When I began my NP program, we had a (long) discussion about self-disclosure. We were told then, and repeatedly throughout the year, that once we’re in practice we’ll learn what we feel comfortable with disclosing. We’ll learn where our boundaries lie.
But as students, the rule they wanted us to abide by was clear: don’t disclose anything other than the fact that we’re students.
Now that I'm working, I've finally transitioned my mindset from that of a student to actually being an employee. What I choose to disclose to patients is now entirely up to me and isn’t being scrutinized by clinical instructors.
My diabetes is something I haven’t felt comfortable sharing with patients. I don’t want to create a dynamic where they’re focused on or worried about the health of the person who’s taking care of them. All they should be focused on is their own health and recovery.
(But, all of my coworkers know, just in case I ever need a hand.)
Sometimes during the summer, the unit will have a cookout. It’s a great way to break up the day, it gives patients a sense of normalcy, and it’s a wonderful time to get to know them in a more relaxed atmosphere.
Yesterday, a woman sat alone at the cookout with slow tears rolling down her face. When the tears continued a little too long, I pulled over a chair. She said she was sad, but I knew it was more. I told her I was there to listen or quietly sit with her so she’d know she wasn’t alone.
After some silence, she said: “this was supposed to be a fun time with friends, but my fingerstick was 342. Now I’m here and I can't have fun until my bloodsugar comes down. No one gets it. They keep offering me chips and potato salad and I can’t have it right now.“
“I get it.”
“You couldn’t possibly get it. It’s like there’s a supermodel on unit when you’re here. You’re skinny and perfect and content to have a salad while everyone else eats burgers and chips.”
I held out my wrist with my medic alert bracelet. “I get it. I promise I get it.”
She stared at it quizzically, having never realized it was a medical bracelet before.
“Go ahead and read the back of the tag. It's ok.”
Her eyes lit up when she saw the word. The word that let her know that I did, in fact get it. That I knew all too well how it feels to be out of range and have to wait when you want to be having fun with your friends. How it feels to be out of range when it’s time for a meal you’ve been looking forward to all day.
We sat and talked a little bit longer. We talked about what could help her make the situation more tolerable while she waited to get back into a more cookout friendly range. At the end of our conversation, she thanked me for sharing and went over to the table where her friends were sitting.
“Hey guys, my blood sugar is a little off right now and I have to wait for it to get into range before I can eat. Please don’t offer me anything right now. I’ll eat when I can.”
Her friends smiled and nodded, asked if she needed anything, and then they put their meals to the side not wanting to eat until she could. It wasn’t about the food, it was about the company they were keeping. She waved at me from across the patio and her tears didn’t return for the rest of the shift.
Knowing someone else gets it is the most powerful support there is. Even when it comes in the form of a making a disclosure your instructors would have cautioned you against.