Diabetes specialist endorsed as nurse practitioner.

LONG-TIME Manawatu diabetes nurse specialist, Helen Snell (right), has been endorsed as the country's 10th nurse practitioner (NP). The endorsement is the culmination of a nursing life devoted to the care of people with diabetes, and the passion for this practice specialty remains.

As a new staff nurse on a men's medical ward at Palmerston North Hospital in the late '80s, Snell wondered why so many of the patients suffered complications from their diabetes. Her questioning coincided with the establishment, by Marion Moore, one of her early mentors, of the diabetes resource nurse programme at the hospital. She did the programme, loved it and in 1989 moved to what is now the Diabetes Lifestyle Centre, where she practises as a clinical nurse specialist. "The more I learn about diabetes, the more I realise there is to learn." And she has dedicated a good deal of time over the last few years to learning more, graduating with a Master of philosophy (with distinction in nursing) last year and graduating this year with a Masters of Nursing. She has just completed her prescribing practicuum and hopes to be endorsed as a nurse prescriber this year.

Snell says as an NP she will have a greater clinical focus than her current role and will work across the primary, secondary and tertiary sectors. Her speciality area of practice is diabetes and related conditions across the life span, a broad scope. She is not yet employed as an NP and while feeling a little frustrated at the length of time it has taken, she is confident it will happen. "The DHB is committed to an NP role for diabetes." She will be the DHB's second NP, following in the footsteps of wound care NP Jenny Phillips.

She believes it is very good for the profession to have a career pathway within clinical practice. "And it is very good for the people we serve. They deserve a high level of clinical expertise."

She believes her role as a prescriber will reduce duplication for the person with diabetes and enable her to make treatment decisions and prescribe at the same time,"but, of course, as a nurse, I will look first to non-pharmacological measures".

Snell loves working with people across the lifespan, with each age group presenting its own challenges and rewards. "One of the most rewarding aspects of my work is providing people with the skills and knowledge so they can live their lives without my input. To see children with diabetes who are well adjusted, happy and coping with their diabetes is very rewarding."

So, too, is seeing "beautiful babies" born to women who have diabetes. "Diabetes in pregnancy is hard work. These women have to test themselves six to eight times a day and are often injecting insulin three to four times a day. I am in contact with them every second day. It is very intensive over a long period of time, particularly if I have been working with them to gain good control pre conception."

Snell has had a long association with NZNO, joining the diabetes nurse specialists' section in 1989, becoming a committee member in 1993 and serving as its chair from 1995-1997. During that time there were many significant developments for the section, including standards of practice, accreditation and the distance-learning course for diabetes nurses through the then Waikato Polytechnic. "That involvement has been an important part of my professional development and the development of diabetes nursing practice nationally."

She continues her involvement with education through teaching at Massey University, the Universal College of Learning, and as a clinical expert for the Waikato course. She is also an NZNO member of the Nurse Practitioners Advisory Committee.

With her endorsement as an NP, Snell is destined to continue her nursing journey caring for people with diabetes.

* The New Zealand and Australian Nursing Councils have launched a research project to develop competency standards for NPs in both countries.