Helping patients breathe easy

Jean Merrington works as a Clinical Nurse Specialist for the Auckland District Health Board. Since qualifying 29 years ago, Jean has enjoyed a long and rewarding career beginning in respiratory health for nearly 19 years and more recently with the domiciliary oxygen service for the past nine years.

"When I started out as a Clinical Nurse Specialist I was working purely for the oxygen service," she says. "The role evolved and now part of my job includes being a bronchiectasis nurse specialist."

Jean's role is fairly autonomous primarily involving the assessment and follow up of patients on home oxygen therapy. She also educates her patients about bronchiectasis and encourages them to manage their disease by teaching them self-management skills.

"Our oxygen service operates within Ministry of Health guidelines for supply. We make sure patients meet the guidelines and we assess patients to see if they fit criteria for

oxygen therapy. We are fortunate that we do own a number of HomeFill Oxygen systems," she says. "It improves breathlessness and fatigue, and most patients find it easy to use. The most important benefit of HomeFill is that it allows our patients to be independent."

Sometimes Jean also needs to manage her clients' expectations.

"When it comes to treating breathlessness there's a lot of perception about oxygen that isn't true," she explains. "I have to make sure it's used correctly so that benefit is gained. It can be very tricky and oxygen isn't always the best treatment."

Jean is very proud of the quality of service her department delivers to patients.

"We have lots of challenges. Some are due to budgetary constraints, but we do our best within our constraints and we believe we provide an excellent service to our patients."

Jean experiences plenty of variety and challenges in her role.

"No two days are the same and that's what I enjoy about my job."

For her, it's the small successes that make it all worthwhile.

"I feel successful when I make a difference, such as improving my patients' quality of life.

Jean has seen many changes within the health sector during her long career - most of them for the better!

"I would say the biggest change in my career is that patients are no longer allowed to smoke in their rooms. When I was in orthopaedics, patients were smoking in their beds. Part of my role was emptying their ashtrays. Then when things changed and they weren't allowed to smoke in their rooms I had to wheel them down the corridor so they could smoke."

In terms of technology Jean has encountered some big changes as well.

"The introduction of a pulse oximeter makes it easy to monitor patients," she says. "Not much has changed in long term oxygen therapy, but the Homefill system and portable concentrators are new."

Jean says there are a number of challenges that still need to be overcome in the healthcare system.

"Obesity has a big impact on respiratory health. We need to promote good nutrition, exercise and healthy eating. Smoking cessation is also hugely important as that also contributes to the problem. And of course, adherence to treatment by the clients."

Overall Jean is very happy and settled in her role. She is married with two children and has a busy life outside of work.

"I used to be a great gardener, but not so much anymore. I have two teenagers and I'm a keen cyclist, so I don't have so much time for the gardening these days!"

Her advice to anyone thinking of following in her footsteps is simple:

"You just need to enjoy what you do."