Type 1: Diabetic nurses - good or bad?

[ChrisM28]

Am struggling to get my husband's BS under control (he has cognitive impairment so is being bloody awkward) but have bought Thinking Like a Pancreas and we're going to do the basal testing tonight, wish us luck! A friend asked me yesterday why we don't go to the doctor and ask to see a diabetic nurse. The reason I'm trying to do it my/ourselves is that when he went on basal/bolus 10 years ago we were sent to the DN she gave us no advice on carbs, and seemed to assume he would be eating the same food at the same time every day. After a week of highs and lows I rang for advice and was told 'Give him a couple of days off and let him eat what he fancies and just inject 16 units.' I had been researching like mad at that point and already knew that if he decided he fancied bacon and eggs and injected 16 we'd be in casualty. We did eventually get everything sorted by way of the Bernstein book (low carb) the internet and hard work.Was I wrong to lose faith in a 'professional'? What are your experiences? Were we just unlucky?
BTW how do I find this post again to see if anyone has answered?

 

[isjoberg]

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I always find that the help from nurses or doctors is only ever worthwhile if you really plan your questions well and prewarn them that you have your information and lots of questions. I used to really struggle with people palming me off with information that was too vague to be of use. Once you turn up armed with your personal (or your husband's) information and get specific, normally you do get far better solutions!

 

[sally and james]

@ChrisM28
"Human beings, good or bad?" I guess there are good and bad DN's. The one my husband saw, in my presence, just repeated the party line, couldn't answer questions which didn't appear on her mental FAQ's list, complete waste of time. We've gone down the "self taught" route, which has been very successful.
Sally

 

[Juicyj]

I agree with what's been said above - they are all different so it depends on who you see, I have had 2 DSNs now and both have been brilliant onto my third now so will wait to see but they are there to help so it's a useful resource to call upon when you need more specialist advice than a GP

 

[ChrisM28]

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I always find that the help from nurses or doctors is only ever worthwhile if you really plan your questions well and prewarn them that you have your information and lots of questions. I used to really struggle with people palming me off with information that was too vague to be of use. Once you turn up armed with your personal (or your husband's) information and get specific, normally you do get far better solutions!

Good advice, mind you I have found that they can find that threatening

 

[isjoberg]

Good advice, mind you I have found that they can find that threatening

True, but it's all about how you present it. At the end of the day everyone's diabetes is different and what works for someone may be a catastrophe for someone else. I try and approach the nurses as part of my team but new members so it's my role to fill them in and allow them to give me advice based on what I've told them rather than just blindly guessing.

 

[asparagusp]

I met my first nurse last sunmer and she introduced me to the joys of injections. All she did was provide what was needed and told to get on with it. The second nurse, I think more junior gradually took over from the first a few months ago. Both are having to cover two large hospitals in central London so not always easy to see. The present one to has forgotten recently to make an appointment with the dietitian. Both nurses are African and I have difficulty understanding them when they speak - (not being racially prejudiced)

 

[Garr]

Hi @ChrisM28 . I can only speak as I find and my DN has been absolutely useless. I asked her 3 questions not long after being diagnosed and all her answers were wrong and she spoke to me as if I was an idiot. Although my blood sugars were good she said I was taking far too much insulin, I was on low carb at the time. When I mentioned I was going low during the night she said I should increase my basal, the dietician corrected her and apparently there is no such thing as the dawn phenomenon. . I bought Think Like A Pancreas and managed to get all my answers from there. Good luck with the basal testing! That's the most important bit.

 

[smc4761]

Wow surprised at the replies so far. I was first diagnosed in early 1980's and to be honest it was quite poor, if I remember correctly. I was advised about carb counting but that was pretty much that. Used to go to diabetic clinic wait for hours see the doctor for 2 mins and that was that

Its probably only been in last 5 years or so that I have been attending clinic regularly although I have been getting eye screening regularly for many years. Saw a new doctor about 2 years ago and he was quite superb, spent a bit of time with me asking lots of questions and offering great advice. Seen another doctor on last 2 visits whilst not as good still very thorogh and helpful

They suggested going onto 2 daily Levemir injections and I saw the diabetic nurse. Again she was excellent spent plenty of time with me explaining everything in detail. Think we spent about 20 minutes just talking about life in general was well and it was a relaxing atmosphere. I was having a few issues with the Levemir and I called her. Again she spent time with me on phone and I made an appointment o see her. Another great conversation and I am feeling more positive now than I ever felt. She arranged a further appointment with her and the dietician for mid February.

Not sure if I have just been lucky but my experience prticularly in last 5 years has been a team of dedicated staff who actually take time to discuss your situation and try to help in any way they can. Appointments are well staggered at the clinic as well, so you rarely have to wait long and you are never rushed.

A big thumbs up from me for Hairmyres Hospital In East Kilbride which covers a couple of large towns

 

[azure]

I currently have a fantastic DSN. She's very knowledgeable, on the ball, and extremely helpful

My pump nurse is great too

Fortunately I was taught carb counting on diagnosis and usually adjust my own insulin anyway so don't have to contact DSNs much for that. I hope it stays that way!

 

[Jaylee]

I had a great nurse at my last surgery.. We might not have agreed on the "finer points" but she cared. & was like a "personal assistant" regarding certain aspects..

But now? They weigh, check feet, & take blood...

The rest I manage personally.
My currant nurse is "pre diabetic" & likes bananas for breakfast... What can I say to her.. It's her life not mine!

 

[CathP]

Our diabetic nurse, and in fact consultant as well are terrible. We learnt very early on that we needed to educate ourselves on our daughters care and have researched and learnt as much as we can. When newly diagnosed we were very worried as our daughter was dropping up to 9mmol over night...terrifying. They confidently told us that this was 'dawn phenomenon ' and to send her to bed at 14mmol! Fortunately we went home, read around the subject and halved her basal independently. And can now send her to bed in range! We manage her diabetes without their input and just see them for her hba1c. It's a shame, but their lack of knowledge is dangerous.

 

[tim2000s]

I think it depends what you class as "Diabetic Nurse". The Diabetic Specialist Nurses at Hospital Clinics tend to be rather better than those at GP clinics.

Mine at Guy's is excellent and very helpful, and so far has always replied to email and helped me get a pump start outside of the normal scheme.

 

[CathP]

I think it depends what you class as "Diabetic Nurse". The Diabetic Specialist Nurses at Hospital Clinics tend to be rather better than those at GP clinics.

Mine at Guy's is excellent and very helpful, and so far has always replied to email and helped me get a pump start outside of the normal scheme.

We're about to get a new paediatric diabetic specialist nurse, with no background at all in diabetes! Thank god we're not newly diagnosed...

 

[noblehead]

@ChrisM28 , if your husband is struggling with his diabetes control ask for a referral over to your local hospital diabetes clinic, they are more adapt in dealing with type 1 issues than your average gp practice so your husband will get more specialist advice.

I'm under a hospital diabetes clinic and find the DSN's really knowledgeable and helpful.

 

[ChrisM28]

@ChrisM28 , if your husband is struggling with his diabetes control ask for a referral over to your local hospital diabetes clinic, they are more adapt in dealing with type 1 issues than your average gp practice so your husband will get more specialist advice.

I'm under a hospital diabetes clinic and find the DSN's really knowledgeable and helpful.

The nurse we saw was at the hospital unfortunately!

 

[AndyS]

My DSN at hospital is brilliant (in fact all of the DSN's in the department are) though at GP's I have been sent to see their "Diabetic Nurse" who turned out to just be a nurse practitioner and was basically clueless about Basal/Bolus. When I mentioned DAFNE she was even more lost. Ask your specialist if you and hubby can get onto a DAFNE course, it is a week of your time but 100% worth it.

Was the nurse you saw at the hospital actually in the diabetes department / team or just a GN?

Other than that I would say that it really is our responsibility to learn as much as we can about our own D since we are all different and while the Dr's and Nurses might be great they aren't living with our D all the time and can only give recommendations or suggestions. Not likely they will ever be able to get it as good as we can.

Sounds like you are already well along the path of becoming your own expert. If you haven't see it yet and struggle to get on DAFNE take a look at http://www.bertieonline.org.uk/ as a great starting point. Given where you are I think some of it will be old hat to you but still worth a look.

A

 

[samantha13]

The diabetes nurse at my gp clinic is useless. Shockingly bad so I don't see her anymore. The dsn at my hospital clinic is fantastic. She is type 1 herself. I see her 6 monthly after I see my consultant but can ring her at anytime

 

[noblehead]

The nurse we saw was at the hospital unfortunately!

Right, if it's a large hospital the clinic will have a few DSN's, ask to see another and see if their advice is any better. Good luck.

 

[catherinecherub]

DSNs at Breaking Point.
https://www.nursingtimes.net/news/w...list-nurses-at-breaking-point/7013656.article