Where is the Respiratory Therapist? - page 3

I have the utmost respect for Respiratory Therapy, even at my current "contracted" facility. Most of them are right on target- and IF they have trouble making it on time for a treatment, or show up a little late on an emergency,... Read More

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    Oh, and don't worry, when I smoke myself into emphysema- I am going to call RRT just so I can draw a deep enough breath through my trach to smoke a cigerette. They LOVE that. Revenge is soooooo sweet.*

    *I did manage to quit smoking 2 years ago, but if I ever find out I have 6 months to live. . . .
    xoemmylouox and VICEDRN like this.

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    Boston, I can fix your issues with the RT. Move to Australia where there is no such thing as a respiratory therapist, and items that are needed for the patient are taken out of the cupboard as required with no need to keep any records as people do not get charged for items used. Your hospital bill will be higher if you need an oxygen mask? That sounds like such a waste of everyone's time!

    Well done on the quitting smoking by the way!
    xoemmylouox, GrnTea, VICEDRN, and 3 others like this.
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    Find me a place by the beach, I'm packing. Lol!
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    I love my nurses because they are smarter than me and can do 90% of the work that I do. But with all this venting about them stupid and lazy RTs, does this all mean that I can no longer come onto your floor for free coffee and donuts? Just trying to clarify some things here before I start making my rounds
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    Where I used to work, our RTs would come for the regularly scheduled treatments, and were usually on time. They would have 2 RTs around for night shift, one to provide regular treatments, one for stat calls. It was a mid-sized facility, probably about 600-700 patients(but I might be way off, this is just a guess-timate). We rarely had problems with our techs. They had pagers on them, if we needed them for stats we would call with *911 message, and they would respond to give us ETA. I think I can count on one hand the amount of times we had issues with them...
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    i was really shocked to read this op. i worked in pacu and icu for years in several different hospital systems and never, ever had anything resembling this sort of problems with the rt folks. they were terrific resources, always around, and i learned a lot from them. i never, ever had one minute's undue delay in a code or other acute situation. i'm wondering if this particular rt has a drug problem or a gambling problem or a girlfriend/boyfriend problem that is obviously occupying so much of his attention.

    i totally agree with the keep-statistics-and-write-him-up-repeatedly approach. your risk manager (and you do have one, somewhere in the organization) really wants to hear about this behavior because it substantially increases the risk of bad outcomes, and that means someday there'll be a huge lawsuit.
    to just put up with it and not have a paper trail makes you look complicit in what you know to be substandard care, and you sure don't want that. you might also make a call to the state agency that licenses him.

    and what's with the intubation and oxygenation equipment being locked up??? that is just nuts. put charge slips on it or make it floor stock or whatever, but you can't possibly have no access to et tubes and wall oxygen in any acute unit, much less icu or ed. there are standards of practice for that.

    * respiratory care
    clinical practice guidelines

    * medical standards of care and clinical practice guidelines

    * agency for health care research and quality
    health care: clinical practice guidelines subdirectory page

    * ahrq (agency for healthcare
    research and quality). medal.org (access and registration are free)

    wooh likes this.
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    I have to say that when I worked in an LTAC our R/T was wonderful. They were just as short staffed and over worked as we were. Despite this they would drop everything if there was an emergency or if I needed help with anything. I was ever so greatful for our team.
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    What a shock. All these "nurses" think they know respiratory. Dont get me wrong there are bad apples in every bunch. Just like I have come across my fair share of bad nurses. Just a friendly reminder stay on your side of the bed and I will stay on mine. There is a reason I have a job, that's because mortality rates were high and physicians asked for a specialist. Maybe next time demanding something from a therapist try asking them their opinion, you might be suprised. The bad ones, will burn themselves out, just like nurses have.
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    I work in a small community hospital. We do not have respiratory therapists. The primary care nurse does everything--except for the intubating--the MD or CRNA's do that. We have multi talented code and rapid response teams. And that is the key to success for the patient in these situations. And a strong leader of code/rapid response who can assign tasks and have follow through.

    Point being that there should be an alternate policy should--for whatever reason--the RRT is not available in an emergency. Because the time to figure out that no one knows how to do things or doesn't have access to what is needed is not when a patient can't breathe.

    I would get creative in alternates. Does your ER tech want to continue education to paramedic? Can anethestia be called to tube someone? Is there a rapid response protocol that other health care providers can be assigned by the leader of the rapid response to task? This is worth discussing with your NM on how it can be better. So if your RRT is not coming when paged, then alternatives need to be viable and immediate. It is interesting when discussing this with your nursing team. Some could have critical care experience that would help with an emergency. Some have emergency experience that perhaps you were not aware of. To have the team an active part of a solution is never a bad thing.

    To cover yourself, I would assign both a code and a rapid response team at the start of a shift. IF the RRT is a no show, then there has to be another nurse, a paramedic, an MD, someone who can tube a patient. Who knows the vent and how to use it. Who has access to oxygen supplies and knows how to use them. Who knows how to give a breathing treatment.

    It is something that needs planning. However, if you can count on your RRT's only 99% of the time, I would present plans to the powers that be for that 1%.
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    I think that's a brilliant idea...if you need an intubater, or someone to dedicate to just airway, call 911. You'll get extra hands and they have the equipment.
    wooh likes this.

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