Where's the NHS logic????

[chocoholicnomore]

I just wonder where IS the NHS logic???

Anyone who read my post last Monday in the metformin and hypos thread will know that I was given a meter and strips last week and told to come back today.
Well, I went back today, meter in hand. I asked if I would be keeping the meter and when she said "yes" I asked for a prescription for strips as I had ran out on Friday. She checked my readings, which were between 7 and low 9s, and advised me that I don't need to test anymore and won't need strips.
She then went on to discuss my metformin which is currently 1x 500mg in evening. She asked my morning BG reading and when I said usually 7. something she told me to increase my metformin and take another 500 mg in the mornings. She advised me that I am aiming for fasting reading to be under 6.
I am generally a shy, non argumentative, non confrontational person so I accepted what she said and left.
Only once I was in the car did I realise :idea: :idea: "How am I supposed to check morning readings without any strips?"

I have already bought my own meter and strips after reading advice on here but she doesn't know that :!:

I thought I had struck gold last week when she gave me a meter :!: :!: Obviously not

Anyway that's my rant over. I know I am not alone and I probably should have said something to her. Maybe next time.

 

[Unbeliever]

I think I might ring her and ask if she could clarify the position for you. As you are new to it all you are feeling a little confused.
She old you to aim for fasing readings of 6 Obviously she meant you to keep on testing until you had achieved his - but you think you may have forgotten to mention that you were out of strips so could you please have another prescription?
Probably worh a try. Sounds as though she may have had somehing else on her mind.

 

[Sid Bonkers]

Only once I was in the car did I realise :idea: :idea: "How am I supposed to check morning readings without any strips?"

As I see it the only alternative is to use witchcraft

Seriously, I would use what your nurse has said and what the NICE recommends to build your case for test strips, why would NICE set recommended levels if you have no way of knowing if you are achieving them???

I dont suppose the argument will make any difference but personally I would enjoy trying, if only to show that you know she is in the wrong

Good luck.

 

[Grazer]

am generally a shy, non argumentative, non confrontational person so I accepted what she said and left

Hi. Sid's right; (makes a change! :lol: ); you should use the NICE argument that says testing should form part of the "structured education" that enables us to manage our diabetes. If you're shy, you may find it difficult to put your point across face-to-face if you get in a flap as some people do. Have you thought of writing a letter? If you laid out your arguments in a letter when you can sit down calmly and rationally, you could then go in to see her and just say "did you read my letter?" and ask for her views. You might find it easier just to rebut any negative views she might have than to make your entire case in front of her. Who knows, she might just say "good point" and give you your strips!

 

[chocoholicnomore]

I attended week 1 of X-pert education course today and asked about testing and strips.
It was a diabetic specialist nurse who took the course and she re-iterated loads of times throughout that there is no need for T2s to test. Her quotes included "it is cheaper to provide metformin than strips" and "people make holes in their fingers 8 or 9 times a day for nothing" and "in the past people found it distressing when not achieving good readings" and "the hb1ac reading provides all the information that is needed" and "where's the point of testing if you can't do anything about the result".
I tried to argue the points about being in control and good management etc etc but she was more confident than me and gave a good talk. She sounded plausible and nobody else seemed to disagree with her so, me being me, gave in

Maybe once I have more knowledge and confidence then I will try again to argue the case for testing. In the meantime I will just have to buy my own strips and in her words "make holes in my fingers for nothing" :?

 

[ladybird64]

Hi Marina

The "Desmond" course was briefly mentioned to me when I was diagnosed with diabetes. I refused at the time because I really did not have the spare time to go and also because I wanted to do my own research first.

Although I am the first to admit I am probably a nighmare patient (I question EVERYTHING!), if it is running along the same lines as the general NHS lines, no strips, fill up on carbs etc then I don't want to know.
All the comments made by the DSN on your course are the kind of nonsense that seems to be trotted out regularly by HCP's and as far as I can see, have no grounding in reality.

I have noticed that this seems to be common thinking by these people and I wonder why? Do they themselves go on a course where some imbecile tells them that there is a whole massive group of type 2's stabbing away at their fingers all day long just for the sheer pleasure of looking at results they are incapable of deciphering? Sounds like another HCP opinion that was raised here recently, that we can all become " a wee bit obsessed" with self testing..funnily enough, a good few of us were hoping that the lady in question would return after her talk to other HCP's but seems like that isn't going to happen.

I think the only conclusion that can be drawn is that a lot of HCP's (not all, apparently there are some smart ones out there!) are under the impression that we lose our ability for rational thought and behaviour when we become diabetic. That can be the only reason for the patronising, condescending comments such as those you have encountered on your course.

As for the remark about not being able to do anything about bg results..perhaps you could point her in the direction of this forum. She will find plenty who are changing the outcome of their results and doing so in a positive manner.

Go on Marina..give her the link to this site. :wink: Will give you some back up in your argument!

By the way..good for you for having a go at arguing the case for self testing..not easy to do in a room full of strangers!

A x

 

[Unbeliever]

When they say you can't do anything about you results I think they mean in the short term or immediately. This is not true of course.
My DSN seems utterly shaneless to me. In the past when my readings were high{ due to stress and inability to exercise because of visual problems} she spent her whole time pestering me to begoin t insulin. Becuase I had very little faith in her knowledge of medication {wih good reason} and I would have been taking insulin and medicaiton , I fought tooth and nail to avoid this,

Now my control is much better she just agrees to everything I say because I am no longer messing up her figures. She seems to find it quite amusing that she doesn't remember the names of new drugs and treatments so I am guessing that few patients are offered these treatments

It is all the more worrying because the Gps in my practice dissociate themselves from anything connected with diabetes.

I read a suggesion on the DUK site a few monhs ago that specialist nurses would take over the mangement of several different diseases and conditions. Replace Gps in fact.This has already happened in effect.in my practice. I imagine it is so that Practices can discard expensive patients such as ldiabetics .

If this is to happen then the sort of thing the Diabetic Nurses are saying becomes even more frightening.

 

[byte83]

Went on living with diabetes course run by the local dietician, She said anyone who takes drugs which increase risk of hypo (glic, insulin etc) should have a meter. In our pack she had put letter that can be given to gp/nurse stating this (she works with the local diabetic clinic). Also told us that carbs raise bg and should try n cut down. and that stress is a factor in onset (was with me). We are lucky in this area for diabetic treatment but everything else it is utter rubbish for.