Eversed, probably the same, even BLU-554 custom synthesis though I am a health professional that is aware of the outcomes if optimal blood sugar control is not maintained. During our conversation, I proposed a question asking Joe to think about an area where he felt he could see change that would lead to improving his current situation. His initial reaction was “you are the expert, I am coming to you to tell me what to do and you’re asking me?” In response, I offered that he is the expert in his own life and his expertise is seen in how he has lived with diabetes over the past 30 years. I explained that as a nurse I could provide an array of information and several resources for what to do and how to do it; however, Joe had acknowledged that he has the information. As a way to begin a relational partnership with Joe, I wanted to accompany him through the Vadadustat supplier process of exploring what changes he felt he could make and how he thought he could approach them; it seemed simple enough. I went on to say, “you are the most knowledgeable about yourself, your current situation and what has worked for you in past situations, so yes I am asking for your direction, I can tell you what you need to do, but would you do it?” He looked at me, and I could see him smile. In that moment we connected and knew that only he could decide how and what would work for him in his life. He had the answers; maybe I could help him find them. Getting to know persons and understanding the patterns of their lives through open dialogue and trust and without judgment are fundamental to the RNHC role. Understanding that change comes from within and occurs only when the individual is at a point where they are truly ready and that big changes often require a process of starts and stops. The success of change is related to how the person is able to sustain it and how environmental influences constrain or enable the change; change is fluid and can regress or flow forward. Change is as much a community affair as an individual pursuit when it comes to health, because poverty, mobility, and accessibility are shared responsibilities of communities. At this point, Joe said he was not ready to make changes due to the overwhelming issues he was currently experiencing. He began to tell me about an experience he had a day prior where he felt he had no control over the drop in blood sugar level, and he attributed it to having started insulin. Joe said, “when you are on insulin the highs and lows are just something you have to live with.” We explored his thoughts about the cause of his low blood sugars, and he indicated that it was due to “taking too much insulin or not eating enough.” We explored his feelings about how he decides about the amount of insulin he takes and food he eats. Joe lives with limited financial resources for accessing food, and the physician directed him to use a sliding scale insulin dose. Through our dialogue, Joe began to realize that he had the knowledge about which foods affect his bloods sugars and in which way. He then looked at me in silence, and at that moment he seemed to have new insight about his diabetes; the insight changed his understanding, perhaps, or shifted the angle he had on the control issue. As I listened to Joe speak and tease apart his thoughts on his blood sugar control, he spoke about feelings of fear and shame that surfaced when he attended appointments withNursing Research and Practice healthcare providers. He felt like he was “wasting their time” which led him to.Eversed, probably the same, even though I am a health professional that is aware of the outcomes if optimal blood sugar control is not maintained. During our conversation, I proposed a question asking Joe to think about an area where he felt he could see change that would lead to improving his current situation. His initial reaction was “you are the expert, I am coming to you to tell me what to do and you’re asking me?” In response, I offered that he is the expert in his own life and his expertise is seen in how he has lived with diabetes over the past 30 years. I explained that as a nurse I could provide an array of information and several resources for what to do and how to do it; however, Joe had acknowledged that he has the information. As a way to begin a relational partnership with Joe, I wanted to accompany him through the process of exploring what changes he felt he could make and how he thought he could approach them; it seemed simple enough. I went on to say, “you are the most knowledgeable about yourself, your current situation and what has worked for you in past situations, so yes I am asking for your direction, I can tell you what you need to do, but would you do it?” He looked at me, and I could see him smile. In that moment we connected and knew that only he could decide how and what would work for him in his life. He had the answers; maybe I could help him find them. Getting to know persons and understanding the patterns of their lives through open dialogue and trust and without judgment are fundamental to the RNHC role. Understanding that change comes from within and occurs only when the individual is at a point where they are truly ready and that big changes often require a process of starts and stops. The success of change is related to how the person is able to sustain it and how environmental influences constrain or enable the change; change is fluid and can regress or flow forward. Change is as much a community affair as an individual pursuit when it comes to health, because poverty, mobility, and accessibility are shared responsibilities of communities. At this point, Joe said he was not ready to make changes due to the overwhelming issues he was currently experiencing. He began to tell me about an experience he had a day prior where he felt he had no control over the drop in blood sugar level, and he attributed it to having started insulin. Joe said, “when you are on insulin the highs and lows are just something you have to live with.” We explored his thoughts about the cause of his low blood sugars, and he indicated that it was due to “taking too much insulin or not eating enough.” We explored his feelings about how he decides about the amount of insulin he takes and food he eats. Joe lives with limited financial resources for accessing food, and the physician directed him to use a sliding scale insulin dose. Through our dialogue, Joe began to realize that he had the knowledge about which foods affect his bloods sugars and in which way. He then looked at me in silence, and at that moment he seemed to have new insight about his diabetes; the insight changed his understanding, perhaps, or shifted the angle he had on the control issue. As I listened to Joe speak and tease apart his thoughts on his blood sugar control, he spoke about feelings of fear and shame that surfaced when he attended appointments withNursing Research and Practice healthcare providers. He felt like he was “wasting their time” which led him to.
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