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Sunday, January 5, 2014

There is respect for respiratory therapists

Once again I must delve into the issue of respect for respiratory therapists, for many times I have been asked by new and aspiring therapists: "Is it true there is no respect for respiratory therapists by physicians."

I can attest that the relationship between doctor and respiratory therapists is not prefect, and I have written about that many times on this blog.  My friend Will Lessons wrote an article recently on how doctors write many orders based on feelings instead of facts.  This is the case when they order albuterol for pneumonia and heart failure patients.

But, I must say, that just because a doctor writes some ridiculous doctor orders does not mean they disrespect respiratory therapists.  I can give you some really good recent examples.

Just today I approached a doctor in the critical care about a patient who was placed on a Servo i during the night. He was intubated because he overdosed on a bunch of prescription pills.  I said to the doctor, "What is your plan for this patient?  Are we going to be able to consider extubation, or will it take a while for the effect of these pills to wear off?"

He said, "I would like to get him off the vent as soon as possible.  Do whatever you think needs to be done to get him extubated?"

I said, "Good, then all I need from you is to write an order for the ventilator protocol."

He said, "Good, you got it!"

I said, "Oh, and I'm not an expert on sedatives, but I need to know if he is on any, and if it will affect his being extubated."

He said, "He is on a little, and I will discontinue it."  He stood up, and said, "Mike, would you discontinue (whatever sedative he was on)."  He looked at me and said, "And one more thing.  You don't need to do an ABG because he doesn't have a lung issue.  In fact, you don't even need to call me.  Whenever you think he's ready to come off just..." he made a motion with his hand by his mouth as if he were pulling out a tube.  "Sound good?"

I said, "Sounds great!"

So, tell me why a doctor would put such faith in a respiratory therapist if he didn't have respect for him?

Then I went to the emergency room, and my co-worker was setting up a BiPAP.  The doctor said to her, "You are the boss.  Do whatever you think needs to be done."

Then, later in that same day, I did a breathing treatment that was ordered, and then I approached this new emergency room doctor.  I said, "This patient greatly benefited from this treatment, and I think he would benefit by having another."

He pulled me aside, and said, "Rick, you are the respiratory therapist.  I totally respect you guys. You know more about this stuff than we doctors do.  Anytime I'm working and you think someone needs an EKG, or a treatment, or anything, just do what you were trained to do."

You see, these things are not said to people who aren't respected.  No, things are not perfect in this world, and they never will be.  But the idea that there's no respect for respiratory therapists is simply poppycock.

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