technology, but I don't see that this will have wide application for a lot of patients. We're still fighting to keep patients interested in the basics. So all this gee-whiz stuff is really neat. But it's going to be a long time before our patients will access it.

Patricia Custer, RD, CDE Program Manager Indianapolis, Ind.

My biggest challenge is helping people understand how to eat right. It's amazing. People don't understand portions. They don't understand calories. Even after going through a program, they'll say, "Yeah, but I don't understand that carbohydrate thing."

Joyce Parrillo, RN, CDE Diabetes Educator Deland, Fla.

TALK BACK: GETTING TO THE TRUTH

To hear some patients tell it, they're doing everything right—eating a sensible diet, getting a proper amount of physical activity, adhering faithfully to drug therapy—and yet their condition remains the same or deteriorates.

It's natural for people to fudge the facts sometimes to make themselves feel better or distance themselves from the consequences of their actions. But when patients fudge crucial facts about their health or habits, they well may be putting their lives in danger.

How do you elicit the truth from patients when taking histories or reviewing treatment compliance?

Send your thoughts and comments to docnews{at}diabetes.org.

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Services Email this article to a friend Similar articles in this journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Search for Related Content Social Bookmarking                What's this?