On Tuesday this week I spoke in scorching North Wales about B12 deficiency to a group of nurses from different disciplines who attended an RCN Event which celebrated 70 years of the NHS.
The hope is that they will be able to take the information gained and make a difference to the patients under their care.
Those present at the event, some who were diagnosed with B12 deficiency, totally understood the situation that many patients face. Nurses are always shocked that they haven’t received any training on this very common condition.
Nurses are the ones who administer injections, hear the complaints from patients who can’t cope on the restricted three monthly regime and who are best placed to report back to the GP’s what the reality of the situation is for a patient who does not fit into the the ‘one size fits all’ treatment regime.
And it’s very clear that many nurses struggle in the same way that patients do in communicating their experience of B12 deficiency (either personally or professionally) effectively with doctors they work with.
One nurse told me that when she asked if a patient who was exhausted could have her injection earlier than 3 monthly, the reply was ‘No, it’s all in her head’. This attitude is not uncommon and even though this nurse could see the need for more frequent B12 for her patient, the door was slammed shut. This situation is ridiculous and harmful and desperately frustrating for both nurse and patient.
The reference range for North Wales is set too low at 150ng/l so consequently many deficient patients will be missed. Point 4 on this page will help you to see how harmful it can be to ignore the clinical picture and base treatment solely upon serum results.
Of course not every symptom is due to B12 deficiency but our nurses can see the benefit of being educated about this very common and commonly misdiagnosed condition. They can see that considerable cost savings can be made by screening those at risk and by giving B12 injections based on individual requirements rather than the bizarre idea that each patient’s need is the same.
I posted the following on facebook on the 3rd of July;
This week the NHS is 70 years old.
If we can help to stop the misdiagnosis of vitamin B12 deficiency, the savings for the NHS and for society as a whole would be phenomenal.
Too many patients remain mentally and physically ill and unable to work.