Being a respiratory advanced practitioner at an advanced clinical practice (ACP) represents a dynamic and evolving aspect of modern healthcare, empowering experienced professionals with enhanced skills and responsibilities to deliver comprehensive patient care. Advanced practitioners come from all walks of life, such as nurses, paramedics, dietitians and finally, members of our profession, pharmacists.
There are different pathways to achieving the title of advanced practitioner and this area of clinical practice has been undergoing a lot of development since it came to be. Nowadays, the most popular way of becoming an ACP is either through an accredited MSc apprenticeship course at a university or through an e-portfolio-supported route. In my case, I signed up to my ACP MSc right after I finished my Independent Prescribing (IP) course, as I considered it a natural way of developing my skills in examination, diagnosis, leadership and research. Every advanced practitioner works across four pillars of advanced practice which are clinical, research, leadership and Education.
A week in my life
Here, I will try to show you what my week looks like with examples spread across the four pillars. When it comes to the most important part of my week, it is the clinical duties. I have two general respiratory clinics a week, where the GPs and consultants from other specialities refer to the respiratory team for our opinion, and some of those patients come to see me. I am often the first point of contact for patients presenting with a wide range of respiratory symptoms. I also run a specialist asthma clinic that works as a spoke to the local severe asthma centre, working up patients for biologics, checking adherence and working collaboratively with the physiotherapy team to provide the best care available. I also often see asthma patients on the wards, especially when I take part in the junior respiratory ward round, often seeing patients with general medical problems independently and making decisions on my own and with the support of my seniors. In this part of my job, the hands-on examination skills and ability to conduct thorough patient examinations is paramount.
I take blood on a regular basis; I perform arterial blood gas sampling on patients requiring non-invasive ventilation and obtain venous access. Interestingly, in my training I have also learned how to insert a chest drain. This hands-on, patient-facing role is incredibly rewarding, allowing me to build rapport and trust while gathering crucial information. Based on my clinical findings, I make initial diagnoses and organise further investigations, which can include arranging CT scans, chest X-rays, and comprehensive pulmonary function tests. I also follow up patients, reviewing investigations ordered by others and providing holistic care as part of the respiratory team.
The integration of my pharmaceutical knowledge is invaluable in my role, enabling me to not only diagnose but also to optimise medication regimens and provide detailed patient education on their treatments. Beyond the clinic, a crucial aspect of my role involves contributing to clinical research. The pursuit of new knowledge and improved patient outcomes is a core passion. In times of the Covid-19 pandemic, I had the privilege of serving as the Principal Investigator (PI) for a study in North Devon investigating the use of Azithromycin in Covid-19 patients. This involved overseeing patient recruitment, data collection, and ensuring the integrity of the research process, culminating in a recently published paper. Such opportunities highlight how ACP pharmacists can directly influence the evidence base that underpins our clinical practice.
Education also forms a vital part of my weekly schedule. I am deeply committed to nurturing the next generation of healthcare professionals and supporting the development of my peers. This includes working closely with trainee pharmacists, showing them possible routes of development and hopefully encouraging them to become the next generation of pharmacist advanced practitioners. I also fulfil the role of designated prescribing practitioner for pharmacists who aspire to become independent prescribers. Sharing my experience and knowledge in this area is particularly fulfilling, as I believe in empowering pharmacists to expand their clinical impact and go beyond what pharmacy is usually associated with.
For any pharmacist considering a similar trajectory, I want to emphasise that a rich and fulfilling clinical pathway exists beyond traditional management roles often associated with bands 8a and above. The ability to directly impact patient care, lead research, and educate future practitioners is immensely rewarding. I strongly encourage anyone with a passion for direct patient contact and clinical development to explore advanced practice; it’s a journey that offers continuous learning and profound professional satisfaction.
By Michal Lamparski, a respiratory advanced practitioner
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