My Working Day: Helen Burkeis the first advanced nurse practitioner in diabetes in the west of Ireland
A 50 per cent increase in the number of people attending the diabetic services at University College Hospital Galway (UCHG) over the past three years led to the creation of my position, dealing specifically with adults and children with diabetes.
I am the first advanced nurse practitioner (ANP) in diabetes in the west of Ireland and I deal with HSE West clients in Galway, Mayo, Roscommon and Clare.
In Ireland, it is estimated 200,000 people have diabetes and a further 20,000 are unaware that they have the condition.
The majority of these will only be diagnosed through an acute medical event of the complications of long-term untreated hyperglycaemia, ie high blood sugars.
A further 250,000 people have impaired glucose tolerance or pre-diabetes, and half of these will develop diabetes in the next five years if lifestyle changes are not made.
Diabetes is a lifelong condition that affects almost all aspects of life. It can affect all ages with increasing incidence with age. One in 11 people over 65 has diabetes and one in four over the age of 85.
Current obesity and physical inactivity trends will ensure that the incidence of diabetes will continue to escalate.
My role as ANP in diabetes includes holistic assessment, monitoring of patient self-
management, screening for and treatment of complications associated with diabetes and facilitating compliance with adherence to treatment regimes and the management of diabetes.
Patient education and health promotion underpins many of the roles of diabetes nurses. My role also involves co-ordination and monitoring of diabetes care provided to patients with other members of the multidisciplinary team and patients themselves.
I usually start work at 8-9am depending on clinic start times and finish generally at 6pm-7pm. My working day varies, depending on what clinics are running on particular days.
The patients have usually been pre-assessed at a pre-assessment clinic two weeks previously where they have their weight, body mass index (BMI) and bloods taken. Education on self-care tasks including monitoring, insulin treatment regimes and general advice is provided and re-enforced with patients at each clinic visit.
When patients attend the diabetes clinics two weeks later, their results are available. This facilitates treatment changes if required. Clinic sizes vary but usually 50-60 patients are seen at clinics.
In the afternoon, there may be another clinic, eg a specialist clinic, group education sessions or patients attending to start insulin.
As we have a telephone support helpline, we will answer or make calls to patients. On average, we can deal with 50 calls daily. This is an invaluable support for patients.
The hardest part of my job is probably not having enough time to do what I want to do and the easiest part is, without a doubt, dealing with the patients.
The area I work in is great. It would be difficult to make our working environment any better as we have wonderful diabetes teams in both the adult and paediatric diabetes services.
In conversation with Michelle McDonagh