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Saturday, November 7, 2009

Here's why we don't have protocols

Ideally, according to Egan, a protocol would work like this:
  1. Therapy can be adjusted more frequently in response to changes in patient status.

  2. Physicians can still be contacted for major changes, but not minor adjustments, thus reducing nuisance calls.

  3. Consistency of therapy can be maintained and nonpulmonary physicians can use appropriate up-to-date methods by simply requesting that protocol therapy be used.

  4. RCPs become actively involved in achieving good patient outcomes instead of performing rigid tasks. This enhanced responsibility attracts and retains better educated qualified practitioners.

Doctors here at Shoreline don't want any of these, and therefore have elected to ignore pleas of lowly RTs.

  1. They don't want frequency to be adjusted. Thus Q4ever for everyone.
  2. They aren't worried about nuisance calls because when they get them they double the frequency and add IPPB that RTs hate.
  3. Nonpulmonary physicians don't have to worry because Q4ever works for everyone regardless of diagnosis.
  4. Physicians don't believe RTs have are smart enough to know who needs therapy. Likewise, RT Bosses don't have to worry about attracting and retaining qualified RTs because there are no other RT departments in this area for us RTs to go.
  5. Our Doctors loved the year 1980, so why use 2010 wisdom.

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