It’s a bright morn­ing in Bul­man, one of nine com­mu­ni­ties Ker­ri Roth­ery vis­its in her role as a CDE. 

She arrives equipped with a Point of Care Machine, haemo­glo­bin A1C and urine albu­minto-cre­a­ti­nine ratio tests, Libre­View sen­sors, Blood Glu­cose Meter machines, book­lets, leaflets, diaries, and lancets, ready to see the patients that the dri­ver is bring­ing to the clinic.

It’s her role to pro­vide infor­ma­tion, estab­lish self-man­age­ment plans, mon­i­tor progress, and fol­low up with over 400 patients. ​“Edu­ca­tion is about pro­vid­ing patients with infor­ma­tion enabling them to make informed deci­sions and choic­es to improve their dia­bet­ic jour­ney,” Ker­ri says. 

“You don’t know what you don’t know… Any­one who wants to learn, whether they’re a RAN, a health cen­tre man­ag­er, an Indige­nous client, some­one walk­ing down the street – I’m just hap­py to sit, have a yarn with them, and see if I can empow­er someone’s choic­es in life.” Hav­ing half the knowl­edge is not enough, Ker­ri says. It’s like ​“work­ing with one hand tied behind the back.”

Incom­plete under­stand­ing can show when clients boy­cott soft drink in favour of orange juice or iced cof­fee, or eat exces­sive car­bo­hy­drates, unaware that unused carbs con­vert to sug­ar in the blood.

There­fore, help­ing to estab­lish a fuller under­stand­ing is key. To gain an audi­ence, you first need rap­port. It’s also ben­e­fi­cial to dis­cuss the broad­er ben­e­fits of the health­i­er lifestyle that results from a dia­betes man­age­ment plan. 

“Man­ag­ing your sug­ars, you’re eat­ing bet­ter, which reduces your weight, which reduces your cho­les­terol, which reduces your blood pres­sure,” Ker­ri says in rela­tion to Type 2 dia­betes. ​“You’ve reduced your car­dio­vas­cu­lar risk, your impact on your kidneys.” 

Hav­ing as many patients as she does, vari­ety is her every day, and Ker­ri must alter her edu­ca­tion style when sup­port­ing patients of all dia­betes types and ages across the lifes­pan – from Type 1 tod­dlers to Type 2 elderly. 

“You have to ask your­self – have they ever had edu­ca­tion before?” she says. 

“What did they learn from that edu­ca­tion? Do they want to know more – or are they at the clin­ic because they’ve been told to be here?

“If they’re chil­dren, you’re edu­cat­ing the fam­i­ly, not the child,” Ker­ri pro­vides as an exam­ple. ​“The young ones are more like­ly to be Type 1s, so you gen­er­al­ly meet adults who are fright­ened. They’ve got this beau­ti­ful child and sud­den­ly he’s Type 1, which is nor­mal­ly found out due to a clin­i­cal event.” 

Deliv­er­ing the best care in a com­plex set­ting requires con­tin­u­ous pro­fes­sion­al devel­op­ment (CPD), which is one of the rea­sons Ker­ri decid­ed to become cre­den­tialed by the Aus­tralian Dia­betes Edu­ca­tor Asso­ci­a­tion. This requires 1000 hours of prac­tice, men­tor­ing, and an ADEA-accred­it­ed post-grad­u­ate certificate. 

Main­tain­ing it requires 20 hours of addi­tion­al CPD annu­al­ly, which helps keep Ker­ri up to speed. 

“When I start­ed nurs­ing years ago there was no con­tin­u­ous glu­cose mon­i­tors, no Libre­View,” Ker­ri says.

“Insulin pumps change about every 18 months to two years… Tech­nol­o­gy is becom­ing an amaz­ing thing. I’ve had to stay up to date to be able to edu­cate appro­pri­ate­ly in this space.”

Ker­ri is proud to have gone down the cre­den­tial­ing path and is lov­ing the kind of remote prac­tice it has opened to her.

“You also have to be smart,” she con­tin­ues. ​“Hav­ing a sat phone in the car. Bring­ing plen­ty of water. Not stand­ing under the sun when it’s 40 degrees. Tak­ing your time, not over­work­ing, because you won’t last.

“Being adapt­able. If a patient doesn’t turn up on the day you’ve turned up, that’s okay. It’s prob­a­bly not because of you. They’re got oth­er con­cerns that are more pend­ing. You have to take it in your stride.

“My role requires me to spend time in com­mu­ni­ties. The nor­mal, every­day per­son doesn’t get to do that,” Ker­ri continues.

“The wel­com­ing I’ve had from com­mu­ni­ties has been amaz­ing; hav­ing the priv­i­lege to stand by and see some cer­e­mo­ni­al prac­tices out at com­mu­ni­ty… It’s been a won­der­ful cul­tur­al learn­ing expe­ri­ence that I will remem­ber forever.

“Com­plet­ing my Mas­ter of Remote and Indige­nous Health has pre­pared me for this jour­ney. How­ev­er, my learn­ing in this space has only just begun. By work­ing with Indige­nous com­mu­ni­ties my knowl­edge is con­tin­u­al­ly expand­ing with won­der and I am for­tu­nate to have this oppor­tu­ni­ty. Being out here work­ing in the bush is my dream job.”