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Sunday, April 7, 2013

The focus should be on the patient... not pride

There is some truth to the notion that some doctors don't want to give up the ability to write orders to other people.  When there was a push for PAs and NPs a few years ago, many physicians fought against it.  Many also fight against RT and RN protocols for the same reason: they don't want to give up autonomy.

I can understand this to a certain degree, considering they went to school for many years, studying their butts off to earn their degrees, only to see some of their power given to PAs and NPs.  And to make matters worse, to give up power to RTs would be to give up power to people who only have associate's degrees, or two years of college.  

Yet what these physicians don't consider is that we as medical care givers ought to do what's best for the patient, not what's best for them.  What they fail to realize is that education does not determine intelligence.  What they fail to realize is how thorough the RT educational programs are, and how much RTs learn by empirical means on the job.  

This may be worded best by historian J.M. Roberts:
Everyone can recognize an educated man when they see him, but not all educated men are recognized as such by all observers, nor is a formal qualification (a university degree, for example) either a necessary or infallible indicator.
A person doesn't need eight years of education to know who needs a breathing treatment.  A person doesn't need eight years of education to manage a ventilator.  To the contrary, a person who spends ten minutes a day visiting with a patient, and the rest of his time in his office or at home, should not be making these decisions: the person at the bedside should.

In other words, the past eight years while the physician was in med school, the respiratory therapist and nurse were already on the job taking care of patients.  In this case, is the knowledge of a physician greater than the knowledge of a well educated and experienced respiratory therapist?  I don't think so.

I've always been a proponent that the best approach to taking care of a patient is the team approach.  This would involve doctors doing what they do best, nurses doing what they do best, and respiratory therapists doing what they do best.  The wisest of wise doctors are the ones who realize this.

I understand the pride involved in being a physician, and I surely would be proud if I were one.  Yet the focus should be on what is best for the patient, not pride of the physician.


silvia szeliga RRT said...

I agree! sometimes we as RT's get so worked up over our pride and our knowledge that it actually becomes a hindrance in our field! we begin to be seen as "know-it-alls" or worse we become so frustrated because of the lack of recognition from our coworkers that we stop trying!

we do the absolute bare minimum for the patient and stop trying to exceed the standards set before us! this makes us look "lazy" in the eyes of our coworkers and we end up losing even more respect and become increasingly frustrated! IT'S A VICIOUS CYCLE!

I know we cannot or rather should not judge others, but I see the results of this sort of behavior all the time! I always hear nurses say things like "wow! you're the only one who does that" or "why do you care? nobody else does in your department?" it gets frustrating because I am trying to represent not only the department but also the field of respiratory in a positive light.

I hope that others who go beyond see this and feel encouraged!

yes we can do just enough to not lose our jobs, but who are we short changing? ourselves or the patient?

end rant!

Rick Frea said...

Hey, that's what this blog is all about -- ranting. You can do all you want here. What you say makes a lot of sense. In fact, just the other day I went into a delivery room to be on standby just in case something bad happened, and afterwords the nurse said to me: "You're the only RT who does that." Yes, it's little acts like this that make us look good. Thanks.

Unknown said...

I am a student at GSU and at my designated hospital for clinical this semester, RT protocols were just initiated. Everytime I go in assess a patient and provide treatment based on that acuity score, the doctor discontinues the order and then re-orders what he had at first! It is really annoying and it just proves that (like you said) many of them are too worried about their autonomy. But at the same time, RT's worry about the EXACT same thing. The only reason most of us want protocols is for our own autonomy and recognition! We stick our noses up at other healthcare members and do "mediocre" assessments of patients (in order to "pay back" other healthcare members) while complaining about the entire lack of recognition and respect in the field. In order for the patients to truly benefit, all of us (doctors, nurses, and RT's included) must forget about autonomy and focus on being a HEALTHCARE TEAM!