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because there is no one to look after her or cook and clean the house. If it happens that she gets hypoglycaemic, which she explained to be a state where the body is running on very low glucose, this affects the brain, resulting in impairment of function. She further explained that she has to deal with it herself. She explained that her biggest fear is that one day she will be found dead because the attacks do not warn when they are about to start. I found that this participant was well-informed about her condition, as she was able to explain to me a lot about diabetes and how to manage it (Sophie).
“The sugar is a very serious illness; it needs to be controlled properly.
When you have no one it becomes harder to handle it” (Sophie).
“I have no one to turn to; even when I feel sick there is no one to help me I am just alone” (Sophie).
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educated on how to manage diabetes it becomes easier for them to look after themselves. Some of the participants seemed scared of the nurses; the generalisation that nurses are rude was embedded deep within the psyche of some of the participants. Some participants had a bad attitude towards the nurses.
Gloria, a 45-year-old, married, diabetic woman was diagnosed with diabetes in 2009. Her first statement was that she feared nurses and did not like the way that they shouted at people. She felt continued to add that the nurses did not have any respect for the patients.
“I find it difficult to talk to the nurses sometimes because some of them do not have a respectful approach to us patients. I am old, my child, I have children that are as old as these nurses and my children respect me not only as a mother but also as an adult. Therefore I find it rather difficult to be shouted at by a child who is the same age as my child. In our African culture as you know [looking at me straight in the eye] we are taught that we need to respect our elders. These nurses lose their sense of respect for elders just because they are educated. How do I them confide in a nurse who shouts at me or treats me like a nobody? How am I supposed to ask questions about things that I am not clear on when it comes to managing this disease that I have” (Gloria).
Clair confirmed this situation when she added her own experience with healthcare providers at the clinic.
“When I first started going to the clinic I found that I had a problem in communicating with the nurses, they would always shout and make me feel
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like a small child being shouted at for doing something so very wrong and more than anything being shouted at would make me feel very stupid. The treatment I got from the nurses was very different to the one that I got from the traditional healer. The traditional healer treated me like a normal human being and respected me; I found it to be very easy to talk to the healer as compared to the nurses” (Clair).
It is not all nurses or doctors that have attitude problems towards patients and not all the patients felt this way. A visit to the clinic for the diabetes support group proved that some of the nurses do actually care and love their jobs; nurses were socialising with the diabetic patients, talking about their diabetes, finding out how the patients were managing the diabetes at home and how the family members were assisting them in coping with diabetes. The participants seemed to be comfortable and replied to the nurses, sharing their experiences and how they were dealing with certain problems. It was clear that a relationship had been created between the participants and the nurses.
Rose, a 43-year-old, single, black diabetic female and mother of seven children, was diagnosed with diabetes in 2011.
“We have to understand that they are people, they will have good and bad days. We never acknowledge when they treat us well” (Rose).
“The education that we get at the clinic is very important because we use it to manage and keep our diabetes under control; there are a lot of things that I have learned from the nurse‟s clinic that I did not know about diabetes. I
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learned that drinking water is a very important thing for a diabetic… my child I have learned so much from the nurses here at this clinic” (Rose).
Clerissa, is a 47-year-old, single diabetic, with three children. She was diagnosed with diabetes in 2009 and shared the same sentiments as Rose. She observed that she had learned a lot from the clinic on how to best manage her diabetes; she noted that the nurses do not shout if you listen to them and follow proper management strategies for your diabetes.
“At the clinic I learned that I have to cut down on eating too much starch. I have to have a lot of vegetables and eat lots of water. I learned that eating too much starch is not good because it is has a potential of increasing my weight. The nurses tell us that we have to make sure that our medication is stored in a safe place and that when I am visiting friends or family I have to pack my pills in separate containers because it is not advisable to put them in one container it makes them less effective” (Clerissa).
“I have learned that taking medication is very important but it becomes ineffective if the patient does not change their entire lifestyle. I need to stop eating too much starch and add a lot of fruits and vegetables in my food”
(Clerissa).
Talking to the doctors and the nurses proved to be difficult due to their busy schedules.
Fortunately I was able to talk to some of the nurses, but the conversations were not long. The clinic was always filled with patients and the nurses were always up and down attending to the patients.
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Nurse A said that being a nurse is not an easy job, but because she loves it it seems easy to her.
Dealing with people can be a challenge because people have different attitudes; some are nice and some are rude. Nurses already have a label of rudeness so some of the patients approach them with that in their minds.
“Working with the diabetic women has its ups and downs; we have our good days with them and the bad, we try our level best to educate patients on how to manage diabetes” (Nurse A).
“I have never had a bad experience with any of the patients... some of them listen and some do not, it is our duty as the nurses to continue trying to get through the patients” (Nurse A).
Alternative medicines are always an issue, which always creates a problem between nurses and the patients. When talking about this, the nurse‟s facial expression changed. She paused for a minute...
“Alternative medicines give us a problem as nurses because patients neglect medicines that they are given by us for them, some of these medicines are not good, they raise the glucose levels” (Nurse A).
“Patients always hide it from us, but when a good relationship has been created some patients do admit to using them” (Nurse A).
Nurse B was very vibrant and out-spoken. Her relationship with some of the patients was very good and she shared jokes with the patients. She really seemed to have a calling for nursing.
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“It is very rare that I shout at the patients; if I do it is always for a good reason. I shout because I care... Some of the patients do not listen, you tell them this month to follow the guidelines on how to manage their diabetes so that they will be able to control their sugar levels, they will come back the following month with a glucose level of > 10mmol/L which is an indication that they do not follow the guidelines that we give them” (Nurse B).