ABSTRACT
Some specific tasks, such as more complicated
lung function, blood gas assessment for long-
term oxygen therapy or the management of
severe exacerbations need to be performed as
secondary care. As with most chronic diseases,
however, regular, planned management by
one or a few individuals provides the most
effective pattern. This is often best performed
by a nurse with training in respiratory
medicine who can spend sufficient time
discussing therapy, checking inhalation
techniques and exploring areas such as diet,
exercise and mood. This allows patients to
build up confidence. Where there is a need for
secondary care, a bridge can often be built by
specialist nurses who work across between the
hospital and the community in liaison with
practice nurses in primary care.
