Having been involved in the asthma deaths inquiry panel, Rebecca Sherrington questions why simple changes aren’t being made in respiratory care
Within the past 2 months, two inquiries have both highlighted inadequacies and compliancy in respiratory care - the National Asthma Deaths Inquiry and this month the All Parliamentary Party Group (APPG) inquiry in to Respiratory Deaths.
As a nurse on the asthma deaths inquiry panels, I examined the records of two people who had died of asthma. It was an incredibly sobering and very moving experience, reading the notes of an anonymous young person, who had died that year as a result of asthma.
As a wife, I never stopped thinking: what position would I be in if this had been my husband or even one of my daughters?
As a nurse, it was also a very sobering professional reminder of the position I would be in if this had been my patient.
“the compliancy about respiratory disease is disgraceful and cannot continue”
Having been on the report panel and at the launch of the respiratory deaths inquiry as chair of a national association (ARNS, which represents respiratory nurses), I fully support the reports. I am now knocking on the doors of those in power to ensure that the deaths of all those within the inquiry have not been in vain.
However, I question whether the current recommendations are simply an extension of the past few decades and whether they really can lead to the vital and monumental shift in change that is truly needed.
I ask this, not because I don’t support the reports, but because I am passionate in my views that the compliancy about respiratory disease is disgraceful and cannot continue.
I strongly feel that perhaps we need a massive and completely new marketing approach that puts the general public in the position power – with greater knowledge and understanding of lung health. In order to do this we need a revolution to completely replace our language and wholly change the technology we use.
For example, if I am concerned about my blood pressure, I can visit my local co-op and have my pressure checked.
What access to lung checks do patients have?
What we really need is for the same accessibility for patients to go to their local pharmacy and use a piece of equipment that will provide a lung check. No appointment to see your GP, no reliance on the practice nurse having been trained in how to use the spirometer, just a simple machine that you can blow in to and get an immediate result – I wouldn’t call it spirometry either!
Again looking at technology, If inhalers aren’t been used properly and only 10% know how to use them – including those who prescribe them – don’t we need to ask why?
Why should we need to rely on healthcare professionals knowing how to correctly use inhalers and then rely on them again to effectively teach patients? If patients’ inhaler techniques drop after one year then perhaps we need to campaign to have the drugs industry standardise and design something that is usable to everyone without having to rely on being shown.
Why don’t we have a single inhaler that has a simple mechanism which allows patients to see if you’ve done it right?
“Why have we not followed suit in respiratory care?”
Similarly, we need to change the wording of our diagnoses. We use COPD as a term that is understood by no-one outside of a respiratory clinic and is rarely said correctly by patients.
If a CVA can be rebranded as “stroke” and the M.I. brilliantly renamed “heart attack” to make it easier for the general public to understand, why have we not followed suit in respiratory care? Chronic obstructive pulmonary disease, Idiopathic pulmonary fibrosis – could we use these terms on the side of a bus or bus shelter for a campaign or in a TV advert? Absolutely not.
We need to market and promote words that are easily understood by the general public and commonly referred to.
So while I support the recommendations, I also believe that respiratory organisations need to look at why patients and healthcare professionals aren’t engaged or profiling respiratory care with the same enthusiasm as other diseases. For this to happen we really need to move the specialism into patient’s hands and minds.
Rebecca Sherrington is Chair of Association Respiratory Nurse Specialists and Respiratory Nurse Consultant, Guernsey
Follow her on twitter: @becksherrington