RT Cave Reaches another milestone.

The RT Cave has reached another milestone today, as reader # 50,000 has clicked on to my blog. When I started this blog a year ago I never imagined I'd pick up regular readers the way I have. I suppose I must be doing something right.

To show my respect for all those who have tuned me on and off over the past 13 months, I am going to pay tribute to all the bloggers out there -- you included -- who have made the RT Cave what it is.

Between Thanksgiving and New Years Day I will try to give a brief description of all the blogs I find interesting. Now I may not have time to read everything written, as I don't expect that you guys read everything I write, but still there's some pretty good stuff out there.

I did this last year, and I think at that point I only knew about 20 bloggers. That list has grown immensely over the past year.

I don't want to over state the influence of this blog in the medical community as it is merely a place for me to communicate my humor and wisdom from the RT world. Still, if nothing else, this is a place -- the blogosphere -- for us lowly and humble "professional" and NOT ancillary staff RTs to have a voice.

It's been a great run and I hope to continue this for many more months to come. And, likewise, I hope the clickers keep on clacking on my blog -- whether they actually read it or not. It's been a fun journey.

I am inspired by my readers

I didn't really have a lot of patient on the floors last night when I worked, but ER was absolutely swamped. I was paged down there at one point to do "Several EKGs." When I arrived, I found there were seven EKGs for me to do.

"We're running a Blue Light Special on EKGs tonight. Anybody else want one?"

Finally around 3:00 in the morning ER gave me a break, and I needed to find something to entertain myself. I was way to tired to write anything intelligent, so I did an IceRocket Blog Search to see who was talking about the RT Cave, if anyone.

This is not something I do on a regular basis, but I was pooped out after working the entire 4th of July weekend. With all the vacationers we have in this town, I'd say about half of them were right here in our ER. Oh, and of course they all needed an EKG and a treatment.

So, I found that a story I wrote a few months back called, "The five different types of COPD patients," was posted and being talked about in a couple COPD community websites. I thought this was so cool.

One such website was COPD International. It was really cool reading all the nice comments about this post, and my blog in general. I will be honest here: I expected when I started this blog that I might get some fellow RT readers. But I never would have guessed in a million years that I would acquire a following of patients.

To me, the fact that patients find entertainment in my RT humor, or useful information from my insights and informative posts, brings me great joy.

Here is my favorite comment: "Thanks Annie most interesting I went to the source and what a wonderful site. Kind of like being behind the door. If you know what I mean."

Kind of like being behind the door. If you know what I mean.

What a cool comment. I might have to steal that and use it in my header, if I ever figure out how to make one that's cooler than what I currently have.

Here's another cool comment: "I'm glad you went to his blog, Madblue. It IS interesting to see this disease from a care giver's point of view...especially from one who has been trained to help COPD patients."

I guess I never really think of it this way. You know what I mean? I write because I love writing. I write about things I am passionate about. I write because there are things in this career field that are great, and then there are things that could be better.

And, if I wasn't optimistic that change were possible in the RT business, I probably would still continue to write on this blog, because there is a certain amount of knowledge base in my head, in all our heads, that others can benefit from.

The fact that I discover that people are reading my blogs and then posting my writings on other websites because they are entertained by what I write, is an absolute honor for me. It inspires me to keep writing.

So, I suppose, by me writing this post, I am saying Thanks.

And that, my fellow readers, is the thought of the day.

Blogging from work: the Unwritten Internet Code

The Internet is so amazing. All the information that's on here has probably doubled my wealth of knowledge, and places a world of resources right at my fingertips. So when I learned eight years ago that some computers here at work had access to it, I begged the RT Boss to put it on one of our computers. He obliged.

It's neat, because every time we have a patient with a disease we are not familiar with, or we simply want to do a review of a disease we already know about, the information is right here. It's also nice to use this World Wide Web as a resource of staying up to date on all the most recent respiratory therapy information.

It was right here that my co-workers and I did much of our research when we were putting together our protocols. And the information we didn't get off the world wide web we obtained through emails and even a few respiratory related chat lines. I've also used this to put together hospital policy among other things.

So, by far, this Internet has benefited this particular department a great deal.

Yet, there are times when it gets slow around here, and during these times some of us RTs like to get on the Internet and play around. I think that I'm the only one who blogs, but I know some RTs here check their emails, shop or read the news or latest sports scores. It's simply a great resource.

Now I have seen notes up in other departments that say something like: "NO DOWNLOADING GAMES," or "NO WATCHING VIDEOS ONLINE." But we all ignore those notes and do those things anyway. We do so even though we know the powers that be can watch every one of our moves on the mainframe in the basement if they so chose to do so.

I know this has been done before. In fact, I know one tech who worked in ER was fired because the powers that be learned he was watching porn. That was an isolated incident I am certain. However, I know in doing RT searches on Google, porn sites have popped up on this screen on rare occasion. I click off as fast as I can. That's one of the side effects of using Google, you can't control what might come up on a search.

There have been problems on occasion that have come up. For instance, this computer got bogged down about five years ago, and I was blamed for it. The RT Boss told me that I was downloading stuff onto this computer. So, for about two years, we lost the RT Cave Internet.

I never said a word. I let the boss blame me for the computer jamming up, even though I knew one of the new RTs was the one who was downloading non-respiratory related stuff. In fact, I watched my friend do it and told him not to. But he was arrogant and told me it wouldn't matter. Well, it did. And, soon enough, I had to go down to the computer lab to play on the Internet instead of doing it here where it is convenient. Like the old saying goes, where there's a will there's a way.

Since then we have our Internet back. And there have been a few problems here at work on occasion, but for the most part we all play on the Internet, including the bosses, so we all usually keep our mouths shut, including the bosses. Lord knows they play on the Internet too.

Now, the reason I bring this up is that before we had the Internet I used to read books when it was slow. I still do sometimes, but most of my free time now is spent right here reading the news, sports, or blogging. It's not like I'm on here playing games or looking at porn, or doing this in lieu of taking care of my patients. No, because the patients always come first.

I don't like to waste my time playing games, however, I would imagine that probably most of the time the net is used by other bees it's for this purpose. Personally, I think playing games is a waste of time. But that's just me. Still, so long as your work is done, and that you follow the unwritten rules that I will list below, I see no problem with using the Internet to play games.

I like to think of it this way, if I wasn't on here reading the newspaper for free on the net, I would be reading the newspaper I bought. If I were not on here reading a short story, I would be reading a book I bought. If I were not on here watching an NCAA tournament game I would be watching the TV in the waiting room. And none of those things are trackable.

There are some unwritten rules that we Internet users tend to follow:

1. No playing on the Internet for non medical purposes in site of patients. This makes us look like we are not respecting the patient. It simply looks bad.
2. No downloading, unless it is absolutely medical related. Or unless you are absolutely burned out and figure the hospital owes you this time.
3. No going online when there is other work to do, particularly work that involves the patient.
4. Get up and tour the hospital every hour and check up on all your patients. This is particularly important on those days when it's REALLY slow
5. If you are paged, get going right away, don't worry about finishing up what you are doing on the net. This is the same for those who read books: if you are paged, stop reading and take care of business.
6. Don't go on the Internet when there is someone around you don't trust. If they happen to be a spy for the bosses, you will find yourself in a predicament. And you all know who I'm talking about.
7. Don't go online when the bosses are around, even though you think you can trust them. You certainly don't want to provide them with an opportunity to cause trouble.
8. Do not check your emails unless it is from someone you trust. This is perhaps one of the most important rules.
9. If you print something, do not leave it on the printer or in the office.

I had to add #9 to this list for personal reasons. I had a really good freind who downloaded offensive jokes and left them on the printer. Someone on the day shift found them and put them in the bosses mailbox. The worst part about it was his name was on each page, and he was fired.

Personally, I think there is nothing wrong with reading the news and sports or even checking on your fantasy baseball team or even your email, so long as you follow these unwritten rules. If nothing else, this makes you smarter, and provides you with information you can use in a conversation with your patients.

Most RTs, however, probably don't have time to blog at work. The day shift RTs here certainly can't surf the Internet while the dragons and doctors are around. And RTs who work in large big-city hospitals probably don't have time either.

They have to wait till they get home. But some of us don't have time when we are home, so we'd prefer to blog at work. Yet, sometimes, bosses can be stingy, as was the case with Djanvk over at RT Driven. And he works in a small town RT Cave just like Shoreline, so he should have plenty of time to blog.

He wrote a post for the first time in a couple months yesterday, and explained his absence this way:

"My hospital started blocking personal (BLOGS) sites from viewing on the Internet so I wasn't able to log onto Blogger here and post anything because I usually did it from work. Home has been a bit busy and there just wasn't enough hours in the day to do much posting."

Why would a hospital go through the effort to block blogs? How rude?

In fact, one of the reasons I started my RT blog was because since I needed something to do during down times at work, this would allow me to spend my time actually reading medical stuff. And there is a lot I have learned from reading medical blogs. So why would the RT Bosses want to stop me from learning RT stuff.

So, that in mind, I see nothing bad about Djanvk working on his medical blog while spending time in his RT Cave, so long as he follows the Unwritten Internet Code.

If one of my readers is an RT Boss, or if you happen to see something here that I'm missing, please feel free to let me know via comment or email.

A little remodeling of the RT Cave

Slowly but surely I'm going to make some changes here at the RT Cave that should make this a more organized blog and, at the same time, make things a little easier for me.

I see that some bloggers have certain things they write about on certain days. What's the word for this? A feature?

For example, I started a couple weeks ago a Monday feature where I respond to some of the web search queries that link people to my blog. This is nice because I know exactly I'm going to focus in on every Monday.

Initially I started doing this because I never work on Monday, and it's one of those days I have trouble revving up the creative writing juices, and if I can just focus in on answering questions that make my blogging day easier -- plus it's fun.

A case in point was yesterday. While most days I can think of 100 things to write, and have to force myself to hone in on one subject, and make it pithy and interesting, yesterday I couldn't think of a dog gone thing to write about. So I simply linked you to someone else's blog.

Then I'm lying in bed in the middle of the night thinking, "Wait a minute! I did have something to write about. I completely forgot about my Monday feature." Oops.

So I'm going to publish that today -- Tuesday.

That in mind, Tuesday is another day I usually struggle to hone in my creativity, so I've decided to start a feature on Tuesdays, and I'm going to cater it to something along the lines of: "Everything RTs need to know about..."

It will be something along the lines of these three articles.

Liikewise, sometimes I might do a review of something I learned in RT school but forgot, such as the oxyhemoglobin disassociation curve, the a-A ratio and how it can be used to help determine whether hypoxia is caused by a shunt or a VQ mismatch, and things like that.

On Wednesdays I'm going to do a third feature, and I'm going to cater this to my other audience: patients and their families. I will cater this day to writing about asthma and other diseases.

It will be something along the lines of these articles.

The reason I have avoided doing this to this point is that for the most part I like to write about whatever is on my mind for that particular day. For example, if I experience an interesting situation at work I blog about it as soon as I get the chance. If I come up with some good RT humor, I blog about it right away.

I'll still be able to do this, as I will save the rest of the week for these so called extemperaneous posts. How's that for a big word.

Plus you might see a few guest bloggers from time to time, as you can see I've already registered my sagacious co-worker Jane Sage. Not only is she the god of RT wisdom, she's extremely funny, and has helped me come up with quite a few 'olins.

My goal from the day I started this was to create a nice banner for up on top of this page, but that still hasn't come to fruition. One of these days I'll have one of my artist friends whip me up something and figure out how to get it up there.

As far as my 'olin list, I don't know if anyone of you other Blogger Bloggers have experienced this, but I don't seem to have access to the ability to edit the bottom half of my page, and that's why I haven't updated my list of 'olins in the past few months.

Plus the spell check here doesn't work for half the time, so if you see a spelling error you know why. I rely on that thing.

One of these days I might just give up on Blogger and change web servers. However, I have no clue how I would do this, nor if it would be worth the effort. The grass isn't always greener on the other side of the fence, they always say.

We'll see how this goes. Since this is my blog, I have a right to skip a week or give up on these ideas all together.

Happy new year with the best RT humor of 2007

"Row, row, row, your boat...," Dr. Sam whistled calmly as he felt for the femeral pulse of the limp patient on the ER cot. "Gently down the stream..."

I handed him a bad copy of an EKG fresh off the press. "This is just a rough draft," I said.

He laughed, looked down at the EKG. "Good enough," he said, and returned his equanimitous gaze back upon the patient, and continued humming his happy tune.

Someone laid out a one-liner, and we all laughed. I set my EKG machine to the side and grabbed an ABG kit. "You want one of these I'm sure," I said, looking at the doc.

"Yepper," he said.

Obviously we wouldn't do this if the family were around, and probably not if it were a young person either. And if you were an outsider observing us, you might think we had an odd sence of humor. Truth is, we do. After you work in a hospital a while, you can't help to develop an odd sense of humor.

It is true, that despite what we do for a living, we medical workers still have to live, and we still have to maintain our senses of humor.

So, while the rest of the world is gearing up to watch the rest of the year wind down, I'm sitting here looking up RT humor, some of which I'm printing off. I think I'll post some of these on the bulleton board above where doctors interpret EKGs, and see how long it takes for them to be taken down.

Anyway, I just thought I'd end the new year highlighting some of the greatest medical humor of 2007 that I've found on the Internet. Consider, however, that I've only been doing this since October, so if I missed your brilliant post forgive me.

The following is medical humor at its best, or, since I've only been blogging since October, some brilliant observations I'll throw in here too. These are in no particular order:

1. The seven dwarves of the ICU: It's funny sometimes how unique our patients can be at times. I thought this was a spectacularly funny observation about working in the ICU.

2. Ativan nebs: I put this post up on the board over where the doctors read EKGs in our department, and it is still there 2 months later. Either that means they are avoiding it, or have read it and soon we'll be giving Ativan nebs just because instead of Albuterol just because. Our patients will love us for it, and we'll love the doctors for it, as all those troubled patients will be subdued.

3. The frequent flyer club: This is an absolute must read. Any medical person who has spent time in the ER has made the observation, "Why is he here?" Or, better yet, "The ER seems to be the hangout club of the scum of the earth." This article describes in detail the many different types of frequent flyers.

4. Stereotypical patient: Sometimes when you are working in the hospital you can't help but feel deja vu while walking from room to room. This author paints a humorous picture of the "stereotypical patient."

5. RTs -vs- RNs : This is a serious differentiation between RTs and RNs. After reading this, I spun off the humorous version: What RTs can do that RNs can't.

6. The naked, the fat and the dead: This may not have been meant to be funny, but it cracked me up none-the-less. Don't take offense at this please. I see it as a simple observation.

8. Musants: Doctor humor can sometimes be as bad as RT humor.

9. Physician's Creed: How to take care of pesky RTs : Just so I don't sound like I'm tooting my own horn, I'll quote a comment to this article: "That's possibly the best post EVAHHhhhh."

10. Ways RNs can iritate RTs: I'm sorry, but you can't keep your sanity as an RT if you don't develop a sense of humor. I compiled this and the above Physician's Creed with the help of my cohorts in the RT cave.

11. RCP, RRT, Mr. Bean: This is medical related, well sort of.

12. Weeding out the garden: This is a great analogy about respiratory therapy school.

13. Clinitian resistance to adapting new practices: Not necessarily humor, but a great observation of why RTs are so resistant to change, despite how many of us complain about frivolous orders.

14. Because I could: Here's a little Christmas poem that only a medical person could find humor in.

15. A funny story occured to me...: This is why I became an RT and not an RN.

16. The 11 Rules of Operating Room Etiquette for staff and patients: This is educational and humorous at the same time. It's seems we med workors find humor in just about everything we do.

17. Video of the week: Who thinks of this stuff anyway. Here is a video that is very educational... no, it's not educational, but it's hillarious. If you don't like spiders, you might want to not watch this one.

18. Dr's come in all shapes and sizes: Do you know what kind of doc you have tonight?


19. The dirty, dirty on ER nursing: What does it take to be a nurse? Well, you know I wouldn't be able to handle it, and this article explains why.

20. I heart pulmonologists: There must be something about working with lungs that makes people humorous and fun to work with. Well, you do know all us RTs are... Oh, never mind.

21. I could go on, but I'll stop here. This spot is reserved for all the humor or brilliant ideas not mentioned on this post. Some bloggers write so much funny stuff I couldn't possibly post it all.

Have a great new year.

2007 great year for respiratory therapy blogs

The RT cave has been around for three months now, and it seems to me to be a pretty good success, especially considering when I started doing this I thought I'd be writing to myself. I'm impressed at how big the medblog community is.

I would like to thank all of you who have responded to one or more of my posts by writing a comment, sending an email, or simply using up some of your valuable time here at the RT Cave. You guys provide me the incentive to keep writing.

To end the year, I would like to pay tribute to all respiratory related medblogs I have discovered to date. I see that 2007 was a great year for the RT world as most of these sites were started just this year. We are the beginning of a revolution.\

The following is in no particular order.

1. Respiratory Therapy 101: I was doing research on protocols when I came upon this website. I thought the Anonymous RT did an excellent job of describing what we do "at the head of the bed." He works at a larger, busier hospital than mine, and it's great to read about what I'm missing by working at a small town hospital -- and what I'm not missing.

2. Respiratory Therapy Driven: Djanvk is in the same boat as me, as he has been doing this for 10+ years and works at a small town hospital. It is a challenge to keep finding things to write about when business is slow, but this guy does a wonderful job of it. He provides an excellent feel for what it's like to be an RT, and he also has a great sense of humor, as do most of us RTs.

3. Snotjockeys: A perfect name for a respiratory therapy blog, and an excellent place to get insightful information about respiratory therapy. Julia has written some excellent posts about the challenges facing RTs, and does the medblog world a great service by her medblog reviews.

4. G's spot. I wish every RT was as pleasant as this blogger, because she's written on more than one occasion how much she loves her job. She works nights as I do, and has to struggle with getting adequate sleep, and I can relate to her that way. And yet she doesn't let the lack of sleep effect her job. She gives an excellent feel of the RT job.

5. respiratory therapy student blog: How cool it would have been to have have had the ability to blog when I was in school. We all remember the struggles of working as an RT, doing clinicals, studying late into the night, fitting in some social gatherings, attending classes, and taking tests. And when vacation time came along, we really appreciated them. Great blog from a student perspective. Soon he'll have to change the name of his blog to RTblog.com.

6. Sleepy RT medic: How cool it would have been to have had experience as a medic before going to RT school. That's what this blogger is doing. This blogger also provides an excellent reminder of how difficult it is to hold a job and go to school. Like #5, he provides some good information on things we RTs take for granted once we finish school.

7. Sometimes I breathe: The same can be said of this blogger as the last two, as he provides a good reminder of how hard it is to become an RT. Since these student RT bloggers are still in school, they have access to all the latest information and can provide us older RTs with links to some cool RT related websites.

8. Breathing through school: Another RT student blogger who has recently decided to brave the blogger world. I think this was a good idea for her, because she's provided some neat incite. In one post she describes RT school as "weeding out the garden." While many aspiring RTs will enter, only a few will leave.

9. RTT with ADD: Despite her ADD, this blogger provides more cool incite into being an RT. She once described reading blogs, "as though I'm intruding...intruding into their personal thoughts, feelings, emotions and most of all, their personal space..." That's very true. And one reason why we bloggers should make money for what we do, say $30 a word.

10. Pulmonary Roundtable: Great place to read about, learn from and discuss RT case studies.

11. Respiratory Therapy Blog: He hasn't written in a while, but when you read what he has written you can't help but to learn something. Here's hoping he writes more soon.

12. The Respiratory Terrorist: Ditto. Here's hoping he writes again soon.

13. Any more RT bloggers out there? If I left your RT blog off this list it's only because I haven't found it yet. Leave me a comment and I'll plug your blog in the new year.

Here's a toast (raises glass) to a happy new year.