OK this might seem a bit out of context but please bear with me.
Having recently been admitted to a hospital (which runs DANFE) for Diabetic Foot Complications I was placed in a "diabetic speciality" ward which I would have thought would at least have had a basic understanding on the principles of DAFNE. Needless to say I had many a battle, usually at 06.30 when they woke me up to do my "BM". I had to constantly tell them I am DAFNE trained and to leave me alone. I also had to try and educate them that I did not know what dose of QA insulin I would take until the tray of 'food' arrived from the trolley. It was an ongoing battle at least for the first 5 or 6 days out of my 2 week stay.
You may say "so what?"
Imagine being woken every night at 23.30 for a blood test to determine your IV Antibiotic level then woke again 1.5 hours later to put up another back of IV Antibiotic only to listen to the pump alarm every 20-30 mins because it was faulty, then to be woken again at 05.00 to have the bag taken down..... it took it's tole on me.
My point is 2 fold though......
1. I was not admitted to the same hospital I did DAFNE at - is there any way the DUAG can ensure consistency in the course education as I noticed some differences in those that had been trained. Even if it meant someone sitting in on the courses - something I would be very happy to do.
2. Can the DUAG provide a free information course day (even 1/2 a day) to allow staff dealing with diabetic patients who are trained in DAFNE some insight to exactly what DAFNE is all about. I ask this as many of the staff I spoke to knew about DAFNE but had no idea what it meant. Again this is something I am very prepared to do.
Anyway my soap box is starting to sag under my weight so let me know what you think
As I said I can see it 3 ways - I'm a DAFNE Grad, who is also a nurse, who has also seen it from patient side.
James Paget University Hospitals NHS Foundation Trust
I understand what you mean, even if my circumstances weren't the same - I went into hospital only last week because I got hit by stomach flu that was making me very sick and I became seriously dehydrated. I had done a great job of keeping things like ketones at bay and my sugar levels somewhat good despite the sickness, but it was only after I'd started recovering that it became clear that my BI doses were wrong because in the morning, my BGs started dropping (unusually, but this may be due to be illness and it's effects on my body afterwards).
Fair enough, but while I was being taken care of, I had explained what times I took my BI doses as soon as I got into the ward because they asked - one at 9pm and one at 7am - and when I showed signs of a hypo in the morning, the staff asked me to wait until a doctor had come to see me after 9am before I took my next BI. I wasn't impressed with what was being asked but I did as asked initially.
If I'm going to hypo, I'm going to hypo - I know to put my overnight dose down instead. -_-;;; I did hypo in the end - before I even took my morning BI dose.
However, considering it was almost 10am before anyone came, I thought "sod this" and took my morning BI at about 9.45am. I even felt bad that I had to apologise to the nurse for my "naughty" decision but at the same time, I knew full well that my BI overlap is needed in the morning and if I didn't take it, I would be paying for it later.
I hope that no one gets me wrong considering they did help me get out of the situation of serious dehydration because I couldn't keep anything down, but in reference to my diabetes care, it was frustrating because I was asked to explain what I do to help myself but I felt I was not taken serious enough. They were overly worried about me hypoing because of taking my next BI dose which was frustrating and did hint at some lack of education.
Thankfully a nurse from my DAFNE team did come see me and confirm that I had done very well with dealing with my short term illness but this was after 10am... The diabetes team are a small dedicated team from what I can tell, there doesn't seem to be on ward staff easily available to see patients at non-office hours when the team seem to be in when it comes to DAFNE.
I think this is a shame to come across this after many years of not needing assistance like I did last week.... and I'm sorry to hear that your situation was just as frustrating (I would've gone mad if I'd had to put up with it for more than one day I think).
I do hope that your idea can go ahead but how well it can be rolled out is another problem of it's own... especially in these harder times, when you start to see news like this (dated yesterday):
Diabetes UK: False economy as 200 frontline Diabetes Specialist Nurses go in NHS cost cutting
Absolutely shocking. I shall be continuing to follow Diabetes UK's Twitter feed to see how their fighting response to this news turns out.
South East Kent PCT
Hi wullie, as the DAFNEOnline DUAG Rep I will take your suggestion to the relevant people. I'm not totally clear what you mean in point 1. In theory all DAFNE educators receive the same training and are all quality assessed, so the course should be the same regardless of where and when you do it. How do you mean there were differences in the way people where trained. With regard to point 2, it sounds like a good idea in theory how easy it will be to achieve in reality is hard to say but I will certainly take the suggestion forward and let you know what feedback I get. One of the objectives of the DUAG is to increase awareness of DAFNE and this certainly fits in that description.
By the way I too had similiar experiences in hospital, fortunately/unfortunately depending on your viewpoint no one tells me how to treat my Diabetes. A Nurse did try and found out pretty quickly I wasn't going to do what she said rather than what I wanted. Without exception all medical staff I encountered had never heard of DAFNE and found the idea of a Diabetic managing their own care an unusual concept. I did my bit to educate them
I would urge anyone who has done DAFNE and is told by medical staff not to follow it, stand your ground and insist unless they can provide a clear and reasonable
explination as to why you should not. This is 2011 and nowadays doctor doesn't necessarily know best.