DSN urges other to ‘cherish’ their experience during second wave
A specialist diabetes nurse (DSN) who worked tirelessly during the first COVID-19 peak is urging other nurses not to “belittle their experience, but to cherish it” as the second wave continues to grow.
Anna Vanderpuye is based at the Royal Brompton Hospital, Chelsea and Westminster Hospital NHS Foundation Trust. It was declared an NHS Level 4 hospital during the peak coronavirus season in the summer, which Anna said “meant all patients admitted were very unwell and the treatment provided from the care team there was their last chance of survival”.
She wrote to The Diabetes Times because she felt “compelled” to share her story. Anna began her diabetes career working at London’s Kings College Diabetes Centre, which is also a Centre of Excellence.
The DSN firmly believes that everything she was taught there has helped her care and manage all the people she has seen during the pandemic.
She said: “I wanted to share how I coped as a DSN, looking after all the people with diabetes who were admitted and had developed hyperglycaemia during the COVID-19 peak season. I believe I was able to cope because of my experience from working in that Centre of Excellence.”
‘Holistic diabetes care’
Anna’s duties were varied over the course of the peak season and she said she felt “privileged” to be asked by her consultant to help out.
She added: “I realised during this COVID peak season that I was able to work on my own with the knowledge I gained as a DSN who has been trained and worked in a Diabetes Centre of Excellence.
“I offered holistic diabetes care for all the COVID patients in the acute intensive care unit then the high dependency unit daily. These patients were on Variable Rate Intravenous Insulin Infusion (VRIII); some were on Extracorporeal Membrane Oxygenation (ECOMO), which during the peak my hospital had 27 patients at any given time, and some were on steroids.
“My care plan included individualised care plans for patients with hyperglycaemia, either on VRIII, on ECOMO, on NG feeds, and sometimes on steroids. It was not just adjusting blood glucose levels; specialised diabetes care is more than just that.
“When patients were coming off example VRIII, I was able to decide which people I thought would do well on oral hypoglycaemic agents or insulin; this was possible because I reviewed beyond blood glucose levels to the looking at the patient as whole, even after discharge.”
Anna’s work did not stop once the person left hospital either. Having identified those who were deemed ‘insulin naïve’ and were discharged home either on insulin or other hypoglycaemic agents for their raised blood glucose levels, she continued to make contact with the patient ensuring they were controlling their diabetes and continuing to recover from hyperglycaemia.
She said: “I worked both onsite and at home. I worked both during the day and at night, my aim was to keep patients as safe as possible. I did not mind the time of day I was contacted, I just wanted patients to be safe.
“I decided to write my story to help other diabetes specialist nurses, especially those who have had the opportunity to work in a Centre of Excellence to give them the confidence to use their skills and knowledge that they’ve learnt which will enable them to work independently.
“I want to encourage any nurse who finds themselves during this second COVID wave not to belittle their experience, but to cherish it, and be able to apply the knowledge gained appropriately when the need arises.
“Diabetes Specialist Nurses working in Centres of Excellence may not appreciate the immersed wealth of knowledge and experience they acquire until they are exposed to a situation where the knowledge and experience is needed.”
Professor Anita Simonds, a consultant in respiratory and sleep medicine based at the Royal Brompton Hospital, paid tribute to Anna’s hard work and dedication.
She said: “I would personally like to say a huge thank you to you Anna. We followed your advice to a T and found it enormously helpful and effective. You also replied at all times of day and night to queries! We trusted you completely and you can be assured you made a big contribution to the quality of care for our COVID patients and the peace of mind of the medical team.
“The experience of blood glucose control in this group, mostly with newly acquired diabetes, has been fascinating and I am glad you are following patients and stepping down therapy as necessary. It’s been a real learning curve. Many thanks again for making an important difference.”