Pneumonia Season & the Course of the Disease

As we move into the cooler months, many of us in medical-surgical care know that pneumonia season is upon us. Lower ambient temperatures, more time spent indoors, increased circulation of respiratory viruses and bacteria—all these factors raise the risk of lung infections.

Pneumonia takes a significant toll worldwide on the health and well-being of both the young and old.

• According to the Golden Burden Disease Report of 2021, pneumonia killed 2.1 million people (Cilloniz et al., 2024)

• The American Lung Association noted that 900,000 people in the U.S. are diagnosed with pneumonia annually, with 150,000 being hospitalized, and 1 in 20 dying (American Lung Association, 2025)

  
  

The typical course

Pneumonia is inflammation of the lung parenchyma—alveoli fill with fluid and cells, gas-exchange is impaired, and ventilation/perfusion mismatches increase.

In a med-surg environment, a patient may present with:

• Increasing cough, maybe productive sputum

• Dyspnea and tachypnea

• Chest pain when breathing or coughing

• Crackles on auscultation, diminished breath sounds

• Fever, elevated WBC, or inflammatory markers, gas exchange is impaired, and ventilation-perfusion

• Confusion in the elderly

• hypoxia and low SpO₂ (American Lung Association, 2025)

  
  

Med-Surg nursing focus (and a shout-out!)

To our courageous med-surg nurses: this is your arena. You're right there at the bedside, managing the airway, respiratory support, patient comfort, monitoring for complications, coordinating care, and educating patients and families. Without the vigilance of med-surg nursing, pneumonia outcomes worsen.

Key nursing roles include:

• Assessing respiratory status (rate/depth, use of accessory muscles, O₂ saturation)

• Positioning (semi- or high Fowler’s) to promote lung expansion and drainage

• Encouraging deep breathing, coughing, and the use of incentive spirometry

• Suctioning or clearing secretions when indicated

• Monitoring for changes (worsening hypoxia, increasing work of breathing)

• Collaborating with respiratory therapy, physicians, nutrition, etc.

(Ignatavicius et al., 2020)

Complications and special considerations

While many pneumonia cases are uncomplicated and respond well to treatment, we must stay alert for progression: respiratory failure, ARDS, multi-organ dysfunction, and sepsis. Especially in patients with comorbidities (e.g., COPD, heart failure, immunosuppression) or in older adults (Gamache, 2024).

For med-surg units, those transitions matter, e.g., patient moves from acute floor → ICU for escalation, or from ICU back → med-surg for step-down care. Med-surg nurses play a critical role in handoff, communication, monitoring, and ensuring continuity of care.

More Complicated Case from Yuan et al. 2025

To illustrate how complex pneumonia can be, let’s look at a recent case of a patient with severe pneumonia complicated by multiple organ failure (Yuan et al., 2025).

Case overview

• Patient: 43-year-old male, admitted for fever (2 days) and dyspnea (6 hours) → diagnosed with severe pneumonia and respiratory failure.

• Imaging: bilateral lung infection (patchy, high-density shadows and consolidation); SpO₂ on admission was only 79%.

• Interventions: The patient required venovenous extracorporeal membrane oxygenation (ECMO), continuous renal replacement therapy (CRRT) for renal failure, and suffered infection with multiple resistant organisms (MRSA, Acinetobacter baumannii, etc.).

• Outcome: After ~70 days of collaborative care by the interprofessional team, the patient was discharged to a rehabilitation center before returning home.

  
  

What this means for med-surg/ICU transition & nursing

• This case highlights that pneumonia sometimes is not just “antibiotics and oxygen” — it can become a critical illness involving organ systems beyond the lung(s).

• For med-surg nurses, being prepared to identify early signs of deterioration (rising FiO₂ needs, worsening gas exchange, increasing secretions, hemodynamic instability) is key.

• The nursing care in this case included ECMO management (vascular access care, anticoagulation/bleeding risks), ventilatory/CRRT support, infection control (multiple MDR organisms), nutrition/gastrointestinal management, staged rehabilitation, and psychosocial support for a prolonged hospital stay.

• The collaborative nature of care shines through physicians, nurses, respiratory therapists, nutritionists, rehabilitation service staff, infection-control nurses, and family/family-care coordination. The care transition between the different units —med-surg, step-down, and ICU —demonstrates how important communication and teamwork are for a successful outcome. (Yuan et al., 2025)

  
  

Implications

• Even in “floor” settings, recognize that pneumonia may escalate. Early intervention is crucial.

• Communication between ICU and med-surg teams matters: handoffs, care transitions, awareness of infection status, and rehabilitation planning.

• Long-stay pneumonia patients may require extra attention to deconditioning, pressure injury risk, nutritional deficits, and psychosocial impact.

• Nurses in med-surg have to be vigilant for complications emerging from the ICU stay (e.g., post‐ECMO limb issues, DVT, cognitive/physical decline).

(Pillai et al., 2018; Yuan et al., 2025)

Inter-Professional Practice (IPP) Focus: Care of the Patient as a Team

When caring for a patient with pneumonia—whether “routine” or “severe complex”— an interprofessional team approach is vital. Remembering the core competencies of interprofessional practice: values & ethics, roles & responsibilities, communication, and teams & teamwork, the team can achieve a higher level of care for the patient and improved job satisfaction for the healthcare team (IPEC, 2023).

Key team members & their roles

• Physician/infectious disease specialist: chooses antibiotic/antiviral regimen, guides diagnostic testing, manages complications.

• Respiratory therapist: provides ventilatory support, oxygen therapy, and airway clearance strategies; monitors gas exchange.

• Nursing staff (med-surg, ICU, step-down): continuous assessment, monitoring, direct interventions (oxygen, positioning, secretion clearance), patient/family education, coordination.

• Pharmacist: optimizes antimicrobial therapy, checks interactions, ensures timely administration.

• Nutritionist/dietitian: addresses increased metabolic demands, supports enteral/parenteral feeding, monitors for malnutrition or GI complications.

• Rehabilitation/physical therapy: especially in prolonged stays — assist with muscle strength recovery, functional mobility, pulmonary rehabilitation.

• Infection control / microbiology: monitors for resistant organisms, helps with isolation protocols, monitors ward environment.

• Case management/discharge planning ensures transitions of care — ICU → med-surg → home/rehab, coordinates follow-up, home health, education.

  
  

How med-surg nursing leads and integrates IPP

• You serve as the hub: you relay information from bedside to team members, alert to changes, ensure interventions are coordinated (e.g., the respiratory therapist schedule, nutrition plan, antibiotic timing).

• You educate patients/families by explaining the disease, inhaler/oxygen use, deep breathing/coughing exercises, signs of worsening, and when to call.

• You monitor for complications: early mobilization, skin integrity, DVT prevention, nutritional decline.

• You ensure continuity: for example, after ICU discharge, the med-surg nurse may pick up the baton knowing which treatments the patient has received (e.g., ECMO, CRRT) and what to watch for.

• You participate in team rounds and handoffs: effective communication prevents errors, ensures cohesive care.

  
  

Tips for effective IPP in pneumonia care

• Use a daily care plan visible to all team members (nurse note plus team briefings).

• Standardize key parameters: oxygen saturation thresholds, mobilization milestones, secretion clearance frequency.

• Encourage early mobilization and pulmonary rehab even while on the floor when safe.

• Ensure antibiotic stewardship: the nurse monitors culture results and antibiotic de-escalation and liaises with the pharmacist.

• Family involvement: educate caregivers early, especially for home transitions and follow-up.

• Debrief after complex cases: what went well, what could improve. This fosters team learning and highlights the core competencies of collaborative practice.

  
  

Staying Well: Handwashing, Vaccination & More`

Finally, let’s circle back to prevention and wellness, especially timely as you guide patients, families, and your own team into this pneumonia season.

• Hand hygiene remains simple but powerful. Proper handwashing and the use of alcohol-based hand rubs, especially before and after patient contact or handling secretions, prevent the transmission of respiratory pathogens.

• Vaccinations: Encourage patients (and staff) to receive the influenza vaccine, the pneumococcal vaccine (for eligible age groups), and other respiratory vaccines. These reduce the risk of pneumonia or its severity.

• Healthy lifestyle: Adequate rest, good nutrition, avoiding smoking (and second-hand smoke), keeping chronic conditions under control—all reduce pneumonia risk.

• Early recognition and seeking care: Teach patients to seek help if they develop a persistent cough, dyspnea, or fever — early intervention improves outcomes.

• For you, med-surg nurses: Stay vigilant, monitor patients for early signs of deterioration, adhere to infection control practices, and model the preventive behaviors for others. (Sattar et al., 2024)

In closing

Pneumonia may be a “common” diagnosis on med-surg units, but its implications range from mild illness to life-threatening disease requiring full ICU support. The role of the med-surg nurse is pivotal, from initial assessment through acute care, recovery, and discharge. Working in a strong interprofessional team can produce quality outcomes for all involved. 

As we honor Med-Surg Week, let’s acknowledge the hard work, dedication, and vigilance of every nurse on the floor. You make a difference.

Reference

American Lung Association. (2025). Pneumonia. American Lung Association. https://www.lung.org/search?query=pneumonia&PageIndex=0&PageSize=10

Cilloniz, C., Dela Cruz, C. S., Dy-Agra, G., Pagcatipunan, R. S., Jr, & Pneumo-Strategy Group (2024). World Pneumonia Day 2024: Fighting Pneumonia and Antimicrobial Resistance. American journal of respiratory and critical care medicine, 210(11), 1283–1285. https://doi.org/10.1164/rccm.202408-1540ED

Gamache, J., (2024). Bacterial pneumonia. https://emedicine.medscape.com/article/300157

Ignatavicius, D., Workman, L., Rebar, C., & Heimgartner, N. (2020). Medical surgical nursing: concepts for interprofessional collaborative practice (10th ed.). Elsevier.

Interprofessional Education Collaborative. (2023). IPEC core competencies for interprofessional collaborative practice: Version 3. Washington, DC: Interprofessional Education Collaborative. https://ipec.memberclicks.net/assets/core-competencies/IPEC_Core_Competencies_Version_3_2023.pdf

Pillai, A., Bhatti, Z., Bosserman, A., Mathew, M., Vaidehi, K., & Sanjeeva P.K. (2018).  Management of vascular complications of extra-corporeal membrane oxygenation. Cardiovascular Diagnosis Therapy, 8(3), 372 - 377. 

Sattar, S.B.A., Nguyen, A.D., Sharma, S., & Headley, A. Bacterial Pneumonia (Nursing) [Updated 2024 Feb 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK568697/?utm_source=chatgpt.com

Yuan, Z., Yang, Y., Liu, Q.,  Zhang, B., Wang, X., Huang, S., & Ma, W. (2025). Nursing care of a patient with severe pneumonia complicated with multiple disorders under a multidisciplinary team: A long-term case report. Medicine, 104(19), e42435. DOI: 10.1097/MD.0000000000042435