Why a CDE went rogue

Abby Bayer-Pratt, RN, BSN, CDE shares how her journey of becoming a Certified Diabetes Educator and Registered Nurse was merely the beginning of her Tidepool story.

We all have a story of “how we got here”. Some of us are proud of that story, some of us are really confused about the story, and maybe a few of us would like to change it. My story begins in 1998 when I was diagnosed with type 1 diabetes. I didn’t know that was the beginning of this story, but hindsight is a blood glucose (BG) of 100mg/dL.

Fast forward to 2003 when I was choosing where to apply to college, and I had this brilliant idea that being a middle school math teacher was the path for me. (Spoiler: It was not).

Another zoom ahead to 2008 (I had quit the math and education thing by now, and was solidly on track to graduate with a Bachelor’s degree in Biology). I was heading into my senior year of college and decided to spend my summer working at a camp for kids with type 1 diabetes (Clara Barton Camp, you may have heard of it). This was when it hit me: I like teaching, I’m good at teaching, and I already know diabetes. I was also facing a dilemma in 2008, one that many young people faced before the Affordable Care Act: How was I going to afford insulin after I graduated and lost my health insurance?

You can see where this is going. I needed a job, I wanted to help others with their diabetes, and I needed health insurance.

I applied to nursing school.

After graduation, I accepted a position in an endocrinology office as a triage nurse. Then I started working in a pediatric endocrinology office as a diabetes educator. I passed my Certified Diabetes Educator (CDE) exam. I moved to a new state, worked in a dialysis clinic for a while. Then I went back to working as a CDE in an adolescent/adult diabetes clinic.

Now I’m here at Tidepool. Not working as a CDE. Not working as a Registered Nurse. Not seeing patients in any form, and instead answering questions for people who are having trouble uploading their diabetes devices with Tidepool Uploader.

I feel this is an important story to tell, both for people who are thinking “why did you leave the clinical world for tech support?” and for my new nurses, my CDE compatriots, and my patients.

I believe in empowering people who are living with diabetes. Tidepool also believes in that, and it feels good to be here.

Tidepool empowers us as a team to ensure that we are creating something for people with diabetes who don’t fit the norm. For people who aren’t getting all the mainstream products and treatments. We believe in not waiting to be heard.

During my interviews, I told the Tidepool team that I had gotten into a few disagreements with providers, management, and fellow staff members during my career when I wanted to think outside the box and push the norm to care for my patients who didn’t fit the traditional care model. Believe it or not, I think this may have been a check in the “pro” column during hiring. Breaking the mold and pushing for something new is what this team does — it’s what we are looking for.

My role at Tidepool is defined on the Tidepool team page as Technical Support Agent. I answer the messages of people who are having a hard time with our software. Sometimes that means I can teach people how to upload their insulin pump, sometimes that means I get to help a provider find the report they are looking for, and sometimes it means I have to think outside the box for someone who doesn’t fit our traditional model.

As we move forward with creating Tidepool Loop, I’ve been able to use some of my experience to help with other departments within Tidepool. Since I was certified to teach many of the on-market insulin pumps, I’ve been helping with the development of our training materials. Since many people who work at Tidepool have a personal connection to diabetes, sometimes I have the pleasure of helping with some internal diabetes questions as well. All of this helps me feel like I can create a small bridge from the tech world to the clinical world, and that feels good.

Really, my work here is not so different — the medium is. It’s been many months since I sat next to a person, in an office, holding their hand as they cried about their diagnosis of diabetes, or hugged a patient who I’ve worked with for six months to get to an A1c goal, or snuggled the newborn of a person I helped manage blood sugars through pregnancy. A really, really long while. I miss it, I do, but what we are doing here is powerful, and I believe in it.