Diabetes specialist nursing: looking to the future, learning from the past

Diabetes specialist nursing, like many other aspects of nursing, is facing a challenging time in terms of limited resources, staff stress and increasing client caseloads (Naughton and Nolan, 1998). This trend seems set to continue and therefore reflection on and analysis of the role of the diabetes specialist nurse (DSN) is essential so that DSNs can understand their role and meet such challenges proactively. This learning experience (Jarvis, 1992) will also enable DSNs to communicate effectively their role within their teams and to their peers and managers. The author contends that many of the problems currently faced by DSNs can be identified in the initial reactive creation and development of the DSN role which, in some cases, was 20 years ago. Therefore, this article discusses how the past could be influencing the present and future for diabetes specialist nursing. It cannot attempt to provide an exhaustive discussion, but will focus on the following major aspects: DSN titles and commencement; role entry and subroles; and role set and role definition. The article concludes with a vision for the future, informed by this analysis of the past.