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Monday, February 19, 2024

I Started Out As A Journalist

In high school, I attended a career day where I had the opportunity to speak with a respiratory therapist. When I asked about the program requirements, specifically questioning the necessity of taking chemistry, he affirmed that it was a requirement. Given my struggles with chemistry at the time, I made the decision to explore another path. With a passion for writing, I ultimately chose journalism.

My decision to pursue journalism felt somewhat like drawing a ball from a lottery bucket, and the ball I selected had "journalism" written on it. That chance moment guided my college choice and set me on the path of studying journalism.

At this time I wasn't the best student. I loved to learn, but had yet to master the art of making what I learned stick in my head. Actually, what I lacked was organization and self discipline. So I mostly got B's and Cs and the occasional D. And I made it through the 2 year associates's degree program. 

We had a school newspaper called the Torch. And I was a writer for one trimester, and this was where I learned the skill of being a reporter. And, being that I am an introvert and have social anxiety issues, it was difficult for me to motivate myself to get interviews. Plus, since I was naive about the world at this time (after all, I was only 18), sometimes I misunderstood what I was being told in interviews. So, this made it a bit challenging for me as a reporter. 

Despite the initial challenges, I persevered and found my footing. During the first trimester, my roommate assumed the role of editor for the Torch, and I was fortunate enough to be appointed as the assistant editor. Little did I know, this would become the most impactful position in my college career.

As the assistant editor, my responsibilities included meticulously reviewing all articles in the news section, a task that significantly contributed to my growth. Critiquing the work of others allowed me to identify flaws, ultimately enhancing my own writing. This role served as a crucible for improvement.

As I became more acquainted with my colleagues and overcame my initial hesitation in communication, especially over the phone, I gradually became more adept as a reporter. This increased comfort translated into a significant improvement in my writing style. I adopted a concise paragraph structure, a stylistic choice that would later carry over into my blog posts.

Although working as a journalist on a college campus presented its challenges, I am grateful for the experience. It not only equipped me with valuable skills but also played a pivotal role in shaping the writing techniques I now employ in my current endeavors.

Saturday, February 10, 2024

What Causes RT Grumpiness

Respiratory Therapy Apathy Syndrome
Sometimes we RTs are busy. And sometimes we are not. And there are two different types of busy. There's the type of busy that involves things that make you feel proud of the job you do. And then there's the type of busy where you're busy because doctors are writing a bunch of stupid doctor orders. 

Let's say someone comes in severely short of breath. And you are a part of the team that helps that patient feel better. This creates a sense of pride and joy. It makes you happy that you have the job that you have. This is the good type of busy. 

But, then you have those days when you are unable to sit down all day becasue you are running from room to room doing breathing treatments for heart failure, cough, no cough, heart failure, pneumonis, influenza, COVID and rickets. And just as you sit down, you get a text that there is an outpatient EKG. And as soon as you are done, and you sit down, you get a page for a STAT EKG on a preop patient.

If a patient has COVID, they get automatic QID breathing treatments. Same for influenza and pneumonia. Of course then you have to gown, glove and wear a mask in every patient room. And then when you are done you ask, "Do you feel any better?" And the patients all say, "NO!" 

Yep. You know what I mean. At the end of the day your feet are burning and you are irritated as all get out. This, my friends, is what causes RT burnout. This is what causes RATS, otherwise knows as Respiratory Therapy Apathy Syndrome

Thursday, February 8, 2024

My Greatest Fear As An RT

There's an old saying that there's nothing to fear but fear itself. Although, I think this saying is poppycock. How can you be afraid of being afraid? A better saying is: 'There's nothing to fear but not being prepared.'

So, this brings me to my greatest fear as a respiratory therapist. It is... spilling that coffee that is sitting on the patient's bedside table.

What did you think I was going to say?

And, as soon as I walk into the room, I prepare myself. I say, 'John, you will not spill that coffee.' It's challenging, especially as I move past the bedside table to plug in the treatment to the flow meter. I worry that my jacket might brush against the coffee and spill it.

Or, worse, that I would forget it was there and knock it over because I wasn't paying attention.

In my 28 years on this job, I've only done it once. And, it wasn't a cup of coffee; it was one of those narrow vases holding a flower. It shattered all over the floor, and I had to apologize. Then, I had to go on a hunt for a new flower vase.

What were you thinking I was going to say? What is your greatest fear as an RT? 

The Unspoken Truth Is A Little White Lie

Sometimes it seems like the higher ups keep adding responsibilities to the to do list. And sometimes it seems that they do this because they have nothing else to do. And some of these new responsibilities have literally nothing to do with anything. And they add nothing to the great care that we already give to our patients. 

So, you want an example? Well, I don't want to get myself in trouble. Yet I will give one example here that I think I am safe sharing. We are told that we are to wash ventilators between patients. And this is common sense. But now they added a step. 

Drum roll please!!!

Now we are to wipe the ventilator down for two minutes. And when I'm asked if I do this I say, "Yep!"

I say this even though there is no clock in our storage room. And i say this knowing I do not have a watch. So there is no way possible I can even keep track of time while I am wiping a ventilator. 

Heck, every person is different. And we all clean things at a different pace. And I can't help it if I happen to wipe the entire thing (every spot) in 30 seconds. Why should I stand there wasting another 1.5 minutes wiping over what I have already cleaned? 

But this is how it is when you have large corporations running things. They want everything in every branch to be the same. And so they come up with these little policies that don't effect them but create more things for us to do. It's fine, I suppose, when it's not busy. But, when we're busy, and you finally get a chance to rest, most of us aren't going to waste that 1.5 minutes wiping for no reason. 

And you can take this analogy to a variety of other tasks doled upon the workers in pretty much any business. And we understand. They have to create these tasks so they can monitor how something is improving. They have to do this so they have something to do, to justify their existence. And if we had such a job, we would do the same. We know this. So, to help them out, even if we don't do things exactly as they plan, we make it look like we do. That's what we do to keep the peace. 

"Did you wipe down that ventilator for 10 minutes?"

"Yep!" Your white lie resonates off your face like a distant echo in an empty canyon, lingering with the unspoken truth—even though you know you did not wipe for 10 minutes.

And it's the same the other way around too. You ask your boss, "Did you talk to the doctors about not ordering COPD education on patients who do not have COPD." 

"Oh, yes I did," Your boss says, her lie resonating off her face like a confident echo in a quiet room, concealing the unspoken truth—even though she knows she didn't address the issue with the doctors. 

And that's fine. That's the way it often goes in the intricate dance of workplace dynamics, where keeping the peace sometimes means navigating through these unspoken agreements.

Saturday, February 3, 2024

Happy To Suction That 1-Year-Old's Nose Out

In our role as respiratory therapists, suctioning infants' noses is a common task, especially during RSV season. At my workplace, we use devices called Booger B' Gones connected to suction for this purpose

I'm assigned to suction an infant's nose in room 224. As I gather my equipment and don a mask, I enter the child's room. The little one is sitting contentedly on his mother's lap, playing a game on her phone. She's perched on the hospital bed, cradling her child. My objective is to improve the child's comfort, even if it entails a momentary bout of displeasure.

Noticing the nurse preparing for a COVID swab, I suggest, 'Let's do this at the same time. We'll have the mother hold the child. You can get your swab, I'll suction the nose, and we'll be done quickly.'

I explained the procedure to the mother, detailing her role in holding the infant on her lap and securing the child's arms, while I held the head for suctioning. The nurse was ready to perform the swab. 

The coordinated effort unfolded seamlessly; the child, although upset, remained relatively still with held arms and head, allowing us to efficiently complete the tasks. The nurse successfully obtained the swab, and I suctioned both nares quickly, extracting a substantial amount of mucus. While I'm confident this will make the child feel better, it also brings me a deep sense of satisfaction.

As soon as the child's arms were free, he vigorously wiped at his nose with his hands, tears still in his eyes. His mom showed him the iPhone, and the child quickly became distracted by it. Within moments, he was happily watching the show again, only now breathing much easier.

Well, that's why I wear a mask," I said. "Because that way, he doesn't know who I am. If I need to come in later on to do something, he will not fight me out of fear that I will do that again." This remark prompted laughter from the nurse and the mom, while the child remained engrossed in whatever was on the iPhone.

The entire procedure was less than five minutes. And, in the end, all parties are satisfied, and breathing easy. 

Friday, February 2, 2024

What Do RTs Need To Know About Heart Failure

Among the most prevalent cases we encounter in our profession are individuals grappling with heart failure. Our responsibility involves utilizing specialized equipment to facilitate their breathing, particularly during episodes of exacerbation. Equipping ourselves with a comprehensive understanding of heart failure is essential, as it enables us, respiratory therapists (RTs), to provide effective care and valuable education to these patients.

Embarking on an exploration of Congestive Heart Failure (CHF) holds particular significance for healthcare professionals, with a focus on RTs. This endeavor allows us to delve into the intricate dynamics of the heart, gaining insights into how heart failure impacts both the cardiovascular system and respiratory functions. In my role as an RT, I aspire to illuminate key aspects that fellow RTs should be familiar with regarding heart failure, contributing to a more informed and adept respiratory care approach.

Understanding the heart

To grasp CHF, it's essential to understand the heart's complexity, with its two vital components—the right heart, responsible for lung circulation, and the left heart, orchestrating blood flow throughout the entire body. The right heart operates as a smaller pump, managing lighter pressure (around 15) to transport blood through the lungs for optimal oxygenation. In contrast, the left heart acts as a robust pump, generating a pressure of about 120/80, crucial for propelling oxygenated blood through the intricate network of arteries and veins.

Understanding this dynamic relationship between the two heart components is essential in recognizing how heart failure can disrupt the intricate balance of blood flow, particularly affecting respiratory functions. While a diagnosis of heart failure may not exhibit daily symptoms, its progression can lead to manifestations like dyspnea and wheezing, often resembling respiratory conditions such as asthma or COPD.

As heart failure evolves, challenges arise in maintaining adequate Cardiac Output (CO), a critical metric influenced by Stroke Volume (SV) and Heart Rate (HR). Monitoring vital signs, including blood pressure and pulse rate, becomes crucial. The progression of heart failure can result in complications like increased Pulmonary Vascular Resistance, leading to Pulmonary Edema and an audible cardiac wheeze. Recognizing these respiratory implications is pivotal for effective management.

Looking to the future!

Advancements in heart failure treatment have likely improved outcomes, emphasizing the importance of regular symptom monitoring, including oxygen saturation and audible wheezing. This post serves as a starting point for RTs to delve into the nuanced aspects of heart failure, empowering them to navigate its complexities and contribute to holistic patient care..


Thursday, February 1, 2024

Yes! It's Heart Awareness Month

February marks Heart Failure Awareness Month, an invaluable period dedicated to shedding light on a condition that affects millions worldwide. For respiratory therapists (RTs), this observance holds particular significance as it presents a unique opportunity to deepen our understanding of heart failure and refine our skills in providing comprehensive care.

Understanding the Significance

Heart failure, a condition where the heart struggles to pump blood effectively, poses intricate challenges that extend beyond the cardiovascular system. RTs, often on the frontline of respiratory care, play a crucial role in assisting patients with heart failure, especially during episodes of respiratory distress.

Navigating the Educational Landscape

Heart Failure Awareness Month is a beacon for respiratory therapists to immerse themselves in the latest advancements, treatment modalities, and emerging research related to heart failure. It's a chance to enhance our knowledge base, ensuring we are well-equipped to address the complex respiratory aspects associated with heart failure.

The Value of Awareness

Increased awareness is a catalyst for early detection and proactive management. As RTs, our ability to recognize the signs of heart failure, understand its impact on respiratory function, and collaborate seamlessly with the broader healthcare team is paramount. The ripple effect of heightened awareness transcends individual patient care, contributing to a more informed and responsive healthcare ecosystem.

What It Means for Respiratory Therapists

Heart Failure Awareness Month serves as a reminder for RTs to engage in continuous learning and professional development. It prompts us to foster interdisciplinary collaboration, fostering a holistic approach to patient care. By comprehending the nuances of heart failure, we empower ourselves to deliver tailored respiratory interventions that align with the broader treatment plan.

In conclusion, Heart Failure Awareness Month is not just a calendar designation; it's an invitation for respiratory therapists to embark on a journey of knowledge, empathy, and skill refinement. As we navigate this awareness month, let's seize the opportunity to elevate our understanding, enhance our capabilities, and, most importantly, contribute to improved outcomes for our patients with heart failure.