Pulmonary nursing is the care of patients with lung disease — chronic obstructive pulmonary disease, asthma, pneumonia, cystic fibrosis, pulmonary fibrosis, pulmonary hypertension, lung cancer, sleep-disordered breathing, and respiratory failure of any cause.
It is unusual among specialties in having no certification of its own, and understanding why explains the shape of the field.
The division of labour
In American hospitals, respiratory therapists are a separate licensed profession responsible for ventilator management, oxygen delivery devices, nebulized therapy, airway clearance, and arterial blood gas sampling. Very little of that work is nursing work in this country, which is a genuine difference from most other health systems.
What remains for the nurse is substantial but harder to name: assessment of respiratory status and its trajectory, recognizing deterioration before the numbers show it, positioning and mobility, secretion management, sedation and comfort in ventilated patients, prevention of ventilator-associated events, tracheostomy care, oxygen and medication titration within protocols, and all of the teaching.
Where the work happens
Intensive care. Respiratory failure is the most common reason for an intensive care admission, so a large share of critical care nursing is pulmonary nursing under another name. See critical care nursing.
Step-down and progressive care. Non-invasive ventilation, tracheostomy patients, and ventilator weaning. See progressive care nursing.
Medical floors. Exacerbations of chronic obstructive pulmonary disease and pneumonia are among the highest-volume medical admissions in the country. See medical-surgical nursing.
Long-term acute care and ventilator units, for patients on prolonged weaning. See long-term and post-acute care nursing.
Pulmonary clinics and function laboratories, including specialist programmes for cystic fibrosis and pulmonary hypertension.
Pulmonary rehabilitation, an exercise and education programme that improves function and quality of life in chronic lung disease.
Sleep medicine, in laboratories and in the growing home-testing and therapy-adherence side of it.
Lung transplant, which combines this specialty with transplant nursing. See transplant nursing.
Credentials
Nurses in the field certify by acuity or by disease rather than by organ system. Those working in intensive care take the critical care credential; those in step-down take the progressive care credential.
The main disease-specific option is the certified asthma educator credential, which is profession-neutral — open to nurses, respiratory therapists, pharmacists, and others — and requires at least 1,000 hours of direct asthma education, counselling, or care coordination. It moved to the respiratory care certifying board in 2022.
Chronic obstructive pulmonary disease has no equivalent nursing credential, despite being the larger disease burden, which is a fair illustration of how uneven the certification landscape is. See nursing specialties.
Why the specialty matters more than its profile suggests
Chronic obstructive pulmonary disease readmission carries a payment penalty for hospitals, which has funded most of the outpatient and transitional nursing roles in the field — the same mechanism that built heart failure nursing. See cardiac nursing and case management nursing.
Smoking cessation counselling sits with this specialty more than with any other, and it is one of the few nursing interventions with an unambiguous evidence base for improving survival. See public health nursing.
Related
Sources
- Certified Asthma Educator (AE-C) — National Board for Respiratory Care, on the credential and eligible professions. Accessed September 9, 2026.
- The National Board for Respiratory Care to Acquire the Certified Asthma Educator Examination — National Board for Respiratory Care, on the 2022 transfer from the asthma educator certification board. Accessed September 9, 2026.
- CCRN (Adult) Certification — AACN Certification Corporation. Accessed September 9, 2026.