Stepping outside the consultation room, which was released in the Journal of Advanced Nursing last month, focuses on nurse-patient relationships and nursing responsibilities during a 20-week type 2 diabetes walking project.

The study concluded that being outside the consultation room with nurses allowed patients to be more open about their lifestyles and contributed to more “continuous and person-centred care”.

However, it also raised some questions about nurses’ responsibilities during physical activity care, as opposed to being in a consultation room, in terms of sharing personal views and feeling like they were stepping outside their roles.

Massey University professor of Nursing and executive director of the College Nurses, Jenny Carryer, said while she wasn’t aware of any projects like this in New Zealand they could be of benefit.

“I’m not sure that anyone will adopt that exact approach here but I think it is positive.”

The amount of time nurses were able to spend with patients during the project was the most important thing, rather than the walking, because evidence showed that patients’ experiences were better when they had more time with nurses, she said.

“What I think is interesting about that approach is that nurses have the opportunity to spend longer with the patients and a lot of them come out feeling a lot more positive.”

Diabetes patients who spend longer with their nurses learn more about their condition and are better able to manage it.

They take in more, know what they need to do and feel more comfortable, she said.

This is being done in South Auckland where nurses are allocated more time to spend with patients with type 2 diabetes.

“I think anything that enables nurses to spend more quality time with people is positive, rather than short medical consultations.

“Reactive appointments for people with chronic conditions don’t enable people to live well.”

When nurses first started being able to prescribe for patients with diabetes in New Zealand, as part of the Medicines (Designated Prescriber – Registered Nurses) Regulations 2016 in September, 2016, it enabled much better care, Carryer said.

Due to the continuous level of quality care being done by one individual (the nurse) patients felt better, happier and safer, she said.

The Dutch study showed that nurses during usual consultations provided education, advice, encouragement and referral to exercise specialists but more was needed to be able to support patients to adopt more active lifestyles.

“Related to this, the walks offered nurses and patients an opportunity to get to know each other beyond the biomedical. For instance, many informal talks about the surroundings resulted in personal talks about where one lived or daily pursuits,” the study said.

Conversations continued over the weeks and patients, when they went back into the consultation room, were more open in what they asked and told their nurses because they were more acquainted in an informal setting.

The study was completed in 2016 following nearly 70 hours of field work by participant observations and informal conversations with nurses and participating patients of two different walking groups.


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