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Monday, October 26, 2009

RT profession growing and gaining respect

It's RT Care Week! It's time to reflect on the fact we are leading the charge to improving a profession that is still in its infancy. We are, as they say in sports, not rookies, but not even in our prime yet. We are, as they say in fantasy sports, the sleepers, the prospects with a lot of upside.

You'll see your friendly neighborhood respiratory therapist walking room to room giving breathing treatments, participating in friendly discussions, and cheering up overworked and exhausted nurses and sick patients with their dry humor.

Yes we are an interesting bunch. Some of us grumble and gripe at each new stupid doctor order. Some of us are cheerful no matter what. Some of us are the kings and queens of hospital gossip. Some of us trudge from room to room without saying much of anything.

Yet, no matter what personality RT is taking care of your patient area, you should always know your RT is available to lend a helping hand. If you need an extra body to boost a patient, your RT will be there. If you need help holding down a child for his daily lab draw, your RT will be there.

You also should know that any time you walk into a patient's room and the patient just doesn't look right, that you should always call your RT. He might look at the patient and say, "Oh, he looks fine," or he may say something along the lines of, "I think this patient is wet. It is my humble opinion he might need Lasix. Let's check the i's and o's, though, before we call the doctor. Perhaps we should also get vitals so the doctor doesn't get mad because we don't have all this information available."

This great profession has come a long way since the day of the OJT; since the day when RTs were nothing more than button pushers, or ancillary staff. Yet, while many physicians, nurses and RT bosses have grown with the RT profession and learned to trust the opinions and expertise of the now well trained through qualified RT programs, continued education and experience RTs, there remain many still stuck in the past who still think of RTs only as an ancillary service.

Yes, even recently I have seen both sides of this coin. I have gone down to the ER, seen a patient in respiratory distress, made the appropriate decision based on my 11 years of experience as an RT and 38 years of experience as an asthmatic, and the patient benefited as a result.

When I was finished, I approached the ER physician and informed him of what I did. He enthusiastically said, "Great job! Thank You! I love it when you take charge! You did a great job!"

I was riding high. I did not grow a big arrogant head by no means, but it felt so nice to have a physician not just respect this profession, but to realize how we can be part of the team, and because he actually told me how well he respects me.

It made me feel good because recently I started an Albuterol treatment on a patient I suspected of being in bronchospasm, and the physician working the ER that day said, "What is this?"

"The patient's short of breath and his lungsounds were diminished," I said.

"Well, we don't start breathing treatments without talking to me first. I'm the doctor and that's my job."

I was beside myself. I took the nebulizer from the patient and dumped it into the sink. If this was a rude thing to do, I wasn't thinking of that. I wanted to simply give up. I wanted to take my brain filled with RT wisdom and go home. I wanted to quit.

But I didin't. I swallowed my pride and stood there feeling like a five foot fifth grader standing in the principal's office waiting to be scolded.

The physician turned to me and said, "I want Xopenex and Atrovent."

So, while this profession was once seen as 100% ancillary and 0% professional, it is now seen as ancillary about 50% of the time and professional about 50%. It basically depends on what nurse is working, and what physician is working.

This is progress. This is good. Yet, while the nursing profession is seen as a well respected profession, the RT "profession" is still lagging behind -- yet growing.

My advice to aspiring RTs is this. If you are looking to be an RT, go for it! This is a great profession and you and I can be part of the effort to driving this profession into the future. The RN profession was once in its infancy and through the years physician's learned that by respecting RNs not only do they benefit, but so to does the patient.

The same will hold true with the RT profession, only we who are presently working in the field have a unique ability to shape it into the form of our choice. So, if we stand by and let stubborn physician's pent on holding onto the past shape this profession, they will define our future.

Yet, if we stand firm, be patient, step forth, and continue to voice our opinions in a professional manner, we will shape this profession into the mould of our choice.

Yes, this is a slow, humble, and political process. It's changing the mind of one RN, one doctor, one RT, one RT boss, one administrator at a time. But we know it can be done. We know this because, as Jane Sage wrote in a recent post, the RT profession has already grown since the days of its infancy.

Sometimes I think we RTs are underutilized. Sometimes this irritates me. Sometimes it makes me feel apathetic. Yet, I also know there are many nurses who call us every time they suspect something is wrong with OUR patients. They know that we are specially trained in an area they glossed over in RN school, and they highly respect our opinions.

I recently overheard one sagacious long-time RN say to a student: "Don't be afraid to call RT. They have saved me many times."

We assess patients. We have listened to so many lungsounds that we might just be better than physicians at noticing little trends, at noticing early pneumonia, CHF, pulmonary edema. "This patient is wet!" The RT might say. "You need to call the doctor right away!"

Or, perhaps the RT was not called when the patient was blue around the lips. The nurse who held onto the old-school belief of RT as an ancillary service may have called the physician panicky. The doctor would order an ABG and write an order for more oxygen.

The nurse who learned to respect the RT on duty called the RT, and said, "The patient is blue, and I just wanted your opinion before I called the physician."

On a whim the RT enters the room and checks to make sure the oxygen is still on and connected. As it turns out his whim turns out to be a good idea, because the oxygen was on but disconnected. Once the problem was fixed the patient pinked up. The nurse was ecstatic, and never had to call the physician. We are a TEAM. What one of us doesn't pick up the other does.

Yes, you can see that we RTs, doctors, and RNs are part of the patient care team. Like RNs, we are not only well educated, we are licenced professionals. We are trained to assess, evaluate, think and communicate. We are not physicians, we are not nurses, and we are RESPIRATORY THERAPISTS.

We are part of the patient care TEAM!

It is now RT Care Week, a time to reflect on a profession that is still in it's infancy and growing in every area. We need to feel proud and joy in all we do, and we certainly hope RNs, physicians and admins appreciate what they have by the RTs working around them.

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