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Friday, August 24, 2012

Are RTs therapists or technicians?

Sometimes I wonder if we are really respiratory therapists where I work.  We are paid like respiratory therapists, yet in actuality the work we do is the work of a technician.

Consider the following definitions:

Therapist:  A person who provides therapy.

Technician:  A person who does procedures ordered.

By interviewing RTs who work at other institutions I know that many RTs are truly therapists.  They are provided with orders such as, "RT Consult."  The therapist then assesses the patient and performs the appropriate therapy.

Yet where I work we don't provide therapy at all.  In short, we are simply techs doing procedures ordered.  In this sense, we aren't therapists at all, we are well paid techs.  In this sense, it is much more understandable how so many of my coworkers present with the symptoms of Respiratory Therapy Apathy Syndrome (RATS).

For example, yesterday I came to work and there were 14 patients on our board, and my coworker told me that none of these patients required the services of an RT.  There was not one of these patients who needed breathing treatments or chest percussion.

Many of the patients would have benefited from education about their disease process, yet we "techs" are so busy doing procedures that aren't needed that we don't have time to sit down and do the job we went to school for:  provide therapy.

I also had the emergency room yesterday, and I kid you not that I did at least 25 EKGs.  We are doing EKGs on every patient admitted with chest pain, rickets, stroke symptoms, hangnails, diabetes, high blood pressure, low blood pressure, no blood pressure, asthma, COPD, and cough.

It's pretty much to the point we are doing EKGs on every patient who hits the ER door.  Many are needed, yet there are so many ordered that I think nurses just order them out of habit.  Heck, I don't even thing nurses order them any more.  I think they are just ordered as part of an order set.

Where I work we are not respiratory therapists at all.

If you're a new or aspiring RT, I want you to know it doesn't have to be this way for you.  When you are looking for a job, make sure you choose an institution that provides respiratory therapy.  Most of your teaching hospitals provide such therapy.  Many smaller hospitals do too, yet not mine.

A good way to know if your hospital provides therapy is to interview the interviewer when you are interviewing for a job.  Ask questions like the following:
  • Do you have RT driven protocols
  • Do you have an RT Consult
  • Do your doctors allow RTs to change or alter therapy without a direct order
  • Do your doctors allow RTs to adjust ventilator settings without a direct order


Aiesha Grant said...

Hey Rick,

As I was reading this post, I began thinking about many of the RTs that I know who have "grown apart" from the field because of situations that are similar to yours. I am an RT student and sometimes I feel like some of them "fall" into a trap of bowing down to doctors/nurses and following orders. I say fall because many RT's don't even seem notice that it is happening until it's too late ! Slowly, a big change occurs. At first (from what I hear) many RTs will begin fighting for their respect and demanding it in hospitals after graduation and maybe a few years after.But after while, they give up and begin conforming to providing unnecessary treatments (such as bronchodilators in many cases) that are usually ordered for reimbursement. Then they become "complainers" (as you mentioned in one of your previous posts!) In my opinion, that is part of the trap.Instead of turning the situation into something positive like you have done and speaking with future RTs about how they can avoid these issues and create respect for themselves, most RTs complain, discourage others from entering the field and do ABSOLUTELY NOTHING to change their circumstances. In truth, I believe that is the real reason why in some institutions we are treated like neb jockeys or techs instead of the valuable assets to the healthcare team that we really are. Even though I am a student, I have researched well and have interacted with many RT's. With that being said, I have come to the conclusion that we (as a whole) are "stuck" because we have no unity. Instead of encouraging others to enter the field, many RT's discourage it and talk badly about it. If we speak badly of ourselves, what does that show everyone else? Think about it. Nursing, in part is as big as it is because they stick together! If you read nursing forums you don't see all the negativity although I am sure that there are negative aspects of the job (just like everything else). If you read an RT forum, you see lot's of negativity and a variety of different ideas about doing things. No one is truly on the same page and it is really sad if you ask me.I have a question for you Rick and I certainly do appreciate you giving advice to new aspiring RTs like me. (and explaining to us that it doesn't have to be that way!) But if you have seen the cycle for yourself and you know that you are not giving "therapy" to patients, then what gives you the strength to keep going?

Rick Frea said...

My kids.

Rick Frea said...

The people I work with

Rick Frea said...

My blog.

Rick Frea said...

People like you

Aiesha Grant said...

=) Thank you! It's people like you that inspired me to pursue respiratory care despite all the madness I hear about and its refreshing to know that someone feels the way I do. If you get a chance, I would like you to check out my blog. I am a BIG FAN of your blog and I provided a link on my site for it because it is my favorite RT blog out there (other than mine of course) just kidding! lol. I'm new to this and I chose to target students and focus on creating awareness and respect by not only telling my story, but by giving advice to prospective students. Hopefully, this will not only inform people and make them aware of who we are and what we do, but also draw people to the profession. Anyway, I'm off to catch up on your posts!