Stepping Down

(Editor's Note: This is a guest post from a senior RT at Shoreline Medical)

In 100 days I will be retiring from full-time Respiratory Care, I guess I'm just not sure how I feel about that. It is what I do best. Perhaps I should supply some history. In the late 50's (think polio), I wanted to become the next Jonas Salk, become a doctor, cure disease, that was me. Of course in the 60's women were discouraged from becoming anything but teachers, nurses or secretaries. In 1966 I entered a nursing program, hospital based, on site residency, and a whole different ball game than nursing is now. About half way through the program I knew that nursing as it was then was not for me. Nurses didn't get "no respect", were not allowed to think for themselves,and above all, the doctor was Divine, and I don't mean he was a hottie! So, I left the nursing program and went into data processing; talk about boring; so I dumped that too. I knew that I really wanted to be in medicine but what? I ended up going into cosmetology and cutting hair for a living. Then in 1979 I gave birth to an infant with severe meconium aspiration. He was an 8lb 12oz fighter who spent 29 days on a Baby Bird ( anyone remember those?).
I took him home with great relief and a huge respect for the respiratory therapists and neonatal nurses who took care of him.

I graduated from a nearby RT program in Dec. of 1984 and have loved every minute of respiratory therapy since. I've seen huge changes in the field, the phasing out of OJT'S, great advances in technology, respiratory therapy driven protocols, the demise of IPPB (that's for another post), and the bottoming out of reimbursement for services rendered. Now don't get me wrong about OJT'S, a whole lot of what I learned came from OJT'S, give me a good OJT with common sense anytime. Remember, you can't teach common sense and you can't fix stupid. Time has also taken away my junk box. Every old RT knows you have to have a junk box, afterall it's what RT's do, jury rig! If you need something, just dig into a box of old spare parts and adaptors and you'll come up with a serviceable device to do whatever job it is you need done. Ah, a sink trap, a couple of one way valves, a little tubing.........!

At an MSRC conference recently, I listened to a, shall we say seasoned, therapist talk about pulse-oximeters and end tidal co2 monitors. He said he smiles to hear today's therapists complain about having to carry the pulse-ox in their pocket! We remember when a pulse-ox was the size of a small suitcase, try putting that in your pocket!

What about pagers? I remember trying to decipher a mumbled overhead page in a patient room with the Price is Right blasting away at full volume. "Fresh and hairy come on down...to umph stat" or "code blue north..." north what for crying out loud. You just gotta luv those pagers and handy little phones we have now, or not. With two pages and one or two phones hanging off you, you can't hold your scrubs up!
Dropped a pager in the john once, gee, I hated explaining why it was all wet, "I don't know why it smells that way, just give me a new one and oh yeah, don't take that one outta the glove".

Oh man, don't forget ventilators. You like microprocessors, say they make your life easier, and wow, ventilator wave forms, self weaning modes, smart care? Well, I remember standing in front of an MA-1 with a stop watch! Anyone for an H valve? In a pinch, I can still use a Bird IPPB or a Bennett PR-2 for a ventilator, no bells and whistles and I can still save your life. After all, what is a ventilator? A machine that pushes good air in and lets the bad air back out, Emerson had it down pat, does anyone besides me see the correlation between peep on an Emerson and Bubble cpap for neonates? There is nothing new under the sun, it is all slightly used, ie; non-invasive ventilation. I'm expecting a resurgence of IPPB, modified maybe but IPPB all the same. Let's see, tack on a couple of high tech monitors, paint them blue, gray or cream, change the name and jack up the price. Don't laugh,it happens all the time! Just promise me this, when all the old RT'S are gone, all the high tech equipment fails, please tell me that you youngsters can still look at a patient and know something is wrong and what to do to fix it based on good patient assessment! Is he breathing, does he have a pulse, is he pink warm and dry or blue cold and clammy? What is the most important thing to do first?

Let's not forget the drugs; we've come a long way since Isoproterenol and epinephrine. My favorite nebulized medication is Ativan, I want to have it nebulized through our ventilation system here at Shoreline, along with vats of Albuterol, otherwise known as Do-allolin. Oh well, that's going to take a little more convincing.

So, back to retirement, I'll still work, do a little relief here and there, someone has to make sure that all you youngsters are doing things right.

Thanks, Plain Old Jane

Respiratory Therapy is not a retirement job

Unlike some nursing departments at our hospital, my RT department has a very low turnover rate. In fact, even while I've been around here for ten years, there is still only one full time person under me in seniority, and I've been next in line for a day job for at least eight years.

However much I love working with the sagacious Jane Sage, she told me two years ago that she was going to retire in two years. Recently I called her on this, and she said that she was going to retire in two years.

"Um," I said, "that's what you said two years ago."

"I suppose I could retire, but I think I'd be better off retiring at social security age, which for me is 62."

That would probably work out good for her as far as money is concerned, but the fact that she has bags under her eyes, and the fact that she limped into the room, are not good signs. "I don't want to sound rude," I said, "but you look exhausted. I think you could use a good retirement."

"I'm 60 now," she admitted, "and I could probably retire comfortably now if I wanted to."

"Well, why don't you. I know you are the most sagacious RT in this department, and I don't know how we'd survive without you, but you need to do what's best for your body, and your sanity."

We had this discussion just before I went to Florida, and I was extremely burned out from all the running around I was doing working solo nights. My feet ached. My brain was fried. And I probably looked as bad, at 37, as she did at 60.

I said, "I never thought I'd admit this, but I think I'm finally ready to accept a day job should one come open. I'm really burned out of wording nights. I'm to the point, or to the age, where it's really running me down."

"Yeah, you look pretty beat."

"So you better watch out, Jane. You better watch out every time you step in front of a window and I'm in the same room."

"What are you gonna do," she said, smiling, "push me out?"

"Absolutely, for your good and mine. It's time you retire, and it's time I go to days."

As much as Jane and I love our jobs, I certainly don't think a human being is meant to do this job until they are 60. There's a lot of mental aspects to this job I think a person at 60 can handle just fine, but the physical end is pretty rough on the body. We have to do a lot of walking. It's physically demanding.

Mike is one of my RN co-workers who has told me so many times that he's going to work until he's 72 that I now have no choice but to believe that he's not simply pulling my leg.

"Why don't you set your money aside so you can retire early, like, say, 58 or 60?" I said to him one night.

"Because the government wants me to retire when I'm 72."

"You always do what the government says."

"Yes."

He tried to convince me that there was no way I could afford health care if I retired early. One time I tried to convince him otherwise. The other 20 times I just sat there and smiled.

Jim, the guy I never saw when he worked here because he worked the nights I didn't, told me that he retired from some company like Bell Telephone with an excellent retirement. He told me he got bored in retirement, especially because his wife was still working. So he wanted to get a job where he could go anywhere in the country because his wife had a traveling job, so one of his friends recommended he become an RT.

What the hell was he thinking? How could anyone be bored in retirement? How could anyone want to be an RT as a retirement job?

I used to golf. When I got married I quit golfing because it was expensive and I wanted to save up this money for the benefit of the family. But I told my wife that I am going to start golfing again when I'm 40.

"Why?" she said bluntly.

"Because I need to prepare for my post retirement job."

"Sounds good to me," she said.

Retirement living is like college -- in reverse

One thing that I'm reminded of every time I see my dad is that I absolutely do not want to work as long as the government wants me to, until I'm 62. I want to retire when I'm 58 and golf the rest of my life away as my dad is doing, and as grandpa did.

My dad leaves Michigan in October and drives to Florida where he lives on this really nice retirement community. Wrapped around the nice homes in the community is a golf course, where my dad and many of his retired friends "work."

The milieu there is akin to the college setting, only the opposite. Instead of getting up late and staying up late, most members of this community go to bed early and get up early. And when I'm there I have no trouble adjusting to the difference, especially since my home sleep schedule is so messed up because I work the nocturnal shift.

Four-o-clock every day is happy hour. This is a time when all of us gather on the back porch of mom and dad's house and enjoy the warm breeze to the tune of a drink or two or three. Then we pack around the dinner table and enjoy some of mom's good home cooking.

After dinner dad and I usually go back outside and watch some TV while the kids watch cartoons on the living room TV and the women do whatever women do.

I pull up one of the other chairs and set my feet on it and get myself real, real comfortable as dad clicks on the TV. Usually it's Fox News or the history channel.

"Everybody watches Fox News," Jim from across the street says as he strolls onto the porch, the screen door slamming behind him.

"Hey, Rick," he says to me as he cordially takes my hand with a firm grip, and then plops into a chair by the TV with an equanimatous smile spread across his aging face. I look at dad, and he too has a happy expression on his face, the countenance of a happily retired man without a responsibility in the world other than when his next golfing match will be.

Some light bantering occurs, but nothing too serious. Some light conversations about politics ensue, and it mostly goes along the lines of this, as my dad said: "Ah, it doesn't matter so much what they do, so long as they don't take this away from us."

By "this" he is referring to the way he lives his life. He's relaxed. He's happy. He enjoys the warm weather instead of the freezing snow. He gets to golf any time he wants. Every day at 4 he enjoys happy hour. He smiles. He laughs.

Then, as I'm feeling happy (not drunk but happy) after two or three glasses of wine, I find myself yawning. "I think I'm getting tired," I say.

"Well, you can go to bed anytime you want here. In fact, your mother is probably in bed already."

"Yeah, well, how about one more drink."

"One more." Dad agrees.

So we enjoy the warm Florida outdoors a while longer. My yawns become more frequent. A few more of dad's friends come and then go leaving me and dad alone again.

"Yep," dad said, "Don't get old son, on second thought, get old, it beats the alternative."

I laughed, and then time went by without as much as a word as we enjoyed the moments.

"Well, I'm going to bed, dad," I finally decide.

"You're on vacation," he said, "you can do whatever you want."

Inside I see that the kids already have their pajamas on. I look at the clock, and it reads 7:30 p.m.

In the morning I wake up to the Weather Channel, every day, at around 6:30. And it's real loud. I don't think dad has a clue how loud it is, or he'd probably turn it down. Neither my wife nor I ever say anything.

"Your up early, dad."

"Yep, gotta get to the clubhouse early so I can get a good t-time. Then I go to work," golf, "and then I take a nap, and then it's happy hour."

"Well, I'll see you when we get back from Disney."

"Yep, you have fun." He gave me that "yep, been there done that," look and smiled as he exited the house.

I told him how Disney was nice the first time just to see what it was like, but the only reason I do it any more is for the kids. I only griped when we went to Animal Kingdom, of which I think is nothing more than a glorified zoo.

But the kids are the perfect age for any Disney park. It was as though they were living in a magic world while they were there. And my 4 YO was so cute as she hugged and kissed every character. That part was cool. And that's the only reason I go anymore -- for the kids. No offense Disney, but this 37 year old RT has had enough of the magic.

We decided last summer that we wouldn't go this year so we could save our money, but as winter loomed we decided better of it. "You know, our kids are going to grow up fast, and your parents aren't getting any younger, we might as well just go."

And she was right. Right around February cabin fever set in with a vengeance, work was swamped, and we were antsy to get on the road.

That's about how it is every year for us

Dad and mom, on the other hand, do this every day. As we pack our bags, load up our car, and drive away with mom and dad waving, we are headed back to two more months of cold and snow, and 21 years before I turn 58, the age both my dad and his dad before him retired.

Mom and dad, on the other hand, will enjoy happy hour with whatever friends come over that day, enjoy moms good home cooking, go to bed at 7:30, and get up at the crack of dawn to to go to work, er, golf.

What a life.

Working as an RT is pretty cool, but the idea of golfing for a living sounds far cooler -- or warmer considering I'll be in Florida.

And hile I don't want to wish my life away, nor do I want to rush my kid's growing up, I'm certainly going to enjoy golfing for a living once I turn 58.