I have only been an RN since last September, but I was an LPN working in cardiac med surg for 6 years prior to that with a total of 10 years nursing experience. I moved to ICU late last year. I feel that I have learned a lot in a short amount of time, but I am very aware that I still have much to learn.
This being said, has anyone ever encountered respiratory therapists who are either paternalistic or just outright condescending towards nursing staff? Either in general or specific examples?
Further background: My fiancee is an RT student getting ready to graduate. He has had clinicals on my floor. I work night shift and he came in one morning with his instructor and another student. They were going to see a patient I had admitted less than two hours before. Without going into great detail, this patient was very sick, as in he was septic. Not on a ventilator at that point, but with rapid shallow respirations. I pointed this out and he apparently didn't agree with me and thought I was going by the respiratory rate showing on the monitor. Anyone could look at this patient and know he was going down the tubes. Anyway, he gave me the "look" as if to silently say, you don't know what you are talking about, but I'm gonna humor you anyways. By the way, this guy ended up being intubated later that day (far too late in my opinion, but that's an incompetent intensivist story which I will not even begin to explain).
Haha...later I find out from my fiancee that this instructor started to make a remark to him and a fellow RT student that "So and so (insert my name here) is one of our new ICU nurses." My fiancee interjected "Yeah, that's my fiancee." Although I am glad to be acknowledged, I kind of wish he hadn't interjected because I would be VERY interested in knowing what this guy was going to say about me...very interested indeed.
Yet another example: There is an RT who works on nights that likes to come up and socialize with the nurses. Fine and dandy, no problem. One night when I was off, our unit received a patient who was benzodiazepene overdosed. The med recon form was not done correctly to begin with and the patient received Xanax than she should have. Basically, he and another RN were dogging the nurse that administered the medicine. Now, I will have to agree that there was a definite lack of critical thinking on the part of this particular nurse, but the error didn't start with her. His comment was "I have nothing but contempt for floor nurses". Since I used to be a floor nurse and know the hell it can be and often is, I was not very happy with his comment and let him know it. I think the real truth is that he is arrogant and has nothing but contempt for nurses period. The only reason he hangs around is because a couple of the nurses stroke his ego.
I could point out some other examples, but I am going to stop there. What do I think the problem is? Part of it lies in education, at least in the two major colleges that teach RTs in my area (I realize that it would be foolish to make generalizations). These RT students are encouraged by both instructors and certain regulating committees to think that they are doctors. In fact, my fiancee noted an example on the patient cited in this post that RTs were charting "ARDS". There was never one mention of ARDS as a diagnosis in the progress notes. I know that RTs are trained to read chest x-rays and by patient assessment I also realize that ARDS was not a far-fetched conclusion. You see, the school associated with the hospital I work at has an MD as the director of the RT program. That's all well and good, but they have to do presentations on patients in which they "diagnose" and give recommendations for treatment. I am all for the development of critical thinking skills, but I disagree with the method. Furthermore, there is an instructor in this same program that makes no secret of her disdain for nurses. Quotes "Don't listen the the nurse" or "That stupid nurse did this". Etc, etc, etc...
Disclaimer: This thread is not intended to start a debate between nurses and RTs. I realize that there are nurses that are just as condescending towards respiratory therapists. I also believe and know that for every RT who has displays this attitude towards nursing staff, there are plenty more RTs who respect and work well with nurses. I just needed to vent a bit. Yes, the pun was intended. :chuckle
Specializes in Medical and general practice now LTC.
I think also we have to remember that not all countries use RT in fact I think for the most it is the US that uses them. I know when I nursed in the UK apart from the physiotherapist helping with really poorly chests the majority of the work was done by the RN. Obviously the op had problems and felt the need to vent but remember not all places will have great RT the same as not all places with have bad RN's
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
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ha! and i work with several nurses that don't know the difference between a venti mask and a nrb. and perhaps most ridiculously, i've never met a nurse that knew the only clinical indication for albuterol. hint: we don't give a bronchodialator to "loosen secretions"! ftr: "dr. jones" is just as responsible for her pt's as you are. you probably don't want to believe it, but my rt licencse allows me to perform absolutely any intervention that an rn is able to. gasp! omg! we're equals! now before you go judging an entire proffession by the actions of a few individuals, read this:
this is a vent thread. i never meant to trigger so much animosity.
however, i'm fairly sure your rt license doesn't allow you to time a balloon pump, take "verbal" orders for blood transfusions or insert a picc line. two of which "dr. jones" attempted and the third of which she insisted she could do better than the two rns attempting it.
rts and rns are different, and while i admit that i couldn't (nor would i want to) do many of the things rts do every day, i'm also sure that you couldn't (and probably wouldn't want to) do some of the things i do every day.
and for the record, i work with some fabulous rts.
Not negative, I am quick to point out differences in our jobs however. I don't think I've ever posted anything blatanly negative about nurses, but I am guilty of having an overbearing sense of sarcasm. Doesn't one incendiary post deserve another? I think we all could rattle off a list of dumb people we work with in many different positions! LOL! OK, so technically speaking bronchospasm is the only indication for a brochodialator, typically indicated by wheezing upon auscultation. Obviously decreased WOB and facilitation of secretion mobilization have its benefits as well. And oddly enough, albuterol can treat hyperkalemia, but I havent seen that since pharmacology class. Never is a strong word, maybe I should've said; I don't recall meeting a nurse who understood albuterol does'nt "loosen secretions".
Underand and fair enough.
I only know albuterol as a bronchodialtor and that's all I've ever seen it used for, maybe that's just me.
.......however, i'm fairly sure your rt license doesn't allow you to time a balloon pump, take "verbal" orders for blood transfusions or insert a picc line. ........................
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it most certainly does. i'm licencsed in several different states, and they are all worded almost identicaly. i've posted on this subject before, and a member, wtbcrna, posted a great link from the nys liscensure faq website. i can't post the link, beleive it or not it's blocked here at work. but when i find it i'll post it. it also states that proper training and competency testing is nesseccary, as i'm sure an rn's liscence would as well.
i hope you read my follow up post, because i was being extremely sarcastic, so much so that i assumed (there's my problem!) it would be evident. ftr: i whole heartedly agree with the rest of your previous post.
it just grates on me when i hear something like "you can't do that, only an rn can.....take verbal/phone orders, administer iv meds, hang drips, ect. in fact there was a thread a while ago here from a nurse that does ecmo. her hospital was training rt's to run ecmo as well, she was concerned because "since she's the rn, she's responsible for the rt's" ggrr.......i mean where does this myth perpetuate from?
here's some info on new legislation for rt's as recognized medicare part b providers, and the aarc's initiative. (more autonomy in the home care and office setting):
Gosh, I love our RT's. Being new, they have taught me so much! They seem brilliant to me. I have had two guys who were especially helpful. I have heard there is a real nasty one on day shift, but the night folks have been terrific. One was sort of a grump but he seemed depressed. I haven't seen him lately. He even responded to questions for info which was helpful. I couldn't imagine not having RT as a back up. That would be awful.
It's too bad that you have had this experience with RTs. I am currently in RT school and doing some clinicals. RTs and RNs at the hospital I have been to seem to have a respectful relationship. Furthermore, in our class, we are encouraged to respect one another. I wish every school taught this so that there could be less tension between RTs and RNs.
but when i find it i'll post it. it also states that proper training and competency testing is nesseccary, as i'm sure an rn's liscence would as well.
Silverdragon102, BSN
1 Article; 39,477 Posts
I think also we have to remember that not all countries use RT in fact I think for the most it is the US that uses them. I know when I nursed in the UK apart from the physiotherapist helping with really poorly chests the majority of the work was done by the RN. Obviously the op had problems and felt the need to vent but remember not all places will have great RT the same as not all places with have bad RN's