slideshow widget

Sunday, March 30, 2008

While on the dock the waters stay calm

When we highly qualified RTs are talking amongst ourselves we know far more than the doctors, who are responsible for every functioning part of the patients we take care of, when it comes to the respiratory system. We are the experts. We don't know it all, but we know quite a bit about respiratory.

We are highly educated on the respiratory system. We not only labored through 2.5 years of RT school, where we focused on nothing but respiratory and other systems as they pertain to respiratory, we ate, drank, slept, licked respiratory. And, now that we are full grown RTs, our lives rapt in respiratory, our respiratory experiences growing on a daily basis, yet we are so often left frustrated by doctors who refused to allow us to use our experience, our education that we worked so hard to develop, and to maintain.

It's ironic in a way that we know far more than doctors as to when breathing treatment is indicated, and yet they are the one's with the power to write the orders, and they are the one's with the respect of the nurses and the other doctors and the administrators and the RT bosses. And, based on that, we have no choice but to do what we are told, whether we agree with it or not.

And, worse of all, when we do have an opportunity to portray that our belief is true, we tend to keep our mouths shut, as to not rock the boat; to not make waves. Why? Because we have to work with these doctors, and we have to stay on their good sides. For no amount of joy can come out of working as an RT when the doctors have lost all respect for RTs, and when a doctor is annoyed because an RT is a know-it-all.

So, instead of chancing it, we keep our mouths shut. We stand on the docks. We stay out of the water. We do not make waves.

"Let's do another treatment," the doctor said. "She's still got a lot of wheezes."

"I think those wheezes are all upper airway," I said matter-of-factly.

"No, I hear those wheezes throughout."

Of course you hear those wheezes throughout, the upper airway congestion is radiating throughout the lung fields. I wanted to say that, but was a good boy.

When the treatment was finished, the patient still had that upper airway congestion that did not sound like bronchospasm to me. "Do you feel better?" I said to the patient while the doctor was still in the room.

"No. I feel the same," the patient gasped in her laborious nature.

Like with Dr. Mast the night before, of whom, three days after the patient had been admitted with pneumonia, realized he forgot to order Ventolin. "Gosh, that patient just won't be able to go home if he didn't get that Ventolin in his system."

Here I am, an intelligent RT (at least I think so), who knows darn well the doctor's is wrong (wrong, wrong, wrong, wrong) when it comes to understanding the purpose of Ventolin, but I do not say anything because I want to be nice to him and not hurt his feelings.

However, I might make hints (plant seeds if you will) like, "Yeah, I think it's all in his throat."

But, not wanting to rock the boat, I say nothing. Perhaps that's the problem with us respiratory therapists. Perhaps the reason we fail to make progress with doctors ordering useless breathing treatments is because we tend to prefer the politically correct route, the I don't want to hurt your feelings route.

Perhaps we ought to speak our minds and say what we think, regardless of who might be offended. Regardless that the doctor will look at us like we are the bumbling idiots instead of them being the bumbling idiots.

The thing is, it's far easier not to rock the boat. It's far easier to come into work and simply do as we are told and not say anything about these treatments not being indicated. It's far easier to come into work, do what we are told, and go home never to think of this place until we get back to work in two days or whatever.

It's far easier to do what we are told, and collect that paycheck at the end of the weak. After all, that is the purpose of doing this great job, isn't it? After all, a paycheck is a paycheck.

I wish it were that easy. I wish I could just be content to simply make a paycheck. I love being an RT, as most of us RTs love our jobs. However, playing this game of appeasing doctors, of doing treatments we know are not indicated, just because that's what the doctor orders, is by far the most frustrating part of this job.

I too, like the old RTs close to retirement, who don't want to rock the boat for fear they won't reach that zenith of retirement a few years down the road, don't want to rock the boat. So, like all of us RTs with a kind heart and empathy for the doctors (or fear of them), just do the procedures they order and keep my mouth shut about it. And, on rare occasion, wine about it amongst my co-workers, or right here on this blog.

We love our jobs, I love my job, but there are areas of it I really, really want to improve. Yet, sometimes, as now, it's far easier to stand on the dock, to do as we are told, to stay out of the water, to not make waves as to not rock the boat.

Sure, progress might be slow by this route, but it's the one sure way that the paycheck will continue to find itself on the kitchen table by the end of the week. And, when it comes to your wife and children who depend on you, sometimes that's all that matters -- in the end.

Wavy waters bring questions, and complete happiness is guaranteed in the calm waters.

No comments: