Response: Clinical practice is the starting point

In reply to the above response made by Eileen Padmore in relation to the article Career Framework for the DSN (Journal of Diabetes Nursing 3(5): 136–8), I would like to say that the statement ‘…a DSN may decide to move back to a more clinical role rather than continue in a managerial role’ was in no way intended to suggest that clinical activity was less important than management activity.

Although the use of the word ‘back’ may suggest regression to some, isn’t that where we all start from – in clinical practice that is? Therefore, going back to a more clinically based role should not immediately suggest a negative move.

I agree with Eileen that any nurse managing in a formal sense should always have the patient as the main focus, and maintain clinical credibility by clinical practice. I believe that some DSNs around the country, who are in a dual role including managing the team and/or the diabetes centre, are in a unique position in that they not only have access to patient views, but can also take those views into consideration when planning future services.