My advice for new or aspiring Respiratory Therapists

So you're interested in becoming a respiratory therapist (RT). If so, you are -- in my humble opinion -- making a great career choice.

First allow me to state here that no job is perfect. You'll read posts by me or other RTs where we complain about low morale, apathy, burnout, lack of respect, poor pay and stupid doctor orders. Those are similar complaints to just about any job in the world -- seriously. So don't let some ornery, apathetic RT convince you to stay away from this career field.

I say this because I was once swayed away from becoming an RT. I wanted to be an RT way back in the 11th grade, yet I was failing chemistry at the time, and during career day the same lady who convinced me to become an RT told me I'd have to pass chemistry.

So the following year when I was filling my application to Ferris State University I did not check the box that said respiratory therapy like I wanted, I checked the box that said journalism instead. Ironically, 4 years later, after failing as a journalist, I went back to school to become an RT. Perhaps it was fate, but here I am.

My point is, if you have a dream, don't let anything get in your way. Yes RT school is hard, harder than nursing school perhaps, yet college is not like high school. In college you're taking courses you want to take, classes are more spread out, and you should have plenty of time to study.

So, if you're interested in becoming an RT, just do it.

Here are some advantages to becoming an RT:

1. The pay is decent: It's a good career. You can support a family. Yet if you're aspirations are to have a million material things, then you might have to work overtime and force your spouse to work too.
2. Workload is flexible: Depending on where you work, you'll have busy days and days that aren't so busy. When it's not busy you can have fun on the job. You can do things like I'm doing right now.
3. Variable hospitals: You can work at large trauma centers where you can work in an ER like what you see on TV, or you an work in a small town hospital like I do where the job is a bit different. In this way, there are choices (more on this in a bit)
4. Transferable: You can be an RT anywhere in the world. If you move, you should have no trouble finding a job.
5. Great people: You'll meet many great people. Not just fellow coworkers, but on the patient side too. If you like people, this is a great career choice
6. Joy of helping people: If you like helping people, this is the perfect job for you. You'll be doing it on a daily basis.
7. Teamwork: To me there is no better joy (other than helping people) than being part of a very good team. Working with others to solve a problem -- to save a life-- is very rewarding.
8. Stepping stone job: This can be a great career choice, or you can use it as a stepping stone to becoming something greater, such as a doctor. Any doctor who has an RRT and a couple years experience as an RT is going to be a much better doctor

So now you've been accepted to RT school. I just want you to know it will be the hardest two years of your life. Talk to your teachers now -- yes right now -- and find out what books you will need in RT school. Pick them up at the school library and start reading.

This is what I did. I didn't want to fail. By the time RT school started I had a pretty good idea of what I was getting into. The first couple weeks of school were pretty easy because I had already been studying. I didn't read any RT books, but I did pick up an anatomy and physiology book and a medical terminology book and studied them. It worked great to prepare me for RT school.

Study ever day. Do not go out and party every night in RT school. If you do you will be the one who fails. You will have to get a C+ or better in most RT related classes, and most RT classes are hard. This is important because there's a lot you'll need to know to be an RT, or at least to be a good RT with great wisdom.

So study hard every day. My advice is that you take great notes in class, and when you get home recopy your notes onto a word processor or a notebook and organize them really well. That way you'll have your own book of sorts to study from.

Then every day look at all the notes from that class that you've accumulated, and study that way. That's what I did, and I got all As in RT school. (I did not get all A's in journalism school, not even close. Yet I learned how to study. Trust me on this).

Once clinicals start, you might become burned out. This is especially true if you have to work a real job too to make money and/ or you have a family to tend to too. In this case, you'll want to make sure you reserve one night a month to go out with your friends or spouse and have a good time.

Look, it's only 2 years. It's really hard, but if you buckle down, you can learn a ton and be one of the 5 or 6 who passes RT school. That's true. On day one of RT school the room will be full, 30 plus students perhaps. Yet on the last day two years later, there won't be many. One will be you.
So now you've passed Rt school, where should you work? Well, that's up to you. Do you want to work at the large teaching hospital in the big city, or a small town hospital like I do where it has busy times and slow times. When it's slow you can do what I'm doing now. Heck, I work at a small hospital, and when it's slow going to work is like being on vacation.

In fact, I joked with my RN coworkers the last time I worked. I said, "Look, if I wanted to get a job where I actually had to do work I wouldn't have become an RT." I was being facetious, yet there was some truth to that. The more education you have, the less real work you have to do. For example, doctors use their brains more than their hands.

My advice is when you are seeking your first job, that you get a job working in that big city hospital. Seriously. You will want to work where you can get as much experience as you can. You'll want to see the trauma, and the brain injury, and take care of all sorts of critical care patients on ventilators.

You'll want to see pediatrics and sick neonates and adults too. You'll want to see it all and do it all. And you should. Also you must work hard and prioritize your work. You must jump up out of your chair every time your beeper goes off. You must work to the point of burnout.

When your coworkers call to ask you to pick up a day, or your boss, you must say, "Yes, I'll come in." You must kiss butt. You must walk fast from room to room. You must be to work 10 minutes early every day. And you must never complain. If others in the room complain, you must keep your ears and mouth shut and not participate. Better yet, you must leave the room. You'll be seen in a better light by every one that way.

Don't think the grass will be greener on the other side of the fence. There are complainers in every job. There is politics in every job. There are those with low morale in every job. Bosses appear to be more concerned with dotting i's and crossing t's in every job than caring for patients. It's not true, but that's what it seems.

Instead of complaining, do something honorable. Find some administrative duty you can participate in. Go to every meeting. When people say, "How are you doing," say, "I'm doing wonderful," even if you feel gloomy that day.

When you're leaving work, never say, "You better wear your running shoes today, because it's not fun out their -- it's hell." Those are words of the pessimist. A pessimist is never seen in a positive light by his bosses and coworkers. You must not be that person. You must say things like, "It was a busy day, but it was fun."

Your boss will come to you with criticism from time to time, and she may even leave you notes with things you forgot to do. When this happens you will smile and say, "I will do better next time." Or simply say, "Yes ma'am." Do not ever defend yourself. Do not say, "But..." Do not say you didn't do it even if you didn't. Be noble. Be a real man or woman. Take the hit and move on.

And then come up with a system to make you better. Double check your charting at the end of every shift. Chart often. Do rounds, and then sit down to chart. Don't sit and chart when it's time to clock out. Have your charting done before then.

Seriously. I'd do this at least for two years before deciding if that's what you want to continue to do, or if you want to get a new job at a small town hospital where I work.

At a small town hospital you'll see it all, but not as often. In a way, you'll have to work harder on keeping up on your critical care skills, your baby ventilator skills, and your sick pediatric skills because you won't see those very often, yet from time to time you will. Most of the time you'll be taking care of adult patients.

I love working for a small hospital. Like I said, sometimes going to work is like going on vacation. Sometimes it can be as swamped as that larger hospital, yet sometimes the patient load will be down and you can do other things, like coming up with ideas to make the hospital better, such as researching and writing new protocols, or blogging, or gossipping (I don't recommend that though).

When I first got my job at Shoreline one of my co-workers who had worked as an RT for quite a few years gave me this same advice I'm giving you now: "work at a large hospital to get experience first. You'll see a lot more, and be able to keep up on your skills."

You must give 100% from the time you walk into work to the time you leave. You must always be involve din something useful. If it's slow, reading an RT magazine is something useful. If you're burned out, you can read your own novel. That's fine. But do not slack. Get your job done.

Never. Never. Never leave work for your replacement. Even if there's a new order right at shift change, go do it. Don't leave incentive spirometers, or smoking cessations, or new treatments for your coworker. Don't leave EKGs, especially if one was ordered two hours before it's time to go.

Be seen as a hard worker. Chart well, chart accurately, give the correct meds, be honest, and you will succeed in this career. Read my blog too. Keep up on your RT wisdom. Don't let what you learned in RT school slip from your mind. Impress a doctor with your wisdom. Read charts first thing every day. Know as much as you can about your patients.

For more tips for new and aspiring RTs, click on the tab above that says RT Student Wisdom.

Important tips for Respiratory Therapy Students

What follows is a letter I have composed for all RT students. This is my advice for you to make the best of your clinical experience.

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Dear RT Students

I have noticed that a majority of RT students are well equipped with wisdom and the skills and or at least the confidence to jump in and try new things. In most cases I find it's easy to work with the student, and help him or her ease into the new task.

Yet occasionally we get a student who just doesn't seem to fit in. While I find that I'm very patient, as are most of us RTs, sometimes even the most patient of us RTs can't seem to help some students.

Yet as a teacher, or preceptor, it's important to never give up, because even the student who appears to be nervous, who appears to be incompetent at first, may turn out to be an elite RT given time and a good teacher.

I say this not just on my experience as a preceptor, but as my experience in real life. During my first clinical rotation, I was not the best student myself.

As a preceptor, I do not expect my students to be perfect. And I don't have a problem if, for example, a student misses an ABG the first time, or even the second, or a third or fourth. Sometimes it just takes time.

Yet whether I decide to let you keep trying, whether I have the confidence to allow you to keep trying, depends on you. So with that in mind, I have composed the following tips to help you, the RT student, make the best of your clinical experience:

1. Do not talk about the patient's condition in front of the patient. Patient's do not want to be reminded they have end stage lung cancer or end stage COPD. The only exception is if the patient asks.


2. Yes it may be nerve racking, but you have to jump in at some point and actually do the task. Sure you can watch once or twice, but if you're in a clinical to do incentive spirometers, breathing treatments, ABGs, and the like, you should already have practiced in school, and at least have an idea of what to do. No RT is going to throw you to the wolves, so just do it and learn as you go. There's an old saying: Action cures fear!


3. No one expects you to be confident the first time you do something. Yet the best students at least feign confidence. Do what you were trained to do.


4. Do not waver. Do not be wishy washy.


5. Do not say things that make the patient and preceptor think you have no confidence. I'll give some examples pertaining to the first ABG attempt: "Why do I feel two pulses?", "Do I poke here or here?" Saying such things will only result in me doing the ABG myself, and my being less willing to allow you a second attempt.


6. Stay calm. Never Panic. Do not let adrenaline get the best of you.


7. If an RT asks that you do something, do it.


8. If you are not ready to do something, just say so. Yet again, you have to do it at some point.


9. If I ask you a question and you don't know the answer, just say you don't know. Do not guess. That only makes you look like like a goof.


10. I do not expect students to know to know the answer to all my questions, yet the more wisdom you have the better you will appear to the preceptor.


11. When you get your work done, ask intelligent questions about interesting patient cases.


12. Know as much about the patients you are taking care of as possible.


13. Reveiw charts as often as you can.


14. Offer to help out as often as possible, especially if the RT already knows you're compitent in an area, such as catching a treatment here or an EKG there. This shows you are willing to work.


15. Again, always be involved in something useful. Homework and studying is something useful. Don't just sit around with your finger up your butt, so to speak.


16. DO NOT PARTICIPATE IN COMPLAINING!!!! A good preceptor will not complain about his job, but if it happens ignore it.


17. Do not play games on the Internet, unless you've earned the right to do so.


18. Use common sense. This should actually be #1 on this list.


19. Do not be over confident. Don't say you can do something that you know you cannot do


20. Never defend yourself. If you're accused of doing something wrong, just say, "Okay, I'll do better next time." I find that denial and defending is often a sign of guilt anyway.


21. Say good things about your preceptor to your teacher, especially if he went to the same school as you.


22. Walk alongside your preceptor. Do not lag behind, forcing the RT to slow down. Keep pace.


23. Don't invade a person's personal space. When speaking to someone, stay at least an arm's length away.

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Again, most RT students are top notch. Heed the tips above and you'll be sure to win the confidence of your preceptor.

RT turned teacher

After you do a job for a while it seems so easy, so second nature. Yet when we have a student we realize how special the skills we have are. We have to slow way down and get right back to the nitty gritty basics.

It's fun in a way, and it's also very educational. It forces you to re-learn some of the elements of the job you forgot and hardly ever use, yet are important in order to develop the skills you now have -- the same skills you hope the student will have one day.

There is another aspect to teaching I think is equally important, and that is making a clone of yourself in the areas you excel, and making sure you do not clone yourself in areas of your weaknesses. That, I must say, is the greatest challenge of teaching.

I suppose this is true of any job, but when you do it a while you develop shortcuts. While shortcuts may be fine for you, they are not fine for teaching. For no other reason than if the student learns the shortcut first, and then later decides to short cut the short cut, the real job is not getting done, and you failed as a teacher.

Likewise, while you are fully competent and confident in your job, and you think anyone could do it with their eyes closed, that is not the case. A new student, even a new RRT who has taken the exam, may see this job as hard and stressful.

For example, when I was in my first conicals, I was nervous as hell. I fumbled with every task to the point my preceptor called my teacher and said she didn't think I'd ever make it as an RT. Well, we all know how things turned out in the end. While honesty with me allowed me to learn the hard way, patients is also a virtue worth having, as everybody grows at a different pace.

I think as I was learning this job about 90% of the people I followed were bad teachers. They just said this is what they wanted me to do and sent me to the wolves. That's fine, but you don't learn that way. You eventually need to be thrown to the wolves, but not when you are first starting out.

I had a non RT job once that taught me the lesson of how important an orientation is, and the importance of a good preceptor/teacher/mentor. Lacking any of these, I failed at my first job as a journalist. I fell flat on my face. In fact, that's why I ended up as an RT, because I failed at that other career.

While I suppose that 90% wouldn't be patient enough to remember the past, I find myself in the 10% -- I think. Perhaps it's easier for me to fall into this percentile because the other thing I wanted to be when I was deciding was a teacher.

Yet, like I wrote before, fate guided me on this path for some reason.

There are certain things that need to be the same way every time. So you teach the student to do it right. Yet, if you teach that everything must be done your way, you put a cork on creativity -- which you don't want to do in any successful business.

So, my point here is that I've decided teaching is a lot harder than one might think. And that's why we must give credit to those who do it every single day of their lives (especially kindergarten teachers).

"If THAT person can be an RT, so can I"

The first edition of the RT blog carnival "A Source of Inspiration" will be released today on the Surviving RT School Blog. As soon as it is released you can get to it by clicking here.

Since the theme was "Surviving RT School," it reminds me that there was a certain technique I used to survive RT school. Honestly, other than as a patient, I had never set foot in a hospital before. There were no doctors or RNs in my family. I only chose RT because of my past experience as an asthmatic.

There were many brilliant RTs and RNs I met while I was a student. And there were many brilliant RT Students I went to school with, but there were also a bunch of students in my class who were not so brilliant. And there were some RTs and RNs who seemed less than stellar.

So, as I started the RT program, I said this to myself often to motivate myself: "If THAT person can be an RN, I most certainly can be an RT."

Now, having been an RT for over a decade, I truly see the wisdom in that quote. There are definitely some RNs, as well as some Drs, and even some RTs, who tend to make the rest of us look good.

And, once you've been in the field long enough, you will know exactly what I'm referring to. Then again, I imagine you could adjust that quote to fit just about any career.

10 advantages to doing at least one clinical rotation at a small town hospital near you

So you live 60 minutes from where you are attending RT school, and 60-120 minutes from the closest big city hospital.

Your clinical adviser comes to you and says that if you want you can do your initial clinicals at your local small town hospital instead of driving.

What do you do? I say go for it.

Certainly you will want to gain some large hospital experience, especially in specialized areas such as critical care units, trauma centers, etc. But there is still of plethora of wisdom you can obtain from doing clinicals at a small town hospital.

What follows are the ten advantages of doing clinicals at a small town hospital:

1. Of course small town RTs get busy too, but there are more down times in smaller hospitals that will allow you to spend more quality time with your preceptor.

2. If you lack confidence in one particular area, a small town preceptor will have the time (and perhaps the patience) to work with you and allow you to harness your skills and confidence.

3. Even better, you will have quality time to pick the brains of experienced and seasoned respiratory therapists. Sometimes you can learn more from a simple RT discussion than from doing random procedures.

4. Instead of just doing breathing treatments and oxygen therapy, you will have the opportunity to do other things -- if you are ready -- such as suctioning, ABGs and EKGs. Many times we have students leaving here bragging to their fellow students.

5. No you will not get to work with trauma, neuro, or cardiac patients, but you will still get to work with ventilator patients. And since we usually only have one or two at a time, the RT will have plenty of time to work with you and prepare you in this area so when it's time for your ventilator rotation you will be ahead of the game.

6. You will have plenty of time to study.

7. You will still have quality time to do your case studies, and equally impressive patients to do them on. Plust you might even have time to spend with the patient so you can get to know him on a more personal level instead of just a number.

8. If you show your are a good worker willing to go out of your way to do things, you might even receive a job offer to work in the pool. Hey, you'll at least have your foot in the door at a hospital in your home town.

9. You won't have to worry about being thrown to the wolves.

10. You won't have to worry about becoming the third RT who so happens to work pro bono. You will actually have a great learning experience.

Well, there you have it. I imagine there are more, and if you can think of any please add to this list in the comments below.