We need to stop just doing and start asking questions

Have you ever found yourself in a situation where a medical intervention is prescribed, and it appears illogical and pointless to you? And you get frustrated, and perhaps grumble under your breath? Yet, out of respect for the doctor's order, you comply. 

Recently, I encountered such a scenario involving the use of a 1 LPM nasal cannula for an infant displaying retractions and wheezing, despite optimal oxygenation levels on room air. The notion that 1 LPM nasal cannula would make a significant difference seemed dubious at best.

Curiosity propelled me to question the reasoning behind this decision, only to be met with the response, "Because the doctor ordered it; it's protocol."

While protocols undeniably play a crucial role in standardizing care, my inquisitive nature craved more. Is it not natural to desire a deeper understanding of the science guiding these interventions? 

So, I asked my question another way; "Does it not frustrate you that doctors order stuff like this?" And she said, "Well, the protocol says it will decrease the patient's work of breathing?" 

You once again grumble under your breath. Such trivial answers obviously satisfied my friend. But they do not satisfy me; they only seem to draw me deeper in frustration. 

It's worth remembering that doctors, like everyone else, are fallible. For over 30 years, we administered numerous breathing treatments with IPPB under the belief that it would force respiratory medicine deeper into the airways. When the studies finally emerged, it revealed that all this did was overinflate healthy alveoli.

So, isn't it plausible that things currently deemed "protocol" might one day be proven by science to be equally "delusional"?

Many hospital protocols operate on algorithms, producing a numerical output based on a variety of factors from our assessments. However, these numerical outcomes remain subjective; one doctor might score a 5, another a 2, and a respiratory therapist, perhaps, a 3. Even if we reach a consensus on the subsequent procedure, there's no guarantee that adding 1 LPM to this patient brings about any positive change.

So, while we unquestionably follow orders, the pursuit of understanding the "WHY" and "HOW" remains paramount in healthcare. No doctor might explicitly order 1 LPM nasal cannula, yet this analogy underscores the importance of questioning and seeking comprehension in our medical practices.

Otherwise we are just creating work that is not needed. And, to make a case to management, this adds superfluous charges to the bill. It's also a possible cause of respiratory therapy burnout, frustration,  and apathy. 

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