Lorna Bingham has been a specialist diabetes nurse with Capital & Coast DHB for 20 years.
She works closely with practices such as Karori Medical Centre, supporting practice nurses like Jacqui Levine and Heather Wilson with their diabetes nurse-led clinics. Jacqui and Heather are now able to start people on insulin, something they didn’t have the specialist knowledge to do before.
Once a month Lorna attends specialist consultations with Jacqui and Heather when they see some of their more complex patients, so they can see how Lorna approaches things – for example, raising with someone that it might be time to move to insulin.
‘Sometimes it takes a bit to tease out what the issue really is. Because of my clinical experience over the years, I can pick up some of the more subtle things, such as what a patient’s real concerns about moving onto insulin are and how we can address these concerns – making the transition to insulin easier.’
Lorna also sees patients at the Wellington Hospital diabetes clinic, runs courses for GPs and practice nurses on starting insulin, and offers free cardiovascular risk assessments at community events.
She strongly supports insulin being prescribed by GPs, rather than having to be prescribed by a hospital doctor. ‘It means everything is kept on one record in the same place, making it easier to see whether patients are up-to-date with their prescriptions and picking them up as they should be.’
Lorna says the connection and liaison between community care and hospital care is the most important thing of all. ‘It’s about being very clear who’s looking after the patient. If someone is sent to a hospital clinic but doesn’t go to their appointment, there is a risk they will miss out on care. However when the specialist works with general practices, we know who is seeing the patient and that they are not falling through the cracks.
Poorly controlled diabetes contributes to kidney failure and Lorna says improving diabetes control will mean fewer people will require dialysis for kidney failure in the future.
‘At Capital & Coast DHB we have introduced a new model of care where specialist diabetes nurses will be linked with general practices, just like we are doing in Karori Medical Centre. I believe that in 5 years’ time we’ll really see a difference and hopefully a reduction in the long term complications of diabetes.’
This story is part of Karori Medical Centre – Supporting patients with diabetes and cardiovascular disease.
Read the next story in this series: Specialist training for practice nurses means people can be treated by those they know.