Graduate college: Check.
Pass my NCLEX: Check.
Accept my first job offer: Check.
When I was going through the mental checklist of milestones I was expected to be meeting after graduating college, I forgot to include one of the most important things – diabetes. My main focus was making sure that I was keeping up with everyone around me.
When I started my first job as a new graduate nurse on a cardiac floor, I already felt behind all of my peers. I was one of the few people in my orientation group who had never had a clinical rotation at this hospital and needed to adjust not only to working full time but also acclimating myself to a new environment.
After training for months on evening shift, I was met with the end of my orientation period and received my official position = night shift. After finally starting to feel comfortable, my entire routine switched completely. My first meal of the day was at 4pm and the only people I saw were my co-workers, my patients, and my family (but only in passing). For a job where I was constantly surrounded by people, I was struggling to make connections with the people who mattered to me and I began to feel isolated.
The one thing that no amount of schooling could have prepared me for is the amount I would think about work, even when I wasn’t there. Outside of the hospital I would find myself hearing bed alarms and IV pumps ringing in my head. I would dream about what my next shift would entail.
With all of these constant thoughts, I felt I no longer had adequate space for was the management of my type 1 diabetes. And slowly, as the worries, anxieties, and stressors of work started to take over my mind, the tasks that had become second nature, like taking my blood sugar and bolusing for meals, were taking a back seat. Every Dexcom alert, felt overpowered by the incessant beeping at work. I felt constantly distracted from these important daily activities, which lead me to spend more than 50% of my day above my target range without even realizing it.
During this time period, I had just transferred my care to an adult endocrinologist who had reduced my visits from 4 times a year to only 2. On more than one occasion she got me confused with other patients she saw and gave me incorrect test results or asked me why I wasn’t taking medications that I was never even prescribed. As a patient, I interpreted this as her not caring, And if she didn’t care that much, I didn’t either. I stopped going to appointments. My A1C began to rise.
Hindsight is 20/20, and while I know now that this was a serious phase of diabetes burnout for me, in the moment I had no idea how bad it had gotten. While I felt the effects of my emotional and mental burnout quicker than I did the effects of my diabetes burnout, my journey out of them was all the same.
I started by finding a therapist. It was a slow process adding therapy to my weekly schedule but I quickly started to see the benefits. I had found a great fit in a therapist who was helping me develop skills in resilience and anxiety management. Three years later I still see the same therapist and am still thankful for that supervisor who encouraged me to get help while I was struggling.
The next thing I did was reach out to mentors in my workplace. I chose strong nurses who had disclosed to me that they also were living with diabetes as we could relate on many levels. They were role models for how important it was to take care of yourself in order to best take care of your patients.
These mentors encouraged me to consider an idea I had never thought of before; find a new endocrinologist. I had never considered that I had an option to change providers after transitioning from my pediatric provider. I requested a referral for a new endocrinologist who worked within our hospital’s network. Within the first few minutes of meeting her, I couldn’t believe I had stuck with the other provider for so long. She showed immediate concern for my management and talked about things I had never discussed with my other provider including the effects of my mental health on my diabetes and how working night shift was affecting my glucose management. I started to view my diabetes management more as a team approach. She wanted to help me and was willing to try different things.
Finally, I started reaching out to the people I cared about. Friends, family, and coworkers helped me to feel less alone about the stressors I was dealing with on a daily basis. I found comfort in reaching out to my friends from The Diabetes Link who were also working in healthcare – we talked about things like the best low snacks to keep in our pockets that wouldn’t melt. It brought back that sense of connection in my life that I had so sorely been missing since graduating college.
Transitions have never been something that have been easy for me. My experience transitioning into my first career and going through burnout has taught me so much about myself and how I handle big changes. It has taught me how to better prepare myself before these changes happen. While I have never let my diagnosis dictate my life, I learned that if I want to be successful, it also can’t take the backseat. I learned the importance of balancing what you allow to take up space in your mind and your life, and that only I can decide how it affects me.
The American Diabetes Association has a list of therapists that are familiar with diabetes here. It may be helpful to utilize this list if you have T1D and are seeking treatment for a diabetes-related mental health concern.
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