Elena Cuaderes may not walk that proverbial mile in others’ shoes, but she does help people with diabetes do so.
Cuaderes, an associate professor of nursing at the University of Oklahoma, knows that one of the best, safest, affordable and most accessible forms of exercise is walking. But for certain patients with diabetes – specifically, those with neuropathy of the foot – even this usually safe form of exercise poses special hazards.
In three research studies that she has conducted among Native American adults, Cuaderes said that walking was the most frequently cited favorite form of exercise. For those with diabetes and peripheral neuropathy, though, the walking habits acquired over a lifetime can result in additional damage. Unfortunately, she said, too often when people with these health issues are warned against walking for exercise, they cease to do any real exercise at all, which of course is extremely detrimental to their health.
“Just as there are recommendations for exercising in terms of frequency, duration and intensity to prevent acute heart episodes and muscle injury, there are recommendations for preventing foot changes that can lead to injury,” says Cuaderes, noting that her research focuses on walking patterns, changes to the plantar – the bowstring-like tissue stretching from the heel beneath the sole – and tools that clinicians can use to help patients determine the right walking pattern for them.
In addition to her research, Cuaderes’ main teaching role for some 17 years involved supervising students in the neonatal and adult critical care and medical surgical areas. She said she still runs into former students who thank her for challenging them as students.
Recently, Cuaderes switched her teaching focus, and is now teaching nursing critical care concepts and skills through the college’s new high-fidelity simulation lab, procured through a joint effort of the college and the Nursing Academy program of the Veterans Administration Medical Center. Established only a few months ago, the lab resembles a patient room, complete with hospital bed, a computer for electronic medical documentation, a heart monitor, and other equipment. Audio-video technology enables the faculty and clinicians to record the students as they practice their nursing skills on the simulator or patient.
Cuaderes teaches two simulation scenarios – Code Blue and sepsis – to senior students, both traditional and ABSN, during their critical care rotations. She and another OUCN faculty member who is using the lab to teach nursing assessment techniques, hope eventually to expand the program to include participation by all undergraduate students every semester. Currently, the lab at the OU Health Sciences Center, as well as those at the college’s Tulsa and Lawton campuses, includes simulators that allow students to learn such interventions as assessment (e.g., pulse palpitations, listening for heart tones), intravenous and urinary catheter insertion, and observation and interpretation of echocardiogram wave forms. In the future, they hope to add other simulators that will allow students to, for instance, practice pediatric and infant scenarios.
Growing up in Norman and Oklahoma City, Cuaderes said it was a natural progression for her to attend OU. She was helped along in her decision to pursue nursing by another nursing student, two years her senior, who shared stories about her experiences in nursing and with nursing school. Another source of inspiration was her mother, a student in the OU College of Nursing in 1948 when she met the man who was to become her husband. After a short (eight-week) courtship, they married, and she left nursing school to raise her family.
Elena Cuaderes stuck with the program, however, earning both her bachelor and master of science degrees from the OU College of Nursing, and then going on to earn her doctoral degree from Texas Women’s University. Before coming to OU, she practiced nursing at Presbyterian, Norman, Baptist and Children’s hospitals.
Cuaderes says she is very proud to serve on the OUCN faculty, and in fact, calls this her “claim to fame.”
“Our college always seems to be in the forefront of the state of Oklahoma regarding the nursing profession,” she said. “When I tell people that I work at the OU Health Sciences Center, specifically in the College of Nursing, I know that they are impressed.”
One might think that this busy teacher, researcher, wife, mother of four and grandmother of one would have little or no time left in the day for play. Somehow, she finds time to exercise (practicing what she preaches), and she and her husband enjoy traveling to state and national parks to hike and observe nature, and they also like to visit Civil War military parks.
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