RANT: You're an RN, suction them yourself.

icuRNmaggie, BSN, RN · Oct 15, 2015

An RT is not in charge of the patient, you are. If the RT refuses to assess a pt in distress, report it.

Next time let him know that the trach and vent are his responsibility. Your responsibility is to ensure that ancillary therapeutic, diagnostic and custodial staff do the jobs that they were hired to do.

There are a some burnt out RTs out there who are taskers, not therapists, and who spend the least amount of time possible on patient care. In one tertiary care center in my region they scream at anyone who pages and laugh about how they have elevated taking breaks to an art form. It's a game for some to dump their duties on the Nurse.

I recently had an RT ask me for the admitting diagnosis for a patient in ARDs on APRV. Some try to get out of running ABGs and calling critical values. The lack of concern and lack of critical thinking by some RTs â€‹ is really appalling.

ixchel · Oct 15, 2015

An RT is not in charge of the patient, you are. If the RT refuses to assess a pt in distress, report it.
Next time let him know that the trach and vent are his responsibility. Your responsibility is to ensure that ancillary therapeutic, diagnostic and custodial staff do the jobs that they were hired to do.
There are a some burnt out RTs out there who are taskers, not therapists, and who spend the least amount of time possible on patient care. In one tertiary care center in my region they scream at anyone who pages and laugh about how they have elevated taking breaks to an art form. It's a game for some to dump their duties on the Nurse.
I recently had an RT ask me for the admitting diagnosis for a patient in ARDs on APRV. Some try to get out of running ABGs and calling critical values. The lack of concern and lack of critical thinking by some RTs â€‹ is really appalling.

Oh, dear lord this would make me cry. We mostly have excellent RTs. I only have one that makes me cringe, and who ducks out of orders. The rest are somewhat territorial of their patients, and I LOVE that. It makes me know that anything, no matter how big or small, will be responded to. I don't call often, but when I do, I'm either truly unable to help because I'm being pulled elsewhere, or this patient is 10 seconds from distress and they need help that's above my own knowledge. I tip my hat to them often with plenty of thank yous, and plenty of acknowledgement that I will gladly hand those lungs over, and I'll take care of the rest.

Man... This makes me so thankful for excellent RTs.

KatieMI, BSN, MSN, RN · Oct 15, 2015

"Already done, your vent is still beeping/guy is still purple. Would you go with me and see him?(smile)" Done. If the RT still refuses, report him same day.

Sick Sensor Syndrome (constant ringing due to poor attachment/malfunctioning of pulse oxymeter sensor) can be addressed by RN, RRTs appreciate it.

In my own experience, super-excellent work of any specialty team usually leads to the fact that everyone else stops practicing and eventually loses corresponding skills. The phrase "we don't do it here, THEY do" means in reality that "none of us has a freaking idea what it might be all about and how to do it because it was done for us for so long". In hospitals where floor nurses rely on wound care team to do wound vacs and anything more complicated than basic wet-to-dry, only one thing everybody knows how to do is to make a phone call and say that "vac is beeping again!" I'd been in a place which, with a lot of bells and whistles, got Rapid Reach team of very experienced ICU nurses who were supposed to accept nursing care for every rapid responce, code and any other emergency that might occur. The idea was, among other things, to free the floor nurses from running emergencies so that "customers" might not thus left feeling abandoned and neglected. In some 6 months, not only the said floor nurses were quickly losing their technical, critical thinking and other skills beyond pushing phone buttons if they even barely suspected something wrong but they also started to hate and bully anyone of their own circle who happen to still possess those skills and attempted to use them.

What I want to say, is that you might want to use less than perfect work of your RTs as massive learning opportunity. Instead of breaking their group protectiveness, you might pick the friendliest and laziest one of them and learn how to read vent, change settings, draw ABGs and read them for real, clean and manage traches, etc. It may lead to you doing other guys' job for free for a while, but also may make you an invaluable person later on into your career.

With all that being said, God bless our RRTs who are excellent, smart, and live to teach and be taught.

Sun0408, ASN, RN · Oct 15, 2015

My first thought after reading your post OP was how often are you calling them to sxn a pt?? In my facility RTs sxn the vented pts q4 with vent checks as well as before and after a treatment just to name a few. However for routine or prn sxn, we as nurses do that as well as Trach care and tie changes. If a pt desats, vent issues, vent changes etc we call them. They are the pros and are a huge asset. I love our RTs but I would not call them for routine care.

Alex_RN, BSN · Oct 15, 2015

The patient asked that I call RT. I had never paged RT before, ever. I was unfamiliar with how to suction around the trach mask and didn't think I should try to figure it out on a patient that was fully A/O.

I would not be so disgruntled if this were not behavior that I witness regularly.

Sun0408, ASN, RN · Oct 16, 2015

Thank you for further details. It helps, any RT that is worth their weigh in gold should have been more than happy to teach you.

RegularNurse · Oct 16, 2015

Call them out on it, and tell them the next time they give you a hard time you are going to involve management-then actually do that.

guest114 · Nov 4, 2015

Don't they just assess and write orders like doctors? I couldn't imagine paging for a suction and I'm LPN , I do it all the time when I have an order. Usually can't wait too long when someone is drowning in sputum either ..

AlwaysLearning247, BSN · Nov 7, 2015

At my hospital we are in charge of suctioning the patients. Respiratory is responsible for all treatments and vent settings and they do suction but if my patient needs suctioning, I do it. I wouldn't call the RT to suction them when I'm in the room. If you are not comfortable with suctioning ask respiratory to go over it with you because it is very important to know. The RT's at my work are very territorial over their patients and vents and they also go over suctioning and what to do with the ambu bag a lot so we know what to do if they're not there. Good luck!

CapeCodMermaid, RN · Nov 8, 2015

At my last facility we had a 'pulmonary rehab program'...NO respiratory therapist was hired. One of the patients had a BIPAP and wasn't doing well. The Pulmonologist wanted the settings changed. None of us had been inserviced. The nurse who had the patient ran from the room in a panic. I was the DNS....I asked the Pulmonologist to change the settings. He told me he didn't know how and relied on the RTs to do it. I had to go in the patient's room with my cell phone and call the company to get walked through changing the settings. NOT a good way to do things. How I wish we had an RT on staff.

Alex_RN, BSN · Jan 20, 2016

Followup: I have made peace with the RTs. I suction often and try to confer with the RTs early in my shift. If I can, I also try to touch base with them towards the end of my shift so the respiratory portion of my handoff is more polished. In retrospect, there was only one cranky RT with whom I frequently shared patients, and we are both extra nice to each other now.