From Bedside to Boardroom, Research to Policy: The Central Role of Nurses in Asthma Care

In Recognition of World Asthma Day
and ahead of International Nurses Day 2025

The month of May offers an important opportunity for critical reflection within the nursing and respiratory health communities. The proximity of World Asthma Day and International Nurses Day serves as a poignant reminder of the indispensable role nurses play in both the clinical and systemic dimensions of asthma care.
As a nurse and leader in respiratory health, I am consistently reminded of the unique position nurses hold at the intersection of direct patient care, public health, and policy particularly in managing chronic respiratory diseases such as asthma.

My professional journey began in hospital-based nursing, where I frequently cared for patients, both children & adults, experiencing acute asthma exacerbations. These encounters underscored the reality that clinical intervention alone is insufficient.

Meaningful care necessitates empathy, emotional support, and the ability to provide reassurance in moments of vulnerability. This formative experience laid the foundation for my ongoing interest is respiratory care and my subsequent work in primary care, where I served as a respiratory lead within a large general practice in Reading. There, I engaged in patient education, inhaler technique optimisation, trigger identification, and the co-creation of personalised asthma action plans – all central to sustainable asthma management.

Over time, my career progressed into roles encompassing clinical leadership, education, research, and health policy development. In these roles, I have contributed to shaping national respiratory strategies and supporting international initiatives focused on reducing the global burden of asthma, particularly in underserved and marginalised populations. 

One theme has remained constant throughout this trajectory: Asthma is not solely a medical condition – it is also a social one.

This assertion echoes the words of Franz Kafka from his book The Country Doctor (1917) : “To write prescriptions is easy, but to come to an understanding with people is hard.” 

Nurses, uniquely positioned within health systems and communities, are often the professionals who bridge that gap between medical science and human experience.

Globally, I have witnessed the transformative impact of nurse-led, community-based asthma programmes. These interventions, characterised by their accessibility, cultural sensitivity, and emphasis on health literacy, have reduced unscheduled care and emergency admissions, enhanced patient self-management, and fostered trust within historically underserved populations. These are not ancillary efforts; they represent scalable, evidence-informed models for health systems seeking to improve outcomes in cost-effective, equitable ways.

The theme of World Asthma Day 2025, “Make Inhaled Treatments Accessible for All,” is particularly apt. While ensuring access to appropriate medicines is critical, it is insufficient in isolation. Without culturally competent education, longitudinal support, and system-wide integration of asthma care pathways, medications alone will not close the persistent gaps in outcomes. Nurses are pivotal in providing this holistic, patient-centred care.

Simultaneously, International Nurses Day 2025 presents a timely and strategic message: “Our Nurses. Our Future. Caring for nurses strengthens economies.” This theme calls on health systems and governments to recognise that nursing is a cornerstone of resilient, effective healthcare delivery. Investment in nurses through education, access to digital health technologies, leadership development, systems thinking, and advocacy skills, strengthens entire health infrastructures. It enables sustainable improvements not just in asthma outcomes, but across all domains of care.
Throughout my career, I have observed the positive impact that results when nurses are included meaningfully in policy development and decision-making. When nurses are equipped not only with clinical expertise but with the tools to lead, innovate, and advocate, their contributions extend far beyond the bedside. They become architects of more equitable, responsive, and efficient health systems.

As we mark World Asthma Day and International Nurses Day this May, I reflect with pride on the profession that shaped my life and the communities that continue to inspire my work. Nurses are not peripheral to asthma care; they are central to its success.

Let this be the year we transition from rhetoric to action by embedding nurses within every level of care delivery and strategic planning.

As Chief Executive of the Centre for Applied Respiratory Research, Innovation and Impact (CARRii), I am committed to supporting a transdisciplinary approach to respiratory care. While we welcome members from a wide range of backgrounds, we would particularly love to hear from nurses interested in contributing to our mission.

Let us commit to a future where asthma care is not only clinically sound but socially just, and where nurses lead from every corner of the health system – from the bedside to the boardroom, and from research to policy development.

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Monica Fletcher OBE is Honorary Senior Research Fellow at the Nuffield Department of Primary Care Health Sciences, University of Oxford, and Chief Executive of the Centre for Applied Respiratory Research, Innovation and Impact (CARRii). With over 30 years of experience in respiratory care, she has contributed significantly to national and international respiratory health policy development.