Like many specialists working in diabetes education, Senior Clinical Nurse Advisor Tracy Aylen’s interest in the area was sparked when a close family member was diagnosed.
“A few years later I was district nursing in Brisbane and realised that many of the older clients I visited had type 2 diabetes, but little access to education and support services.
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“At that point a 5-day diabetes course was being offered through my employer and I took up the opportunity to learn more.”
Ms Aylen helped establish Bolton Clarke’s team of Senior Clinical Nurse Advisors, whose work influences and leads service delivery across community-based home support and residential aged care – the culmination of years of work in diabetes education, an area she says is constantly evolving.
“Back in the mid-1980s the need for diabetes education was gaining further recognition and was shifting from the traditional, medically focused approach.
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“The Australian Diabetes Educators Association was a relatively new and they were working hard to develop Australian standards, establish course guidelines and support better access to quality diabetes self-management education and support for those living with diabetes.
“Few people with type 2 diabetes had attended any formal diabetes education, understanding of the impact of diabetes in people’s lives was limited and most services were hospital based.
“GPs had little time to teach about diabetes self-care and there were not many practice nurses to support chronic condition management.
“At the same time, leading diabetes researchers were predicting increases in the number of people diagnosed with diabetes.
“I was motivated to undertake a graduate certificate in diabetes education and management through Deakin University to expand my knowledge and skills, and then diabetes education became my career path.”
Ms Aylen says diabetes management and self-management education are constantly changing and expanding, making it crucial for nurses, particularly those working in aged care, continue to update their skills.
“There are new medicines, management algorithms, technology options, dietary and behavioural approaches to name just a few areas of change.
“In order to provide current, evidence based and individualised care you need to constantly update your knowledge and skills.
“Like all health professionals you need to be very aware of your scope of practice.”
“Nurses undertake a number of roles in diabetes education, from delivering diabetes care as part of generalist nursing to working as an independently prescribing diabetes Nurse Practitioner.
“All nurses should have a basic understanding of principles of diabetes management and how to support self-care as part of their undergraduate programs.
“Regular updates of skills and knowledge relating to diabetes are needed because as already noted, there is constant development and change in this area.
“Nurses can work with the person with diabetes to identify information and support needs.
“They can also arrange referrals as required, either directly or through appropriate channels, if the person’s requirements fall outside the nurse’s knowledge, skillset or scope of practice.”
It’s also important for those with diabetes to be across as much information as possible to ensure their own good health.
With the growth of Australia’s ageing population, Ms Aylen helped developed The Talking Books, an information source designed to cater for those with reduced vision or low literacy, originally tested with the Macedonian seniors community.
“Bolton Clarke now has talking books available on a number of health topics - including diabetes- in five languages including English, Macedonian, Greek, Italian, Vietnamese.
“Talking books can be accessed independently on the Bolton Clarke website.
“When used by a health professional we always recommend appropriate use of an interpreter and supplementing with other appropriate materials that match the person’s preferred learning style.”
As a nurse within the aged care industry, Ms Aylen is passionate about the need to update, reskill and expand personal knowledge in order to keep up with the pace of change in diabetes care, a policy area she has been instrumental in changing.
“I would describe it as a contribution to improving national policy through working with ADEA, other diabetes-specific health professional organisations and Diabetes Australia, as the consumer organisation.
“My representative roles allowed me to interact with an inspiring group of leaders in diabetes, including participating in the development of a new National Diabetes Strategy.
“This provides the basis for achieving improvements across diabetes management, research and support services on a national basis, as well as a timeframe against which to measure progress.
“Apart from that, taking up opportunities in volunteer roles in my professional association has led to new areas of interest and better understanding of organisational management and governance.”