The Invisible Experts: What Nurses Know About Aging and Chronic Illnesses Like Diabetes

Is it any coincidence that AJN recently heard from editorial board member Michael Desjardins and contributing editor Jane Seley about ways physicians and the mainstream media remain blind to the cutting-edge work being done by nurses in developing new models of care for the elderly and the chronically ill, including those with diabetes? This is a narrative that has to change if our health care system is going to face the challenges coming its way.


Desjardins, MSN, APRN, is a family psychiatric mental health nurse practitioner at Valley Mental Health in Salt Lake City, Utah. Here’s his take on a recent Frontline documentary and what it left out:


On Tuesday March 17, 2009, the PBS series Frontline aired “Living Old,” a TV documentary on growing old in America. The show provided a compelling look into the daily lives of the fastest growing population in our society, the elderly. “Living Old” was written, produced and directed by Miri Navasky and Karen O’Connor. They did a decent job of portraying the daily struggles that the aging experience in the United States, but I was baffled by the lack of nursing presence in this program. Several physicians were interviewed, and their role in the diagnosis and treatment of medical conditions is irrefutable. But lets face it, the reason nursing homes have that title is because 24-hour nursing care is provided. And who knows the patients better than the nurses that are spending 12-hour shifts caring for these patients? Nurses are the experts in providing health care to the aging in America because our entire training and focus is on caring for people with chronic conditions.

From this series, you’d never guess that specialized gerontological programs are now offered at many nursing schools across the country. In recent years, AJN has completed two major series focused on improving the care of the aging with evidence-based interventions: “A New Look at the Old” and “How to Try This.” It never ceases to amaze me that mainstream media doesn’t get us, or even see us–-we are just the background “bodies” doing some nonessential tasks while the docs swoop in for 15 minutes and save the day. When I grow old, if I have to spend time in a nursing home it will be the nurses there who make the difference in my daily comfort—let’s hope nursing doesn’t continues to be treated as a second-rate profession.


Seley, NP, BC-ADM, CDE, coordinates the Diabetes Under Control column in AJN and is a diabetes nurse practitioner at New York Presbyterian/Weill Cornell.

If diabetes depends on self-management, she wonders, isn’t it obvious that it’s nurses (oh yeah, and the patients themselves!) who know what patients really need? Here’s what she sent us:


I just came back from the 2nd International Conference on Advanced Technologies and Treatments for Diabetes in Athens, Greece—71 countries represented, multiple speakers for four days. And not one nurse. I approached the organizer (a well-known and highly regarded endocrinologist from Israel) and asked, “Why, if diabetes is a self-management disease, is there no nurse speaker?” (Editor’s note: Not long ago, Seley was a guest editor for a major series on diabetes self-management that grew out of a collaboration between AJN, the ADA, and several other stakeholders.) Much to my delight, he responded with the following: “You’re right. What should a nurse talk about?” I gladly supplied him with a topic and speaker for next year’s conference. We all need to be more proactive in reminding others of our unique and equally important role in health care and in getting more nurses to speak at interdisciplinary conferences.

Jane Seley at Parliament in Athens changing of the guard

Jane Seley at Parliament in Athens changing of the guard











Tell us your own stories about what nurses know and aren’t always able to tell, and about what you think can be done about it.

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Senior editor/social media strategy, American Journal of Nursing, and editor of AJN Off the Charts.

One Comment

  1. Shawn Kennedy March 20, 2009 at 6:55 pm

    Again, nurses are dissed! Bravo to Seley for addressing it head-on – and getting results! As nurses, we need to speak-up and speak out and stop being the quiet, invisible, “background noise” in the health care system that gets tuned out.

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