On the day of the NHS 75th anniversary, Jo Reed talks to us about her unique role as a Diabetes Specialist Nurse (DSN) dedicated to the Renal team at Imperial College in London.
My time is split between inpatient and outpatient care of diabetes patients with renal disease of any modality. I educate our healthcare professionals and lecture at the local university.
How did you develop an interest in diabetes?
As far back as when I was a student nurse, at Southmead Hospital in Bristol, I was interested in diabetes. When I trained, we had many patients who unfortunately had renal disease alongside their diabetes which was pretty devastating to witness as the consequences were grave.
Of course, at that time diabetes was much more difficult to manage. Some of the more mature readers will remember glass syringes, different strengths of insulin (the maths that went with this was never my strong point but somehow it fell into place), Clinitest and the real ‘BM sticks’ used for testing blood glucose.
As my career progressed, I broadened my perspective of diabetes care by working in acute and community care, which really helped my insight and understanding.
And last but not least, my brother had a friend at school who had type 1 diabetes from a young age. He is now my husband of more than 30 years which means I live both sides of the patient experience and can appreciate how difficult this is to live with day to day.
What do you find most challenging and rewarding about your role?
Diabetic nephropathy is the single largest cause of end-stage renal failure, and as the number of diabetes cases continues to increase dramatically, the incidence of chronic kidney disease follows, so the pressure is on.
Renal and diabetes care are both highly specialised areas and a lack of coordination between the two can result in unstructured and unsafe care for our patients, so it’s important to join the two specialities to prevent this happening. I feel very strongly that we need to work together to support each other in this important work.
This is a unique role where I’m privileged to work within the Imperial renal team. I was on a big learning curve when I first started and would not have been able to navigate my way through it without the support of other specialist nurses who worked in similar roles. Now things have come full circle and it’s really rewarding to regularly share that knowledge with my peers.
From a people perspective, you get to know the regular patients using the service really well, and it’s so fulfilling to build strong long-term relationships with them over the years.
What have you achieved recently in diabetes care that you are excited about and keeps you motivated?
My biggest motivation is flying the flag for renal patients and ensuring they get the appropriate complex care that they need.
One of the things I’m trying to do is to link up all diabetes specialist nurses who work within renal so we can share ideas and experiences, as I remember how much hard work it was at the start of my renal, diabetes journey.
What is coming up for your next at work?
I feel that dialysis patients in particular can be overlooked, often resulting in poorer outcomes. It is known that there are barriers for this group, such as accessing the services that they need, leading to fragmentation of their care.
With my colleagues from diabetes and renal, we are striving to raise the profile and management of these dialysis patients.
One of the things we are doing is running a pilot at one of the Imperial haemodialysis units to assess if more educational and clinical input improves the outcomes for these individuals when they are transplanted. This fits closely with previous work which I have been involved in with diabetes care in haemodialysis (DiH) working group, and is ongoing.
This could not be done without the huge support from all the healthcare professionals from different teams and services.
What do you think is the most exciting thing on the horizon for diabetes care?
So much has changed involving diabetes management over my career, but for me, significant advances have been made in recent years on new interventions which provide cardio-renal protection as well as glycaemic control which is very exciting!
What do you do to relax outside of work?
I think it’s really important to set an example for my patients. I enjoy going to Zumba, yoga classes locally, and playing squash. But most of all, I like sitting around the dinner table with my family chatting and catching up about what we have all been up to in the day.
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