3 / 4
Verna Schwendemann has always
lived life with gusto, so developing
type 2 diabetes had a devastating
impact on the quality of her life and
her plans for the future.
Verna was told that managing her
diabetes would include daily insulin
injections. Although her provider had
been clear about her need for injec-
tions, Verna’s intense fear of needles
kept her from getting the lifesaving
treatment. Her family desperately
watched her health deteriorate.
“You have no clue how scared I
was of shots,” Verna recalls. “Nobody
could talk me into it—not my doctor,
not even my husband. I just wasn’t
going do it—even though I knew it
meant I would not live. I went to a
family reunion a couple weeks ago,
and everyone told me they thought
I wasn’t going to be around for this
one.”
Overcoming her fears
When diabetes case management
became available for patients like Verna
under the new patient-centered primary
care medical home (PCPCMH) program
at the Regional Medical Clinic (RMC),
registered nurse Doreen Dobyns, also a
Certified Diabetes Educator (CDE), was
asked to work one-on-one with Verna.
At the time, Verna’s A1C number
was nearly 19. The American Diabetes
Association suggests an A1C level of
less than 7 percent.
“The A1C (or glycated hemoglobin)
test is a three-month average of
blood sugar scores used for test-
ing persons with type 2 diabetes,”
explains Doreen. “It is an important
test for indicating how well your
blood sugar is being controlled.”
Verna was skeptical of meet-
ing with a CDE at first, but under
Doreen’s continued patience and
guidance, she eventually took that
first injection.
“Doreen walked me through this
whole process with kid gloves—let
me know it was OK to be scared,”
Verna says. “The first time I had
shots, I was shaking like a leaf,
and she was right there beside me.
I found out it didn’t hurt. There
weren’t any big, long needles. From
that day on, my life changed. I had
no idea how lousy I felt.”
With her A1C levels now at nearly
half where they once were, Verna has a
lot of living to do in a healthier future.
Ready to save more lives
As a PCPCMH, the RMC offers
health care that is designed to meet
the majority of a patient’s health
care needs through a team-based
approach—including one-on-one
case management if needed. Having
a CDE involved in case management
at the RMC has the potential to save
other people with diabetes like Verna.
A major project for the community
benefits fiscal year 2014 program
was ensuring that both the RMC and
Grande Ronde Hospital Children’s
Clinic met all requirements to obtain
PCPCMH certification.
One patient at a time
The community benefit of a patient-centered primary care medical home
Verna Schwendemann, left, and Doreen Dobyns, RN, CDE, manage Verna’s diabetes.