More and more doctors and nurses are using the Luscii app to monitor their patients remotely. Today, we talked to Monique van de Kragt, a physician assistant in the pulmonary department of Zuyderland Hospital.
Have you been involved in healthcare for a long time?
“I started training to become a lung function analyst in Maastricht in 1998. A great profession. Using all kinds of examinations, you can help the pulmonologist make a sound diagnosis. What is the patient’s lung capacity? And their strength of exhalation? Do they have an allergy? In 2001, I joined Zuyderland Hospital in Sittard. When the chance came up to become a physician assistant there, I grabbed it with both hands”.
What does a physician assistant’s day look like?
“Very varied. I mainly work with people who suffer from COPD. I see some of them at the outpatient clinic in the afternoon. I spend a lot of time explaining the influence of lifestyle choices. In the morning, I visit patients who have been admitted with an acute lung attack. I try to take the time and delve deeper into nutrition, exercise and anxiety”
Are people with COPD often anxious?
“During a lung attack, people are really terrified, which is very unpleasant. That is why I always try to visit on the second day of admission. Then the treatment has often already had some effect. I try to make everything open for discussion, even the end of life. About future wishes; what patients still want and don’t want. Sometimes, they are shocked by this, but afterwards almost everyone is happy that I started talking about it. One patient still wanted to visit Indonesia. I said; if that’s what you really want, then you have to do it now. He went right away and had a great time”.
It’s great that you take the time for that.
“Taking the time is so important. I hear that from patients and I also notice that I am achieving more. That people, for example, stop smoking or take up exercise again. Sometimes, it’s a struggle to find enough time for a conversation, but I really believe it pays off. Doctors only have ten minutes per patient. What can you do in such a short period of time? They are far too busy in my opinion, and the real wave of the aging population is yet to come”.
Do these lung attacks always occur so suddenly?
“We are constantly preaching that patients have to exercise more, but before an admission, we often find that people do less and less. For example, they have already stopped physiotherapy for a while and their condition has slowly deteriorated. Then it would only take a virus or urine infection for the COPD to start playing up again”.
Does remote monitoring help to prevent a lung attack?
“We have not been working with Luscii for very long, but I think it does help to see decline earlier. I had a patient who was in the hospital six times in six months. Now that he uses telemonitoring from Luscii, he has become more stable. Once, when his condition began to deteriorate, we saw it early and could treat him with prednisone at home. He was really happy with that. In a way, it provided confirmation that he is being closely monitored from a distance”.