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Thursday, August 29, 2013

My argument against respiratory therapy practitioners

There is a lot of talk among the respiratory care profession about changing the RT degrees.  One idea as proposed by the National Alliance of Respiratory Care Professionals (NARCP) is to create a new profession of Respiratory Care Practitioners.  As noted on a recent Facebook entry: 
Much like nurse practitioners help to fill the shortage of doctors, we strongly advocate for the creation of cardiopulmonary practitioners and critical care practitioners; a mid-level Masters program for Respiratory Therapists that specializes in critical and cardiopulmonary care to help fill the shortage of critical care specialists and the rising number of patients with cardiopulmonary disease.
My argument is in opposition to the NARCP.  In response to the above, I wrote:
I think we are already qualified to do that.  i see no need to go to school for 3-6 years to learn what we already know after 2 years.
Their response to me was:
Frea: An mid-level provider will require more than an AS degree, and there is a vast amount to learn about cardiopulmonary disease and treating it.  We have the best foundation to advance to these levels.
That argument didn't settle me, and I wrote: 
It would make more sense if physicians would learn to respect what we already are - well qualified.  More schol will not make us smarter, IMO.  If someone wants to become a practitioner, they go to practitioner school.  If someone wants to be an RT, they go to RT school, for 2 years.  If the RT program was more than that, many of us wouldn't be here, and the profession would be losing out.  
I think this is so true.  School is expensive, and most of us chose this profession because it was less costly, and less time consuming, than pursuing a bachelor's or doctorate's degree.  And I can personally contest to the idea that the only reason I became an RT was because I could start working right away, and have a degree in only a few short years.  If the profession was anything more, your humble author here would not be doing this (or I'd be doing this for some other profession).  
A later response was by Jason Cook, who wrote:
We need both clinicians as well as technicians, and it depends on your personal mastery of the concepts.  I have met 2 year CRTs who knew more and could diagnose better than a physician, and likewise, I have met some RRTs with Master's degrees who couldn't wean their way out of a wet paper bag.  We need groungpounders as well as Top brass.  I'm just sayin, "Don't be hatein.  Somebody has to do the dirty work while the manager goes home to do whatever it is they do...
So, what are your thoughts on this?

6 comments:

Anonymous said...

I would argue for. While agree with what you say about us being the speicalist. I still fell a higher education would be beneficial. I am curently going to school for MS in healthcare managemnt and can tell you I miss treating and being with patients. I am going to school because my hospital supports education. I have gained a BS and ACCS, CPFT, AE-C all on the hospitals dime. If a critical care respiratory practitioner existed I would be all over it. I think it would give new practitioners the fell that they can move forward in the respiratory field.

Jim

Anonymous said...

I find this topic interesting as I am working on leaving this misserable profession. I think it comes down to supply and demand. If there is a real demand for a respiratory practitioner then there will be a supply from the market, but who is hiring for these jobs? What is the reimbursement like? NP's and PA's who work under docs get reimbursed for their services and their license allows them so much more autonomy. I would love to see this happen for the respiratory practitioner, but I think we've pigeoned holed ourselves into a corner. Respiratory is very specialized and only so much will EVER be covered under our license. And you're right about going to school another 3-6 yrs to do the same job we already do, but that degree looks nice on paper. I feel like the more letters I see behind a RT or RN's name the less bedside care they know how to do. I'm tired of the apathy, attitude, and knob turners amongst us which is why I'm in school with a focus on leaving respiratory. Instead of tearing each other down we should be building each other up, but I don't see therapists striving for this. I think most are quite content to remains knob turners or neb jockeys, and managers try to "keep you in your place" even though they may deny this. Heaven forbid you might actually put your critical thinking skills to use and do what's right/safe for the patient because that makes others look bad. This is a hard profession that breeds apathy and laziness. I don't see it being any different if the practitioner degree happens. Thanks for reading my rant. It's not even noon, and I'm burned out.

Rick Frea said...

I have no problem with being better educated, but I do have a problem with forcing all RTs to go to school for four more years just so physicians have better respect for us. That's like saying current RTs are incapable of deciding who needs a treating patients, when that's not true. It would also means that people like me, who only have limited finances, would not be able to become RTs. I think it is poppycock that you have to have more education to become smarter. In fact, there are many people with no degrees who'd make fine RTs. To make such a change would force many young people interested in respiratory to seek another profession, and I think that would be unfortunate.

Rick Frea said...

I talk to people of other medical professions, and there is burnout in every one of them too. Studies show there's burnout in any profession where you work with people: RT, RN, DR, pharmacists, journalists, advertisers, police, etc. So I will never buy that argument.

Anonymous said...

I truly believe that all the extra schooling is just about the money! I am a 51 y.o.CRT and have been practicing for 15 years. Short of Intubating and art lines, I can do anything an RRT can do, often better. I've taught many new RRT's the most basic of things like how to set up a BIPAP. I have worked in ICU's from transplant to neuro to burn. I can wean ETT and trach pt's from the vent all the way to extubation/decannulation. I have known RRT's that are dumber and lazier than rocks, yet I can't get hired by most hospitals because I have the wrong three letters behind my name! Thank God I love my job because I refuse to go back to school and have student loans to pay back when I retire.

Anonymous said...

I agree many therapist are great and it does not matter one's education. The point I am trying to make is I would like younger generation know that their is an option to advance forward. I would like an opportunity to be more autonomous. As for credentials, I don't think they make a better therapist but I do think they help motivate staff to get educated and bring something more to the department and field. When I went for ACCS I got staff involved and was able to get another therapist on board and 2/3 more in the wings.

Jim