Hospital Targets

A friend recently wrote a post about breaching a hospital time and therefore became one of the statistics.

I have been in this situation to and it was for exactly the same reason why I breached a hospital target time and reduced their good statistics!!!

The press focus so much on hospitals missing targets and patients breaching the four hour time you are to spend in A and E. Like my fellow asthmatic who also breached the four hour time in A and E I am glad I did breach.

I had had a bad asthma attack at home. I had to call 999. It had hit me out the blue which are the scariest ones. I had no option but to call 999. It was such a bad attack that the first responder travelled in the ambulance to A and E with us leaving the car at my flat. We had to stop on the way for me to be given adrenaline to try and keep the attack at bay. I was also cannulated and given IV hydrocortisone in the ambulance. This normally happens once in A and E.

Arriving at A and E I was taken straight to resus and jumped on. Not literally but it felt like it. I was attacked from all angles. I had both arms grabbed for ABGs and more access, stickers stuck on me for heart monitor, clothes cut off and gown put on. It was mental. They took 1hr 30mins in resus to get me to a point where I was good enough to be moved into the HD part of the A and E. After a while I started to get worse so was moved back to resus, stabilised again and then moved back to HD. It was decided I needed to go to HDU but they didnt want to move me there until I was going to be stable enough to be transferred safely.

By the time I was moved I had been in A and E for 7 hours. 3 hours over the specified time by the government. I am so glad that there are some people who acknowledge that targets can not always be met. I would prefer to breach a target and be safe than meet a target and be unsafe.

I wish all staff would see this. During the time in A and E the bed manager/ co-ordinator came several times and asked me why I had not been moved yet and also had conversations with nurses why I had not been moved yet. If I had the puff I felt like screaming that I was not well enough, could they not see it. It felt that their need to meet targets was more important than the health and safety of their patients.

I do think that targets need to be put in place but for those patients who require resus or other major intervention to stabilise them should be exempt from the targets. There are always going to be cases which do not meet targets but they are often those who have been very unwell but not unwell enough for ITU.

People who use A and E for Anything and Everything should also not be part of the statistics because many of these people do not need to be in A and E and should wait while those who are sicker  are seen. It is nurses and Drs who are having to see people for cut fingers etc that cause the breach and targets to be missed. If these people used the service properly and as it is meant to targets wold not need to set to try and get the best out our health service.

I see this from both sides of the coin- as a patient and as a nurse. It is a real frustration and one that is never going to change unless the health service is privatised but then as a patient privatisation of the health service would probably see me not being able to sustain my health and I would be in a worse state than I am.

It is a really tricky balance and no quick fix. But one thing I do know is that I am glad I breached the targets to ensure my own safety. If this were to happen again due to my health I wouldn’t complain.

You only get one life at the end of the day.

A question that changed my life.

What is that question?

“Do you want to die?”

Never a question you want to hear but one I have. It haunts me so often. Especially at this time of year. It was the night of my birthday in 2008 and my friends went to such great lengths for me to have a great birthday that I just had to enjoy it and wanted to take part in everything. I didnt care about my asthma at the time. I wanted to take part in the ten pin bowling, the dance mat at the arcade, the meal and then Flirt (a university event) in the Student Union.

It was not for much longer that I didnt care.

But I wanted to enjoy my birthday. And I really did up until I started feeling really poorly.

(if you wonder why everyone has Fosters beer hats on- my birthday is on Australia Day and the student union was giving hats, beach balls and flip flops away. Of course we had all of it!!)

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(the top right photo if you are wondering if I am wearing a bumbag- your right I am but it was holding my subcutaneous syringe driver of terbutline in it- my supposed life line!!)

The photos above you can see I am having great fun. The photo below you can see from the colour in my face I am starting to not feel well but try to push on. About half an hour after this photo was taken I had been taken by ambulance and was in resus.

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These photos show some of the good times and the great memories. A great rugby tournament where clearly some of us had less suncream on than others. A random social which included on drawing on t shirts wacky hats and for me a neck tie, and the last a trip to bournemouth beach where the boys went swimming in the sea!

 

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These photos don’t show much. They are not even the best pictures but looking at them so many memories coming flooding back. My really closest friends when I was down in Winchester were the rugby girls. They were the ones who named me Tux and really did look out for me. I think they are possibly the only group of friends who get away with coming dancing into Shawford Ward (the reap ward in Winch), in fancy dress, slightly tipsy, stealing wheelchairs and generally carrying on. But you know what it was the best thing.

Up until this point I have to be honest and say that I really didnt take responsibility for my asthma. I did what I wanted, when I wanted. I paid for it but I did it.

I find my self reflecting back and wondering would I have changed anything. Part of me instantly says yes I would. I put my body through hell, I put my family through hell, I put my friends through hell. I caused myself so much upset but in causing that upset I also had the time of my life. So this is the part of me that thinks maybe No I wouldn’t change any of it. Sitting where I am now I know that in order to not land myself in hospital all the time I would not have been able to take part in everything my friends were doing. It was not just the going out to the student union but day trips to the beach or BBQs and huge assortment of different activities I would have missed out on just to avoid not potentially precipitating an attack and a hospital admission. This would have led to quite a lonely life at university.

Why am I writing about this now?? I reflect back on it every year but this year has seen the biggest changes in me. The Tux in 2008 was living life, doing what she wanted, when she wanted and not having a care in the world. I was at one extreme. I find myself now at the other extreme. I don’t go out to parties, I don’t play sport, I do everything I can to avoid potentially setting my asthma off so I don’t have an attack which will land me in hospital and result in me missing work something I am desperately clinging on to. I can’t afford to not have no cares in the world anymore. Tux of 2015 is very different.

2007 to 2015 has been slow gradual switch from one extreme to the other. This change came about because of a question my Dr asked me “Do you want to die”. The consultant who said this to me I had a rocky path with. He is the old school Dr and says it how it is. Calls a spade a spade and doesn’t mince his words. there were times after ward round I hated him and never wanted to see him again. He probably thought the same about me. But it was that question that hit me like a ton of bricks. I had never really considered that MY asthma could kill ME. I either chose not to understand or chose not to remember all the frightening nights in intensive care on CPAP helping me breath and having a nurse stay with me because my family were up in Scotland. Every 999 call would end up with me in resus Drs and nurses pumping me full of medication and on one scary moment having the Dr use the mask and bag to help. I didnt comprehend just how serious some of the situations I got myself into were. I was never really aware of just how easy it was for asthma to kill you. From working with AUKCAR I know that asthma needs to be respected otherwise it can result in death. Not only could it happen to me but it could happen to anyone with asthma if they don’t take it seriously.  From that day I knew I had to change. There were hiccups along the way and I did go back to my old ways sometimes and not care about my asthma but generally I did take note of it.

The week of the “do you want to die” question I made my mind up to go home to Scotland and leave university and get myself really properly better. I am still trying to get totally better and get toady control but I think this is unrealistic. I want to get myself as well as I can and be as stable as I can on the correct medication regime.

In many ways that birthday in 2008 was a pivotal moment. Had events not have unfolded as they had I would not have left Winchester, I would not have studied nursing, I would not be a nurse, I would not working with AUKCAR trying to make a difference for all people with asthma. My life may have ended up as it is now but probably not. We don’t know how our paths change and what will cause change but for me it was being asked if I wanted to die.

Every birthday that comes I do think how lucky I am to have such supportive parents, friends, work colleagues and medical team. Without them I don’t know where I would be.