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Diabetes review at new practice

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rockin67

Newbie
Messages
4
Well, I had a very bizarre experience at my so-called diabetes review. Here's some snippets.

DN: Do you have difficulty attending appointments?
Me: No, why?
DN: You missed one...
Me: No, you cancelled it, as you were sick!

DN, I can't find a pedal pulse...
Me: Use ultrasound
DN: I dont have one
Me: I was a nurse for 15 years, I can feel it, can I show you where it is?
DN: No, I will refer you to PODIATRY

Me: Heres my blood pressures for last month
DN: What is it ?
Me: Its a printout of twice daily pressures for last month
DN: I dont know what that is
Me: What do you mean? Its just a printout from my home monitor, I give it to my GP
DN: No, you need to write it down
Me: Write what down, all the readings are printed
Me: Ok, lets try and get back on track, you seem a little hostile , whats my liver results looking like
DN: I dont know
Me: Errrrmm just look under under results

DN: I see you have had pneumonia in 2000, dont know what you were doing then
Me: OK, I dont recall that, is it relevant in some way?
DN: Well, it says it there (points at screen)

DN: Your cholesterol is ok, but you may benefit from statins
Me: My thyroid is ok too, perhaps I would benefit from levothyroxine

DN: What are your goals for the next year
Me: Is this some sort of joke?

Needless to say it was a waste of an hour, very surreal. she was determined to just work through a work sheet and speak to me as if I was 5. I am diabetic, I am not a small child.

The diet or the fact I am overweight wasn't mentioned. Anyone else had strange experiences ?
 
Hi rockin67 and welcome to the Forum. You may well have seen @daisy1 ’s post but I’ll tag her for her welcome info post in case you haven’t.
I’m sorry to hear about your experience with the nurse. A lot of people post about Drs and nurses appearing to just tick off check lists and not treating you as a whole person. I have been lucky in that I’ve only ever seen my GP (I don’t think there’s a nurse specialist at my practice) and he spends plenty of time with me having proper two way adult conversations.
 
rockin67 said:
Well, I had a very bizarre experience at my so-called diabetes review. Here's some snippets.

DN: Do you have difficulty attending appointments?
Me: No, why?
DN: You missed one...
Me: No, you cancelled it, as you were sick!

DN, I can't find a pedal pulse...
Me: Use ultrasound
DN: I dont have one
Me: I was a nurse for 15 years, I can feel it, can I show you where it is?
DN: No, I will refer you to PODIATRY

Me: Heres my blood pressures for last month
DN: What is it ?
Me: Its a printout of twice daily pressures for last month
DN: I dont know what that is
Me: What do you mean? Its just a printout from my home monitor, I give it to my GP
DN: No, you need to write it down
Me: Write what down, all the readings are printed
Me: Ok, lets try and get back on track, you seem a little hostile , whats my liver results looking like
DN: I dont know
Me: Errrrmm just look under under results

DN: I see you have had pneumonia in 2000, dont know what you were doing then
Me: OK, I dont recall that, is it relevant in some way?
DN: Well, it says it there (points at screen)

DN: Your cholesterol is ok, but you may benefit from statins
Me: My thyroid is ok too, perhaps I would benefit from levothyroxine

DN: What are your goals for the next year
Me: Is this some sort of joke?

Needless to say it was a waste of an hour, very surreal. she was determined to just work through a work sheet and speak to me as if I was 5. I am diabetic, I am not a small child.

The diet or the fact I am overweight wasn't mentioned. Anyone else had strange experiences ?
Click to expand...

That was so bizarre that, by comparison, my GP seems like the most humane, receptive, understanding person ever.

I've also posted about my GP, as many here have, after a bizarre encounter with him in which it becomes apparent we know better about T2.

But now I feel I want to defend my GP - the best thing he ever did, on a non-diabetes issue, was after assessing me based on my reported symptoms, asked: "what did you think the problem was?" and I told him that I'd looked things up on Google and thought it might be a certain thing. Rather than getting annoyed, he immediately told me to strip off and he checked for all the signs of that thing.

I think he's pretty useless at reading up on the latest science of T2, but compared to your GP, at least he's receptive to patient input and can, in the right scenario, respond well to a patient telling him what they think the problem might be.
 
rockin67 said:
DN: Your cholesterol is ok, but you may benefit from statins
Me: My thyroid is ok too, perhaps I would benefit from levothyroxine
Click to expand...

A brilliant response! Well done.

Yes, I have had experiences like this regarding my other conditions, including from hospital specialists, even heads of departments.

Honestly, sometimes it takes the patience of a saint to put up with these people.

I'm so lucky that my GP and DN are the opposite and provide wonderful, respectful care.
 
@morlena

Hello Morlena and welcome to the Forum :) Here is the Basic Information we give to new members and I hope you will find it useful and interesting. Ask as many questions as you need to and someone will try and help.


BASIC INFORMATION FOR NEW MEMBERS

Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you'll find well over 235,000 people who are demonstrating this.

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

The role of carbohydrate

Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

The bad news

Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

The good news

People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

Controlling your carbs

The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.

There are two approaches to controlling your carbs:
  • Reduce your carbohydrate intake
  • Choose ‘better’ carbohydrates
Reduce your carbohydrates

A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

Choosing better carbohydrates

The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

Read more on carbohydrates and diabetes.

Over 145,000 people have taken part in the Low Carb Program - a 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.

Eating what works for you

Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

The blood sugar ranges recommended by NICE are as follows:

Blood glucose ranges for type 2 diabetes
  • Before meals: 4 to 7 mmol/l
  • 2 hours after meals: under 8.5 mmol/l
Blood glucose ranges for type 1 diabetes (adults)
  • Before meals: 4 to 7 mmol/l
  • 2 hours after meals: under 9 mmol/l
Blood glucose ranges for type 1 diabetes (children)
  • Before meals: 4 to 8 mmol/l
  • 2 hours after meals: under 10 mmol/l
However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

Access to blood glucose test strips

The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:
  • structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
  • self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to blood glucose testing supplies.

You may also be interested to read questions to ask at a diabetic clinic.

Note: This post has been edited from Sue/Ken's post to include up to date information.
Take part in Diabetes.co.uk digital education programs and improve your understanding. Most of these are free.

  • Low Carb Program - it's made front-page news of the New Scientist and The Times. Developed with 20,000 people with type 2 diabetes; 96% of people who take part recommend it... find out why

  • Hypo Program - improve your understanding of hypos. There's a version for people with diabetes, parents/guardians of children with type 1, children with type 1 diabetes, teachers and HCPs.
 
Wow. I'm so lucky. The two DNs I've had (the first one left) are really good. Both have always treated me as a knowledgeable adult and accept my BP readings sheet. My diabetes GP although a good GP was useless on the diabetes front so I'm pleased I was referred to the surgery DN for reviews.
 
rockin67 said:
Well, I had a very bizarre experience at my so-called diabetes review. Here's some snippets.

DN: Do you have difficulty attending appointments?
Me: No, why?
DN: You missed one...
Me: No, you cancelled it, as you were sick!

DN, I can't find a pedal pulse...
Me: Use ultrasound
DN: I dont have one
Me: I was a nurse for 15 years, I can feel it, can I show you where it is?
DN: No, I will refer you to PODIATRY

Me: Heres my blood pressures for last month
DN: What is it ?
Me: Its a printout of twice daily pressures for last month
DN: I dont know what that is
Me: What do you mean? Its just a printout from my home monitor, I give it to my GP
DN: No, you need to write it down
Me: Write what down, all the readings are printed
Me: Ok, lets try and get back on track, you seem a little hostile , whats my liver results looking like
DN: I dont know
Me: Errrrmm just look under under results

DN: I see you have had pneumonia in 2000, dont know what you were doing then
Me: OK, I dont recall that, is it relevant in some way?
DN: Well, it says it there (points at screen)

DN: Your cholesterol is ok, but you may benefit from statins
Me: My thyroid is ok too, perhaps I would benefit from levothyroxine

DN: What are your goals for the next year
Me: Is this some sort of joke?

Needless to say it was a waste of an hour, very surreal. she was determined to just work through a work sheet and speak to me as if I was 5. I am diabetic, I am not a small child.

The diet or the fact I am overweight wasn't mentioned. Anyone else had strange experiences ?
Click to expand...
Oh dear. Both the DNs I've seen have always left me wondering why I bothered with the appointment.
 
AdamJames said:
That was so bizarre that, by comparison, my GP seems like the most humane, receptive, understanding person ever.

I've also posted about my GP, as many here have, after a bizarre encounter with him in which it becomes apparent we know better about T2.

But now I feel I want to defend my GP - the best thing he ever did, on a non-diabetes issue, was after assessing me based on my reported symptoms, asked: "what did you think the problem was?" and I told him that I'd looked things up on Google and thought it might be a certain thing. Rather than getting annoyed, he immediately told me to strip off and he checked for all the signs of that thing.

I think he's pretty useless at reading up on the latest science of T2, but compared to your GP, at least he's receptive to patient input and can, in the right scenario, respond well to a patient telling him what they think the problem might be.
Click to expand...
I think, basically, we just picked the wrong condition. Anything else, and they would do their best to look after you. I have always received good treatment for all my problems pre- diabetes. After diagnosis it's just been awful.
 
Last edited:
rockin67 said:
...she was determined to just work through a work sheet and speak to me as if I was 5. I am diabetic, I am not a small child.

The diet or the fact I am overweight wasn't mentioned. Anyone else had strange experiences ?
Click to expand...

As a fellow nurse, I cringe when I read things like this. Another nurse in a GP practice who is out of their depth, lacking the skills and knowledge to conduct an assessment based on individual patient need and terrified of stepping off the protocol in order to give personalised care; sadly it is much too common.

~heath
 
rockin67 said:
Well, I had a very bizarre experience at my so-called diabetes review. Here's some snippets.

DN: Do you have difficulty attending appointments?
Me: No, why?
DN: You missed one...
Me: No, you cancelled it, as you were sick!

DN, I can't find a pedal pulse...
Me: Use ultrasound
DN: I dont have one
Me: I was a nurse for 15 years, I can feel it, can I show you where it is?
DN: No, I will refer you to PODIATRY

Me: Heres my blood pressures for last month
DN: What is it ?
Me: Its a printout of twice daily pressures for last month
DN: I dont know what that is
Me: What do you mean? Its just a printout from my home monitor, I give it to my GP
DN: No, you need to write it down
Me: Write what down, all the readings are printed
Me: Ok, lets try and get back on track, you seem a little hostile , whats my liver results looking like
DN: I dont know
Me: Errrrmm just look under under results

DN: I see you have had pneumonia in 2000, dont know what you were doing then
Me: OK, I dont recall that, is it relevant in some way?
DN: Well, it says it there (points at screen)

DN: Your cholesterol is ok, but you may benefit from statins
Me: My thyroid is ok too, perhaps I would benefit from levothyroxine

DN: What are your goals for the next year
Me: Is this some sort of joke?

Needless to say it was a waste of an hour, very surreal. she was determined to just work through a work sheet and speak to me as if I was 5. I am diabetic, I am not a small child.

The diet or the fact I am overweight wasn't mentioned. Anyone else had strange experiences ?
Click to expand...
This deserves a winner hug and all, as such a situation should be in place for anyone from any surgery or person appointed, indicates, following a check list, not taking individuals situation explanations given, should not continue in their role, even if they are following rules of the system, that is not to say the system is always right, and seems total lack of respect for a patient has taken place. Appalling, especially you had gone to lengths of taking printed update and records of your situation to be ignored in that format style, is deplorable you were subjected to this.
 
I'm seriously considering just sending in the 'answers' to the Diabetes nurse when my next review is due. I can fill in tick boxes just as easily as she does, and I won't get in such a stressed out state either, if I do this ;)
 
liarsdance said:
As a fellow nurse, I cringe when I read things like this. Another nurse in a GP practice who is out of their depth, lacking the skills and knowledge to conduct an assessment based on individual patient need and terrified of stepping off the protocol in order to give personalised care; sadly it is much too common.

~heath
Click to expand...
IMHO it's an indictment on the recruitment, selection and management process at the practice. When selecting job candidates, they should find a way to assess a nurse to see if he or she has the skills to do it the right way. (As you will know), medical exams involve a test case with signs and symptoms laid among the breadcrumbs to see if the student will pick up the trail. I think the same approach could be used with nurses.

The risk of hiring and not sufficiently re-training a nurse like this one is that life threatening issues will be missed but, more commonly, the patient will be put off complying with their therapy and monitoring regime, only to come back to the practice later with major consequences like actual diabetic complications.

It makes me annoyed for the patients AND for the rest of the nursing profession, who can be tarred with the same brush through no fault of their own.

Venting over. I feel better for it, thanks for listening.;)
 
Energize said:
I'm seriously considering just sending in the 'answers' to the Diabetes nurse when my next review is due. I can fill in tick boxes just as easily as she does, and I won't get in such a stressed out state either, if I do this ;)
Click to expand...
When I've had situations like this, I mention it to my GP, in a way that lets him know the essence of the problem, but that I don't want to be associated with having told him, and I don't want the nurse to be ripped to shreds by her boss. He is always happy to hear the feedback because it improves patient safety.

It's GPs and specialists and nurse managers who have to clean up the messes made by the poor performance of others. I've even "reported on" a specialist (consultant) head of dept when he stepped way out of line. I only blow the whistle on people to a doctor I trust, as it's not worth my while to have it backfire on me and affect my own care.
 
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