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Saturday, May 30, 2009

The growth of the RT profession

While there is still room for growth, respect for respiratory therapists has grown immensely since the profession was first created in the 1940s.

In the 1940s and 1950s respiratory therapists were called inhalation therapists, and there job was to set up and manage oxygen, do intermittent positive pressure breathing (IPPB) treatments, do CPR when needed, and manage negative pressure ventilators when needed.

In the 1970s and throughout the 1980s EMTs and nursing assistants did many of the duties that respiratory therapy performs now. Other people were hired off the street, and were trained on the job (they were called OJTs). For the most part, they were button pusher. Doctors told them what needed to be done, and they did it no questions asked.

By 1969 the National Board of Respiratory Care was established to create schools and testing criteria for those interested in the profession of respiratory care. Yet, while there was increasing demand and few people interested in going to school, few in this profession were interested in becoming formally educated.

Yet this gradually changed, mainly due in part to the efforts of the NBRC. One of the methods of generating respect for this profession was to create better educated therapists who would do more than just push buttons. But this would be years in the making. The first step would be to encourage or provide incentives for OJTs to go to school.

Yet another challenge occurred in the late 1970s and early 1980s as positive pressure ventilators were invented and became popular. It was determined, more so than in the 1950s with negative pressure ventilators (iron lungs), specially trained people were needed to run this equipment and assist physicians. This caused an increase in demand, once again, for RTs.

This resulted in hospitals hiring in more people to fill these positions from the streets. While this was contrary to the wishes of the NBRC, more people who lacked any respiratory education were hired to become respiratory therapists.

Because many didn't want to go to school (mainly because they didn't need to), programs were set up where therapists could sit through day long classes for one or two days and when they were finished they qualified to take the test. If they passed they earned their CRTT certificates. The same process was continued on the way to earning an RRT.

So you can see that slowly but surely respiratory therapists became better and better educated. Eventually the field became saturated and requirements to becoming an RT were increased. To get a CRTT you had to go to school for one year. To get your RRT you had to finish a two year program.

Then, at the turn of the millennium, the requirements were increased once again so that you cannot even get a CRT (changed from CRTT) until you have finished two years of RT school. So, basically, the CRT program is pretty close to being all but phased out. Because as long as you've already finished your two years of schooling, you might as well just take the test and get your RRT.

So, as the requirements to become an RT have improved so has the educational level for RTs. Where I work, and in other hospitals in this region, hospitals will only hire RRTs.

Like nurses, we are put under the same level of educational stress. We are trained not just about respiratory, but about the entire body and how it relates to respiratory. We are not just trained about oxygen and respiratory equipment, we are trained to think along the same lines as physicians.

And, therefore, by the time we become full fledged RTs we are fully capable of working alongside with nurses and physicians rather than for them. We are fully capable of making recommendations and suggestions to improve patient outcomes. We are now the well educated profession the NBRC set out to create nearly 40 years ago.

Yet there is still room to grow. There are still old school nurses and physicians who still think of RTs as button pushers. They have trouble setting aside their pride and giving up the autonomy
necessary in trusting the wisdom of the new improved RTs. Instead they overrule us and order useless treatments anyway.

And, to be fair, there are still some RTs who are afraid to take on responsibility and prefer to be button pushers. While these RTs may be great people, they do nothing more than set this profession back. When old school doctors and nurses work with these RTs, their old notions about RTs are confirmed.

Likewise, you still have RT complainers who also do little to move this profession forward. Instead of working to improve respect and come up with ideas to make the job better for all, they complain. Now, to be honest, we all fall into this trap from time to time, but it accomplishes little.

Unlike the profession of nursing, respiratory therapy is still a maturing profession. If you refer to the 40s and 50s as the infancy of this profession, we are now entering adulthood.

This might be the best time to enter this profession, because the respect we earn, and the protocols we create, will set the way for all who walk in our shoes in the future.

So you can see there remain obstacles to the zenith of respect for the RT profession, but we have made great strides from the day of the OJT.

1 comment:

whimsygirl said...

I really appreciate your last 2 posts. As a student entering RT school this fall, I was starting to feel pretty discouraged. Did I really want to put in the same amount of training time and effort to make less than a nurse and get less respect?

But alas, my heart is in RT and there I will go.