Specialist nurses keep care in the community

There are plenty of fond farewells for Kirsten Hatton as she packs her bag and heads off from the monthly diabetes clinic at Woodend Medical Centre.

Practice nurse Marilyn Herbert-Spain (left) with community diabetes nurse specialist Kirsten Hatton.

The community diabetes nurse specialist has seen 4 patients with complex diabetes issues in the last 3 hours and after a debriefing with practice nurse Marilyn Herbert-Spain is setting out to visit another patient, 26 kilometres away in New Brighton.

Woodend Medical Centre is one of 110 general practices that Kirsten, two other community diabetes nurse specialists and a community diabetes dietitian visit regularly to assist with diabetes patients. Support is also provided by a GP liaison.

Kirsten says their roles were established in 2011, through Canterbury District Health Board’s Canterbury Initiative, in response to ‘a tsunami of patients with type 2 diabetes’.

Sole general practitioner Steven McGregor has 73 patients with diabetes on his register at Woodend, which he manages on a day-to-day basis with Marilyn.

With Kirsten running a monthly clinic at his practice, he says his patients with complex diabetes issues are receiving the time they need for the best management of their condition. ‘I rely on her, especially in introducing people to insulin. Kirsten is the expert. She knows more than I will ever know about the subject,’ he says.

GP Steven McGregor

Before Kirsten and her predecessor began visiting his surgery, he says he would have referred people with complex issues to the Diabetes Centre. ‘I still liaise with them (the Centre) and some patients need to go there but having the clinics means that we tackle things earlier. I think the diabetes management here has greatly improved.’

Marilyn says the introduction of community diabetes nurse specialists has made her much more confident in supporting people with diabetes to manage their condition. ‘Kirsten also has a great way of describing what diabetes is and how it affects people. Once people comprehend what is happening, it is easier to support them.’

The community diabetes service also provides a conduit between specialist diabetes services and general practice.

Kirsten says the team has weekly meetings at the Diabetes Centre, where community referrals are discussed, along with monthly meetings with the Diabetes Centre nurses. ‘We also liaise with district nurses regarding insulin administration in the community and run education sessions for nurses, pharmacists and general practice teams.’

‘Primary care for people with diabetes is much wider than just nurses and doctors. Pharmacists play a key role in supporting people. For example, when people receive a script for their insulin, a pharmacist can ensure they also have enough insulin needles. People need to change these daily but are not always aware of this and sometimes we find they don’t ask for needles to be prescribed as they have stockpiles at home.’

Kirsten says she loves her job and hopes that over time community diabetes nurse specialists and dietitians will become even more valued in the system. ‘It’s still fairly new and people are adjusting to the part we can play in supporting other health practitioners and helping people to better manage their diabetes.’

This story is part of Canterbury finds better ways to care for diabetes patients.

Read the next story in this series: The way to kickstart your day.

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