I came across an article recently that really resonated with me because it addresses the problems a lot of members have in dealing with the attitudes of the health care professionals we all come across in the course of our diabetic care. It was very American, but I have "translated" it as it would apply to us in the UK and our HCPs. No More Shame and Blame: Helping Your Health Care Professional Learn How to Give You the Support You Need
It’s easy to forget that the NHS employs the Health Care Professionals to help you. They should not be treating you as though you were a nuisance. You are the reason they have a job, not an interruption to it. Your HCP’s role is to help you and support you in the totally overwhelming task of managing blood sugar levels. So, if your appointments leave you feeling shamed, guilty, powerless, and void of any motivation, there may be a few things youcan do within the conversations you have with your HCP that can give you the jolt of power you need to maximize your results. And here’s a little hint: they involve you
being in charge of that conversation, not the other way around. The “Non-Compliant” Diabetic: A Term That Should Be Obliterated From the Medical World
Every three/six/twelve months you have an Hba1c that essentially gives your HCP the information they need to make a big judgment, even if that judgment is never said aloud: good diabetic or bad diabetic. Or, my least favourite term: non
The problem with any of the above (good, bad, or non-compliant) is that they all imply that managing diabetes is easy
. That all you have to do is follow the rules and—poof
—your blood sugars will be what they ought
The moment you feel judgment coming from your HCP is that same moment you might be tuning out, because that feeling of judgment actually reveals a lack of empathy for just how overwhelming diabetes can be every single day
—no matter what your A1C is. If it were easy then the profession of being a DSN probably wouldn’t even exist.
If you’re feeling judged at your next appointment, try saying something like this when your A1C comes back at a higher number than your goal: “Okay, I want you to know that I know this is high, and I know my blood sugars have been high. But this stuff isn’t
Give your HCP a moment to think about this, and even to hopefully reply with empathy: “You’re right—managing
diabetes is not
Then, ask for the help you need. Too often, at the doctor’s office we’re made to feel as though what they give us is all they have to give, but it’s quite possible that they have another version to give… you just need to ask for it. (They aren’t psychic!)Here are a few ways to ask for that help:
- “I’m having a hard time with my diabetes right now because ______(personal example goes here)__________. Instead of focusing on the A1C right now, I think it would really help me to focus on trying to _____(examples: take daily walks, eat breakfast regularly, cook more meals at home, start meeting with a therapist, repair my relationship with my parents, get a healthier job, etc.)____.”
- “The reason my blood sugars are so high lately is because ____(examples: I’m binge-eating every night and I can’t stop, I hate taking injections, I’m afraid to see the number on my meter so I don’t check, I’m feeling really depressed and I don’t have the energy for diabetes right now, I’m so overwhelmed by diabetes responsibilities that I just give up). Instead of focusing just on the A1C, could you help me figure out how to address this other issue that’s inevitably having a huge impact on my blood sugars?”
- “To be really honest, the reason I haven’t felt motivated to manage my diabetes lately is because my appointments leave me feeling guilt-ridden, like I’m a horrible person because I can’t be the perfect diabetic. I really want to look forward to meeting with you, and I want to feel like we’re on the same team instead of feeling judged. Can we talk about how to change that so it doesn’t feel that way?”
This is about you taking control of the conversation. Standing up for yourself. Expressing yourself. If you were at a restaurant and your meal was served cold, you would do something about it, wouldn’t you? You would let them know that that’s not what you ordered and definitely not what you’d like to eat or pay for. The same simple logic applies at the doctor’s office, too—bearing in mind of course that an adequate amount of thoughtful respect should be applied in both the restaurant and the doctor’s office!
Your HCP is there to help you, but they aren’t mind-readers either, and their schedules are jam-packed, and they’re juggling a whole lot of personalities throughout the day as they meet with their patients. You need to take control of the appointment by expressing your needs, explaining your obstacles, and asking for the help you want instead of just accepting the version of help they’re serving.
If the idea of actually speaking up (like, really speaking up
) at your next appointment feels like something you can’t do… you can always just send this article anonymously, too. You never know, you might accidentally help change the way your HCP communicates with several patients instead of just how they communicate with you. (And simple tip for any HCP who is reading, just ask: “What can I do to help you?” and then… listen.)