Bernie Maynard began her career in neurosurgical nursing before moving into emergency nursing, where she spent 17 years.

Seeking a change, Bernie then took the leap into primary health care as a practice nurse, and began work at The Lake Munmorah Doctors’ Surgery.

It was here Bernie recognised the need for a diabetes service, and embarked on a plan to establish a nurse-led diabetes clinic.

“We have a large cohort of patients with diabetes, and diabetes services were hard to access promptly, so I approached my practice manager and GPs and discussed setting up a nurse-led diabetes clinic for our patients,” she says.

Diabetes Australia statistics show about 1.7 million Australians have diabetes, including 1.2 million people with diagnosed diabetes, and an estimated 500,000 people with undiagnosed type 2 diabetes.

There are three main types of diabetes - type 1, type 2, and gestational diabetes. This serious complex condition is the fastest growing condition in Australia, with more than 280 people developing diabetes each day.

Bernie completed the Graduate Certificate of Diabetes Education in 2013, and became credentialled with the Australian Diabetes Educators Association in 2014 after completing 1800 hours of clinical practice.

As a Credentialled Diabetes Educator, Bernie’s position involves all aspects of diabetes education and management - educating the newly diagnosed patient about the condition and self-management, and ongoing education and management of patients with established diabetes to improve their glycaemic control and quality of life.

The position also covers insulin initiation and titration, supporting families and carers of patients with diabetes, and advising GPs about better management options for their patients.

Bernie runs two clinics a week focused on helping patients to manage their type 1 and type 2 diabetes and pre-diabetes.

“Patients have their blood tests done prior to their appointment. When they come in to see me, a care plan is completed which focuses on all aspects of diabetes management and reducing risk of complications,” she says.

“It also encompasses their other health issues or comorbidities and addresses preventative or screening health, for example their immunisation status, current electrocardiogram and women's health - mammograms, pap tests.

“I spend time addressing the patient’s main concerns with their diabetes management and working with them to devise smart goals and strategies to improve their glycaemic control and sense of wellbeing.

“I also provide referrals to other allied health professionals, for example dietitians and exercise physiologists, as required. The patient’s GP will then come in and we will discuss best management for the patient, for example change in medication, and often congratulate the patients on their self-management achievements.

“If insulin is recommended for the patient, I provide education for this and then work with the patient outside clinic hours either by phone or email to titrate their dose as required.

“I see my patients formally in the clinic every three or six months depending on their glycaemic control and informally as required.”

The clinics have been a major success, helping around 450 patients to improve their health outcomes, and leading to a significant reduction in the number of patients referred to public hospital outpatient clinics and endocrinologists.

Bernie says diabetes clinics offer numerous benefits to people living with diabetes.

“They provide the patients with focused education using best practice guidelines, and it gives them the tools, knowledge and support they require,” she says.

“Any changes to management happens on the day and patients are closely followed up. Patients are comfortable coming here because it is a familiar environment and familiar people looking after them.”

Bernie provides education days and evening sessions featuring free screenings, and she also established the Heart Foundation Munmorah Movers walking group in 2016. The group meets three times a week, with Bernie encouraging local residents and patients to step up to regular exercise.

Bernie was recently recognised for her outstanding contribution to the nursing profession when she was named a finalist in the 2017 HESTA Australian Nursing and Midwifery Awards.

She hopes her nomination will encourage other practice nurses to establish nurse-led clinics.

Helping people to manage their diabetes is rewarding work, Bernie says.

“It is a challenging condition and everyone’s diabetes experience is different. Not only are you dealing with the physical side of diabetes but also the social, emotional and psychological aspects as well,” she says.

“The management of diabetes is evolving all the time which makes it so interesting. I would encourage all nurses to give it a go. There are not enough of us to go around!”