Do you hear nurses will take over respiratory work?

elkpark · Jun 10, 2014

I am all for new allied health players who exist to make my job easier. Sheesh.

Yeah, that sounds great -- until there are suddenly a lot fewer nursing jobs around. RNs tend to be the most expensive of hospital employees, and most of the efforts over the years to shift some of our responsibilities/practice to others have been undertaken with the larger goal of employing fewer RNs. The "easiest" nursing job is sitting at home, unemployed ...

Dranger · Jun 10, 2014

I can't name a singe RT who can intubate. After 18 years, working in 4 states as a staff RN, and several more as a traveler, and working in two countries as an RN I have yet to see an RT intubate anyone. I have seen at least hundreds of people intubated by RNs. I intubate regularly. All 5 of our full time RRT (rapid response team) RNs are trained to intubate and do so pretty regularly.
Maybe that is the case in some places. Not something I have seen.
(shrug) So what? Did I miss sombody making the argument that intubation is a standard part of ICU and ER RNs job?
You will have to speak for your own state in that matter as intubating is most certainly NOT outside a hospital RNs scope of practice. Of course assuming that the RN is specialy trained and has an established way of maintaining compentency and policies to support RN intubation, as my hospital does for the RRT RNs.
I don't really know what their scope of practice is. However the next person I see intubated by a respiratory therapist will be the first.
A non MDA intubating in the ER or ICU is rare in my experience. Usually they leave it to the professionals (CRNAs).

So just as you said different hospitals different states. I work in a level 1 trauma center....

1. We don't use CRNAS, believe it or not a lot of hospitals don't use them.

2. ED docs or select intensivists intubate. Anesthesia will comes down once in a while

RTs are amazing at what they do which is more than nebs and setting up equipment. Even as a critcal care nurse a I think any floor nurse that says they know and can do/know just as much as an RT is full of it.

Dranger · Jun 10, 2014

Yeah, that sounds great -- until there are suddenly a lot fewer nursing jobs around. RNs tend to be the most expensive of hospital employees, and most of the efforts over the years to shift some of our responsibilities/practice to others have been undertaken with the larger goal of employing fewer RNs. The "easiest" nursing job is sitting at home, unemployed ...

Is that my problem? If you do your job well I guarantee you won't be sitting at home. I get called in for OT everyday and we still have RTs. Im not exactly shaking in my boots unless the hospital closes down we will always need experienced RNs

PMFB-RN, RN · Jun 11, 2014

So just as you said different hospitals different states. I work in a level 1 trauma center....

So do I in my second job. I have worked in a number of them, YMMV.

1. We don't use CRNAS, believe it or not a lot of hospitals don't use them.

Naturaly.

RTs are amazing at what they do which is more than nebs and setting up equipment.

Completly agree.

Even as a critcal care nurse a I think any floor nurse that says they know and can do/know just as much as an RT is full of it.

I haven't seen that argument used anywhere. I do have experience working as a critical care (ITU - Intensive Therapy Unit) and ER nurse in a country where RTs don't exsist (New Zealand). I observed several differences in RN practice between NZ and USA. Among them that in NZ the ITU RN is expected to be able to deal with everything, including the vent and what would be RT jobs here. The standard of care there is superb and patient outcomes better than our, though of course there are many other things that would account for that. Also noticed lower nurse to patient ratios.

ThePrincessBride, MSN, RN, NP · Jun 11, 2014

It's funny; many nurses complain about all the work load, but at the same time, they want to limit the roles of other jobs and "take back" what is "rightfully" theirs. I actually had one nurse tell me that aides shouldn't be allowed to do vitals or accuchecks! :sarcastic: Yeah...don't come around whining about having to get four (or more) per patient with multiple DM patients and vitals Q8/4/whatever on all five of your patients (unless you work in an intensive care unit) ON TOP of med administration, assessment, etc.

The two hospitals I've worked at both had/have RTs, and RTs can be a tremendous help. Nursing school doesn't go into as much depth about respiratory issues/care as RT school, so they are a great resource to have, along with OT/PT/Speech, etc.

Nursing has evolved and become more advanced, and that is a good thing!

PMFB-RN, RN · Jun 11, 2014

It's funny; many nurses complain about all the work load, but at the same time, they want to limit the roles of other jobs and "take back" what is "rightfully" theirs. I

I don't see any inconsistancy in this position. Nurses do need to take back what is rightfully their. I think few nurses have any issue with respiratory therapists doing respiratory jobs, but when they started doing things like PICC placements they are stepping out of bounds.

Nurses should be responsible for more, and staffing ratios should be lowered to accomadate.

RNforLongTime · Jun 20, 2014

In my hospital, on night shift, there IS no RT after 11pm until 7am, so I AM RT. There's one on-call though, in case she is needed for the ER because I cannot play RT for them if they need to intubate a patient down there while taking care of my own patients. I draw ABG's, set up the vents, etc. The one RT, this hospital is the ONLY one she's ever worked at. We don't have art lines very often and when we do, I have to show her how to draw a gas off of it because she's forgotten...it's time for her to retire as she's well over 60:scrying:

GrannyRRT · Jun 24, 2014

You can follow the Sunset meeting for the Delicensing of RTs in Texas today and the rest of the week at:

RT Focus - news and resources you care about

Final decision will be in August.

If delicensing happens, I can see at least a couple of RNs will be celebrating. PMFB-RN, I have been an RT since before it was a profession and we functioned in many roles in the VA hospitals. I do know some of the reasons why RT separated from nursing. Both professions were able to evolve. We probably would not have the technology of either and the EBM to back up what we do had we not been able to put concentrated effort. We are no longer using MA1 ( predecessor to the 840). All professions have come a long way and each grew to meet the challenges of medicine. Functioning as a team and drawing on the expertise of every member benefits the patient more than believing you are the only one who can do anything. At a code, RNs play a lot of roles in an emergency and being tied up bagging the patient shouldn't be one of them. You have IVs, medications, family members, lab orders, results to interpret and getting the patient a bed in a higher level unit to worry about. Airway is also important in an emergency which is why it deserves one person to see it is maintained appropriately rather than trying to do a dozen other tasks at the same time.

PMFB-RN I can see you do not have much respect for RT or for some of the nurses participating in this discussion with so I will not engage you any further. I just wanted the OP to be aware of what is happening in RT right now this week.

RunBabyRN · Jun 24, 2014

As already stated, many hospitals are already doing this, and have eliminated RTs.

In the Navy, we never had RTs, and we performed all treatments as corpsmen. I'm glad I have that experience moving forward as an RN, because I'm sure I'll be drawing on that experience at some point!