This International Nurses Day we’ve sat down with three nurses to hear their perspective on the pulmonary rehabilitation field. First up is Sarah Kearney, Lead Respiratory Clinical Nurse Specialist at St Mary’s Hospital Pulmonary Rehabilitation Programme, and member of the Associated Respiratory Nurse Specialists (ARNS).

How did you join pulmonary rehabilitation (PR)?

I’ve been a nurse so long I can barely remember! It’s a bit cliché, but I don’t remember wanting to do anything else. My mum was a nurse, and I used to play dress up with a doctor’s bag as a kid.

I started my career in general medicine and by chance started working in a respiratory ward. It just clicked. At the end of my first year as a student nurse, I met two staff nurses – Claire and Debbie. They were inspirational for me – they had endless knowledge, managed to get everything done in time and still had fun. Their compassion and care for the patients was just boundless, and they motivated the staff and patients around them.

When my son was a week old, a position opened on the Isle of Wight as a respiratory specialist. It felt like the stars aligned for me to take the next step. I moved over from London, and here I am twenty-four years later!

At the time the role was relatively new, they were looking for a nurse to focus on the lung cancer pathways. After a year, we employed another team member who took on that aspect of the service, so my role then steered more towards PR.

Around 2001, one of our consultants expressed interest in PR and offered a list of patients who might want to take part. They asked to find a physiotherapist and for help setting it up, so I became involved in the creation of the new service.

Initially we hosted the programme once a week. We had this little band of patients who were really willing to give it a go, they were fantastic. I have photos from back then, and looking back to our PR programme’s beginning always feels nostalgic.

How do you think PR nursing has changed since you started?

The role of nurses in PR has definitely grown and changed over the years. Nurses now have more opportunities; for instance, I’m lucky to be leading an amazing team that does not just PR, but also community respiratory nursing, home oxygen and a long COVID virtual ward. This does come with the caveat that there’s fewer of us now, and a lot of nurses are getting ready to retire which can put pressure on the workforce.

Nurses come into the profession very well educated with a wealth of experience. Sometimes PR can be seen as the domain of the physiotherapist, but really it is the domain of the respiratory team as a whole.

I feel lucky to be working as part of a small integrated team, as our nurses and physios work seamlessly together. In our service, we generally have a nurse and a physio working together on each PR course we run. As a nurse, we have different strengths when it comes to running and supporting PR courses. Nurses have a really strong skillset when it comes to encouraging self-management techniques through PR programmes – for example, we help with inhaler technique, recognising an exacerbation, and knowing when to call for help. Nowadays we work as a much more integrated team with our allied healthcare professional (AHP) colleagues to pool our experiences to offer the best possible care for our patients.

How would you encourage others to join the field of PR?

I think to bring more people to the field we should emphasise patients’ stories: when a patient participates and really commits, you see what a difference it can make. It seems like such a small thing, to do a little bit of activity and read a bit of information, but it can end up being the most important thing a patient can do to look after their lung condition.

Respiratory nursing has always had its challenges depending on the cohort of people you’re looking after. One of the important things about PR is that you’re improving someone’s quality of life, making the best of what they’ve got. It is really rewarding, seeing someone who is terrified about their breathlessness and feels that they can’t do anything – as a clinician, you get to see them learn how they can manage their breathlessness better and push themselves further.

What advice would you give your younger self?

I would say to have a flexible approach, not every patient is the same. Being able to adapt what we offer them, even when we’re restricted by various circumstances, can make a huge difference. When we are doing PR, it is important to make sure that the work we do translates to their everyday life.

Real progression comes when you set a realistic goal: a small change that would be really meaningful to a patient. If you can’t do the hoovering before you come to PR, and by the end you can manage the lounge, that’s a big change to your daily life and independence.

Why did you join PRSAS?

I’ve wanted to be a part of the process for ages. I did an evaluation of a service as part of accreditation in the pilot phase, and it was amazing. It was so interesting to see how differently thigs are in another service, and I wanted to take the opportunity to make sure that our service was offering the best it possibly could. Having the backing of PRSAS meant we could point to the standards as a basis for our requests to leadership – we could say to them that in order to achieve accreditation, they would need to offer us this bit of support or these resources to facilitate our work as a team.

Is there anyone you would like to mention?

At the moment I have a team of two who are doing an amazing job: Nikki, our physio assistant, and Ian, one of our nurses. A huge thank you to both of them, they’re doing amazing work.