No wonder asthmatics don’t go to hospital early!

One of my previous posts I titled as the most terrifying experience. At the time I thought it was, but sadly it was not and last week it went to a whole new level of scariness.

I had not been discharged long but I needed up needing to go back to hospital.

It all started well. I was seen in resus and after a few hours was stabilised with IV Magnesium, IV Salbutamol, IV Hydrocortisone and lots of nebulisers driven by oxygen. All was going well. My care plan was being followed and all going well. Maybe a little to well!! Coming out of resus was where it all went downhill and led to the worst time I have ever had.

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Being moved from resus to IC/HD is always a good move so when they said I was moving I was happy. It meant I was getting better and on the road to recovery. This was not the case this time. There was a plan in place for when I was moved. To continue on back to back nebs to keep on top of my attack but this was not done. I had to wait an hour and a half and ask over 6 times to get a neb to be told by a nurse I was fine and he was too busy and would come back to be later. By this time my blood pressure was rising my heart rate was rising and my oxygen was dropping. This was not the time to say I was fine and he would come back to me. I felt the nurse didnt think I was ill. I thought he thought that because I was young I would be ok. I was not ok. I was terrified. It was harder and harder to breathe and I thought by going in early I would be seen early and be back out again. I kept asking for nebulisers and not getting them. writing it like that makes it sound like I was unhappy because I was not getting what I wanted but it was far from it. I was desperate for a neb. My chest was getting tight and I really couldn’t breathe. On top of that I was scared and thinking all this stuff about what might happen. Eventually I got to see a Dr who questioned why I had not had the nebs etc I was meant to. I felt relief at being given a neb but also because I thought the plan would be followed again.

I got two nebs but after that it all slipped away again. I tried to tell the nurse about my care plan but was told he didnt need to see it and wasn’t his concern. I kept asking for nebs but was being told he was too busy. I am sure he was busy but all the times he told me he was busy would have taken up more time than actually giving me a neb and the amount of time he had to look after me in the long run. I ended up using my own supply of nebules to treat myself as I felt so scared and want to get better. By this time I had had enough. I tried to get up so I could get dressed but I fell and really hurt my knee but at this point a combination of lethargy, fear, tiredness and the effects of the asthma attack were taking their toll and I decided it was time to self discharge myself. It was rash but I felt it necessary. It got the attention I needed and the Dr came over to see me with the nurse in tow. I also ended up being reviewed by intensive care. I told the nurse that this was all on him and if I went to ITU or had a prolonged admission it was on him and I strongly believe it was. His attitude was horrible and it has made me really question going into hospital and getting help. If I saw him again as I came into A&E I would refuse to go in as I really thought I may not get out of A&E in his hands.

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After falling and threatening to self discharge I was moved through to the assessment unit where I was in such a state they wanted to give me lorazepam to calm me down. Thankfully the Dr had been filled in on what had happened and knew I just needed out of A&E and I would be ok and they were right. The rest of the admission was fairly uneventful but I shall blog about it another time.

I wanted to concentrate on my experience in A&E. I have had so much time to think about it and the consequences of it. A few years ago the national review of asthma deaths was published highlighting the shocking statistics of asthma death and admissions to hospital. From this I tried my hardest to make sure I was very proactive with my treatment and get help quickly to as to make asthma less of a killer than it is. How can we do this if asthma is not taken seriously in hospital where it is meant to be safe and you are meant to be looked after.

I am lucky in that I have been to hospital a lot and luckily never had such an experience and I knew what I needed. What would have happened had I been new to asthma or not known what was happening. I was able to self medicate to make sure I was ok but others may not have been so lucky and the statistics would just get worse. 

The support I have received from Drs, and the respiratory nurses has been fantastic and I have had the help to come to terms with what has happened and also will get the help to put a complaint in about the treatment I received. It is important that feed back is given because if I have been so scarred by events imagine what someone else could have been. They may have taken themselves out of A&E and died from not getting help for their asthma. Its important to get the message out and get people to see how serious asthma is.

I have never made a complaint to a hospital about the treatment I received but I feel this time it is so important that I do for a number of reasons. I was still trying to come to terms with my previous hospital admission and how I went down hill so quickly in a safe environment, I also had lacrosse trials of Scotland and it was my 30th birthday which I had a number of plans for. All of which I missed as a result of the poor care I was given. I may be unfairly putting all the blame on one person and that person being the nurse but to me it is no
t unfair. The way in which I was spoken to and the lack of respect and care I was given has left a huge black mark and really scarred me. For my own sanity I need to deal with this and make it known what happened and what is being done to resolve it.

It will take a lot for me to get my confidence back and feel safe going to A&E again. I know I will have to go back to A&E at some point and the whole reason I do everything about raising awareness for asthma is to changes opinions of asthma and get people getting help early by taking it seriously. If I don’t feel confident and don’t go to hospital for help then I am a hypocrite and should stop doing all the raising awareness and campaigning I do.

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As you can tell this has left a really black mark on me and I will get over it but it will take time. I do want to add that as a nurse myself I do understand how busy days/nights can get and we can’t do everything the patient wants us to do but when you see them laughing and joking and talking about nights out standing round the computer it is fair to see and hear they are not as busy as they are saying and when I see them as a patient doing this it makes me really angry.

I would hate to be in this situation again which is why I am going to share it with everyone I can. I could have gone home but I managed to stay and ended up receiving some of the best care I have had and did get better. I was not able to trial for lacrosse, or be at home for my birthday or go to any of the planned meals etc but I am now home and will enjoy that.

For now I will continue in the work I am doing to make sure that asthma is taken seriously and awareness raised.

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It never gets easier!

Just under 2 weeks ago I had another pretty serious asthma attack which ended up with me being admitted to hospital for over a week. Over the years I have had loads of asthma attacks and all of varying degrees, different situations and surroundings yet this past one is one I am finding the most difficult to process and one I am feeling the most insecure and scared by. As far as asthma attacks go it was not the worst but not the mildest either. So what is bothering me so much?

The weeks preceding the attack I have been slowly but surly going down hill. I was having difficulty fighting off a viral infection which plagued me. Ironically when I got up to go to work the morning I ended up having an attack I actually felt better and thought I had turned a corner and was throwing off the infection. The previous day I felt awful and was debating not going into work. I felt better so I went in.

It didnt take long or much to start me sliding down the slippery slope. I had to go from inside to outside and back in again to see a patient and doing this really hit me. The change in temperature felt like fire in my chest. Walking back to my unit it felt like someone was tying a belt around my chest and not letting any air out. By the time I got back I knew I needed to go home but I didnt want to admit it. I found my charge nurse and told her. I don’t think I needed to tell her I was not well as her reaction was to take me into a treatment room for me to have a neb. I struggled to put it together but didnt want to show how much I was not managing. My charge nurse was great. She asked if I needed to go to A and E at which point I said yes. No sooner had I said yes, I was in a wheelchair and on the move to A and E. We flew through the corridors of the hospital. I don’t remember it at all really. The next thing I was there in triage having obs done. From here on everything moved so quick. I was hoisted up onto a trolley and taken through to the Resus room with a consultant and reg who looked after me. My anticipatory care plan came into its own as I didnt need to say much and all the information the Drs needed was there. I was in Resus for quite a while before I was stabilised and brought back into the main bit of A and E. The Drs were all fantastic. I needed a lot of IV medication this time. IV aminophylline was started in A and E. For me we normally wait a bit and see if lots of nebs etc can get on top of it because of the issues with my heart but the Dr’s decided to start it. I was glad as I was getting very tired and felt like I had no energy to fight anymore. I was moved through to a monitored bed in the assessment unit after that to wait to be seen by Respiratory and a bed in the Resp Ward.

The whole A and E experience was really weird for me. In fact the whole attack was. I don’t know how to feel about it. It was a number of firsts for me. It was the first A and E visit using my anticipatory care plan which worked well so thats good. This time was the first in a very long time I have ever had anyone with me in A and E. I often find it difficult to have people around me because I see how scared they can get and the fear I see in them makes me scared which ends up being a bit of a vicsious circle. I did like having someone with me. It was a comfort when getting stabbed and poked and all sorts to have someone there to distract you and take your mind off it. The other thing about this attack is that it was the first really serious attack I have had at work in front of my colleagues. I have had days where Im chesty and not great but never had a full blown asthma attack in front of any of them. They are all nurses so will have seen people with breathing difficulties but when it is your colleague it is a bit different. Part of my anxiety about this is that sometimes when I have an attack due to being short of breath and oxygen etc I can do and say stupid things (for example I once tried to squeeze through the cot sides of the bed cause I thought this was the way to get out of bed!!). You can do and say stupid things in front of family but work mates is a bit different.

I shouldn’t be surprised that it has happened. I have done pretty well to avoid any major attacks in front of them until now but it has shaken me quite a bit. This whole admission has shaken me quite a lot of a few different levels. I will post about them once I have sorted my thoughts from the rest of the admission out. I have only processed the acute phase of the attack as so much happened.