Some RT departments have RT driven protocols. This, one would think, would be the ideal way of preventing needless therapies. However, most RTs who work at hospitals that have such protocols note that, "I discontinued the therapy only to come in the next day to see the order was rewritten."
Either that, or senior RTs refused to discontinue un-needed therapies. Why would this be? Well, the answer appears to be obvious: It's called criteria. In order for the hospital to get reimbursement, certain criteria needs to be met. At least this is according to my RT Boss.
For example, if a patient is admitted with pneumonia, most insurance companies (and the government) will not reimburse the hospital unless a breathing treatment is ordered. By golly, if a patient isn't sick enough to need a bronchodilator they don't need to be admitted.
This is funny (irritating would be a better word), because some person in Washington who had no clue what he or she was doing made this decision, when the truth is that bronchodilators have no effect on the inflammation in the alveoli that pneumonia is. Bronchodilators don't even get down into the alveoli.
Regardless, this pretty much explains some of the stupidity. This is why we have a pneumonia protocol (order set I call it) that requires all pneumonia patients to receive Q6 hour Ventolin.
Yes this is frustrating, but it's the way it is.