DSN Spotlight – Victoria Alabraba
The role of the diabetes specialist nurse is continually evolving and is crucial in ensuring high-quality diabetes care. Our DSN Spotlight series celebrates the people who work tirelessly in this role, while also finding out what inspires them to keep them wanting to make a significant impact on people with diabetes every day.
Job Title: Community Diabetes Specialist Nurse
Trust: Liverpool Diabetes Partnership
Time in position: 4.5 years (DSN since 2005)
What’s you biggest challenge in diabetes today?
Trying to engage with and build relationships with those people living with diabetes who are “hard to reach”, although we have done a lot of work in this particular area, but there is still more to do.
Also providing access to ongoing diabetes education and training for primary care health professionals with our current resources can be a challenge. We have made good links with our practice nurses and district nurses which is ongoing. We are also focusing on care homes, care agencies and nursing home staff as one of our lead areas.
What’s your biggest achievement in diabetes care?
I’ve been a diabetes specialist nurse since 2005 and in that time I’ve been lucky to have published some of my work. In 2013 I also developed and introduced the self-administration of insulin policy at Aintree University Hospital NHS Foundation Trust.
However, the last four years of my career, as part of a newly commissioned integrated diabetes team in Liverpool which has included helping to develop the service, has been my greatest achievement.
It became fully operational in 2015 and is jointly run by Liverpool University Hospitals NHS Foundation Trust and Merseycare NHS Foundation Trust.
Our approach to diabetes care moves the focus from the hospital setting to community based which aim to promote good self-management, integrated delivery and education. We are part of the Healthy Liverpool Programme which aims to transform healthcare in the city.
We achieved several awards in 2018, including the RCN North West Black History Month Award, QiC Diabetes: Hypo Awareness Week Excellence Award and Proud of Aintree Excellence Award for Team of the Year 2018.
What would you like to see change in diabetes?
I would like there to be greater access to psychological support for people living with diabetes and also to structured education for people living with type 1 diabetes within the community setting.
I also think there needs to be easier access to help people make healthier lifestyle changes and nurses need to be able to gain post graduate diabetes qualification more easily to secure the future workforce.
What has been the biggest development in the last 10 years?
I think new diabetes technology, such as flash glucose monitoring, CGM, blood glucose monitoring devices have been significant. We’ve also seen access to online platforms, such as web based apps forums and websites, improve.
There has also been a wide range of new diabetes oral and injectable treatments made available, which has helped make a huge difference, in addition ongoing research and studies have been providing us with ever-changing evidence-based medicine.
The development of integrated and community diabetes teams and services has also made a difference. .
What is the best way to achieve good health outcomes with your patients?
I’m a firm believer that building trust and rapport with patients is the most important starting point. A lot of my patients really find it useful being able to see the same Specialist Nurse on a regular basis to build trust which often allows for greater outcomes. It’s important to remember that although I am the Specialist Nurse, my patients with diabetes have their own experience, often many years of experience, living with diabetes so working together in partnership with joint decision making is vital.
Forming close working relationships with our primary care colleagues, is a big part of my role and this allows for diabetes care to be more fluid and streamlined which can only be of benefit to our patients in the longer term.