THE National Review of Asthma Deaths (NRAD) was published in May 2014.
I was lucky enough to be granted a place on one of the paediatric review panels, however due to covering maternity leave, I had to give up my place and a close colleague and friend of mine took it up. And it had a significant effect on her every time she came back from a panel meeting. She kept reminding us of the severity of asthma and that people can die. However, the majority of people with asthma appear to underestimate their symptoms.
We have seen this for years and years in clinic. When you ask a family about the symptoms a child has they say “They’re fine”, then on specific questioning say “Oh well yes, they cough a few nights a week and when they exercise, but they have asthma”. It’s my job to reset everyone’s boundaries – child and family.
It’s a mantra now: “cough is not normal”, “wheeze is not normal”. And I always say it with a smile. Because patients and their families have lived with these symptoms for so long, that they either don’t notice them or “have seen them worse”. I understand both philosophies. I’ve seen it countless times before. And I would never make someone feel inadequate or stupid for thinking that (what do I know about adult diabetes or car mechanics?)
But, it’s one job we can do every single day. Ask the right questions. Don’t accept “They’re fine”. We can reset patient’s boundaries. And we can reset the boundaries of their family and friends. And we can remind each other that asthma still kills. Be vigilant and challenge everything, for the sake of our patients.
Elaine Anderson is a clinical nurse specialist in children’s asthma
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