What Powers does the Diabetic Nurse Have?

[Lenny249]

Following my recent two HbA1c blood tests of 50 (26 Sep) and 49 (14 Oct) the Dr phoned me on 17 Oct and suggested I go on medication (Metformin).

I asked her for a stay of execution for six months to try and sort myself out with diet and exercise.

She kindly agreed but said I’d benefit from an assessment with the Diabetic Nurse (DN) and has arranged for an appointment on 17 Nov.

Does it vary from practice to practice what powers the DN has? Ideally I’d like another HbA1c test 3 months from when the Dr phoned me (17 Dec).

If the DN talked me into having Metformin (unlikely) is she (in this case) the person who would up/lower the doses or does one have to go back and see the Dr on each occasion. My friend (I have one honestly) has been on Metformin for some years and told me, albeit it before I was diagnosed, that he’d had problems with it but the Dr had changed the medication to slow release and he was suiting him better.

Can the nurse prescribe monitors/strips etc (a bottle of Chivas Regal would be better!)?

Please, any pointers what I should expect from the assessment? Another blood test? Feet inspection? The Dr told me on the phone the assessment would take approximately 40 minutes.

Thanks

 

[Lainie71]

My check up would consist of a diabetic eye screening at a clinic, bloods taken at 6 month/1 year for HBA1C and urine test for cholesterol (when my BG is more stable). Health care assistant checks feet, legs for numbness etc although as yet this has not been done and will be having this done in December. I've manged to get my BG down with diet and exercise and refused meds (big heated discussion over the phone with GP). I intend to carry on without meds but I am under no illusion that at some point in my life I may need some kind of medication intervention. I think the GP/DN has the say in what meds you take but you yourself have the ultimate choice to say " yay or nay" They are there to advise. My DN prescribes the strips but they are ultimately overseen by the GP - apparently. I also self fund, the monitor was provided by the GP surgery when I was first diagnosed but I have self funded another one also. Other kind people on here will be able to tell you more, regarding their experiences with monitors etc but my understanding is if you are on meds you get the strips etc but not if you are diet and exercise. I guess I was lucky in that respect They also check your BP

 

[Grant_Vicat]

Following my recent two HbA1c blood tests of 50 (26 Sep) and 49 (14 Oct) the Dr phoned me on 17 Oct and suggested I go on medication (Metformin).

I asked her for a stay of execution for six months to try and sort myself out with diet and exercise.

She kindly agreed but said I’d benefit from an assessment with the Diabetic Nurse (DN) and has arranged for an appointment on 17 Nov.

Does it vary from practice to practice what powers the DN has? Ideally I’d like another HbA1c test 3 months from when the Dr phoned me (17 Dec).

If the DN talked me into having Metformin (unlikely) is she (in this case) the person who would up/lower the doses or does one have to go back and see the Dr on each occasion. My friend (I have one honestly) has been on Metformin for some years and told me, albeit it before I was diagnosed, that he’d had problems with it but the Dr had changed the medication to slow release and he was suiting him better.

Can the nurse prescribe monitors/strips etc (a bottle of Chivas Regal would be better!)?

Please, any pointers what I should expect from the assessment? Another blood test? Feet inspection? The Dr told me on the phone the assessment would take approximately 40 minutes.

Thanks

This link from this site is useful: https://www.diabetes.co.uk/emotions/communicating-with-healthcare-professionals.html
Of course a DN is just as variable as any other profession. But I can tell you that I once visited the Diabetes clinic having just come out of a car crash 20 minutes earlier. I suggested they didn't take my blood pressure reading until I had time to feel my pulse calm down. They took it all the same. I then went to see a new doctor and she added yet more medication to the list. When I got home I burnt the prescription! Certainly they should hear you out and, especially in your case, listen to what your doctor has said. If she still closes her ears or doesn't treat you with respect, humour her and ignore the prescription till you have been given a fair chance to see if your stay of execution works. Good luck!

 

[catinahat]

It depends on the nurse
The nurse at my GP‘s is just a nurse with no specialist diabetes training or knowledge. She is capable of checking my blood pressure, tickling my feet to see if they still have some feeling and giving out dubious dietary advice. She certainly can't diagnose, change medication or prescriptions.
There are more qualified nurses called ANP's who can assess, examine, make a diagnosis and provide treatment including a prescription if required. You might get lucky.

 

[lucylocket61]

urine test for cholesterol

Cholesterol is a blood test.

 

[Lainie71]

Cholesterol is a blood test.

They DN told me the wee test was for cholesterol, so what's the wee test for then...

 

[filly]

Following my recent two HbA1c blood tests of 50 (26 Sep) and 49 (14 Oct) the Dr phoned me on 17 Oct and suggested I go on medication (Metformin).

I asked her for a stay of execution for six months to try and sort myself out with diet and exercise.

She kindly agreed but said I’d benefit from an assessment with the Diabetic Nurse (DN) and has arranged for an appointment on 17 Nov.

Does it vary from practice to practice what powers the DN has? Ideally I’d like another HbA1c test 3 months from when the Dr phoned me (17 Dec).

If the DN talked me into having Metformin (unlikely) is she (in this case) the person who would up/lower the doses or does one have to go back and see the Dr on each occasion. My friend (I have one honestly) has been on Metformin for some years and told me, albeit it before I was diagnosed, that he’d had problems with it but the Dr had changed the medication to slow release and he was suiting him better.

Can the nurse prescribe monitors/strips etc (a bottle of Chivas Regal would be better!)?

Please, any pointers what I should expect from the assessment? Another blood test? Feet inspection? The Dr told me on the phone the assessment would take approximately 40 minutes.

Thanks

Remember it is your body. Do what you feel is right for you depending on your situation. Looks like you results are still going down all be it slowly. If you are not happy about something, say so. Feet and circulation test not a bad thing. How long have you been using diet to get your numbers down? I have someone who is not a doctor who changes my medication. Nurse practitioner. Best of Luck.

 

[lucylocket61]

They DN told me the wee test was for cholesterol, so what's the wee test for then...

Good grief. The dn doesn't know how cholesterol is tested???? The wee test is kidney function. It's sent off to a lab. Unless she is dipping a testing stick in it, in which case it's for blood sugar levels.

 

[JohnEGreen]

My DN is great she has had over 25 years of experience with diabetes patients both in the diabetes department at the local hospital and the GP's surgery'

She recently gave me a meter they don't prescribe meters but she has a supply of meters to hand out and is prescribing me strips for it though the doctor is reluctant to put them on repeat, when I have used a tub I just phone the surgery she writes out a script and it is at the pharmacy the next day who put it on delivery and it is delivered to me at home the same day.

 

[Lainie71]

Good grief. The dn doesn't know how cholesterol is tested???? The wee test is kidney function. It's sent off to a lab. Unless she is dipping a testing stick in it, in which case it's for blood sugar levels.

mmmmm.......as I said before I think she needs re educating just as I have re educated myself in the last 2 years, or so I thought

 

[ianf0ster]

Might not the urine test be for Ketones?
But anyhow it sure isn't cholesterol. Although most doctors are taking the p... when they check for total cholesterol rather than a full lipid profile.

 

[lucylocket61]

Might not the urine test be for Ketones?
But anyhow it sure isn't cholesterol. Although most doctors are taking the p... when they check for total cholesterol rather than a full lipid profile.

Not the test which they do annually. It's sealed and sent off to the labs for kidney function tests. A wee sample for ketones is done immediately by the nurse, using a dipstick.

 

[Mossy28]

Following my recent two HbA1c blood tests of 50 (26 Sep) and 49 (14 Oct) the Dr phoned me on 17 Oct and suggested I go on medication (Metformin).

I asked her for a stay of execution for six months to try and sort myself out with diet and exercise.

She kindly agreed but said I’d benefit from an assessment with the Diabetic Nurse (DN) and has arranged for an appointment on 17 Nov.

Does it vary from practice to practice what powers the DN has? Ideally I’d like another HbA1c test 3 months from when the Dr phoned me (17 Dec).

If the DN talked me into having Metformin (unlikely) is she (in this case) the person who would up/lower the doses or does one have to go back and see the Dr on each occasion. My friend (I have one honestly) has been on Metformin for some years and told me, albeit it before I was diagnosed, that he’d had problems with it but the Dr had changed the medication to slow release and he was suiting him better.

Can the nurse prescribe monitors/strips etc (a bottle of Chivas Regal would be better!)?

Please, any pointers what I should expect from the assessment? Another blood test? Feet inspection? The Dr told me on the phone the assessment would take approximately 40 minutes.

Thanks

I was diagnosed with diabetes start of covid and was told to change diet and exercise, this over the phone
Which I did and when I was able to physically see DB nurse was told I had reversed it- then bad habits came back and of course it came back.
So was put on metformin
From having a perfectly good bowel caused lots of internal problems prescribed sukkarto which again caused problems so then now on Truilcity one injection a week not perfect but far better plus increased my exercise and moderations to diet
I’ve reversed it again
I’ve learnt my lesson but I would recommend Truilcity
It’s a constant battle
Diabetes gave me a scare as a new grandfather and I want to be in my granddaughter’s life for a long time

 

[Lainie71]

Not the test which they do annually. It's sealed and sent off to the labs for kidney function tests. A wee sample for ketones is done immediately by the nurse, using a dipstick.

Yer the second time I had my hba1c the vampire nurse took the blood then dipped the urine and said it was fine! The last couple of times its been a case of "no the lab deals with that" so I have no idea where my wee is going and what for

 

[lucylocket61]

Yer the second time I had my hba1c the vampire nurse took the blood then dipped the urine and said it was fine! The last couple of times its been a case of "no the lab deals with that" so I have no idea where my wee is going and what for

And now you know : )) it's being tested to check your kidney function.

 

[Lainie71]

And now you know : )) it's being tested to check your kidney function.

Yerp I do now and have yet again learned more here than through the dn

 

[MrsA2]

Does it vary from practice to practice what powers the DN has?

Yes, and knowledge, and experience, and training, and empathy
And availability, and manner

 

[onnecar]

Following my recent two HbA1c blood tests of 50 (26 Sep) and 49 (14 Oct) the Dr phoned me on 17 Oct and suggested I go on medication (Metformin).

I asked her for a stay of execution for six months to try and sort myself out with diet and exercise.

She kindly agreed but said I’d benefit from an assessment with the Diabetic Nurse (DN) and has arranged for an appointment on 17 Nov.

Does it vary from practice to practice what powers the DN has? Ideally I’d like another HbA1c test 3 months from when the Dr phoned me (17 Dec).

If the DN talked me into having Metformin (unlikely) is she (in this case) the person who would up/lower the doses or does one have to go back and see the Dr on each occasion. My friend (I have one honestly) has been on Metformin for some years and told me, albeit it before I was diagnosed, that he’d had problems with it but the Dr had changed the medication to slow release and he was suiting him better.

Can the nurse prescribe monitors/strips etc (a bottle of Chivas Regal would be better!)?

Please, any pointers what I should expect from the assessment? Another blood test? Feet inspection? The Dr told me on the phone the assessment would take approximately 40 minutes.

Thanks

The short answer is yes the DN deals with everything post diagnosis, unless there are complications. They are specialists and often have more knowledge than the doctors in their specialist field. They do indeed have the power to prescribe and change meds and to issue monitors, strips etc. However, they can only advise and ultimately it is down to you, what you agree to, regarding treatment, diet control etc.

 

[Lenny249]

How long have you been using diet to get your numbers down?

Thanks

I was given my 1st figure of 50 on the afternoon of 11th Oct
I cut out the carbs and took to the pavements
2nd Blood Test on 14th Oct at 0830 hrs
I was given my 2nd figure of 49 on 17th Oct

By my recconing I reduced my figure by one point in just over 2 days?

 

[Rokaab]

Thanks

I was given my 1st figure of 50 on the afternoon of 11th Oct
I cut out the carbs and took to the pavements
2nd Blood Test on 14th Oct at 0830 hrs
I was given my 2nd figure of 49 on 17th Oct

By my recconing I reduced my figure by one point in just over 2 days?

Nope. afraid not , its within the margin of error for that test
The HbA1c is an average over 3 months, weighted more to the recent weeks, so in essence it was just a confirmation blood test that the original HbA1c was correct that you are diabetic. Basically 2 days of changes wouldn't really change it because of how it works