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Monday, September 16, 2019

What Determines Success?

Prepare for the worse and hope for the best. 
We are health care providers. We are nurses and respiratory therapists. Our success is not determined by how many sick people we care for. Our success is determined by how many people don't need our services.

Look at asthmatics as a good example. Back in the 80s, it was common to have sick asthmatics. In fact, it got so bad that asthma organizations were formed. Heads of these organizations, along with many of the top asthma research physicians in the world, put their heads together. They created asthma guidelines.

Today, regional asthma doctors are educated on how best to treat their asthmatic patients. Asthmatics themselves, in turn, are well educated how to stay healthy and out of hospitals. And it was a huge success. Today, we don't see a fraction of asthmatics we used to.

See, that is a success. The fact that most asthmatics are able to stay out of hospitals is a success. If they were still being admitted at record levels, that would not be a success. Sure, we would make more money if asthmatics were filling hospital beds. But, that they are breathing easy and avoiding us is a good thing, not a bad thing.

COPD right now is at epidemic levels. There are COPD patients getting admitted every day. There are also many COPD patients that become regulars. They are discharged and readmitted on a regular basis. That, my friends, is not a sign of success. It is a sign that we are failing them.

Let's talk intubation.

You don't want to intubate people. Sure, it's very profitable when we have ventilators. Sure, it might stimulate your excitement level. But, it's not something that's good. It's a last-ditch effort to save a life. It's nice that we have that skill. It's nice that we know how to save lives this way. It's great that we manage ventilators.

But it's not something we should look forward to. Someone comes in the door of the ER, we should be praying that they don't need us. We should be hoping they get better. But, I'm afraid there are many of us who hope, maybe even pray, that we get to intubate.

That is a sign of failure, not a success. Success is not needing to intubate.

Obviously, some people LOVE intubating. That's understandable. You want to do it to keep up your skill level. And Managers WANT ventilators. In most instances, they are very profitable for respiratory therapy departments.

But hospitals, especially the not-for-profit variety, are not in the market to make a profit. That's the whole point. We are here in case we are needed. We are the cost of being in the healthcare business.

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