Resp. tasks VS. Nursing tasks

HawaiiRRTRN · Sep 18, 2006

Lisa,

I'm in the exact same boat as you are. RRT who became a RN, stayed at the same hospital, now working in SICU. I leave pretty much all of the RT work to my fellow RT's (Vent changes, ABG's, retape ETT's, breathing tx's, extubations, etc.). I have more than enough work to do as a nurse.

However....I will not hestitate to make changes in an emergency and I do try to keep current on ABG sticks by just asking the RT if they mind if I did the stick, when I have time. I have never had a RT tell me "No, I don't want you to do my work for me!" Of course, I always talk to the RT if I make any changes. I have never gotten any flack from them. Of course, I don't know what they say about me behind my back! HA!

Waiting 10-15 minutes for a RT to show up for a vent change/abg is unacceptable in my book and if you have to wait that long, I think you should have the right to make changes/do abg's as a RT. Why does it take so long to get a RT to the bedside? If you can come to an agreement with your manager and the RT department about your duties, that would be good but in the end, I think it may create more work for you because the RT will say "Oh, that's Lisa's patient, she can do all the RT stuff!" and it may cause some resentment on the part of the other RT's. You know how territorial RT's can be!

I already find myself being used as a RT resource on the unit by the other nurses when the RT is not around and they will ask me to check their vents/explain why changes were made after the RT has been there. I don't mind that at all. Helps keep me thinking about RT stuff and I don't hesitate to bring up the waveforms on the vent and make adjustments to Esens, PF, flow trigger, etc. if needed to make my patient more comfortable.

Good luck with trying to get those duties in writing. I've seen you posting on the CRNA pages. I am interested in that career path also. If you'd like to compare notes, I'd be happy to keep in touch. Take care.

HawaiiRRTRN

LisaRRT · Sep 18, 2006

Hello Hawaii,

Thanks for responding. Your situation sounds great. I guess mine is not so bad either, save the therapist or two that is O' so territorial (just like you mentioned).

I also have the nurse or two that is perhaps; jealous, intimidated, or whatever? and gives me a hard time about doing things respiratory. "They" make little comments such as, "Well, your not respiratory anymore." When in fact I am, my RT liscense expires after my current RN liscense does. Besides that, 95% of the respiratory tasks are in the nursing scope of practice for my state.

Then there are the RN's who really appreciate me and love to hear me teach about respiratory. I am hoping in time things will just fall into place and ALL of the staff will be more accepting of my somewhat dual role. I love it and as you know, want/need to keep up on all things respiratory for my future acceptance into grad school.

Eventually I may take a PRN position at another facility as RT just to keep up with intubtions and the like.

As far as the RT's not responding to wean, do vent changes, or ABG's, well it is 99% usually one of two things; 1. extremely short staffed and only two therapists are on for the enitre house or 2. the therapist assigned to our unit (CVICU) is out in the butt hut.

Thanks again for responding, I hope to hear more from you and would love to hear more about the path you are taking to anesthesia school.

Lisa RRT/RN

98.6 · Oct 13, 2006

i am interested in what tasks you do as a nurse that could be considered the respiratory dept.s
i am in the process of figuring out (on paper) with my manager and with the respiratory dept. at my facility what tasks i should be allowed to do on my patients (as a nurse, who also happens to be an rrt). i work in a cvicu and the management would like to see me be able to continue the care of my assigned patients who need to be weaned off the vents in a timely manner post op. i would love to keep up my rrt skills by way of abg sticks and vent weaning. i am currently licensed as both and my scope of practice as just the rn in my state allows me to do all of the tasks that respiratory does at my facility.
i really hate waiting 10-15 minutes for a vent change or to get gases, when there is a completely capable rrt (me) already there for my patient.
i would love to hear what tasks you do at your facility that could be considered respiratory personnel's. i am getting some, flack?? from the rt's that i used to work with before i became an rn about all of this. i don't want to fight them, but i want to do what i am allowed to do and what is timely and competent care for my patients.
advice please.
lisa rrt/rn

lisa -

i would strongly recomend consulting your 'house' counsel so you are covered by them if there were ever any complications. you don't want to be left out to 'dry' if the pt's family comes back at you.

don't put your scope of practice too thin as to screw yourself if deposed.

lajean · Feb 9, 2007

As far as the RT's not responding to wean, do vent changes, or ABG's, well it is 99% usually one of two things; 1. extremely short staffed and only two therapists are on for the enitre house or 2. the therapist assigned to our unit (CVICU) is out in the butt hut.

Short staffed seems to be more and more the case these days. Giving Respiratory a bad name!

carrie-rt · Jul 1, 2007

I would advise checking hospital policy,etc. The issue of concern is: if position of hire at the facility is RN:nurse:(even though you possess different licensures) you are covered on your current hired position and house policies...

As for long response times from rt dept. -As in any profession (regardless of field) you have lazy people :uhoh3:and people with work ethic-go figure:bow:

Currently an rt in a rural community with only 4 staff therapists to cover: outpatient/er/ob/medsurg/surgery and thank goodness no vent patients..... :eek:

work 12 hr shifts/on call the other 12/ return to work the next day to do again...yes, again, as long as you have recieved a 2 whole hour break......:smilecoffeeIlovecof

pnstudent007 · Jul 15, 2007

i am a current resp. therp student,but i also want to become an rn. actually i got into rep therp,b/c it was my 2nd choice.nursing was my 1st, but where i live in san diego, the waiting lists to the nursing programs are insane. ive decided to get my associated in rt and then transfert to a 4yr school for bsn. anyways, iv been curious if you could work as both oncehaving both liscences or do you guys think the demand is too great from one or both of these jobs to work as both an rn and rt

pnstudent007 · Jul 15, 2007

i am a current resp. therp student,but i also want to become an rn. actually i got into rep therp,b/c it was my 2nd choice.nursing was my 1st, but where i live in san diego, the waiting lists to the nursing programs are insane. ive decided to get my associated in rt and then transfert to a 4yr school for bsn. anyways, iv been curious if you could work as both oncehaving both liscences or do you guys think the demand is too great from one or both of these jobs to work as both an rn and rt

mcm1213 · Sep 8, 2007

I was just curious as to how you RRT's got your RN. I am currently a RRT in Wisconsin, and am taking my RN through Excelsior College which is a distance learning school. I am finding it semi- difficult because our scope of practice and Nursing practice is so different. Any helpful hints in continuing my RN ???

pavanneh · Mar 16, 2008

I would ask the nurses in your facility if you can do "follow on" days with them. You can't do anything out of your scope of practice, but on days you are off you can follow them and see what they do and how they do it. That is one way to get more of an idea of what procedures are and how they are done. I am probably going to go through Excelsior for my degree, so I am trying to plan the same type of thing at the hospital where I work.

jasmine2g3 · Apr 6, 2008

Well I have a question....I'm an RRT but I haven't started working yet. I recently passed the RRT Exam and I'm awaiting graduation next month (May 10th woohoo)...anyways I'm thinking about getting a second degree as an RN b/c that was my original major but my school's waiting list for nursing school is rediculous. As a student I've had plenty of experience in the NICU and that's where I'm applying to work...but I would like to know are you paid more for having both degrees. In 2 hospitals that I've don't internships/externship at RRT/RN duals are common but I've never asked if they are paid more.

OH and you should know why it take so long to get an RT at the bedside to get a gas....we have like 15+ patients while nurses have like 3. LOL!

judytheoldrn · Apr 11, 2008

I have to say I agree with the post above that cautions against doing things that are not currently in your hospital's listed scope of practice. Although my state board of licensure allows me as an RN to do ABGs, and the hospital approved it as well, they have recently changed the policy to all ABGs are done by Respiratory Therapists. I would love to keep up my skills, but hesitate to do so. If there were to be a complication from anyone doing a blood gas, and I was one of the people who had done one, my name would be in the hat with all the rest. I seriously doubt my hospital would cover my for going outside the guidelines of what I was responsible/covered for.

The issue with our change of policy was that there had been no competency check set up and when we merged with another hospital who did not allow RNs to do ABGs, it was decided to place the responsibility with respiratory only. :sniff: