Chapter 13: Patient, service user, family and carer perspectives

Case study: Jag

 

My name is Jag, I am sixteen years old and recently I have been diagnosed as having diabetes. I had been feeling very tired and unwell for some time and my mum put this down to the fact that I had been growing a lot recently, doing a lot of sports and also working hard at school for my exams. However, when it seemed to be going on she decided that I needed to go to the doctors. They did some tests and also sent me to the hospital where I was told that I had diabetes. I was really shocked when they told me this because I thought that diabetes was something that only happened to older people who were overweight. I was also really scared as I thought it was going to stop me doing a lot of things I enjoyed. I didn’t want to be seen as different or ‘ill’. However, the specialist nurse saw me both on my own and with my mum. She explained to me the type of diabetes I have and also what it would mean to me day to day. She explained in a way that I could understand but didn’t treat me like a child which was good: she stressed that I would need to take responsibility for managing my condition but there would be a lot of support for me. As I like being active she explained to me the importance of making sure that I eat the right foods, monitor my blood glucose levels and told me what to do if the levels go too high or go too low. Like most teenagers I like using my mobile phone a lot so we sorted out together how I could use my phone to set reminders to do things like checking by blood glucose and taking my insulin. With my mum she also explained these things and told her what she needed to do to help support me. This was really helpful as although it was good to be treated as an adult it was also good to know that there was someone else at home who understood what I needed to do. So far I have managed quite well – although it has meant a lot of changes the fact that things were explained to me has helped a lot. Also I know that if at any time I have got any questions or concerns I can always get in contact with the nurse as she gave me her phone number and email address and I have these on my mobile phone. It feels as though we have a partnership which helps me deal with my diabetes.

  1. How do you think this nurse has empowered her patient?

  2. What elements of care could you emulate in your own practice?

› Solution

In this scenario the nurses demonstrates the key elements needed for person-centred care described by Manley et al. Success involved working in partnership with Jag, making sure Jag understood the diagnosis, having the skills and knowledge needed to help Jag learn how to manage the condition but reassuring Jag there was support from Mum and the nurse if and when it was required. By empowering Jag, the nurse promotes autonomy, leading to improved adherence and better diabetes control.

Being knowledgeable, acting as an advocate and allowing the service user to set the pace of care, are all essential nursing skills.