Interview Essay with a Life Long Condition Patient
Michael is a man diagnosed with type 2 diabetes mellitus (DM), at the age of 45 years a disease he believes is genetically acquired as his parents had been diagnosed with the same years back. Currently he lives in New-Zealand. Type 2 diabetes mellitus is the most common type of diabetes that affects how the body metabolizes. Michael believes that he cannot carry on his daily routines the same way he was before his diagnosis.
Since Michael was diagnosed with DM, he experiences hypoglycemia and hypercholesterolemia. He has been suffering from impaired vision due to diabetic retinopathy. He has a history of acute kidney diseases alongside health problems such as weight gain and ankle swelling. He cannot travel long distances due to weakness and fatigue and this has made it difficult for him to maintain physical fitness.
Socially, Michael cites that he should learn to contain his moods which have eventually cost him several friendships. Such a loss is the fact that Michael was abandoned by his family although they visit him regularly. On the other hand, Michael believes that diabetes has made it imperative for him to retain spiritual values. His health has also made it difficult for him to work, making him to lose his independence. His energy has been reduced due to frequent fatigue and dizziness. His economic status has also been greatly affected as he lost his job. This makes it difficult for him to handle the expenses as some of the foodstuff that has low amounts of sugar is quite expensive.
Type 2 diabetes mellitus is a result of poor lifestyle habits that mostly occur in younger people leading to many cases in America over recent years. Family history of diabetes also affects the oncoming generation as they are at risk of being diagnosed with it. Other risk factors include obesity, inactivity and the age factor (Dyson, 2014).
Factors that play a major role to the disease include reduced insulin sensitivity and beta-cell dysfunctions. With insulin resistance, there is no movement of sugar in the cells which results to less insulin for maintenance of a normal glucose level (Riedl, Robausch, &Berghold, 2016). This is because sugar builds up in the blood stream, making the beta cells to release more insulin but they become impaired because of the body’s abnormal demand. This level is called pre-diabetes and is characterized by an abnormally higher blood sugar level. The patient is now at a risk of getting type 2 diabetes mellitus but it can be prevented (Fox, 2015).
Hypoglycemia happens as a result of the high sugar levels. This begins with fatigue that can lead to a seizure or even a comma to the patient. The liver is now at risk if the situation is not reversed. There is low production of glucose due to the lack of insulin in the body as the cells are fatigued. The symptoms at this stage are poor vision (blurred); slow healing sores and frequent infections (OTTO, 2011).
The disease trajectory refers to the experience of the patient with illness over a given period of time (Singh, 2013). If the blood sugar level is not controlled, major organs such as eyes, kidneys, blood vessels, heart and nerves face complications. Concerning the heart, cardiovascular problems such as the coronary artery disease, stroke and high blood pressure are the risks (Scirica, 2013).
The complications of type 2 diabetes include nerve damage (neuropathy) which is as a result of injured blood vessels. The symptom at this stage is numbness and burning pain that begins at the tip of fingers and toes then gradually spreads upwards. Nephropathy is a kidney damage complication that is experienced too. At this stage a kidney transplant may be required due to irreversible kidney failure. Other complications are hearing impairment, skin conditions, Alzheimer’s disease, eye damage, foot damage and retinopathy.
The psychosocial impacts of diabetes manifest on the patient and the family. Major lifestyle changes occur on the patient in areas such as diet, exercise and the treatment processes. As seen in the life of Michael, fatigue has made it difficult for him to travel long distances. He cannot eat foodstuff that is not medically prescribed which is a major change in his daily diet. His economic status has been affected as he lost his job and depends on friends and relatives to sustain his medical bills.
The patients therefore have poor mental health that leads to hyperglycemia. They deal with denial anger and stress that result to depression. Stress has caused Michael to have mood swings that the family and friends have to deal with. The lifespan of the patient is an issue that they have to deal with too. This is because Michael is at a stage that needs treatment but will eventually lead to death.
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Type 2 diabetes involves a multidisciplinary team which is important in managing the patient’s health. Michael is currently under the care of a general practitioner, ophthalmologists, dieticians, nurse educators, nephrologists and psychologists.
The general practitioner is the main physician that has to visit every three months. He receives medical results from the tests that the patient has undergone. He then uses these results to evaluate the blood sugar level, cholesterol and other factors to come up with a prescription.
Dieticians in Michael’s life ensure that healthy and nutritious foods are included in his diet on a daily basis. Their role is to advising the patient on self-management of the diet then confirms it through regular visits.
According to Michael, he gets medical education from his nephrologists. He learns about the risks of his activities and preventive measures to minimize the pain that he undergoes. He also visits the ophthalmologist regularly for follow up of diabetic retinopathy and to do retinal screening. Psychologists are needed for the mental care of patients with diabetes. This is because Michael deals with stress anxiety and depression, observed in his mood swings. The psychologist also consults the medical team to incorporate psychological principles for patient care.
Michael has several complications such as hypercholesterolemia, kidney diseases, weight gain, poor vision, fatigue and hypoglycemia. These conditions need appropriate nurse care to avoid more complications and reduce the pain that he undergoes through regular management of his prescription. This management improves the quality of life by avoiding more complications.
The nursing care team needs professionals who help the patient to manage a healthy diet. The nursing team should ensure that Michael is controlling his sugar intake to prevent heart disease, stroke and accompanying effects. The nurse also advises on intake of saturated fat and other nutritious foods. A nurse can also monitor the mental health through various ways. Their presence should motivate Michael to have a positive attitude on life.
Nursing partnerships with the patient provides a systematic and comprehensive rapport between the nurse and the patient and involves the two discussing treatment with the patient in a more active and empowered way. The new code of conduct in New Zealand has four core values with partnership being the third one (Jenkins & Huntington, 2016). Nurses are reminded to maintain the patient’s privacy and respect the wishes of the patient so long as they are medically effective.
A partnership is important as it empowers the patient (Robert, 2015). Research indicates that partnership increases the patient’s safety by making the patient to be involved in treatment and decision making. So long as the patient is willing, the expectations of positive results will be achieved in patent participation (Chwastiak, 2017). This research found positive results in diabetic care. The nurse should allow the patient to express their concerns and preferences. Michael spends a lot of time with medical practitioners. This brings about the issue of mutual trust. Once there is a partnership with the nurses, Michael will trust them more hence increasing his safety when he is around them.
A nurse-patient partnership involves educating the diabetes patient on the current situation that they are in and the subsequent methods of solving it. This improves self management that is crucial for diabetes patients (Tobiano, 2015). Once a patient is an effective self-manager, he or she can work well even without the presence of the nurse. Michael has been living without his wife and three children and this leaves him under self management. Throughout the years that he has been alone, Michael has been dependent on the instructions given by his physician and his team and this has helped his situation to get better. This approach can also be used by the nurse to educate Steve on blood sugar levels.
A nurse-patient relationship increases the well-being of the patient’s family. The family of the patient is usually affected emotionally. The friends and relatives are usually worried since they know that the life of their loved one could end at any moment. When they gain information from the nurse, they participate in the healthcare of their loved one, hence maintaining the latter’s health status (Jenkins & Huntington, 2016). Michael stated that his family has been improving his well being by visiting him regularly and helping in the administering of his medicine. This makes him feel accepted’ giving him psychological support. The family does this because of the instructions that they receive from the nurses concerning Michael’s conditions.
Michael encounters three problems; limited physical activities that are caused by fatigue, high blood sugar levels and depression. These problems need solutions that improve the quality of life he is living hence giving him fulfillment.
The physical activities that Michael was involved in before his diagnosis ceased, causing a major impact in his current life. He lost his independence since he cannot work and stopped getting involved in vigorous physical activities. This is a problem in his weight as he cannot exercise. To solve this problem, physical activity educators from the central public organization can be recommended to help in the knowledge of being active (Bolinder, Ljunggren & Johansson, 2014). The physical activity educators offer physical activity lessons that help the patient to be physically active. After this, Michael can attend U-Kinetics Exercise and Wellness Centre, which is conducted by Universal College of Learning (UCOL). This is a free 12 weeks specialized exercise program designed for clients with medical conditions. The nurse can advise on the benefits and how this program improves the self-management of the disease and enhance physical activity.
Although Michael regulates his sugar levels, at times this goes wrong, making his blood sugar level to rise. This problem of uncontrolled sugar levels is a major concern in diabetes patients. This problem makes Michael worried every time it happens. One of the main symptoms reported by Michael was depression. The nurse needs to establish a therapeutic relationship with Michael to achieve assessment of his depression (Co, 2015). Conversing with him and making him feel appreciated should enlighten his moods (Riedl, Robausch, &Berghold, 2016). In a case where psychological support is medicinal, the nurse should ensure that Michael takes antidepressants on the time that was prescribed.
From the case study, we find out that diabetic is a condition that needs extensive medical care. The disease does not have a cure hence the society needs to contribute to it through prevention or thorough support of the patients. The public needs to live healthy lifestyles as they contribute positively to the prevention of the disease. When the symptoms of type 2 diabetes mellitus are recognized, one should quickly reverse them so as to avoid complications that lead to diabetes (Chwastiak, Jackson & Russo, 2017). A multi-disciplinary team is needed for the management of a patient’s condition so as to improve the quality of life. A care plan should also be formed and keep the patient’s concern as their priority. A partnership system is also needed whereby the care of the patient is the core area while information is shared by the two.