To my GP Practice Nurse

To my GP Practice Nurse,

You sent me a letter telling me to come in for my annual asthma review. To be honest, I felt irritated by the whole process. I felt you were ‘going through the motions’ because you had to.

It started out well- you introduced yourself cheerfully with ‘hello, my name is… and you’ve come for your asthma review. What’s the problem?’. I said I don’t have a problem with my asthma, I only came for the annual review. Your attitude completely changed. You stopped telling me what you were doing and focussed on your screen, pausing periodically to ask disjointed questions, without actually looking at me. You asked me what my medications are, so I started to list the ones specifically for my asthma, but you stopped me and said ‘I only care about inhalers.’ Which might be the case, but it was pretty rude the way you said it.

At one point, you got a really battered notebook out of your handbag and started flicking through it. You were clearly looking for some kind of information, but it took a few minutes to find. I felt a bit awkward sat there watching you look for something- I really hope it was something to help you fill in the computer system, rather than something telling you how to do an asthma review.

It felt a bit like you were copying information from my GP profile over into the form. You kept going backwards and forwards between screens. If you were just going to ‘copy and paste’ and not really talk to me, did I actually need to come to the appointment? You came across my spirometry tests and asked me about those. Then you heard me say about the Regional Asthma Service. You took a breath, scrolled back up with your mouse and said ‘Oh yeah, I remember you, I need to ask you these questions then.’

It felt a bit like if you hadn’t seen those results, you would have filled the form in without actually asking the questions. Does that mean that most asthmatics you review don’t get asked the questions and/or you don’t do the review properly? You were talking to me again. You changed some of your responses on the form where you’d wrongly assumed something. You asked me about my last A&E admissions, exercise and smoking. You’d assumed most of it right, but some of it was wrong.

Assumptions are dangerous in healthcare. Did you also assume I’m on the SMART plan because I take Symbicort? Because I’m not. Did you assume I have a written asthma plan? Because I don’t actually have an updated one at the moment. Did you assume I know all of my triggers and how to manage them? I do, but that’s not the point.

I’ve had at least a decade’s worth of asthma reviews, and you didn’t ask me half of the questions I usually get asked. Perhaps I’m assuming too much myself- you might have been about to ask the questions and you had every intention in completing the review fully. In which case, you could have communicated with me better as to what you were doing on your screen and why.

You didn’t tell me I was managing my asthma badly, but you didn’t tell me I was managing it well either. If I were the type of patient to ignore medical advice and not turn up to appointments, I wouldn’t bother coming back to an asthma review because you made it clear to me through your actions and your lack of communication with me (verbally and looking at me) that you thought the whole process was a waste of time.

I know I manage my asthma well. Maybe you assumed I knew that too. I just feel that you could have done more to make me feel like I wasn’t wasting your time, considering it was an appointment you asked me to attend.

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