Caring for children with diabetes

“I cannot reverse the diagnosis but I can support you. You are not alone; we are in this together.”

Meet Dr Joyce Lim, a diabetes specialty nurse with a heartwarming story rooted in KKH. Born at KKH, Joyce celebrated the birth of her three children in these same halls. Over the past 26 years, Joyce has also dedicated herself to caring for our young ones at KKH, embracing her deep connection to the hospital with warmth and compassion.

A pioneer among paediatric diabetes specialty nurses, Joyce’s insatiable desire to provide better care for her patients led her to pursue a Master’s degree, and eventually a Doctor of Nursing Practice degree. She shares with us about her connection with KKH and what keeps her going.

Q: Tell me about yourself! What do you do?

I am an Advanced Practice Nurse specialising in diabetes care for children for over 20 years. Every moment I spend with my patients and their families has been a humbling experience. I see their display of strength and resilience in the face of this life-changing diagnosis. At the same time, it is also a learning opportunity – with a better insight into their lives, dynamics and preferences, I am able to better understand my patients and support them in managing their condition.

As a specialty care nurse, I educate children (and their families) on diabetic care, such as how to manage the child’s insulin levels or what to do during an acute scenario like when the child experiences a sudden surge or drop in sugar levels.

We also provide counselling for patients and their families. Type 1 diabetes is a chronic condition and can start as young as when the child is 18 months old. As the child grows up, there are different challenges with each milestone. From developmental issues to managing the child’s emotional needs and guiding them to overcome the perceived stigma, it can be very demanding on all and difficult to accept. Hence, I often counsel my patients on how to adapt and live with the diagnosis.

One unique area in my work is ensuring the continuity of care for my patients as they grow older and transit to an adult-based diabetes centres. In diabetes care, rapport is fundamental in ensuring success. Especially with the teenagers, where life events (e.g. relationship issues, bad grades, etc.) or emotions (e.g. “I don’t like you”) can make a difference between whether they take their insulin or “don’t feel like it”.

This is how we help the healthcare provider from the adult centre, by providing them with information taken over 10 to 15 years of care, of the patient’s likes, dislikes, preferences, major events, to help them build a better connection.?

A pre-reg pharmacist who participated in my clinic sessions once told me that I am a ‘love pill’. She said that as she watched me prescribe medications for my patient, she could sense the love and empathy I have for each of them. It’s as though I was also infusing my heart into their medications. It was very heart-warming to hear her say that.?

Outside of work, I love to spend quality time with my husband and three children. Even simple activities like watching television and snacking together or going to the beach to watch the children play, bring me much joy and rejuvenation.

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Q: What is your favourite story about KKH (e.g. patients, colleagues; touching or inspirational moments)?

Recently one of my 20-year-old patient invited me to join his family dinner. He is a really sweet boy, and even though he has left our care, he would often come back to dine and chat with me.

At dinner, he shared with me that he wrote a ‘storybook’ for me. The book included his pictures and reflections from when he was diagnosed with Type 1 diabetes at 18 months old. It showed his journey from then, through his teenage years, to the present day as a young adult with a girlfriend.

It was an unexpected and sweet gesture, and is one of the most touching moments in my nursing life.

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Q: With many stories out there of overworked nurses, what keeps you inspired to do better and even pursue a Master’s degree and Doctor of Nursing Practice degree? Any encouraging words to nurses who are new to the industry or feeling burnt out??

Feeling burnt out in Nursing is unfortunate as we need to juggle so much work. It is important to not keep our unhappiness bottled up and not let them simmer, as it will eventually explode. Seek out avenues to share your concerns.

Identifying with and finding purpose in your work can also help reignite your passion towards patient care. Seek clarity in what you are doing and the goals you would like to achieve.