My Working Day Claire Byrne describes her role as clinical nurse manager and co-ordinator of Beaumont Hospital's COPD outreach and pulmonary rehabilitation programmes
Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death in the world, and the World Health Organisation (WHO) estimates that by 2010 it will be the third leading cause. It is an illness of the airways causing shortness of breath and recurring chest infections, and is predominantly a smoker's disease. Current figures estimate that 200,000 Irish people suffer from COPD.
I usually work four days a week and as I work extended hours, my day lasts from 8am until about 7.30pm. In Beaumont we have the respiratory centre where the outreach office is and where my two colleagues and myself are based.
Initially I go into the office and check e-mails and from there I also check our casualty list, comprising patients who have come in presenting with COPD. We then head down to the A&E department and assess any patients that have come in during the night to see if they're suitable for our early discharge programme.
To be eligible, they would have to be suitable for discharge within the following 24 to 48 hours.
Sometimes they're ready to be discharged straight away, and then we put our home package in place. We do our own medical assessment on the patient, mobilise them to make sure they are able to walk and discuss the programme with them.
We then return to the office and plan how many home visits we have that day. When someone is discharged, we visit him or her for the first three mornings.
Normally, we try to continue care, so if you bring someone home initially yourself, you try to follow up and carry out the visits to that person.
Usually we go out visiting at 10.30am. On any day I could go from Skerries to Raheny to Balbriggan, so time management is important. We monitor the patient's progress, ensuring that their condition is not worsening and that their medication is working.
We aim to provide a "hospital at home" for sufferers, with the same amount of safety and care that they would expect in hospital. Education on the illness is also a major part of it, as fear and anxiety are significant elements of COPD.
We return to the hospital at about 1.30pm and, after lunch, we hold pulmonary rehabilitation classes. These are seven-week exercise programmes where early discharge clients come back into the hospital from 2pm-4pm.
In the first hour, they carry out their exercises, and in the second hour they have a lecture on how to manage their illness, perhaps from the dietician or pharmacist. Talks may also be offered on subjects such as complementary medicine. The programme has been very successful and patients see a real improvement in their quality of life at the end of the seven weeks.
It's then back to the office where we review the classes and catch up on clerical and administrative work.
No two days are the same in my job. At the moment, the COPD outreach programme has more than 400 patients on its books and this number looks set to increase. We are growing all the time.