Diabetic Nurse

nopudanymore

Member
Messages
10
I spend a large proportion of my time abroad, so was surprised to return home to a letter from my surgery's Diabetic nurse accusing me of not attending for an appointment (which had been made in my absence) In this (very haranguing) letter, she also mentioned that I missed an opportunity for her to support me in my 'very poor diabetes control'. I have therefore come to know that I am considered to have poor control by this roundabout method. And here I was, patting myself on the back. My last HbA1c was 7.5, which was down from the 9.4 previous result. I feel very depressed about all of this, particularly as I feel that from all directions I am receiving the 'message' that somehow just being a diabetic is my own fault; my 'poor control' is evidently a result of my ineptitude, despite the very many changes I have made to my diet (I'm low carbing) and exercise levels, and my inability to lose weight (I've been around the same weight for more than 20 years). I feel totally unsupported by the medical profession and am being made to feel guilty for having this condition. Do others feel this? How do they deal with it?

HbA1c 7.5
glucophage 500 mg
thyroxine 150 mg
 

viviennem

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3,140
Type of diabetes
Type 2
Treatment type
Other
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Football. Bad manners.
Why don't you write back, putting everything in your letter that you've told us, very simply and unemotionally, and suggest some times convenient to you when you could attend for an appointment?

It's not your fault. Don't let anyone make you think so! Obviously your control is improving, with the improvement in your HbA1c. Do you have your own meter and test regularly? When you see her, you could explain how much better your control would be if you were given the correct tools - particularly with travelling a lot and differences in diet/food, depending where you are.

Don't get mad - get even!

I'm very lucky in that our practice nurse acts as our diabetic nurse, and she's brilliant. I'd sooner go to her than the doc, most times.

Best of luck with her, and let us know how you get on.

Viv 8)
 
A

Anonymous

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i argee with viv.but remember they will only wont to see you so they can make the numbers ok. :twisted:
 

Unbeliever

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1,551
I totally agree wih the last poster. You may-are doing very well nopudanymore - but for the DN's purposes you need to be just one point under your last reading. Then you will find she probably won't be at all interested in you!

Don't take it personally. It is all about numbers unless you are very lucky , like Viv. There are two lovely practice nurses in my practice but unfortunately neither is the DSN.

If your next HBA1C is 7-4 or under you will find a otally different attitude.
 

anna29

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Hi, very very interesting reading this post, as I have been preached at n bulldozed by a highly ambitious DSN at my clinic to the point of her reducing me to tears. My hba1c has been 9.7% is this why she has been so beligerent with me? Have been advised to report her to my consultant and insist of a change of DSN . H ave found it extremely stressful and upsetting n hardly supportive to me. Hate even going to the building now as result of her approach and treatment to me. Is this the case how a nurse treats you is regarding Hba1c results and numbers? They can bully you if results are high and treat you better when numbers in Hba1c drop? IF this IS the case then its abuse to me.... As in my case despite a low carb and healthy well planned and thought out lifestyle my Hba1c remains high alongside high BS yet and out of control I can be victimised by a DSN . Its WRONG, ABUSE, and OUT OF ORDER and goes against my patient charter right. I am questioning this as I am yet awaiting a new DSN to continue clinical appts with. I have even requested to be treated elsewhere as a result via my consultant at my GP's advice. Anna. :(
 

Unbeliever

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1,551
I think the hardest ,yet possibly the ost difficult thing about treatmen of diabetes is finding HCP's you can trust and talk to honestly and openly.

Some people are very lucky in this way bu others are very unfortunate and I think the importance of these relationshps is underestimated.

IThere have been many posts about dreadful DSM's and many others abut very supportive and understanding DSN's. As mentioned in a recent discussion sometimes he nurses themselves are bullied and under pressure.

I hope you manage to change to another nurse soon Anna because he presen situaion isn't helping you.
I have an absolute hatred of bullying and don't put up with it from anyone - but many of these nurses would be horrified if they realised that their behaviour was perceived as bullying.

Often I think that they have too dogmatic an approach and actually can't believe that the accepted wisdom doesn't always work. if the patient only did as he'she was told there would be no problem!
Even if the patient has been trying their best to do all the right things - the figures say otherwise to someone with that mindset.

Of ourse you have to find someone more compatible who can empahise with you. and help you.
Isn't that what they are for? Gaining the patient's rust should be a priority. It could even help to achieve targets,!

There are good and bad in every profession and sometimes it is just a clash of personaliies.

Stress doesn't help anyone. No one should be dreading their appontments bu unfortunately many of us do.
 

Eiche

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Do what I do. SPEAK UP! When a doctor or nurse or receptionist is being rude and condescending or belittles your efforts, don't take it quietly. Tell them to their face what you're thinking and how they made you feel. They are not some godly being, just people like you and me who had the money to go to medical school but learned from text books just like everyone else!!! Don't sit back and take their bad bedside manner, SPEAK UP AND BE HEARD!!!
 
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Does your Diabetic nurse make appointments for you to see her? If so how fortunate you are.I met the DN once,about six years ago after diagnosis by a BUPA doctor during a periodical medical appointment that all Train Drivers get on reaching 60.Post that first visit to see her,the only time I get to see a GP about the T2 is to renew medication and a form for the A1c bood test twice a year.No strips are prescribed,as in the GP`s opinion I do not require them.Hba1c was 6.8 amonth ago,so that must be the guide.One or two acquaintences say they are sommoned by the Nurse,oft times for a ticking off.

Lucky blighters.
 

Unbeliever

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1,551
Only lucky if its helpful surely? Unfortunately that is not always the case. I hope things are changing but it has often been just a box-ticking exercise.

"Summoned for a icking off" just about hits the nail on he head.

With your levels you probablly won' be summoned. You are ticking the boxes .
 

HLW

Well-Known Member
Messages
723
Type of diabetes
Type 1
Treatment type
Insulin
When dealing with the NHS you need to remember that you are the customer - it's not a free service, it is paid for out of your taxes. NHS staff should treat you as politely as you would be expect to be treated anywhere else you are a customer, don't accept anything else.
 
Messages
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HLW said:
When dealing with the NHS you need to remember that you are the customer - it's not a free service, it is paid for out of your taxes. NHS staff should treat you as politely as you would be expect to be treated anywhere else you are a customer, don't accept anything else.

There is a receptionist at the practice that I use,who is very testing at times.There are usuallt two or three,and I avoid the one like the plague.I called for the prescripions,and also to make an appointment to see the Doctor,to arrange a blood test.She went straight into what I thought were confidential, my records, and told me"You saw her last month"I was tempted to ask "Your point being?".The other receptionist glanced across in disbelief at her antics.I suggested to the high and mighty one that I would try later to arrange an appointment, and merely moved across to the human one who gave me an appointment.
 

anna29

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Hi all, So you see there ARE some awful, condescending, ambitious, bulldozing, over confident, preaching, n judging HCP's [she pipes up with we dont judge - obviously said to diffuse her very thoughts!] I think I drew the short straw with my diabetic clinic experiences [nightmare now n wish to avoid like the plague] it left me stunned n stressed n upset, worse as I knew it shouldnt even have happened! Am yet left out here in limbo without support [thank god for this forum ] have reported it all to my consultant after taking my GP's advice and refuse to return under her care. Am awaiting letter n reply from the consultant which am told is in the post so hopefully make some form of progress? It is awful to be on the recieving end of this quality n type of care, felt bulldozed n bullied under pressure to give in n do what she wanted, surely this IS WRONG??? and she calls it she likes to challange patients!!! Even weirder am tiny in body frame n size not like I had to be firmly told to eat less or do more due to larger body frame n size. Words fail me with what n why she treated me so negatively? It still stresses n bothers me every day as am just out here in limbo without support n darent return to her care. Anna. :(
 

Unbeliever

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Messages
1,551
That woman is a bully. Pure and simple. If more people complained perhaps something would be done. it is sometimes very difficult so good for you in not accepting it.
 

Kasia

Member
Messages
8
I do sympathise with everybody who has been bullied or made to feel bad by a Diabetic Nurse. I'd like to tape one of my appointments. I've no doubt that my DN is a well-meaning woman but she treats me as if I were a naughty child. Whenever I mention a concern or worry, she pooh-poohs it. I've survived cancer and been privileged to be treated by Macmillan Cancer nurses who work in PARTNERSHIP with their patients. If a cancer patient says he/she feels exhausted then their cancer nurse believes them. They work out together what the best plan is. But when I tell my Diabetes Nurse or even my GP that I'm exhausted then they say, "That's not possible, your number is not high enough. Only people with a number over 20 feel exhausted." And since we're not allowed to self-monitor (a rule which thankfully I've broken) we never get to learn that it's the 'post-prandial-peaks' that are contributing to the exhaustion. We never get to address and fix the problem.

Have just spent a gruesome day at the DESMOND course and witnessed 2 nice, well-meaning DNs. But how small they must have made some people feel with comments like, "None of you are morbidly obese YET; Now which of you have got depression? Now if you have a reading like that you must have been naughty; How many apricots did you put on your oats? All exercise bikes end up in the garage." Yes - maybe I'm sensitive. But I'm sensitive about OTHER people's feelings and I don't think all Diabetic Nurses know how to motivate, praise and empathise. Maybe DESMOND would be better if there were one DN and one 'expert patient' who could give actual practical advice and a warm smile.

I was livid to find at the end of the DESMOND day, on a distant table in a box packed away, a set of leaflets from the Diabetic Research Unit at our local hospital inviting Type 1 and Type 2s to ring up and see if there were any clinical trials they'd like to join! Oh, and there was also a local family support group that we could also join. But the DNs clearly didn't think these enterprises worth mentioning.

End of rant!!!
If you have been ... thanks for listening.
 

anna29

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Messages
4,789
Type of diabetes
Type 2
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Cruelty to Animals/Children
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Hi all, well kasia gives some true grim examples in her post. Its dreadful to know this IS how some DSN are treating new n future diabetics and it IS happening... plus helpful literature being with held also just what the heck [being polite] is going on???? Am taking the bull by the horns [DSN team leader] on the 6th july n will insist on new sensitive human caring DSN or else will take it over n above her head [ higher powers that be ] All this should NOT be happening its WRONG .... :shock: Here I am left unsupported and in total limbo trying to cope alone n isolated with yet out of control BS. :( Anna.x
 

nopudanymore

Member
Messages
10
Thanks for all the comments and for making me feel like I'm not alone. I wrote a very calm letter which explained the situation and that I obviously couldn't have kept the appointment as I wasn't in the country. However, I have not received a reply to date...
 

nopudanymore

Member
Messages
10
Thank you all for your replies. I wrote a reasoned letter to the Practice Administrator and got a very apologetic reply saying that they would consider the points I made at their next meeting. I haven't yet been to see the diabetic nurse who wrote the letter, but have an appointment to do so in July. I have been attending to see a doctor for blood test results and advice and asked what the purpose of the diabetic nurse role was (i.e., I wanted a reasoned argument for seeing a nurse rather than a doctor). The reason I got was that in a practice of many doctors, patients may not see the same doctor on consecutive visits and the diabetic nurse keeps the records and can prescribe/change medication. I checked that I had understood correctly and asked "so it is entirely for continuity"? and was told yes. This raises far more issues than it answers, as I get the impression on here that the diabetic nurse is meant to be an 'expert' who is preferable to seeing a GP because of superior knowledge in this one area. However, if I was to be cynical I might think that the invention of a diabetes clinic is one which hives off a relatively large proportion of patients and places them in the care of a relatively junior (and therefore less well paid) member of staff, thereby saving practices money. The one occasion when I did see the diabetic nurse, she told me that I shouldn't measure my blood sugar myself (as it was against NHS guidelines) and advised me to stick to the standard low fat/high carb diet which she said was best for me (even though I knew that my blood sugars had fallen through low carbing). She did not respond adequately to the questions I asked and I felt that I was being a nuisance by asking them. I have some worries that nurses, although well educated (with the introduction of nursing degrees), do not have a medical degree and cannot make the same judgements as doctors. I say this even though doctors seem to use a computer 'tick list' to diagnose/make clinical judgements these days (making everyone feel like a collection of statistics rather than an individual). I know enough about diabetes through researching it, to understand that I know nothing - and to understand that the medical profession itself does not fully understand how it works (they don't know why gastric bypass works, for example). In my last visit, the doctor mentioned some new research which showed that a very low calorie diet for 6 weeks had successfully remitted diabetes in a number of patients (although the number of subjects was low) and advised me to read it and see what I thought (obviously not advising me to do it!).

Type 2 (1000 mg Glucophage)
Hypothyroid (1.25mg Thyroxine)
Last HBA1c 8.5 (up on previous despite doing everything the same)
 

marigold36

Active Member
Messages
25
I feel very thankful that I have a very good diabetic nurse at my practice. I feel very supported, can phone her or advice if I need it. i never feel spoken down to and she recommends medication changes but lets me decide what I want to do. Oh and I never have a problem getting test srips and she even told me this morning to test a bt more often as we have added in a new med, until I know how its going to affect me.

Just want to point out that they are not all bad and there are some good ones out there.
 

anna29

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Type of diabetes
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Liars/Manipulators/Bullying
Can I come and live next door to you? and then I can registered with her too? I have had a nightmare experience with mine! So bad I need and want to avoid her like the plague, [plus dont trust myself to be in the same room with her would lose it !!! ] Am meeting her team leader on july 6th and its pay back time.... will insist on inquest n it must NEVER EVER happen again. Am too terrified to return or even ring up as result, she has no idea of the damage she did. And I so DO envy you marigold, any houses for sale near yours??? Anna.x :)