Parking is not the only issue at the RIE

In the press today and on social media there is a lot of energy being focused on the Royal Infirmary in Edinburgh and its issue with parking. Ever since I have worked at the RIE there has always been an issue with parking. There has never been enough parking for the number of staff let alone patients or visitors.

This summer the new Sick Kids hospital is moving out to the RIE site as well as DCN. Now the new departments have been built on one of the previous car parks and there has been no replacement car parks being put in place.

There is up roar about this especially as staff have to pay to park. You can apply for a permit which costs £25 a month but these are now in short supply and to qualify for a permit you need to meet certain criteria. I remember when I was applying for my permit first off having a blue disabled parking badge did not move me up the line I still had to wait. I did eventually get a permit and was able to get a permit for a car park close to the hospital because of my blue badge but this to me is almost a waste of time because the welfare of the people working there is not addressed or prioritised.

For me and many others one of the biggest issues at the Royal Infirmary in Edinburgh is the smoking issue. There was a supposed smoking ban on NHS Lothian sites but what it seems to have done is nothing more than encourage people to smoke right outside the hospital doors. I remember just after the smoking ban came in I was working a night shift and halfway through hand over I had to get taken to A&E due to an asthma attack as a direct result of making my way into the hospital from my car. Sadly this was not the only occasion this occurred. There have been at least 6 occurrences where me getting from my car in the car park to the front door have resulted in me being exposed to people smoking where they should not be and ending up requiring hospital treatment and sometimes needing to go to intensive care.

Just now I am on a career break focusing on research but I am very concerned about going back to work next year. I will need to reapply for my permit but also if I don’t have a permit I will need to either pay for parking which is not always guaranteed, or risk getting public transport which could put my life at risk. I worry that will my hard work this year to get my health better be then set backwards by the risks that are involved in just getting into the hospital.

I have tried to speak to anyone who will listen about the smoking issue which is particularly bad at the Royal Infirmary but it seems to fall on deaf ears. The really shocking thing is that an area which is probably the worst for the number of people smoking is right below the respiratory ward and not even that is doing anything to get the smokers moved. I am not against people smoking- it is their choice if they want to end up giving themselves COPD and a self inflicted breathing condition but I am against them inflicting others to their bad habit. I didnt do anything to cause my lungs to get like this they are just like that so I do not expect to have them deteriorate as a direct consequence of someone breaking the law and smoking where they should not be working.

The most shocking bit about it is that the Royal Infirmary in Edinburgh are happy to patrol the car parks and put tickets on cars which are parked in the wrong place but turn a blind eye to people smoking. I tell you a car parked in the wrong place does a lot less harm than people smoking.

When it comes to April 2020 I will need to think about wether it is worth the risk  to come back to work if the smoking issue is not addressed.

It is a sorry state of affairs when healthcare workers are questioning wether they continue in the career or where they are working because there is not adequate provision to support them.

 

The uniform that saves me, is it drowning me at the same time?

Since my attack at the end of November/ December I have really struggled mentally and physically. The initial recovery was good, my lung function returned to my normal fairly quickly and my energy stores were up, I was able to get about and get on with my daily routine without much limitation. Reducing steroids was a bit hairy but with the help of my consultant and asthma nurses we managed to keep on top of things although the reduction has only got as far as 30mg but hey its better than 60mg.

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I was confident this speed of return was due to the new treatment I am on but now I am not sure. I think a lot of it probably was at a basic level. The treatment helped me get back to my baseline to function quickly but Im not sure it got me to the baseline for work. I was excited to get back to work but I wonder now if it was too quick and the timing didn’t help. Looking back now despite reduced hours apart from the first week I was never able to get away on time because there were patients who needed to be seen and I was the only one about. I already arrive 30 mins early for work (this is my choice) because I have worked out that this is when there are the least number of people smoking outside the doors mainly due to breakfast and drug round on the wards! Many say that I can get the ward to see the patients etc but being a patient and having had this done to be it breaks the patient nurse relationship and you lose confidence in them so for me it is not an option.

But i now need to put my own health first. I keep going round in circles with it and I love my job and love working with the patients etc but then I get my body into such a state and I often don’t realise it until I am told. Last week I noticed patients commenting on how awful I looked and should I be in work, the people I was in the lift with would ask if I was ok because I was so wheezy, the finally after spending a weekend in bed and thinking I felt better I went into work to be sent home by one of the other charge nurses because I felt so awful and sounded it.

Part of living with a chronic illness is that you don’t often know how bad you are feeling until your on your knees. I know a lot of patients have said the same that they didnt realise how unwell they were until we got them on a treatment and it is once they are established on this that they really see how unwell they were. I think is how I feel that things just decline slowly and it takes a huge attack or event to stop the downward spiral and start getting better again.

Going back to the title of this post. I love putting on my uniform, I worked hard to be able to get it and then be able to keep wearing it. It is also the uniform the nurses who look after me wear as they get me back on my feet and my lungs working a bit better. But then I also wonder if my drive and love of work is also what is causing me to not get to my full potential of wellness. I am really torn with what I should be doing and need to stop and evaluate what is important to me and what is in my best interests.

I have an appointment with my consultant this afternoon where I am going to ask his opinion as I really cant continue as I am. I am back to the point of living to work and that is it. I love my job but need to have more to life than work.

I wish my lungs felt as good as these ones do!!!!

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The NHS Long Term Plan

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No one can have missed the news recently about the NHS Long Term Plan for NHS England. Even those of us not living in England can’t miss it!!! I know I live in Scotland so it does not impact me directly but I am pretty sure the Scottish Government will take on a lot of the plans for the Scottish Health Service that are talked about in the NHS Long Term Plan.

The biggest thing that I have noticed in the news, on social media from news agencies is surrounding smoking and the help that is going to be given to people who smoke that are admitted to hospital. Any time I see anything about the plan this is what I see and it just angers me so much. I know I am not alone either as have spoken to many people who are in a similar position to me with their lungs that are frustrated and angry about it to. For me what it me most was that along with the national news agencies and NHS health boards tweeting about it, my own local health board posted (once again) about how they were going to give smoking cessation help and advice to patients admitted to hospital.

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I know this is a very good step etc and that people who smoke should be offered help to stop however on a daily basis just to get into work I run a gauntlet to try and avoid breathing in any smoke. The NHS made a huge deal about how their sites were to be no smoking sites and that smoking is banned on their sites yet nothing is done to enforce this. They have signs everywhere yet those who smoke just stand by them and light up. Some don’t even wait till they clear the door before they light up. This is not unique to me and the hospital I work in. I regularly see on different forums asthmatics saying they had to go to hospital but just trying to get into the hospital left them in a worse off state than they were when they arrived in the car park etc because of all the smokers they had to pass.

Until you have put up the fight of your life just to get a breath in you cant understand what it is like. It is one thing when you may have been a bit silly and done something stupid which provokes an asthma attack but when you have done nothing other than try and get into work and you end up in intensive care it can leave you feeling really angry and bitter.

What I would love to see and so many would love to see is the smoking ban being enforced or at least a shelter to provide those who smoke a place to go and then leave areas such as the main doors to the hospital as a safe zone. Also when there are the groups of people congregating outside the doors of the hospital- many of whom are patients why are the smoking cessation nurses not down there encouraging them to not smoke or at least smoke in an area which won’t risk killing people.

What is worse is that the main doors to the hospital I work in which are always flanked by people smoking, are over looked by 3 of the four bedded bays in the respiratory ward so during sweltering summer days you cant have the window open because you end up with a room full of seconds hand smoke.

I am not alone in how I feel and what I think which is why I am writing this. I am at a total loss as to what to do because everywhere I try and get the issue addressed cant give me any answers. Is it going to take someone dying from an asthma attack as a direct consequence of people smoking outside hospital doors for action to be taken?? I have got in touch with ASH, Unison, local MP none of whom could give me an answer or willing to take action.

My working hours are 9am to 3:15pm, I have a blue badge due to the severity of my asthma so can park close to the hospital however I have had to start arriving earlier and earlier so I can have the time to wait till the doors are clear of people smoking and then take my chance. This time is different each day but it shouldn’t need to be done. There is then the reverse when it comes to leaving work however I tend to end up just trying to get out and get to my car, once in the safety of my car I can have some nebulisers to alleviate the effects the smoke has had on my lungs. I just wish those who smoke understood what they were doing to others.

It is so hard to see so many struggle. I have read how people feel like turning back and missing their hospital clinic appointments because of people smoking at the doors and the risk this poses to their health. This should never be a choice that someone has to make.

It would be great if others could share this and try and get change to happen.

If the NHS are committed to help people stop smoking, then they need to be down there with those who are smoking not up in offices making plans. Smoke is not just effecting those smoking but also others around them and not only those with lung disease either.

Please lets try and get things changed. I don’t want to risk losing my job (which could be a real possibility) because I have once again ended up in the intensive care unit as a result of people smoking where they should not be smoking.

#stopsmokingonNHSsites

Passive smoking……what does it mean???

apart from death?

I cannot count the number of posts I have done about smoking, passive smoking, the smoking ban and how it effects my lungs and the lungs of many others like me.

It really hit me the other day after parking my car in the carpark at work and walking the 200m to get into the hospital how many people I had to pass firstly at the pedestrian crossing, then the pavement to get to the narrow walkway to get inside the doors and then the narrow walkway itself and the doors was just like running a gauntlet and taking your life into your hands.

24….thats how many people (patients) I had to pass who were smoking on the short 200m walk. It is sickening to have so many people.

Im not sure those who are smoking really understand just what the effect is on other people as there is no way to liken it to anything else. I can never explain the mental and physical negative effects that it has on me (and Im sure I am not alone in those thoughts).

The fear I have is unreal. I am terrified that this is what may happen AGAIN

Both these photos are from the effects of passive smoke which hit me when I was no expecting it. The first photo was just before going to ICU after spending about 8 hours in resus, getting stable, moved to assessment unit to then get bad and need ICU. The second was taken in ICU after someone smoking below my open window and me having an asthma attack.

The fear of having asthma attacks is like no other. There are theories that you can make someone run up stairs with a close peg on their nose and breathe through a skinny straw to simulate what it is like to not be able to breathe but they can always take the peg off and open their mouth.

In the photos above I was so tired I just wanted to give up and stop fighting but you cant. If you give up you risk being intubated or dying. This is the reality. So many people die from asthma attacks that come from triggers that are out with their control. It feels like you are being punished for something you didnt do. It is more than just the attack itself but the consequences that go with it- being off work, missing holidays, medication that causes side effects, family being so worried about you, family needing to look after you to name a few.

Before the ban on smoking there were visible smoking shelters and it never used to be a risk to just get from your car into a building. I am not saying that everyone used the smoking shelter but a majority did and the risk was greatly reduced which matters so much.

My biggest fear in life is having an asthma attack, so imagine being faced with your biggest fear on a daily basis multiple times. It seriously makes me wonder if working is really worth the risk. I don’t know who to speak to about it. I blogged about it, tweeted about it, spoken to my union and will just about tell anyone who will listen. I love my job but it is getting to the point of weighing up risk and reward especially with being on a new treatment. Can I really justify the expense this new treatment will cost the NHS vs exposing myself to a major trigger everyday and risk attacks which could jeopardise the success of the trial.

Anyone who can suggest or make a difference to the smoking obstacle course I face please let me know (I have tried using other entrances but this is an issue at other ones too). as I am desperate now.

 

Returning to work in a fog of smoke.

I have been back at work now on a phased return and it is going fairly well except for one part. When my chest feels tight I do find it a bit of a struggle to get from the car park to the hospital. The staff car park is the furthest out from the hospital and includes crossing the road that circles the hospital. It is not to far only about 400m probably but when your chest is tight it feels like a marathon.

To compound this staff seem incapable of waiting until they are either in their car or off the hospital site before they light up they cigarette and go on their way. I see them walking out the hospital cigarette and lighter in hand before they are even out the building- it is almost like you can see them itching to light it which they do as soon as they are out the building. It appears that they cannot survive without their nicotine that they don’t have a care for who is around them all they are focused on is lighting up and getting their fix not worrying about the effect they have on others as long as their cravings are satisfied.

I guess I am more sensitive to triggers now than I ever was before because of the attacks I have had since the start of the year- they terrified me and still haunt me. My lungs are still twitchy so any trigger will make me feel tight and wheezy. When I was off sick I longed to go back to work to have a purpose to the day and get back to the job I love but how can I do the job I love when getting into work I can only describe as running the gauntlet not knowing what I am going to have to go through just to get from my car and into safety of the hospital. This really hit me yesterday when I had 3 people in front of me smoking as I left the hospital to get to my car. I had to wait outside in the cold until they had moved far enough away that their smoke had dissipated and was no longer a threat. To me smoke is as much of a threat as a dangerous patient if not worse. You can’t call security for help from someone smoking but you can for a dangerous patient. I don’t mean to trivialise a dangerous patient but to me right now smoke is more of a danger to me than anything else. I don’t want an attack triggered- the fear of another asthma attack like I had grips me so hard I can’t shake it off.

I know you can’t go around dictating what people do but what I have huge difficulties with is that the hospital is meant to be a no smoking zone and there are signs everywhere which are just disregarded and no notice is taken of them. Many of the people I see out smoking are nurses. The same caring compassionate profession that I am in yet they really don’t actually care for those around them. There is nothing worse than being a patient and having a nurse come off their break smelling of smoke and you are sitting in a respiratory ward and could quite easily be set off just by the smoke that is lingering in their hair or on their clothes.

I think my issue that I have trouble accepting is that I did not choose to have my lungs like this. I am trying to do all I can to stay well and achieve what I want to do but I see all these people who choose to smoke and are choosing to do damage to their lungs and other peoples lungs. I do remember once I was subject to one persons smoke which caused me to have an asthma attack and go to hospital- the nurse’s smoke that caused the asthma attack was the nurse who ended up looking after me. I found this really hard.

I have rambled a little bit here but I am just so frustrated that by trying to work and get to work I am risking my own health to get inside the building. I have asked to move carpark to one that is closer so that the gauntlet I have to run is shorter and therefore the potential risk is much less but this is yet to happen and Im not sure if it will happen. It is a very small request but it does make me think what is the point of pushing myself to work when those around don’t want to try and help. To put it bluntly if those who smoke think about those around them and perhaps smoke only where they are meant to they would not effect other people, they would reduce the number of people who end up in hospital and therefore reduce their work load making their life easier.

This is a little bit off the deep end but its how I feel.

Venting frustrations…..again

Everything seems to be a bit negative just now and I really don’t like it but I do find writing down things that bother me cathartic and really help get them out my head and mulling over them. It is often things I won’t speak to anyone about as I think people would be bored of hearing me moan but also they really have absolutely no understanding of what it feels like sometimes.

My biggest issue I have with my asthma is that there is nothing I can say caused it to get bad. I have not always been a perfect patient and not always taken medication as and when I should (I learnt my lesson with that and now keep to a strict regime) but I desperately wish there was a cause for it to have got so bad. No matter how much I try I really cannot come to terms with the fact that there was nothing that I could really do to prevent this. It just happened.

 

I am hugely anti smoking yet so many of my family smoke and they don’t get that they take their breathing for granted. They have all seen me have asthma attacks yet they still smoke. They also don’t think when they light up and leave a door open that it will bother me, they don’t think that the smoke stays on their clothes can have an effect on my breathing, they just don’t think because they take their ability to breathe for granted. If I make a fuss that they have lit a cigarette around me and I get a face full of smoke they get all annoyed and tell me to go away, I am the one that ends up moving and having to stop what I am doing to accommodate them when they are inflicting something I a) chose not to do and b) something that negatively affects me. I would never wish my asthma on anyone but sometimes I would love for them to feel what it is like for me to breath on a daily basis but also when I am near smoke of any kind. It is horrible and to know that this is your family members that are doing this is awful and they just don’t see it. Years down the line they will have damage to their lungs and suffer the consequences of it but weirdly in my mind at least they have a reason for having bad lungs. It was what they chose to do to themselves so they need to live with the consequences of it.

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For me I don’t have that reason or any reason. I have just bad asthma that wants to control my life and requires medication several times a day to keep it in check and be able to breathe adequately.

This now is a total moan- even more than what I have just written but those that smoke and then they get a cough or cold hey feel their life has fallen in. Someone said to me that so and so was not well and had an awful cough. I turned round and replied that if they chose to stop smoking or smoked less Im sure they wouldn’t feel so unwell or have such a bad cough to which I was told I was not being very sympathetic or supportive. But hello….they chose to do it. How can I be supportive or sympathetic to someone who will most likely not give two hoots about lighting up a cigarette and won’t care who is around and who it is going to bother.

I really hate it if you can’t guess. It seems to be more prominent now as well. Everywhere you go there will be someone smoking in a 5m radius of you. Its disgusting but god forbid you make a fuss. I remember once needing to get into a restaurant but a man was smoking in the doorway. When I asked him to move so I could get through avoiding the smoke I got a whole heap of dogs abuse for it. Smokers think it is their right to be where they want and smoke without giving a care to anyone else.

This brings me onto the ridiculous idea of having no smoking on NHS sites. I still can’t believe that I really don’t agree with it and wish they would reinstate smoking. Now I can’t walk around the hospital grounds without coming across someone hiding behind a corner trying to be out of site smoking because they are too lazy to go off site. At least before when there was the smoking shelters you could avoid them but now it seems like no where is safe. It makes even getting from my car and into the hospital more hazardous than it was before.

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YEAH RIGHT!!!

I am such a grump but if you hadn’t guessed smoking it really getting to me just now and I want to scream at people who smoke. I would love them to do a day in my shoes and Im not even that bad compared to many people. I should be lucky I have the health I have as so many have it worse than I do but just now I can’t let it drop and I keep getting so wound up by it. I am hoping that by writing it down and getting it off my chest then I will feel better for it.

Fingers crossed!

23 days on….. and its only got worse!

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Smokers need to imagine what it is like to fight for your life, to work so hard to get that tiny bit of breath in to supply oxygen to your brain and body. They need to experience this. They need to fast forward 10, 15, 20 years and try taking those precious breaths which they won’t be able to due to all the damage from smoking for many many years. They will soon have to fight for each breath. Only there fight will never get better. Their obstruction will not be reversible it will be permanent, there cough will not go away, the chronic chest infections won’t get better with antibiotics they will be stuck in a downward spiral as their airways get smaller and smaller due to inflammation and obstruction. They will rely on Drs and Nurses to fight to make them better. They will need the help of social services and be left gasping for breath just getting out of bed or standing up. This will all be due to the years of smoking cigarettes. The feeling they will feel are the feelings they make me feel every time I have to pass someone who is smoking. They don’t give a second  thought about it. They think I am over reacting about the effect the smoke has one me. They will comment about it being a free country and they can smoke when and where they want without thought of the damage it does to others. They will expect the health service to look after them and some of the people they have made ill will have to be looking after the people who smoked.

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The day that you fight for your breathe and fight for your life will be the day when you experience exactly what many asthmatics feel like when exposed to smoke.

Back on the first of April I questioned wether or not the NHS going smoke free was a big April Fool. Its the 23rd April and it appears that the NHS are not going smoke free even though they say they are. Rules are made to be broken but this new rule seems to be the easiest one to break of all.

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I and many of my asthmatic friends would be the first ones to stand up and rejoice that hospital sites are meant to be smoke free. It would mean so much more than not having to wonder how many times you will need to use your inhaler from taking your first step into hospital grounds to getting inside the door. It would mean no longer having to walk the long way round to find a door not many use to enter the hospital avoiding smokers hovering outside, it would mean being able to do your job or attend appointments without being worse than you were when you left your own house. The list is never ending for the benefits of not smoking.

There are no benefits to smoking what so ever but occasionally when I am very frustrated and having trouble to breathe, part of me wishes I had smoked. If I had smoked there would be a physical reason why my lungs don’t work as they should and why I need inhalers, nebulisers and tablets to keep my lungs working. This only comes into my mind when I am sitting awake in the small hours of the morning using my nebuliser wishing there was a cause for all this illness which just now I don’t have.

This is why I can not believe what I am about to say. Never in my wildest dreams would I ever dreamt that I would be in favour of revoking the rule and allow people to smoke on site again. I am stunned I would even consider thinking such a thing, but the reality is I would prefer it. I hate part of myself for this as I know what it feels like not to be able to breathe and I watch powerless as strangers choose to inflict damage and give themselves a future of pain and suffering.

Why do I want this?

Since the ban on smoking on hospital sites it feels like there has been an epidemic of people smoking on the hospital site and they are everywhere. Around every corner there will be someone puffing on a fag. It has made getting from the carpark to inside the building a logistical nightmare trying to find doorways which are not clouded in a plume of smoke.

At least before there were smoking shelters which were used pretty well and for those who did not use the smoking shelters there were the hot spots where you could find a group gathered. You knew the areas to avoid but now it feels like there is no where to hide from people smoking.

The biggest irritation is that no one is patrolling and enforcing the ban. No one is picking people up on smoking and god forbid you take it upon yourself to suggest people did not smoke the looks and comments you got were not worth it.

As a worker on an NHS site I despair on many occasions. There are rules for everything and it begs the question why are some enforced and some not. For example parking. You are quizzed about why you are trying to get into a carpark on arrival at the barrier and if it not for a reason that is approved by the car park people you don’t get in. As a community worker based in the hospital I have to take a lot of stock out to patients which can be very heavy. The solution is that it is dropped down stairs and I then bring the car round. The number of times a warden has come to tell me my bumper is over the yellow hashed lines or I am in the wrong place is astonishing. Half the time I spend arguing with them about being allowed to park to pick up stock I would have been away far quicker had they not caused an issue. I would have been creating less of an obstruction. My issue is that there are people enforcing rules which are doing no damage at all and not preventing someone getting treatment or anything being detrimental to someones health yet a ban is in place to stop people smoking on NHS sites and there is no one to enforce it.

It is disgusting that they can get away with this. I am sure if I went (wearing a mask and protection) and sprayed air freshener or a substance with an unpleasant smell all the smokers would be up in arms about someone spraying something yet they have no issue making others breathe their smoke in when it could damage their health.

I was so annoyed last nigh about it as I suffered a bit of an asthma attack- nothing major on my way home from work as I was rushing to get my haircut, I wrote to Asthma UK, Asthma UK Scotland, ASH and also my local MSP about how the smoking ban on NHS sites has almost caused a bigger problem than smoking was before. At least before you knew were people were and could avoid areas. It was not ideal but it worked. Now previous “safe spots” are a hazard making an already slightly problematic task nigh on impossible. I decided to take action and will await my responses. It may not come do anything but for myself I feel better for expressing how I feel and doing a small part to try and make life better for myself and others who suffer at the hands of those who are selfish and smoke.

I feel so passionately about this subject more so than any others because it effects my ability to carry out the care I need to give my patients to ensure they have the best quality of life they can possibly have.

My whinge is over sort of!! Had a pretty awful day at work and it has left me questioning why I bother killing myself to do  the best job I can. Pushing myself is making my life very restricted. I love my job and I love my job so much that I am prepared to sacrifice some of my free time to rest and recover from hard days at work. But today I really wondered why I bother. Many more days like that its not going to be worth it as I really can’t afford to sacrifice any more of my social time to allow myself to rest and get better and stronger for the next day ahead. I have a lovely weekend planned as it is my Stepmums 60th so we are all going out for a family and friends lunch on saturday and then I have golf on Sunday before more golf next weekend!