Jill’s insightful letter raises a number of issues, many of which have been unresolved for a considerable time. When the majority of DSN posts were created in the 1980s, there was little, if any, consideration of career development, role clarity or definition, or quality of nursing care (Da Costa, 2000). This lack of foresight is also evident with the profusion of clinical nursing posts that were recently developed in response to the reduction in junior doctors’ hours (Doyal, 1998). Lack of vision and nursing seem to go hand in hand! However, it is never too late.
Jill identifies issues worthy of action and resolution; however, we must recognise that 20 years of neglect require more than a quick fix. I believe a strategy shared and owned by diabetes nursing organisations is the way forward. This will require communication and planning; prioritisation of projects with realistic objectives and timescales; and skilled management.
DSNs will also be needed to contribute in working parties which would need to be fully funded. Personnel and money are key to the success of any venture and need consideration at the outset. One of the UK Association’s objectives is to advance diabetes nursing and we would obviously contribute to resolving the issues.