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One nurse’s 50-year nursing career should inspire us all to improve inpatient care

Debbie Hicks

In just one week, more than 60 hospital inpatients with diabetes developed a life-threatening but preventable complication, according to the recent National Diabetes Inpatient Audit (Health and Social Care Information Centre, 2013). The report says it is “shocking” that inpatients should develop diabetic ketoacidosis during their hospital stay and calls for a change in culture to recognise and address problems earlier. 

The report also found that the majority of hospitals in England and Wales made medication errors. During the five days of the audit, more than a third of inpatients with diabetes experienced a medication error. Poor levels of diabetes-trained staff were also highlighted in the report:

  • Among those who should have seen a specialist diabetes team, just 58.5% of the inpatients in England and 59% in Wales actually saw one.
  • 32.2% of sites in England and 47.1% in Wales had no diabetes inpatient specialist nurse provision.
  • 7% of sites in England had no consultant time for diabetes inpatient care. In Wales all sites had at least some consultant time.
  • 78.4% of sites in England and 64.7% in Wales did not have any specialist dietitian time for inpatient care for people with diabetes.

In response to this report, Bridget Turner, Director of Policy and Care Improvement, Diabetes UK, said:

“It is appalling that some people with diabetes are being so poorly looked after in hospitals that they are being put at risk of dying of an entirely preventable life-threatening condition. Even a single case of diabetic ketoacidosis developing in hospital is unacceptable because it suggests that insulin has been withheld from that person for some time. The fact that this is regularly happening raises serious questions about the ability of hospitals to provide even the most basic level of diabetes care.”

However, amongst all this doom and gloom is a chink of light, which has been shining for the past 50 years. Next month sees the 50th anniversary of Pat Clarke joining the nursing profession. Pat began her nurse training in August 1963 in Nottingham. After working on the wards Pat decided to move to district nursing. In 1978, Pat moved into the role of a diabetes specialist nurse. I met Pat in 1995, when I was a rookie DSN, on a trip to the USA. My three heroes in diabetes nursing were on that trip including Pat, Mary MacKinnon and Sue Cradock . I learnt so much from these nurses, which helped shape my career in diabetes nursing.

Pat is still working in diabetes nursing today, helping to enhance diabetes care delivered by a few general practices in Nottinghamshire. Pat has always been passionate about diabetes care and is a true advocate for the many people with diabetes she has helped over the years. She has an amazing skill of putting people at ease and empowering them so they feel they can deal with their diabetes. She is respected by her peers and doctors alike for her calm and compassionate approach. Long may she stay in diabetes nursing. Congratulations Pat!

In just one week, more than 60 hospital inpatients with diabetes developed a life-threatening but preventable complication, according to the recent National Diabetes Inpatient Audit (Health and Social Care Information Centre, 2013). The report says it is “shocking” that inpatients should develop diabetic ketoacidosis during their hospital stay and calls for a change in culture to recognise and address problems earlier. 

The report also found that the majority of hospitals in England and Wales made medication errors. During the five days of the audit, more than a third of inpatients with diabetes experienced a medication error. Poor levels of diabetes-trained staff were also highlighted in the report:

  • Among those who should have seen a specialist diabetes team, just 58.5% of the inpatients in England and 59% in Wales actually saw one.
  • 32.2% of sites in England and 47.1% in Wales had no diabetes inpatient specialist nurse provision.
  • 7% of sites in England had no consultant time for diabetes inpatient care. In Wales all sites had at least some consultant time.
  • 78.4% of sites in England and 64.7% in Wales did not have any specialist dietitian time for inpatient care for people with diabetes.

In response to this report, Bridget Turner, Director of Policy and Care Improvement, Diabetes UK, said:

“It is appalling that some people with diabetes are being so poorly looked after in hospitals that they are being put at risk of dying of an entirely preventable life-threatening condition. Even a single case of diabetic ketoacidosis developing in hospital is unacceptable because it suggests that insulin has been withheld from that person for some time. The fact that this is regularly happening raises serious questions about the ability of hospitals to provide even the most basic level of diabetes care.”

However, amongst all this doom and gloom is a chink of light, which has been shining for the past 50 years. Next month sees the 50th anniversary of Pat Clarke joining the nursing profession. Pat began her nurse training in August 1963 in Nottingham. After working on the wards Pat decided to move to district nursing. In 1978, Pat moved into the role of a diabetes specialist nurse. I met Pat in 1995, when I was a rookie DSN, on a trip to the USA. My three heroes in diabetes nursing were on that trip including Pat, Mary MacKinnon and Sue Cradock . I learnt so much from these nurses, which helped shape my career in diabetes nursing.

Pat is still working in diabetes nursing today, helping to enhance diabetes care delivered by a few general practices in Nottinghamshire. Pat has always been passionate about diabetes care and is a true advocate for the many people with diabetes she has helped over the years. She has an amazing skill of putting people at ease and empowering them so they feel they can deal with their diabetes. She is respected by her peers and doctors alike for her calm and compassionate approach. Long may she stay in diabetes nursing. Congratulations Pat!

REFERENCES:

Health and Social Care Information Centre (2013) National Diabetes Inpatient Audit. Available at: www.hscic.gov.uk/diabetesinpatientaudit (accessed 11.07.13)

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