‘Okay, so I’ll deal with the diabetic who’s just been brought in. She’s been in here four times in the last couple of months. Completely non-compliant.’
Whoa!
I was walking through the rabbit-warren-like corridors of the Epworth Hospital and passed a nurses’ station at the exact moment those words were spoken, stopping me dead in my tracks. If I was in a Warner Bros cartoon, there would have been a dust and smoke cloud around me as I screeched to a halt.
‘Move on, Renz,’ said the first voice in my head.
‘Not freaking likely,’ said the louder voice.
I turned to the nurses who hadn’t noticed me yet.
‘Hi,’ I said. I was trying for sweet and polite, but could already hear the patronising tone in my voice.
They turned and looked at me.
‘Um. I just wanted to say a couple of things. Calling someone a ‘diabetic’ isn’t helpful for anyone. It labels them as their condition and I’m pretty sure that the person you are referring to is a lot more than her insulin problems. Secondly, non-compliant is a really nasty term. I’m guessing that you’ve no idea what else is going on in her life – I have no idea either – but I am pretty sure that there is a reason that she is not managing her diabetes as well as she’d probably be hoping to. Non-compliant suggests that it is a deliberate ploy to make herself unwell – which it may be and if that is the case, then that is something that needs to be addressed.’
At this point, the nurses were just looking at me with a mix of surprise, suspicion, annoyance and interest.
‘Also, to be compliant means following a defined set of rules or guidelines. Diabetes has a funny way of mocking such an idea. The rules keep changing – without notice.
‘Now, I am hoping that you wouldn’t use this language around the person you’ve been referring to when you are actually in the same room as them, but here’s the thing. You’re saying those words now, and that means that somewhere deep inside (or, probably just on the surface) that’s how you really feel.
‘No one wants to have diabetes. No one wants to be in hospital. No one wants to be so overwhelmed by diabetes that they don’t – for whatever reason – manage their condition the best way possible. But sometimes, it gets like that. The never-ending relentlessness of diabetes can be so debilitating that all self-care stops. And then, sometimes, you wind up in hospital. Four times in a month, sometimes.
‘I have diabetes. I’ve been that person you are speaking about. But I wasn’t being non-compliant. I just couldn’t cope. And I felt really bad and guilty that I couldn’t cope. So on top of feeling crap about my diabetes, I also felt crap about not looking after my diabetes.
‘So. Maybe think about what else is going on in her life. She is more than diabetes (that’s why calling her a ‘diabetic’ isn’t a great idea) and I bet she is going to respond a lot better to some kindness and concern and perhaps a suggestion she see a psychologist if she’s not already doing so. Because the judgement and judgemental language is not helping at all.’
I looked at both nurses. I was still using a really calm, level voice, but I could tell that they were a little annoyed. And more than a little stunned. I smiled at them.
‘Okay then. Bye.’ I started to walk off, but stopped and turned back around. ‘Oh – can you tell me how to get to room 18A please?’
Right-oh. Next up on the holiday playlist is James Taylor. Have Yourself a Merry Little Christmas.
15 comments
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December 9, 2014 at 12:04 pm
Ashley
Yes! This is why you’re so amazing.
I find that the stigma and judgement is the worst at hospitals, sadly. People are already at their worst. They don’t need another layer of emotional abuse to deal with while they’re trying to get better. What happened to hospitals being a safe place for healing and learning about health.
Ash
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December 9, 2014 at 12:33 pm
RenzaS
Thanks for your comment, Ash. I think that there is a way to go with changing the attitudes of some HCPs because they are so ingrained. But there are certainly improvements being made – which is terrifically positive.
Thanks for reading.
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December 9, 2014 at 12:57 pm
Jeann
Congratulations for your brave and calm attitude to these nurses! I hope it will make them stop and think….well…we can always hope.
I also hope that I could be so brave if I overhead these comments.
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December 9, 2014 at 12:58 pm
RenzaS
Oh Jeann – I know you! I am sure you would say something. Thanks for reading and thanks for your comment.
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December 9, 2014 at 2:53 pm
Samantha Thompson
Solid Gold, Renza.
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December 9, 2014 at 2:56 pm
RenzaS
Ha! Thanks Sam.
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December 9, 2014 at 6:19 pm
Cas
Renza you are an absolute legend! If what you said changes even one or two peoples way of thinking there might even be a ripple effect…..
I also hope I could be so brave if I heard the same comments. Maybe, but probably not as polite!
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December 13, 2014 at 12:18 am
RenzaS
I’m not sure that I was as polite as I could have been, Cas. There was definitely a patronising tone used, which I just couldn’t seem to shake. Thanks for your comment!
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December 10, 2014 at 12:45 am
StephenS
Yay you! And thank you.
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December 11, 2014 at 9:08 am
Katie
I love that you said this! I work as an RN and have had T1D for 33 years. I try to advocate for those with diabetes, especially T1D, but I don’t know that I’ve ever been that eloquent. Even if they were annoyed I think that something probably sunk in. I like that you made a constructive suggestion- the psychologist referral- because often depression does play a role in not wanting to deal with diabetes.
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December 13, 2014 at 12:08 am
Chris B
Katie you are spot on. The incidence of clinical depression in people with diabetes (all kinds, I’m T2) is about 50% greater than the wider population. And it is such an annoyance that this is not generally known even in the medical profession. Even I’m dismayed to say among diabetes “professionals”. The patronising ill informed rubbish I got shoved down my throat is why I ditched my diabetes educator. My GP (hero that she is) knows a damned sight more about the total picture than most of the so called experts.
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December 13, 2014 at 12:20 am
RenzaS
Sorry you’ve had such disappointing experiences Chris, but great that you have a terrific GP. I have a great endo; she knows a lot, but never pushes her agenda – it’s always up to me.
Thanks for your comment and for reading.
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December 13, 2014 at 12:21 am
RenzaS
Thank you for all your advocacy efforts from ‘the inside’, Katie!
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December 12, 2014 at 10:45 am
kerrie gray
my endo said that to me once, I have excellent control of my td1 but forget to take my cholesterol tabs to which he said it was fairly good considering im non compliant! pfffft
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December 13, 2014 at 12:23 am
RenzaS
I wish there was a giant swear jar, and every time a HCP said ‘non-compliant’, they would be compelled to donate a couple of dollars. At the end of the year, all the money could be spent to buy cupcakes for people with diabetes. Or, you know, insulin for people who can’t afford it. Yes, that would probably be a better use of funds.
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