Nursing Spotlight: CKHS Center for Diabetes Nurses
Mary Jane McDevitt, RN, BSN, CDE
When two of Mary Jane McDevitt’s five children were diagnosed with Type 1 diabetes, she became very motivated to learn as much as she could about the disease. At the time, she was a nurse for Delaware County Memorial Hospital Home Care/Hospice. Soon, she started handling all diabetic education for home care patients, and was encouraged by her nurse manager to become certified as a diabetic educator. In 2006, she received her certification. The following year, she became program coordinator for the CKHS Center for Diabetes.
At the Center, McDevitt leads a team of three nurses who conduct diabetic education classes, provide intensive management for patients who require insulin, administer continuous glucose monitoring, and make recommendations to physicians regarding insulin dosage. They also organize community outreach efforts such as the annual “CKHS Healthy Living with Diabetes” event. In addition, McDevitt provides education to home care nurses and speaks at CKHS hospitals on diabetic education, insulin and care of the diabetic.
“Education is a huge piece of our work at the Center,” says McDevitt, a member of the American Association of Diabetic Educators. “In addition to teaching patients how to monitor and take care of themselves, we make sure that nursing, case managers and other hospital staff understand the scope of services we provide so they can refer patients to us for assistance.”
On a personal level, McDevitt has contributed to juvenile diabetes research efforts for almost a decade by organizing a team, the “Mighty McDevitts,” to participate in a fundraising walk each year. “We always have more than 100 walkers on our team,” she says. “Over the past nine years, we’ve raised more than $80,000.”
A 34-year nursing veteran, McDevitt finds it enormously rewarding to be able to effect change in her patients’ lives. Her experience includes 10 years as an oncology nurse prior to hospice care and diabetes care. “I have found rewards in each type of nursing,” she says. “In oncology, it was providing emotional support that was so necessary and helpful to patients. As a hospice nurse, I felt that I was providing a very valuable service to patients and their families facing the end of life. Now with diabetic patients, I find it rewarding to teach them how to take care of themselves so they have a better, more normal life.”
McDevitt is continuing her own education by pursuing her master’s degree in nursing with a clinical specialty in education at Widener University. She holds a bachelor’s degree in nursing from the former Philadelphia College of Textiles and Science, now Philadelphia University.
Kathleen Plecenik, RN, BSN, CDE
When Kathleen Plecenik, RN, BSN, CDE, began her nursing career at Crozer-Chester Medical Center in 1972, diabetes control and education were vastly different than they are today. At that time, patients with diabetes were often hospitalized for a week while physicians and nurses Staff nurses volunteered to teach diabetes education classes offered four times weekly for inpatients. Plecenik was one of those nurses, and her interest and expertise in diabetes education has continued to grow ever since.
After serving as a med/surg unit staff nurse and nurse manager early in her career, she moved into Staff Development where she was part of the nurse leadership team that organized diabetes education classes and developed Diabetes: The Goal of Control, a patient education book for Crozer patients.
When the Center for Diabetes first opened at Springfield, Plecenik worked PRN while raising her family. She became a full-time educator in 1999. Certified as a diabetes educator in 1987, she has particular expertise in intensive glucose management and insulin pump training. “Research in controlling diabetes complications has shown that individuals do well when given some flexibility with insulin dosing depending on blood sugar level and how much food they are planning to eat at any given time,” says Plecenik, who is a member of the American Association of Diabetes Educators. “In the study, they discovered methods for individualizing insulin to carbohydrate ratios so, for example, if your ratio is one unit of insulin for every 10 grams of carbs you eat, and you’re eating 30 grams, you would take three units of insulin. We use this evidence-based research to calculate ratios as well as individualized correction or sensitivity factors for each patient.”
Plecenik also provides training for intensive management patients who transition to an insulin pump. “We teach them how the pump gives background insulin and mealtime insulin and how to fill it,” she relates. After calculating settings for the pump and verifying them with the patient’s physician, she coordinates the pump start date and follows up with the patient to make sure everything is going well.
“The technology is constantly advancing, so training is never really done,” says Plecenik, who helps patients learn to use a pump for the first time or upgrade to new, more advanced pump.
A member of the American Diabetes Association, Plecenik finds great reward in successfully helping her patients control their diabetes and, as a result, enjoy better quality of life. “I had a patient who was in a car accident because of a severe low blood sugar episode,” she says. “We worked to adjust the insulin dosage so the patient would stop having so many low blood sugar episodes and be able to drive more safely.
“The whole reason I became a nurse was to be able to help people,” Plecenik says. “Educating diabetes patients gives me great opportunities to do that every day.”
Mary Weldon, RN, CDE
Mary Weldon RN, CDE, is known for going above and beyond the call of duty. Just ask her patients. Recently, she was conducting continuous glucose monitoring on an elderly patient. His five days of monitoring ended on a weekend when he was scheduled to work. To accommodate his schedule, Weldon met him at his home to take off the monitoring sensor just before he was leaving for his job. She immediately went to the Center for Diabetes at Springfield to download the information from the sensor to her computer. His last blood sugar reading was alarmingly low -- 46.
“He had been having a problem with passing out from low blood sugar,” relates Weldon, a 37-year nursing veteran. “I knew he was on his way to work and was worried that he would pass out and have a car accident on the way there. I called the store where he worked and was very relieved when I heard that he had arrived safely. He told me that he had recognized that he was having low blood sugar and got something to eat, so he was feeling better by the time I spoke to him.”
This is typical of Weldon’s relationship with her patients. “She goes out of her way to empathize with her patients and help them with whatever needs they have,” says Mary Jane McDevitt, RN, BSN, CDE, the Center’s program coordinator.
With the help of the glucose monitoring data that Weldon collected, Center director Ruth Ann Fitzpatrick, M.D., was able to regulate her patient’s blood sugar.
A certified diabetic educator for 19 years, Weldon initiates continuous glucose monitoring for about 150 patients annually. “The technology is getting better all the time and is much easier for patients to use than the earlier systems,” she notes. “The information is invaluable to physicians, with blood sugar readings broken down by period of day so they can see critical times - like 3 a.m. to 6 a.m., when patients often experience the ‘dawn phenomenon.’ You can see what’s going on when the patient is not actively testing, and that is critical to controlling diabetes.”
A member of the American Association of Diabetes Educators, Weldon also teaches diabetes education classes in collaboration with McDevitt and Plecenik. “I teach about the complications of diabetes which can be depressing to patients, but I emphasize prevention,” she says. “I tell them, ‘This does not have to happen. These complications can absolutely be prevented. You can control the outcome, unlike other diseases like cancer.’”
Weldon knows this firsthand because she has a son with Type 1 diabetes. “My personal experience has enabled me to empathize and relate in a special way to my patients,” she says.
This year, Weldon has found it especially rewarding to begin teaching classes at Community Hospital. “The patients at Community appreciate our help so much,” she says. “I’ve had more hugs from them in a month than I’ve had in the past 10 years! Going to Community brings back into focus what nursing is all about – helping people in need.