Are most people under the nurses CNS or the consultant?

[Vonnie10]

Hi hope your all well, I was wondering if people are under the CNS and are they discharged from there consultant?

[helixhelix]

When I was in UK I had alternate appointments with the specialist rheumatology nurse (CNS), and the consultant.

I was under the impression that you had to be on the consultant's list be be treated, no matter whether by nurse or doctor, as if you were discharged it would be back to the GP.

[Vonnie10 in reply to helixhelix]

When I rang today about my benepali,nurse told me I was under there care I needed to rearrange a appointment was told by the secretary she could arrange a visit with the consultant but it would be 8 weeks. The nurses must have meeting with the doc to discuss our treatment plan , I'm confused 🤷‍♀️ I must be on the list like you said, helix once I've seen a doctor in 18 months and that was at the very start.

[Hidden]

Hmm that doesn't sound right. As you said, only consultants can prescribe anti TNF drugs and they need to see you to monitor you. If the medication isn't working and you need a proper review, then you need to see rheum consultant but the nurses are there in a supplementary role.

[Vonnie10 in reply to Hidden]

I get this doll I see the nurse again on the 19th of this month isn't that along time 18 months without seen a doctor I'm just trying to get a understanding of everyone else.im sure they must have monthly medical meeting and discuss who and what and who needs and so on but 18 months isn't that to long ?

[Hidden in reply to Vonnie10]

That's a very long time. I know rheumatology clinics are under a lot of pressure but even so, that's not acceptable or safe.

I am seen 4 times a year - every 6 months by my consultant and in between, I see the rheum nurse. I don't know if this is just policy at my hospital but people on biologicals drugs must be seen by their consultant every 6 months.

[Vonnie10 in reply to Hidden]

To be fair I've only been on biologic 12 weeks,even prior to that I never seen a doctor, it's disgraceful, I will ask what the policy is,when I go. I need to be on top of it from now on don't just presume the nurses are doing what there suppose to be doing,I don't want to be seen as been difficult. Thankyou doll.

[Elmo333]

I see the nurse every 3 months and only ever see the dr if there is a big problem. This works ok for me. They do know a lot about ra and sometimes are less rushed than the consultant.

[Gigi71]

I have had erosive RA for over 30 years and seen many changes in care. I now see the consultant once a year and and the nurses every 6 months we have a help line and can also write to the rheumatologist. My bloods are done every month and this year had other test done, ordered by the consultant, I still feel very much under her care. They also take care of my OP. The consultant has also phoned me at home if she has been concerned about something. They work as team despite being very stretched. X

[Mandalou]

The Rheumatology nurses are the forefront of the treatment I get. From what I can see when the clinics are being run that there always is a Consultant on duty as it were and at any point the nurses can go and get them, run things by them etc. Several times I have had my 6 monthly check up and the nurse has popped out to ask the Consultants advice.

Most of the nurses are fabulous , just the occasional one who's character grates.

My biggest bug bear is when they don't listen and their report back to my GP states something that I categorically didn't say and omits something I did.

For example last week my letter stated that I was complaining about pain in my knees. This was categorically NOT true.

The nurse had got it into her head that the way I walk was causing the pain in my feet ( which I was indeed complaining about)she said the bad way I walk to compensate the pain in my knees in turn was causing the pain in my feet!

She said its the inflammation that causes pain and as I have no swollen or tender joints and my CRP is low and steady the cause of my pain cannot be RA the letter said Im controlled and in ( drug induced) remission.

This is all well and good but Im the one with the disease and I know the pain in my fingers that preceeded my explosive polyarthritis and its this same pain I get in my feet. Its pain whether I sit, sleep or stand,.

Today its not hurting much at all, nothing to do with the way I walk.

I have much respect for the Rheumatology nurses a couple of them in particular but I resent the occasional one who doesn't seem to' get it' and who's reports of the appointment stray from the actual reality.

Sorry for yacking on about myself. I needed to get this off my chest.

But yes Vonnie, i reckon you will see a Registrar every third visit the nurses mostly and a Consultant only for diagnosis and deterioration of symptoms/change of drugs.

Mx

[BoneyC]

I only see a Rheumatologist, never a nurse.