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How do I become ... a diabetes consultant?

Student Nursing Times talk to Diabetes Nurse Consultant Jill Hill about what makes her job so worthwhile

Why did you decide to do this role?

“GPs and practice nurses can give an excellent holistic, local service and I felt working in the community, developing the skills of primary care colleagues and making specialist diabetes nursing services available in local venues was the future.”

What do you do in your day to day role?

“I am employed by a community trust so I don’t work in secondary care, but have still close links with local hospitals as well as GP practices, pharmacists, district nursing teams and assertive case manager teams

The nurse consultant role has 4 main components:

  • 50% expert practice: (for example, I have direct referrals for people with complex diabetes problems who I see in community nurse-led clinics. As I am a nurse-prescriber, I can assess patients, discuss treatment options and initiate medications like insulin therapy)
  • 20% education: (I run a variety of diabetes courses for health care professionals across Birmingham, as well as structured education programmes for people with type 1 and type 2 diabetes in the community)
  • 20% leadership and service development (for example, re-designing services to improve quality and cost effectiveness and adapt to the changing NHS agenda, developing local guidelines and pathways in partnership with primary, secondary and community care diabetes stakeholders)
  • 10% research and evaluation

The role is expected to have a national profile too, so I keep busy regularly writing articles and speaking at conferences and workshops locally and across the country (and internationally on occasions too!) I am involved with national diabetes issues too, for example as a member of the All-Parliamentary Diabetes group, and I am currently working with NICE on the guidelines for management of people with a high risk of developing diabetes, to delay or prevent them getting the condition. This is an important piece of work, given the increasing prevalence of diabetes (currently estimated at 2.9 million in the UK).”

What qualifications did you need for your position?

“In addition to being a registered general nurse, I needed a recognised diabetes specialist qualification, and to be educated to masters level. Non-medical prescribing, education, and managerial qualifications are desirable as well as extensive experience as a diabetes specialist nurse and in management.”

What skills are the most important for your job?

“Communication skills. Also, the ability to multi-task as the job is so varied. Clinical skills are essential as GPs refer patients to me rather than a consultant in secondary care for advanced diabetes management advice, so I have to be competent!”

What is your favourite part of your job?

“Working with people with diabetes, particularly those with type 1 diabetes. We deliver the Dose Adjustment For Normal Eating (DAFNE) in the community, which is a week-long course for about 8 people with type 1 diabetes. We cover all aspects of managing the condition, particularly enabling them to adjust their insulin to eat what they want, cope with illness etc. You get the chance to really get to know your patients in the week and we have a lot of fun! Living with diabetes is hard work and it never fails to amaze me how people cope.”

What advice would you give someone who wanted to do this role?

“Resist specialising too early. Diabetes affects all body systems and most aspects of life, so the broader your experience, the more you have to offer. Becoming a diabetes specialist nurse is a gradual process and you can access the national diabetes nursing competency framework at www.trend-uk.org to plan your diabetes.”

How can students obtain the right experience?

“Most diabetes care these days occurs in primary care, so experience in district nursing, practice nursing, and nursing homes is invaluable.

Education is a key component of the management of diabetes, so any experience in running groups, teaching, and developing communication skills is useful. These skills can be gained in everyday life, not just nursing.

Accessing diabetes information is easy. For example, Diabetes UK has a wealth of information and links on their website: www.diabetes.org.uk , and there are lots of diabetes guidelines available on the NICE website.”

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