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Friday, October 30, 2009

Stepping Down

(Editor's Note: This is a guest post from a senior RT at Shoreline Medical)

In 100 days I will be retiring from full-time Respiratory Care, I guess I'm just not sure how I feel about that. It is what I do best. Perhaps I should supply some history. In the late 50's (think polio), I wanted to become the next Jonas Salk, become a doctor, cure disease, that was me. Of course in the 60's women were discouraged from becoming anything but teachers, nurses or secretaries. In 1966 I entered a nursing program, hospital based, on site residency, and a whole different ball game than nursing is now. About half way through the program I knew that nursing as it was then was not for me. Nurses didn't get "no respect", were not allowed to think for themselves,and above all, the doctor was Divine, and I don't mean he was a hottie! So, I left the nursing program and went into data processing; talk about boring; so I dumped that too. I knew that I really wanted to be in medicine but what? I ended up going into cosmetology and cutting hair for a living. Then in 1979 I gave birth to an infant with severe meconium aspiration. He was an 8lb 12oz fighter who spent 29 days on a Baby Bird ( anyone remember those?).
I took him home with great relief and a huge respect for the respiratory therapists and neonatal nurses who took care of him.

I graduated from a nearby RT program in Dec. of 1984 and have loved every minute of respiratory therapy since. I've seen huge changes in the field, the phasing out of OJT'S, great advances in technology, respiratory therapy driven protocols, the demise of IPPB (that's for another post), and the bottoming out of reimbursement for services rendered. Now don't get me wrong about OJT'S, a whole lot of what I learned came from OJT'S, give me a good OJT with common sense anytime. Remember, you can't teach common sense and you can't fix stupid. Time has also taken away my junk box. Every old RT knows you have to have a junk box, afterall it's what RT's do, jury rig! If you need something, just dig into a box of old spare parts and adaptors and you'll come up with a serviceable device to do whatever job it is you need done. Ah, a sink trap, a couple of one way valves, a little tubing.........!

At an MSRC conference recently, I listened to a, shall we say seasoned, therapist talk about pulse-oximeters and end tidal co2 monitors. He said he smiles to hear today's therapists complain about having to carry the pulse-ox in their pocket! We remember when a pulse-ox was the size of a small suitcase, try putting that in your pocket!

What about pagers? I remember trying to decipher a mumbled overhead page in a patient room with the Price is Right blasting away at full volume. "Fresh and hairy come on umph stat" or "code blue north..." north what for crying out loud. You just gotta luv those pagers and handy little phones we have now, or not. With two pages and one or two phones hanging off you, you can't hold your scrubs up!
Dropped a pager in the john once, gee, I hated explaining why it was all wet, "I don't know why it smells that way, just give me a new one and oh yeah, don't take that one outta the glove".

Oh man, don't forget ventilators. You like microprocessors, say they make your life easier, and wow, ventilator wave forms, self weaning modes, smart care? Well, I remember standing in front of an MA-1 with a stop watch! Anyone for an H valve? In a pinch, I can still use a Bird IPPB or a Bennett PR-2 for a ventilator, no bells and whistles and I can still save your life. After all, what is a ventilator? A machine that pushes good air in and lets the bad air back out, Emerson had it down pat, does anyone besides me see the correlation between peep on an Emerson and Bubble cpap for neonates? There is nothing new under the sun, it is all slightly used, ie; non-invasive ventilation. I'm expecting a resurgence of IPPB, modified maybe but IPPB all the same. Let's see, tack on a couple of high tech monitors, paint them blue, gray or cream, change the name and jack up the price. Don't laugh,it happens all the time! Just promise me this, when all the old RT'S are gone, all the high tech equipment fails, please tell me that you youngsters can still look at a patient and know something is wrong and what to do to fix it based on good patient assessment! Is he breathing, does he have a pulse, is he pink warm and dry or blue cold and clammy? What is the most important thing to do first?

Let's not forget the drugs; we've come a long way since Isoproterenol and epinephrine. My favorite nebulized medication is Ativan, I want to have it nebulized through our ventilation system here at Shoreline, along with vats of Albuterol, otherwise known as Do-allolin. Oh well, that's going to take a little more convincing.

So, back to retirement, I'll still work, do a little relief here and there, someone has to make sure that all you youngsters are doing things right.

Thanks, Plain Old Jane


Steve said...

Are you like retiring -retiring? or just going part time? Are you going to do something else?

Yes, and I can relate to Baby BIRDs, H valves, MA-1s, PR-2s, manual ABG machines, all that junk.

Rick Frea said...

Hi Steve, I will be retiring to work when it suits me. How nice to find someone who started out early in the field. jane