Do you hear nurses will take over respiratory work?

applewhitern, BSN, RN · Jun 8, 2014

In the ICU where I work now, the nurses do almost all of the RT work. Respiratory does not suction the vented or trached patients. They don't do the ABG's. We only have one RT in the entire building at any given time. The nurses do it.

applewhitern, BSN, RN · Jun 8, 2014

Arterial sticks are not outside the scope of the RN; that is one of those facility specific things. If your hospital allows it, then you will have education on it. Every hospital I ever worked at allowed RN's to do arterial sticks. As a matter of fact, at the university hospital when I worked in PICU, only the RN could do arterial sticks! Respiratory wasn't allowed to! Now I work in a hospital where only lab can draw them. Every place has it's own policy.

DoGoodThenGo · Jun 8, 2014

It's more a matter of "taking back" than "taking over." RT is yet another of those occupations that was spun off from nursing. Back in the day, everything that was done for people outside of actually ordering the medications (physician) was nursing practice, and done by nurses. Over the decades/generations, RT, PT, OT, etc., all got spun off as separate fields. When I started in nursing a long time ago, we had RTs in ICU, but all the respiratory stuff on the floors was done by the RNs. It's not that big a deal. Many of us, over the years, have been concerned about how much of nursing practice we have "given away" to other groups.

Repped!

Think many "youngsters" to the nursing profession are unaware that most if all of the various technician jobs were spun off from professional nurses. In short there isn't anything a RT, nursing assistant, etc... can do that a properly trained/educated licensed nurse cannot.

Much of this spinning off occurred either during wars (WWI, WWI, etc...) when there was weren't enough nurses to go around, and or when there were otherwise legitimate shortages. In any case the theory was the same; by removing some duties from the RN she would have less on her plate and thus more could be done with less nursing staff.

For the record ages ago nurses preformed what would be considered ward clerk and or other administrative duties in hospitals. When you watch television shows or films set in the 1940's through 1960's or so and see nurses (complete in whites and cap) staffing admission desks for instance it wasn't a joke. In some places you also had nurses (again complete in uniforms) working in administrative/secretarial settings like the DON's office suite.

sallyrnrrt, ADN, RN · Jun 9, 2014

What is the role of RT? Assess respiratory status? Nebulisers? Oxygen therapy?
Can they prescribe O2 or nebs etc?
Does a nurse have to do anything respiratory wise for a patient or does RT do it all?
Interesting that US created this job.. Sorry for the questions!

a respiratory therapist can assess, and some facilities i have worked, intubate, abgs, the physician wrote resp. therapy consult and treat........we actually assessed, wrote teeatment orders as XOPENEX!, aTROVENT, PULMICORT, O2 delivery device frequency etc, the physcian would co sign, some are bsn, most assic degree, ms and doctirate, myself i am a RN, RRT......

kalevra, BSN, RN · Jun 9, 2014

In my facility RT are only seen in ER and ICU. Sometime they are on the floors for ABGs.

Due to cost saving interventions they no longer exist on the rest of the floors unless for ABGs. ICU/ER they have vent and intubation responsibilities.

RTs do a lot, in my facility they incubate, run ABGs and maintain the vents. They dont just give breathing treatments. There is another level of responsibility they have that many RNs do not see, especially the ones on the floors.

I will gladly hand over some of the workload to RTs. I have a lot on my plate as it is. Why would I say no to help? Its like saying we should take back our poop wiping responsibilities and get rid of CNAs. I am glad for anything that makes my life easier.

RTs make my life easier. Once an MD says Resp. Therapy Protocol, the RTs put in order sets and the whole long list of documentation.

Wait till they remove janitorial staff on nights and you have to clear a clog out of the toilet. Yes it is in our scope of practice to do a lot of janitorial work. So guess who just got more crap added to their workload, now that we are " taking back" our profession from the encroaching interlopers.

Some people dont know how good it is until they lose it. Trust me I want to be properly staffed. I like having support personnel. I like having secretaries

Been there,done that, ASN, RN · Jun 9, 2014

This is not an issue of CAN we perform respiratory therapy's duties...

the question is how are we going to find the time?

We are already stretched too thin, now the corporate masters rub their hands together as they force nurses to take on yet MORE duties... and cut their costs of respiratory therapy.

Even the "simple" of task of adminiistering nebulizer treatments is TIME consuming and time is what nurses no longer have to do NURSING duties.

DoGoodThenGo · Jun 9, 2014

This is not an issue of CAN we perform respiratory therapy's duties...
the question is how are we going to find the time?
We are already stretched too thin, now the corporate masters rub their hands together as they force nurses to take on yet MORE duties... and cut their costs of respiratory therapy.
Even the "simple" of task of adminiistering nebulizer treatments is TIME consuming and time is what nurses no longer have to do NURSING duties.

Of course you know where all that would lead, don't you? Any nurse who complains she or he does not have enough *time* to accomplish the added RT duties will see it spun around. Long story short they will be sat down and spoken to about their time management skills (or lack thereof) . Press the issue further and it can become "are you unhappy working here?" *LOL*

Been there,done that, ASN, RN · Jun 9, 2014

So , what I hear you saying is... we should just keep on accepting all of the outrageous demands of the corporate masters, even if it leads to unsafe nursing care?

DoGoodThenGo · Jun 9, 2014

So , what I hear you saying is... we should just keep on accepting all of the outrageous demands of the corporate masters, even if it leads to unsafe nursing care?

No, not at all, would never.

Just sadly know all too well how "business" and make no mistake that includes healthcare today, is done.

Now that one is on the "bad side" of 40 and having held a wide variety of jobs can see why so many just keep their heads down and bide their time. Employees in the United States really have so few protections, especially in right to work/at will states. Basically all of us regardless of where we work or what we do can be gotten shot of if we tick someone *upstairs* off. Absent strong union or other protections persons who complain even often with valid points get labeled "trouble makers".

PMFB-RN, RN · Jun 9, 2014

There are other things they can do that we can't - RTs can do arterial sticks, so they get our ABGs and drop arterial lines as needed. Radial ones, anyway. They are also allowed to intubate patients, so if someone is crashing and we have orders to put the patient on the ventilator, we don't necessarily have to chase down a physician if a RT is immediately available.
Quick question for you - who does ABGs in countries without RTs? Only RTs draw ABGs in my hospital - nurses and lab are not allowed to do it.

There is nothing an RT does than RNs can't do. If you are not doing things like ABGs it's because of your hospital policy. That policy is most likely in place so that they can bill for it separately. Billing is exactly why RTs were created, and why they don't exist in countries with single payer health systems. Arterial sticks have always been standard nurses work in most of the ICUs I have worked in.

I work in a medium sized teaching hospital and we don't have RTs. Well we have one on duty. They do vent checks and are expert consultants. Otherwise nurses do all of what is usually RTs work in other hospitals. We set up the vents for ICU admits, make vent adjustments, and wean to extubate on a protocol. Certain nurses are also trained to intubate. However most intubations are preformed by CRNAs.

Nola009 · Jun 9, 2014

No, I haven't heard that. Is it because people aren't smoking cigs and crack as much as they used to? So there isn't as much of a need for their specific specialty??

wanderlust99 · Jun 9, 2014

Strange. I'm a travel RN and have worked in dozens of hospitals. There has always been a RT. Always. In the ICU and on the floors.