Mary BrydonMary Brydon

RGN, OHNC, OBE, FRCN

Mary Brydon was awarded Fellowship of the Royal College of Nursing in 1998 for her contribution to managing allergy care and development of advanced nursing practice.

Mary was the first self-employed allergy nurse practitioner to provide a peripatetic service in the UK – a service to GP surgeries and hospital consultants in Norfolk.

Mary started her career in this field 22 years ago when she was employed by a pharmaceutical company to provide allergy screening clinics for GPs. In 1986, the Committee on Safety of Medicines put in place stringent guidelines for hyposensitisation leading to the withdrawal of the clinics by the pharmaceutical company for which Mary worked. Acting on her theory that there was still a need for an allergy screening service offering diagnosis, advice and recommendations on avoidance and treatment measures, Mary set up the Norfolk Allergy Diagnostic and Advisory Service (NADAAS).

Initially, as there was no funding, Mary operated a private service which gained support from some of the GPs who had used the previous service. Slowly, with professional recommendation, the usage increased. To back her belief that NADAAS was offering a needed service, Mary undertook a research project which demonstrated that there was a demand by both doctors and the public. The research findings were presented to the then local FHSA and led to the provision of funding for a free service to GPs and their patients. This was the first stage in achieving Mary’s ambition to get allergy recognised by the NHS within primary care. Her second research paper in 1993 demonstrated the cost effectiveness of such a service to both the NHS and the patient.

Another research project in 1997 involved a review of 1,000 patients. She discovered that three quarters of patients with asthma also suffer from rhinitis (which they developed first). This finding has acted as a catalyst for more research and raised the possibility of the prevention of asthma by the early detection of allergic rhinitis, allergen identification and avoidance.

In 1988 Mary was the first nurse to join the British Society for Allergy and Clinical Immunology (BSACI) and in 1989 was awarded one of the four bursary places to attend the first BSACI Allergy School. In 1992 Mary joined the management committee of the British Allergy Foundation (now known as Allergy UK) and she has served as a member of the Board of Trustees, is on the Clinical Advisory Board, and is its Vice-President.

The service Mary provides in Norfolk is unique within primary care in the UK. Mary sees patients referred to her by GPs or hospital consultants. She provides a comprehensive consultation which involves taking a detailed patient history, family history, and recording current symptoms and treatments using a holistic approach to determining the atopic status, by skin prick testing. She has developed a standard questionnaire and a protocol for the assessment process.

The excellent data from the audit and evaluation of Mary’s work has convinced eminent allergy consultants that the future of allergy care will be better managed largely by allergy nurse practitioners in primary care. She has pushed forward the frontiers of nursing by showing that management of allergy, a chronic and complex disease, is ideally suited to holistic, advanced nursing practice rather than organ-based management.

The knowledge she has gained and its relevance to asthma and other allergic conditions, the incidence of which are rapidly increasing, has been disseminated to nurses nationally and internationally through nursing and medical journals and numerous meetings of nurses from various fields. Nurses and doctors are also able to gain insight into allergy management by ‘sitting in’ on Mary’s clinics. Courses for specialist allergy nurses have been formulated, based on Mary’s style of nursing practice and another nurse practitioner set up an allergy clinic in 1998/1999, based on Mary’s blueprint. Mary has now achieved national and international acknowledgement in her field for the quality and effectiveness of her innovative way of managing allergy.

Mary has been nominated twice for the BSACI William Frankland Award for outstanding services to clinical allergy. Also in 2000 Mary was awarded a travel scholarship for outstanding poster presentation at the World Allergy Organisation conference in Sydney Australia. In the same year she was awarded an OBE for her contribution and services to allergy and published the first book solely dedicated to skin prick testing in clinical practice.

Since 1997 Mary has been involved with the House of Commons Health Committee and the Department of Health Review of the Provision of Allergy Services. She is also a member of the RCN Immunology and Allergy Nurses Group.

Publications

Mary's key publications are:

  • Skin prick testing in clinical practice, Norfolk Allergy Diagnostics and Advisory Service, Norwich, 2004
  • Patient audit for allergy, asthma and rhinitis, Asthma Journal, June 1996, 29-32
  • The effectiveness of a peripatetic allergy nurse practitioner service in managing atopic allergy in general practice: a pilot study, Clinical and Experimental Allergy, 23, 1037-1044.