Key Responsibilities and Required Skills for Allergy Nurse

🎯 Role Definition

An Allergy Nurse (Registered Nurse) provides specialized clinical care in outpatient allergy and immunology settings, delivering skin testing, immunotherapy (SCIT/SLIT), acute care for allergic reactions, patient education, and administrative coordination to support allergists and multidisciplinary teams. The Allergy Nurse ensures safe preparation and administration of allergen extracts, monitors patients for adverse reactions including anaphylaxis, documents care in the EHR, maintains regulatory compliance (HIPAA, OSHA), and contributes to quality improvement and clinical outcomes.

📈 Career Progression

Typical Career Path

Entry Point From:

Staff RN in ambulatory/primary care or urgent care settings
Medical Assistant or Licensed Practical Nurse (LPN) transitioning to RN
Critical care/ED RN seeking ambulatory specialty practice

Advancement To:

Lead Allergy Nurse / Clinical Coordinator
Nurse Manager for Allergy & Immunology Clinic
Clinical Nurse Specialist or Family Nurse Practitioner with Allergy focus
Clinical Research Nurse in allergy/immunology studies

Lateral Moves:

Pulmonology or Asthma Specialty Nurse
Immunology or Rheumatology Clinic Nurse

Core Responsibilities

Primary Functions

Administer subcutaneous immunotherapy (SCIT) and supervise sublingual immunotherapy (SLIT) according to individualized physician treatment plans, including precise dosing, timing, and documentation in the electronic health record (EHR).
Perform and interpret allergy skin testing (percutaneous/puncture and intradermal), accurately measure wheal-and-flare responses, document results, and report findings to the supervising allergist for care planning.
Monitor patients pre-, during, and post-immunotherapy or skin testing for adverse reactions, recognize early signs of anaphylaxis, and initiate emergency treatment protocols including epinephrine administration and activation of emergency response.
Prepare, label, dilute, and store allergen extracts and immunotherapy vials according to clinic protocols and USP/OSHA standards, maintain lot records, and ensure cold-chain or temperature-controlled storage when required.
Triage patient calls related to allergic reactions, medication questions, side effects of immunotherapy, and urgent symptoms; provide evidence-based nursing advice and escalate to the provider as appropriate.
Perform venipuncture and collect specimens for laboratory testing (IgE, specific IgE panels, CBC) when ordered; ensure proper specimen labeling, handling, and shipping per lab requirements.
Educate patients and caregivers on allergy management, avoidance strategies, inhaler/epinephrine auto-injector technique, self-administration of SLIT (if applicable), and written action plans for asthma and anaphylaxis.
Maintain up-to-date medication reconciliation and allergy lists in the EHR, review current medications for interactions with immunotherapy or allergy treatments, and communicate changes to the care team.
Conduct pre-visit chart reviews and documentation to prepare the provider visit, obtain informed consent for testing and immunotherapy, and ensure comprehensive problem lists and order reconciliation.
Document all clinical encounters, immunotherapy administration, skin test results, adverse events, and follow-up plans in compliance with institutional policies, billing, and regulatory standards.
Maintain clinic readiness for allergic emergencies by ensuring crash cart contents, epinephrine availability, oxygen, and rescue medications are checked, in-date, and accessible; lead emergency drills as needed.
Coordinate care with pharmacists, allergists, pulmonologists, ENT surgeons, and primary care providers for complex cases, immunotherapy scheduling, and management of comorbid conditions (e.g., asthma, atopic dermatitis).
Perform spirometry, peak flow measurements, and basic pulmonary function screening when indicated; interpret results to assist the provider in asthma control assessment.
Manage immunotherapy scheduling and patient appointment flow to support safe observation periods post-injection and optimize patient throughput in the allergy clinic.
Train, supervise, and mentor medical assistants and nursing staff in allergy clinic procedures, injection safety, skin testing technique, and documentation standards.
Track and report immunotherapy compliance and missed dose protocols; contact patients for dose rescheduling and education to maximize adherence and therapeutic benefit.
Assist in billing and coding accuracy for allergy services by ensuring correct procedure codes (CPT) and clinical documentation to support reimbursement and quality metrics.
Ensure compliance with federal, state, and institutional regulations (HIPAA, OSHA, CMS) as they relate to patient privacy, infection control, sharps disposal, and clinic safety policies.
Participate in quality improvement initiatives—collecting data, reporting outcomes (e.g., adverse event rates, immunotherapy adherence), and implementing process improvements to enhance patient safety and clinic efficiency.
Respond to adverse events and complete incident reports, root-cause analysis contributions, and follow-up documentation including communication with the provider, risk management, and patient/family.
Provide pre- and post-procedure counseling for procedures such as patch testing, intradermal testing, and drug allergy evaluations; screen patients for contraindications and ensure appropriate monitoring.
Maintain and inventory allergy clinic supplies, allergens, and PPE; coordinate ordering and vendor relations to prevent stock-outs and ensure quality of extracts and devices.

Secondary Functions

Support clinical research and registry participation by consenting patients, collecting data per protocol, and maintaining regulatory documentation for allergy/immunology studies.
Participate in cross-functional meetings with scheduling, billing, pharmacy, and quality teams to optimize clinic workflows, reduce appointment wait times, and improve patient satisfaction.
Contribute to patient education materials, online resources, and community outreach programs on allergy prevention, immunotherapy, and anaphylaxis awareness.
Assist with prior authorization processes and insurance communications for allergy testing, immunotherapy supplies, and biologic therapy referrals.
Engage in ongoing professional development by attending allergy/immunology in-services, national conferences, and vendor training to remain current with practice standards and new therapies.

Required Skills & Competencies

Hard Skills (Technical)

Allergy skin testing proficiency (percutaneous/prick testing and intradermal testing) with accurate wheal measurement and interpretation.
Safe preparation, dilution, labeling, and administration of allergen extracts and immunotherapy (SCIT/SLIT) with adherence to clinic protocols and USP/OSHA guidance.
Recognition and emergency management of anaphylaxis, including epinephrine IM administration, airway support, and post-event monitoring.
Proficiency in electronic health records (EHR) — Epic, Cerner, Allscripts or similar — for charting, orders, documentation, and coding support.
Venipuncture and specimen collection skills with knowledge of proper labeling and lab handling procedures.
Competency in basic pulmonary testing (spirometry, peak flow) and interpretation to assist provider assessment for asthma control.
Medication reconciliation, allergy documentation, and ability to identify drug-allergy interactions and contraindications.
Understanding of billing/coding basics for allergy services (CPT codes related to skin testing, immunotherapy) and prior authorization workflows.
Strong infection prevention and sterile technique practices relevant to injection preparation and clinic safety.
BLS certification required; ACLS preferred or available for clinics handling complex patients or procedural settings.
Familiarity with state and federal regulations (HIPAA, OSHA, CLIA where applicable) and institutional policies governing ambulatory care.

Soft Skills

Clear, compassionate patient education and counseling skills, able to translate complex medical information into actionable self-care plans.
Strong clinical judgment and critical thinking to triage symptoms, escalate care, and make timely safety decisions.
Excellent verbal and written communication for interdisciplinary coordination, documentation, and patient follow-up.
Attention to detail and high degree of accuracy in dosing, labeling, and documentation to minimize clinical risk.
Organizational and time-management skills to balance scheduled injections, observation periods, and unscheduled acute visits.
Team orientation with leadership ability to train and mentor support staff and collaborate with providers.
Cultural sensitivity and patient-centered approach to support diverse populations and varying health literacy levels.
Adaptability and problem-solving mindset in a busy outpatient specialty clinic.

Education & Experience

Educational Background

Minimum Education:

Active Registered Nurse (RN) license in state of practice. Associate Degree in Nursing (ADN) or equivalent acceptable.

Preferred Education:

Bachelor of Science in Nursing (BSN) preferred.
Advanced certifications (e.g., Certified Asthma Educator, allergy-specific training) are a plus.

Relevant Fields of Study:

Nursing (ADN, BSN)
Allergy & Immunology clinical training programs
Respiratory therapy background (helpful for asthma-focused clinics)

Experience Requirements

Typical Experience Range:

1–5 years as an RN in outpatient/ambulatory care, emergency department, or allergy/immunology setting.

Preferred:

2+ years specifically in allergy/immunology, asthma management, or experience administering immunotherapy and performing skin testing.
Prior experience with EHR systems (Epic, Cerner), immunotherapy protocols, and outpatient clinic workflows.

Certifications: BLS required; ACLS preferred. Additional allergy/immunology or asthma educator certifications are advantageous.