Wednesday, 19 January 2011

Nurse, med student, patient

Last week was all about Asthma and as an asthmatic I had the opportunity to fill the role of expert patient for my PBL group.

"Expert patient" was a phrase I heard bandied around during my nursing training as a kind of gold standard of educated, engaged patient - someone who "knew more than the doctors". I found by and large patients just wanted to be told what to do and those that knew their condition inside out were more of an annoyance "I don't take my pills now/ do you even know what you're doing/ why can't I keep my tablets on my bedside table?" than a useful resource.

But here I was, telling my group about the ins and outs of asthma, medication and emergency care. I've never really thought of myself as someone with a chronic illness - I've never missed work because of it, never had an ED admission because it, exercise as well as anyone on my course (110% of predicted lung function and capacity, what up). But in my backpack is my salbutamol inhaler (just in case) and I take beclomethasone 50mcg BD, so I guess I am chronically *ill*. It was the main reason I didn't get into the RAF after my nursing training. It gives me pause for thought when it's really cold out. I know what it feels like to have your bronchial smooth muscle contract, leaving you fighting for breath. It's terrifying.

My mother was a stickler for me knowing my condition, I used to read her BNF in high school and learnt early on about corticosteroids and beta agonists. Then as a nurse I learnt about nebulisers, anti-muscarinics, how to read a blood gas and how to correct it and what to do when the shit hits the fan.

The week really pushed two thoughts to the front of my mind:

  1. There is value in the expert patient. I am one - I know how to manage my chronic disease and I would kick up a storm if I thought a healthcare professional was treating me incorrectly
  2. Respiratory medicine is something close to my heart. I'd never even considered when, sat with coursemates and coffee, the question is asked "What speciality do you think you'll get into?"
Food for thought.


  1. In my years as a nurse I have had many nurses and several doctors as patients. They are either the best or worst patients to have.
    I remember one post-surgical doctor signing himself out, he had abdominal sx, even his surgeon recommended him staying the night.
    He told me he could write for his own pain meds and stay in his bed, I probably would have done the same thing.

  2. I'd have plenty to say about the 'expert patient' ;-) but first things first: You wanted to join the Royal Air Force?