Nurse-led care helping Indigenous diabetes

12/11/20

This year’s World Diabetes Day celebrates the role of nurses in the prevention and management of diabetes.

Trained nurse and PhD candidate, Sharon Atkinson-Briggs, has made a huge impact on the prevention and management of diabetes-related eye damage in the Indigenous community in regional Victoria.

Diabetes is a major health issue among the Indigenous community, with an Indigenous person four times more likely to have type 2 diabetes than a non-Indigenous person.

Sharon has run a nurse-led model of eye care across five locations, including her hometown of Shepparton, for the last seven years.

Nurse-led model

The model sees Sharon, a proud Yorta Yorta woman and community elder, provide two services in one consultation. At a GP or medical centre, Sharon enquires about a person’s background, measures their blood glucose levels, and then asks them to fill out a survey before screening for retinal damage. She uses images to educate people about the trajectory of eye damage from diabetes.

‘The consultation gives people a great insight into what’s happening in their bodies. Many are moved to tears. They might have been avoiding taking insulin or ignoring eye damage or going to their GP,’ Sharon said.

‘Because l’m Indigenous, patients feel culturally safe to ask questions. If anything warrants an urgent referral, I advise them to go see their GP or speak to an optometrist.’

Sports club origins

The idea to help her community tackle diabetes came when she worked as an accredited fitness instructor at her local football and netball club in Shepparton.

‘I was very active in sports and always encouraged my kids to play. My son played football and my two daughters played netball. I became a health promotion officer at the club and thought we should be doing something for the adults as well.

‘In exercise groups, people started coming forward and telling me they had diabetes. I started to do a bit of a research and became aware of the huge problem of type 2 diabetes in Indigenous people.’

Sharon noted westernised change as a cause, but she went one step further to pinpoint trauma and stress from history as key contributors.

‘If someone smokes too much, eats too much or drinks too much, it’s a symptom of their mental health.’

While working at the football club, Sharon was asked to be involved in a diabetes research project in the Northern Territory funded by Melbourne University. In the TEAMSnet [Telehealth Eye and Associated Medical Services Network] project, Sharon worked as the Indigenous project officer and learned more about diabetes and its chronic complications.

‘I realised then it was a lifestyle disease and it was only a matter of time before my community would be affected. I wanted to do something to change that.’

A surprise career

Sharon decided to become an accredited diabetes educator to help her community. The only snag was that she had to be a registered health professional. Not wanting to waste any time, Sharon signed up for a nursing degree and completed her 1,000 hours in Katherine.

Sharon kept in touch with two mentors from her eye screening time in NT, one of them being the CTC’s Prof Alicia Jenkins. Both mentors encouraged her to take on a PhD to continue to do real life research that would impact her community and others.

“I have lost many family members in the last ten years from diabetes-related illness. The burn inside to help people prevent getting diabetes has kept me going. I started studying when I was 48 years old.”

For her PhD research project, Sharon has consulted 207 out of 250 community members across five locations (Shepparton, Bendigo, Geelong, Epping and Fitzroy). This has resulted in screening 137 out of 172 people with diabetes for eye damage, guiding them to treatments, better diets and a healthier lifestyle.

When COVID-19 struck, she had to cease consultations, but luckily she had sourced enough data. It was a landmark moment for the girl from Shepparton who had spun wool and picked fruit and vegetables in her early life to support the family.

“If you’re passionate about what you do, you draw on your goals throughout and remember why you started it in the first place, and you get there in the end.”

Facing up to the past

Sharon’s trajectory is all the more remarkable given her upbringing. She was born in regional Victoria and spent many of her childhood years on her ancestral land Cummeragunja, an Aboriginal mission near Shepparton.

‘Due to government polices at the time, both my parents only received a grade six education. My father was a hardworking man, and went to work in the shearing shed with his father and older brothers. My mother was really interested in learning but she too wasn’t allowed to progress her education.

‘Just like other Indigenous children at the time, l experienced racism and discrimination in school that negatively impacted my life for many years.

“Having such great mentors has helped me focus on my weaknesses and face the struggles that have made me feel uncomfortable for years.”

The future is education (and a great role model helps)

In the final stages of finishing her PhD, Sharon is looking to further awareness and treatment of diabetes in her community.

‘I would like to be able to offer support and mentoring to other Indigenous women who are passionate about Indigenous health and are interested in becoming nurses, to ensure healthcare given to Indigenous people is culturally appropriate and safe.

‘For those Indigenous nurses that have already embarked on this wonderful profession, I want to provide them with continuous support and the opportunity to update their skills and medical knowledge,' she said.

Reflecting on this year’s theme for World Diabetes Day, Sharon said nurses deserve more recognition for being soldiers on the frontline.

Sharon is more than a solider in the frontline of closing the gap in Indigenous health.