Spotlight on Debbie Johnson - Rheumatology Nurse Consultant

Debbie Johnson has been a Rheumatology Nurse Practitioner at Lewisham Hospital for nearly 8 years.

Debbie recently received an NHS Heroes award after being nominated by a member of the public. We caught up with her to talk to her about her role here at Lewisham and about the award.

Firstly, could you tell us about the sort of conditions that would be treated by a rheumatologist?

Rheumatologists see and treat patients for rheumatic complaints, including connective tissue disease, inflammatory arthritis (both adults and paediatric) and musculoskeletal conditions

What does your role entail?

My role involves looking after patients with inflammatory arthritis, such as rheumatoid and psoriatic arthritis. Once patients are diagnosed I see them to talk about their disease and the need for medication, monitor their disease activity and try and help them self manage their disease through education. I also see patients with other conditions who might need some of our specialised drugs.

I work closely with the consultants and liaise with GP surgeries to optimise care. I also run the rheumatology advice line where patients are able to contact me directly if they are having problems with their arthritis or are worried about possible drug side effects.

What do you enjoy most about your role?

I most enjoy the fact that I can develop a strong relationship with patients. As the patients have a chronic condition, I get to know them (and their families) well as they need to be reviewed regularly. 

Can you tell us more about the rheumatology service at Lewisham?

I work with four consultants, two junior doctors, and nurses in the outpatient clinic, who run the weekly injection clinic and clinic support staff. We also have invaluable secretarial support.

At Lewisham, we have services treating a range of rheumatic conditions, including a dedicated connective tissue diseases service, as well as a treatment and monitoring service for patients with inflammatory arthritis, which is a large part of my role. We also treat children with rheumatological problems in conjunction with a paediatrician, have combined clinics for patients with respiratory and rheumatic conditions and those with renal and rheumatic conditions. We take part in research to look for improved ways of treating patients.

You received an NHS Heroes award after being nominated by a member of the public. How does it feel to receive this sort of feedback?

I was surprised but very pleased to receive the award. It made me realise just how important good communication is for patients and their carers and the difference it can make to them.

What do you like most about working at Lewisham?

The hospital is very friendly, made possible by the patients that come for treatment and the excellent staff who work here. It definitely has a good community feel about it and this has been reinforced by the campaign to save our hospital services, supported by the staff but especially by the patients.  They tell me they do not want treatment elsewhere.

What is your proudest achievement at Lewisham?

I think it would be helping to develop shared care guidelines for methotrexate, one of the drugs we regularly use, which have significantly improved patient safety. The guidelines were developed in conjunction with the Primary Care Trust and the GPs and are now part of all our usual working practice.  

We have also recently started a service to allow patients to self inject methotrexate which means they no longer have to attend the clinic weekly but can do the injections at home at a time to suit them. This has made a big difference to these patients.

What do you feel are the most important aspects of good patient care?

I think it is being able to communicate with patients to ensure they understand about their condition. It can be daunting for patients to take in information about their condition and the need to start medication straightaway. Another important aspect is staying up to date with the latest research so that the patients receive the best possible treatment for their condition.

How has treatment changed in the last five years for patients with rheumatological conditions?

There have been a number of new drugs developed which target different pathways for treatment of inflammatory arthritis over the past few years. This gives the patient far more treatment options to treat their disease. However, the clinical evidence shows the importance of early aggressive combination therapy of inflammatory arthritis so that we optimise the use of our standard treatment first - this can prevent or delay the need to use the newer drugs.

What made you decide to become a nurse?

My Mum was a nurse and I use to visit her ward on occasions and realised it was a career I would like to follow. I worked as a volunteer helping the nurses and so had some understanding of what being a nurse involved before I started my training.

What would you do if you weren’t a nurse?

I wanted to be a nurse from an early age and so never really considered another career but have at times thought I might have liked to work in a garden nursery or have a tea shop!

What do you like to do in your spare time?

I enjoy gardening (and have a large garden on which to practice), baking and decorating cakes and travelling. I am currently helping my eldest daughter plan her wedding next year.