I work at Overlake Hospital Medical Center on a Medical Surgical and Oncology Unit. As a bedside nurse, my job and responsibility not only centered around vigilant monitoring for physiological changes and immediate needs of patients but also centered around an emotional aspect of caring and advocating. Our 37-bed unit provides care for various medical-surgical conditions, chemotherapy infusion, blood transfusion, dialysis, oncology with hospice, and end of life care patients on a day to day basis. As a bedside nurse, every day I take care of patients with various medical conditions and often times people admit here with new diagnosis as well as treatment of chronic conditions. My job and responsibility focus around not only the immediate needs of patients but also an emotional aspect of caring.
Diabetic patients (Type and Type II) are frequently admitted to our unit, usually for chronic ongoing treatment, Hyperglycemia with Diabetic Ketoacidosis (DKA) due to noncompliance with diabetes management, as well as new diagnosis of Diabetes. Our goal is to return the patient to a stable glycemic balance, educate them on diabetes management and ensure a smooth transition to outpatient/home care. But these goals are not easy to achieve for various reasons. In this paper I will attempt to explain how theories relate to and inform nursing and issues with Diabetes in my unit. Diabetes Melius (DM) is a serious disease. According to Centers for Disease Control and Prevention (CDC), more than 100 million U.S. adults are now living with diabetes or prediabetes (2017).
1.5 million Americans are diagnosed with diabetes every year and it was the seventh leading cause of death in the United States in 2015 (“New CDC Report,” 2017). If diabetes is not controlled properly, many serious acute and long-term complications such as premature death, vision loss, heart disease, stroke, kidney failure, and amputation of toes, feet, or legs can occur (“New CDC Report,” 2017). The data shows that in 2014, a total of 7.2 million hospital discharges were reported with diabetes and a total of 14.2 million emergency department visits were reported with diabetes related to hypoglycemia and hyperglycemia crisis (“New CDC Report,” 2017).
Among those with diabetes, moderate to severe kidney disease (stage 3 or 4) and foot ulcers were common. Across the United States average medical expenditures among people diagnosed with diabetes were about 2.3 times higher than expenditures for people without diabetes (“New CDC Report,” 2017). However, Type II Diabetes can be managed by diet, physical activity and proper use of insulin or diabetic oral medication. As a nurse it is our responsibility to educate these patients so that they can manage their own and will decrease diabetes related complication and expenditure.