IAANMP: Meet the Members

Meet Lynn Fox, ANP in Interstitial Lung Disease, Mater Misericordiae University Hospital

My name is Lynn Fox and I work as an Advanced Nurse Practitioner (ANP) in Interstitial Lung Disease (ILD) at the Mater Misericordiae University Hospital, Dublin. Due to the nature of ILD’s, patients often have high morbidity and mortality rates. It can be challenging, managing a patient’s symptoms and having difficult conversations with patients and their families; however, it is a privilege to care for these patients.

My journey to ANP role
I remember attending a lecture by Valerie Small during my training in the 1990s, never in my wildest dreams did I think of becoming an ANP. I started specialising in respiratory nursing after the medical ward I was managing was designated a respiratory ward. I completed my Post-graduate Diploma in Respiratory at this time.

I then had the opportunity to apply for a clinical nurse specialist position in 2014. It was brilliant to work in an autonomous environment where my respiratory CNS colleagues had developed numerous nurse-led clinics in asthma, COPD, and oxygen.

There was an exciting opportunity to develop a nurse-led clinic in ILD at this time with Dr Kate O’Reilly, ILD Consultant Specialist. A lot of research was ongoing in ILD at this time with the development of medications. Previously there were no treatments for progressive ILDs. 

In 2017, I applied to University College Dublin (UCD) for the Master’s in Advanced Practice along with my friend Diane Moran (RANP COPD OLOL). This was a hard two years, working full-time with only 10 days study leave. Also, there was no guaranteed job at the end. This was before the commencement of the demonstrator project for increasing the number of ANP’s.

With extra funding available from the Nursing Practice Development Unit, 30 uplift posts were funded around Ireland. I was told about this on a Tuesday with the application due for submission on Friday. I was the only successful applicant in the hospital.

I commenced my role in February 2020. With Covid-19 and maternity leave, I completed my job description in 2023 and was signed off by the Director of Nursing as a registered ANP. I have been registered with NMBI as an ANP since completing my studies in 2019.

Since then, I have established two clinics a week. These are held on a Tuesday afternoon and a Wednesday morning. Both cater for one new and four returning patients. Referrals are received from all respiratory consultants.

There has been a significant increase to the numbers attending the ANP clinic – multiple factors including commencement of the second clinic in February 2023, some clinics being cancelled due to academic requirements in 2023 and establishment of the ANP service. There were over 200 more attendances at the ANP clinic in 2024 compared to 2023.

I complete numerous virtual consultations for patients as needed. These clinics are for symptom management, side effect management of oral antifibrotic therapies, issues with oxygen, and symptoms of disease progression. I also present my ILD patients at the monthly radiology multidisciplinary team meeting to ensure correct diagnosis and treatments as per international guidelines (Ragu et al, 2022).

I work very closely with Dr Kate O’Reilly, ILD Consultant, and we are extremely fortunate to have great support from Grainne Murphy, Senior Respiratory Physiotherapist.

I am part of the ITS ILD working group. This is a multidisciplinary group that meets quarterly to highlight educational needs and advocate for ILD patients. Also, I have served as a committee member for the Irish Lung Fibrosis Association (ILFA) since 2015.

As part of my professional development with the support of Dr Bridget Murray (RSCI), I have had two articles published this year. The first article was in Nursing in Practice Ireland, and my second article was in the British Journal of Nursing.

The ANP role in ILD is very rewarding. I am in a very privileged position to get to know and support my patients and their families through their ILD diagnosis and treatments. I am part of a small, but cohesive team that tries to do the best in the current healthcare setting.

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