21 September 2021

By Claire Jackman, Royal Brompton Hospital

Good morning! I’m Claire, paediatric respiratory nurse specialist at the Royal Brompton Hospital. Follow me while I navigate you through a day in the life of an asthma nurse. There is no such thing as a typical day’s work as every day brings something new.

Grab your morning coffee and let the day begin!

9am

The first task of the morning is monitoring asthmas admissions, collaborating with the ward and other healthcare professionals such as respiratory physiologists. Since COVID-19, we are able to monitor children’s lung function at home and if their results come back low, we will call and support families and patients – this can sometimes mean advising them to go to A&E if we are really worried.[1] We will also support and see any children and families admitted to the ward.

Some mornings we hold an outpatient clinic concentrating on new referrals and children with difficult asthma who require increased monitoring.

Whenever we see a patient – whether that be via video call, during clinic or while they are on the ward – we always offer education around what asthma is, the importance of remembering to take inhalers and inhaler technique. We also make sure everyone has an up to date asthma plan and that they understand it. Sadly, we know from the National Review of Asthma Deaths 2014 that poorly controlled asthma and lack of an asthma plan are factors in asthma deaths.

11am

Throughout the day we conduct video nursing consultations, including for children receiving homecare for their biologic treatment. During the video consultation we support the families in administering the injections as well as asking the patient and their family numerous questions about their asthma and asthma control over the past month and providing education and tips on inhaler technique. (Unfortunately, not all patients receiving a biologic can receive homecare and these patients will come to the hospital every 2 weeks or every month for their injections.)

We also conduct home visits, because seeing the children and families in their own environment is great assessment tool. We assess the child’s asthma control, inhaler technique, and consider the impact of their home environment on their day-to-day life. Sometimes we have to have difficult conversations if we think a family pet may be making a patient’s asthma worse. That’s a part of the job we really hate.

1pm

You will catch us having some lunch; we do our best to take a break for 20 minutes, but usually lunch is eaten on the go (especially if our morning clinic has over-run). We then prepare for the second half of the day.

Once a week the whole team (doctors, physios, pharmacist, psychologist and the specialist nurses) discuss any particular worries or concerns with any of our patients – it’s a great way to get support and advice from the wider team and further improves the care we give our patients.

If we have patients admitted for assessment of asthma control and symptoms, we take them out to the park or to a museum not only to have some fun and build a professional relationship with these children, but also to assess their asthma symptoms when exposed to different environmental factors. It also allows us to assess any exercised-induced symptoms. This has got to be one of my favourite parts of the job.

3pm

Our team provides education to other healthcare professionals within the hospital to ensure everyone is up to date with the correct research and asthma treatments available. We provide our colleagues with short in-service training sessions on how best to manage a child with asthma. We also signpost to the many resources available to healthcare professionals as well as children and their families.

5pm

It’s now coming up to 5pm – sometimes known as the hour of power where you try and finish off all the tasks you didn’t manage to complete earlier in the day, and we do our best leave the office on time.

I enjoy the autonomy and variety of the work, particularly seeing the positive difference that can be made in a child’s asthma symptoms and management through education. I love being part of a team of likeminded colleagues who are all so passionate about helping children and young people with asthma.

End of the day

It’s now time to put your feet up and relax for the evening. Thank you for coming on this journey with me.

[1] Before giving patients and families the at-home device, we provide them with the necessary education, so they know when to present to A&E and know not to wait for our follow-up call. This is very important with at-home monitoring devices because in emergency scenarios every second counts.

See more from #AskAboutAsthma 2021