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Confronting COPD - Nurses' tales
We are nurses who have been very much in contact with COPD patients and their relatives over the past couple of years. One of us is a COPD disease manager and the other, a home nurse. Together we have been providing nursing support in an innovative hospital-at-home programme for COPD at a major hospital in Singapore. Caring for COPD patients is indeed challenging. Many of them are advanced in years as well as disease severity and often have other illnesses or social problems to put up with. Trying to cope with the disabling nature of the illness is difficult both for patients and their relatives. COPD really requires and deserves our care and attention.

 Ms Chong Wai Fung
 Ms Tan Seow Pek
As Chronic Obstructive Pulmonary Disease (COPD) affects a patient's life physically, psychologically and socially, respiratory patient education serves as an important element of COPD care. A COPD Nurse Clinician is one who demonstrates competence in advanced nursing activities in relation to her specialized field of discipline. The role covers in-depth counseling, case reviews and assessment of inpatients as well as coordinating caregiver teaching sessions for family members in preparation of home care.  In her line of work, she is required to maintain professional communication and consultation with a multidisciplinary team whereby she facilitates referral to pulmonary rehabilitation as outpatient basis.She also provides clinical leadership by acting as a resource, facilitator and coordinator, involved with community liaison and support for patients requiring home ventilatory assistance. In addition, she helps to establish effective links with community health care services. These integral roles aim to increase compliance, reduce re-admission, optimize learning needs and most importantly, empower self-management and promote comfort.

Ms Choo Yee Mun

Confronting COPD - GPs' perspective

If 15-20% of all cigarette smokers develop COPD, and the risk of having the disease is twice in smokers who have complaints such as chronic cough, sputum production and breathlessness, we wonder how many patients we see in the clinic  have COPD that is not diagnosed. Are these patients only diagnosed with COPD when they end up in hospitals with breathlessness or respiratory failure? Some of us make routine measurements such as patients' height, weight or blood pressure regardless of the reasons they come to the clinic. Will we be able to make an earlier diagnosis of COPD at the GP clinic if we routinely identify smokers at risk of COPD with a questionnaire and confirm the diagnosis with spirometry. We are especially glad to hear that the COPD Association has plans to assist primary healthcare doctors make an early diagnosis of the disease before the patient's condition worsens.

Dr Goh Pui Kiat
Dr Lorraine Tan


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