Clinical Nurse Consultant in Diabetes Management

After being diagnosed with Type 1 diabetes at age 16, Anthea Cavanagh became intrigued by diseases and disablements of the human body and exposed to the broad range of healthcare professionals providing diabetes care.

It inspired her to pursue a career in nursing, focusing on diabetes education, to help other people manage their shared chronic condition.

“From then [being diagnosed] my long-term goal was to one day belong to this team and have more answers than questions,” she recalls.

Anthea went on to complete a Bachelor of Nursing, undertaking her graduate year in the acute sector before returning to university to tackle a Graduate Diploma in Community Health Nursing.

Working across numerous settings, including pharmacy and home healthcare, Anthea found herself continually supporting people living with diabetes.

She says joining the Royal District Nursing Service (RDNS), now Bolton Clarke, introduced her to the concept of mobile nursing.

“I quickly realised the home setting was the best place to truly get to know the client, where realistic and holistic approaches to goals and care could be achieved, all from a wellness and reablement perspective,” Anthea says.

“The experience I gained with diabetes and wound management, case management, team building and external networking built the framework to confidently transition into the specialty of diabetes nursing.”

With 14 years under her belt in district nursing, Anthea returned to university and obtained a Graduate Certificate in Diabetes Education.

The qualification was only the first step, Anthea says, with Initial Credentialing as a Diabetes Educator requiring 1,000 practice hours, participation in a six-month mentoring program, 20 hours of specific CPD and a referee report – all supported with evidence-based documentation.

Recredentialing is then required annually.

A registered nurse with 25 years’ experience and currently a Clinical Nurse Consultant in Diabetes Management at Bolton Clarke, Anthea says diabetes nursing has advanced significantly during her time in the speciality, especially due to the evolving technology available.

“These [technologies] include new and improved insulins, insulin pumps, and continuous and flash glucose monitoring. Ongoing education and research is invaluable. Remote consultancy enables more productive direct care and improved client outcomes in a timely manner, which undeniably improves the client’s quality of life.”

Anthea says people living with diabetes can be impacted by their socioeconomic status, comorbidities, carer strain, social stigma and limited access to support.

Ongoing challenges for people with diabetes include restricted availability to subsidised medications, she adds.

Anthea says common signs and symptoms of diabetes include increased thirst, frequent urination, blurred vision, an increased appetite, and extreme fatigue with irritability.

More specific symptoms often indicate which type of diabetes a person has developed.

For example, Type 1 diabetes also presents with extreme weight loss and a sudden onset of all symptoms, while Type 2 diabetes typically presents with additional signs, such as slow healing wounds.

“Australians can be better prepared if they are aware of these symptoms and have regular check-ups with their GPs, especially those with risk factors already present,” Anthea says.

“A healthy lifestyle can protect against Type 2 diabetes as the risk factors are modifiable. They can include being overweight, a poor dietary intake high in fats and cholesterol, high blood pressure, stress, reduced physical activity and drinking alcohol and smoking. Ethnic backgrounds and a history of gestational diabetes also make people more susceptible.”

Anthea says a typical day on the job as a CNC in Diabetes Management can involve conducting home visits with a nurse, education, counselling, carrying out demonstrations, making referrals to other agencies, and phone calls to endocrinologists, GPs, dieticians, and podiatrists.

“Reports are entered on computers and remote consulting via videoconferencing is also common practice,” she explains.

“Rain, hail or shine the day continues and driving to the next client can often take an hour. Providing written resources and prompt cards are very helpful, especially for our CALD clients and with clients with comorbidities, case conferences are often held with my colleagues who specialise in dementia, mental health, wound management, continence and social work.”

Anthea says diabetes nursing offers a diverse and rewarding career and she would encourage any early career nurses to consider the specialty.

“If you are considering a career in diabetes nursing all I can say is do it,” she says.

“I love my job and every day is completely different, as every client has a unique story. Daily challenges keep me motivated and I’m continually learning new approaches to improve client outcomes. The appreciation shown when participating in the client’s journey towards gaining independence and improving glycaemic control is often humbling.”