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In uniform, 1968

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 In uniform, 1968 Mary MacKinnon, 2007
 
 
Interview 62 Mary MacKinnon

Nurse and Diabetes Education Consultant. Also has diabetes.
Born in London in 1945.


Overview: Mary MacKinnon was one of the earliest practice nurses, from 1980-85, and attended one of the earliest training courses, in 1983, for nurses wishing to specialise in diabetes. Since then, she has worked as a Diabetes Research Sister and Diabetes Service Co-ordinator in Sheffield, and in the late 1990s helped set up Primary Care Diabetes UK. She has lectured on diabetes care at the University of Warwick and was Director of Education for Warwick Diabetes Care from 2000-1. She has published throughout her career and now works as a freelance Diabetes Education Consultant. She diagnosed her own diabetes in 1999.

Please note that Overview relates to date of recording 23 April 2007

 Short samples

1 When she was training at St. George’s Hospital, London, in the 1960s, she remembers that mistakes were sometimes made, but thinks that in some ways there were more safeguards then than there are nowadays. [ 63 secs ]

2 The course she attended in 1983 was called ‘Specialising in Diabetes for Nurses’ and was set up in Birmingham by a nurse called Janet Kinson. Mary MacKinnon regards that course as one of several key developments in the 1980s. [ 58 secs ]

 
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01 Father army. Educated abroad. 11 schools. Boarding school to get qualifications for nursing training.
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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.
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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.
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04 Practical experience important.
Saw diabetics mostly in comas. No blood sugar monitoring. Urine testing imprecise.
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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.
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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…
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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.
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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!
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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.
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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.
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11 Turf wars - hospitals v. GPs.
Janet Kinson`s course trained general nurses as specialists. Important in1980s - DSNs, blood glucose monitoring, U100 insulins.
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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.
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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…
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14 Education sessions. Space for distressed. Other staff came from outpatients to see individuals or address groups. Less a ‘cattle market` than outpatients.
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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.
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16 1999 - set up Primary Care Diabetes UK. Then Warwick Diabetes Care – became Director of Education. Formal career ended 2001.
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17 Diagnosed myself, 1999, when taking blood sugars as part of training course. Next exercise: how to manage newly diagnosed woman!
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18 Participants had good ideas, but helped most by man who put arm round me. Very upset.
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19 Poor control for 2 years. Not conventional Type 2 – pancreatitis as child. Needed insulin. GP no longer wanted to treat me.
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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.
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21 Although knew re diabetes, knew nothing re own diabetes. People who`ve helped most - others with diabetes. PROUD – Professionals United by Diabetes.
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22 Basic training improved. 2 biggest improvements – preventing amputations & blindness.
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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.
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