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|01 Father army. Educated abroad. 11 schools. Boarding school to get qualifications for nursing training. |
|02 SRN training, St. George`s, 1964-7. Then one year as staff nurse in diabetes ward - St. George`s required 4 years. Nowadays nursing degrees, but little practical knowledge.|
|03 Our training - 2 months PTS, then wards, supervised by ward sister. Nightingale wards at Tooting. Competency in every procedure tested. Injections worried nurses – barbed needles. |
|04 Practical experience important. |
Saw diabetics mostly in comas. No blood sugar monitoring. Urine testing imprecise.
|05 Nurses dreaded injections - units of 20, 40 & 80 – mistakes. Fewer mistakes than now, because workforce constant, nursing valued, matron helped, proud of ward & hospital. |
Didn`t see outpatients. Diabetics on wards often died.
|06 After St. George`s, married surgeon. Moved to Hastings. Ward for fractured hips. Then job making ward safe for general surgical. |
10 year career break. Moved to Sheffield. Worked briefly in operating theatres. Offered job by GP…
|07 …became practice nurse. Already had diabetes session - research programme discharged hospital clinic patients. Mixed population. Part-time, but didn`t feel it – only nurse. Practice manager. Training practice for GPs.|
|08 Practice nurses & managers new. I set up meetings with other practice nurses. (National Practice Nurses` Conference, Sheffield, 2007.) Learnt general practice is business. Rebuked for amount spent on dressings etc. – I proved only 1p per patient!|
|09 When research programme discharged hospital clinic patients, many thought they`d been cured. I set up diabetes register. Home visits. Mostly Type 2. Type 1 went to hospital.|
|10 Practice nurse 1980-5. Gradually more involved in diabetes - John Ward`s unit, Hallamshire Hospital. Met with him & GPs. Around 1983, hospital group education sessions. Early diabetes training programme run by Janet Kinson. |
Then got 3-year grant to research Sheffield GPs` diabetes services – published in BMJ.
|11 Turf wars - hospitals v. GPs. |
Janet Kinson`s course trained general nurses as specialists. Important in1980s - DSNs, blood glucose monitoring, U100 insulins.
|12 During research 1985-8, provided educational materials, learnt re different care standards. Learnt more re business – GPs could make money from having practice nurse & diabetes clinic.|
|13 Got job as diabetes nurse specialist co-ordinator – specialist & primary care. Set up diabetes course at college of nursing - later became diploma. Based at Northern General, where Colin Hardisty established diabetes centre – just me, another nurse & volunteers…|
|14 Education sessions. Space for distressed. Other staff came from outpatients to see individuals or address groups. Less a ‘cattle market` than outpatients.|
|15 Large outpatients clinics continued, but nurses taking over tasks reduced waiting. In ‘90s, people rejected same-time appointments. |
1988-99 - more physicians, specialist nurses & training - & eye screening programme. Co-operation.
|16 1999 - set up Primary Care Diabetes UK. Then Warwick Diabetes Care – became Director of Education. Formal career ended 2001.|
|17 Diagnosed myself, 1999, when taking blood sugars as part of training course. Next exercise: how to manage newly diagnosed woman!|
|18 Participants had good ideas, but helped most by man who put arm round me. Very upset.|
|19 Poor control for 2 years. Not conventional Type 2 – pancreatitis as child. Needed insulin. GP no longer wanted to treat me.|
|20 Care changed since Quality Outcomes payments. GPs paid for ticking boxes. More likely to prescribe insulin for good control. Testing good, but need personal care & education too.|
|21 Although knew re diabetes, knew nothing re own diabetes. People who`ve helped most - others with diabetes. PROUD – Professionals United by Diabetes.|
|22 Basic training improved. 2 biggest improvements – preventing amputations & blindness. |
|23 Locally, nurses` diabetes course gone. No money for nurses` education. National Service Framework for Diabetes, 2000, requires competent workforce. Successful businesses train workforce. Not NHS.|