From "Wandering Nurse" to Certified Diabetes Educator
A True Teacher
Elliott P. Joslin, M.D., was a firm believer in the importance of patient education. In fact, in spite of Dr. Joslin’s many outstanding accomplishments in diabetes care, his obituary stated: “Joslin was best known for his inauguration of education for the diabetic patient.” Dr. Joslin was a passionate teacher devoted to educating patients and families as well as physicians and healthcare providers. He was a prolific writer and during his lifetime published 10 volumes of a textbook for physicians and 10 editions of an education book for patients. A favorite quote that appears in the front of many of his books is “Learn as if you are to live forever, Live as if you are to die tomorrow.” (Archbishop of Seville, circa 570-636)
Empower & Educate
Joslin believed in empowering patients to care for their own diabetes. He often remarked, “Teaching is cheaper than nursing,” reflecting the importance he placed on patients handling their self-care and preventing problems instead of paying for costly medical treatment. He was ahead of his time and truly a pioneer in this approach to what is now commonly referred to as “DSME” or Diabetes Self-Management Education.
Launching the Diabetes Educator
“A well-trained nurse is of more value than the patient’s doctors,” remarked Dr. Joslin. Dr. Joslin initiated the role of the diabetes teaching nurse or nurse educator. He created a fund to support the role of the “wandering nurse,” which he described as a nurse who would be free to wander in whatever direction the patient might call her—from accompanying families home to visiting schools to making periodic home visits to teaching about diabetes in hospitals and in diabetes camps. Acknowledging the importance of team care and family involvement, Joslin wrote, “Experience, the nurse, the doctor, the parents, grandparents, brothers and sisters will finally bring success.”
The Power of Groups
Dr. Joslin’s dream to create a model diabetes treatment and education center was realized in 1957 with the opening of the diabetes treatment unit (DTU). Within the DTU, there were classrooms, a teaching kitchen and a gymnasium. Patients would stay for about a week to learn as much as possible about living with diabetes in a more real-world setting. Dr. Joslin not only had his physicians’ teaching classes, he also modeled excellent teaching himself by being a favorite lecturer for patient classes. “We can only scratch one back at a time, but we can teach many patients together and each is likely to teach another.”
Reward & Recognize
Dr. Joslin believed strongly in always conveying a message of hope and encouragement to patients and families. After all, he had witnessed many “miracles” as patients who looked like near-death grow into healthy-looking, active adults. He initiated the special tradition of honoring individuals with medals as a way to provide “recognition of his (the patient’s) personal share in the management and control of his disease.” Receiving the Joslin medal for having diabetes (and on insulin) for 50 years continues to be a highly regarded honor. More recently the 75-year Victory medal was created, which has been awarded to 22 individuals—truly examples of hope and inspiration.
Allen, N.A.The Diabetes Educator inThe History of Diabetes Nursing, 1914-1936, 29:976- 989, 2003.
Barnett, D.M. Elliott P. Joslin, M.D.: A Centennial Portrait, Joslin Diabetes Center, 1998.
