Where is the leadership in diabetes nursing? Are all DSNs striving for the same goals or do we each have our own separate agendas?
The formation and leadership of different groups within diabetes nursing can be linked to that within the animal kingdom. DSNs may sometimes be likened to sheep, going blindly down a well-trodden path, herded by medicine, having no control over their direction. Despite bleats of protest, it is rare that a single sheep is able to escape from the pen into which they are being driven.
Although some DSNs see medicine as the driver of this behaviour, medicine cannot be blamed because, like the behaviour of sheep, theirs too is inherited and no other way is known.
On an annual basis, the sheep enter the pen of a diabetes conference, where they are dipped and shorn to rid them of the outer coat of indifference acquired over the previous year. They emerge frisky, full of the joys of spring, but have no ability to change their environment or their behaviour, and the ensuing year becomes a repeat of the one before.
Occasionally, there are those who see things differently, who present new ideas that break away from the traditional work of their DSN colleagues. While these ideas may be innovative and lead to progress in diabetes nursing, the sheep feel vulnerable if their traditional ways of working are challenged. The instigators are seen as black sheep, felt to be disruptive, needing to be controlled or ignored.
Some DSNs, on the other hand, may be seen as queen bees, sitting in their hives, protected from the rigours of daily life. This small number of queen bees might be seen to wallow in the subservience of others, enhancing their belief in their own superiority. They utterly believe that their way is right and their authority is unquestioned. However, without them the worker bees would be leaderless and no progress would be made.
It is impossible to tell whether the worker bees are unhappy, or if they resent their status, as their busy working lives allow no time to express this. Alternatively, they may be content in the belief that only a small number of bees can attain the qualities possessed by the queen.
There may also be DSNs who behave similarly to geese, flying steadily in one direction with a clear vision of their goal. The role of each goose is vital in making the formation work and each one feels valued in the part they play.
Although there is a clear leader, when that individual tires, it falls back and others move quickly to the vacated position, maintaining direction towards the chosen goal. If a goose falls to the ground injured, rather than being left alone, it is aided by two other geese who stay with it until recovery or death intervenes.
Where do you stand?
Where do you fit into the animal kingdom? Many DSNs do feel threatened by those in leadership positions – seeing them as queen bees trying to maintain their hives – but they may fail to see the reasons for the leaders’ actions. We could all simply be sheep, and accept that we have little influence over our destiny, or we could accept that we need leadership in order to move forward.
Within nature there are always leaders, and things work better with strong enabling leadership. Some DSNs also tend to forget that leaders, like geese, also need care. We are all vulnerable and need help and support from others. When leaders struggle, we should resist the temptation to kick them, but try and support them, nurture them, or share their responsibilities. Leaders change from time to time, but their purpose remains constant. Pulling in different directions or simply bleating in protest is unlikely to result in progress.
So where are the leaders in diabetes nursing? The answer is that the potential lies in all of us, and progress depends upon our recognition of the importance of giving support to those who push forward, whilst flying in formation to tackle the real challenges that face us all in diabetes nursing.
This piece was written by a group of DSNs who believe that it raises significant issues in diabetes nursing, and we would welcome responses from readers of this journal.