10 Things That Will Never Change

I have now been a respiratory therapist for 25 years. And in all that time, there are at least 10 things that have not changed. 

Doctors and nurses still believe...

1. That all shortness of breath must be treated as asthma.
2. That a little albuterol will resolve pulmonary edema in acute heart failure
3. That albuterol can somehow get down into the alveoli and reduce inflammation due to pneumonia.
4. If  patient's sats dip into the 80s a 10 mg albuterol treatment is the solution.
5. 10 mg of albuterol will lower your potassium unless you have asthma or COPD.
6. Any patient who has prn nebs at home needs them QID in the hospital setting
7. Any patient who has inhalers at home requires nebs in the hospital setting
8. Anyone who has ever smoked has COPD and must be treated as such
9. That, on a patient in pressure support mode who is spontaneously breathing, lowering the set rate will help improve blood gases

And, administrators believe...

10. That you chart and chart well is more important than the care you give.