RT over-stepping boundaries?

[1RN4Christ]

Hello! Quick background then a question...

I overheard an RT giving lab work, values and their own interpretation of how this played a role in the patient's diagnoses to a patient's family member. Now, I guess I can see an RT discussing ABG's and maybe even a CXR, but CMP and CBC? No. I think this is over-stepping. Anyone know for sure? Or have experience as an RT? I called the board in my state and they said "interpretation is wrong." Then I was referred to the web site that was not very helpful. I don't think they should be reviewing these results with the family, period. I think that question needs to be referred to nursing, or better yet, the physician. Any thoughts?

[1RN4Christ]

You will be surprise how much a respiratory therapist may know due to the experience one has. It's more than breathing treatments and suctioning. And where I work we have plenty of interaction. We also participate in rounds and have every right to put our two cents in. There are times when we are trying to resuscitate a patient and or wean a patients and if it just isn't working , some doctors will appreciate our input. Of course some doctors just wouldn't want anyone to suggest anything. I still practice as an RT and won't be shy to tell a nurse to increase her sedation when an intubated patient is on the verge of putting out their tube. Regardless if it is comes off overstepping boundaries or not. We are all a team.

Don't get me wrong. I appreciate the role of the RT, they are an incredibly valuable resource for nursing and the patients and we are all a team. I do not have the luxury of rounding with RT's...in fact, we do not round at all, and I wish we did. It is important to know if it's over-stepping because I do not want any confusion regarding information given. It looks bad when nursing says one thing (after communicating with the physician) and RT says another. RT and nursing need to communicate closely regarding the patient's status. Giving inaccurate information can create a mess for nursing and upset among clients and their families. That is all I am trying to avoid. We are a team, need to respect one another's roles and should be on the same page.

[1RN4Christ]

I forgot to mention that I called their department several times to inquire and no one answered. I was not going to page overhead for something like this. I also asked around and no one thought what was done was appropriate, so I went to a reliable source.

[Ruby Vee, BSN]

I also work in small rural hospital where I do not have quick access to the RT department (as they float everywhere) and often need to be paged. I was going to ask. I'm not trying to get anyone in trouble and did not report this person. As I said, I am just trying to understand the role they have, better.

If you're not trying to get anyone into trouble, the best thing to have done would have been to speak to the RT first. You CAN page them for that. If you had succeeded in talking to someone in the RT department, you would have caused problems for that RT, whether or not he did anything wrong.

I see nurses complaining about being "thrown under the bus" -- that's what you were doing.

[1RN4Christ]

Regardless of what you THINK I was doing, I was not trying to throw them under the bus. I was not going to name anyone specifically, just ask a generalized question. As I said, I'm just trying to gain a better understanding. There is nothing wrong with asking questions. No one has to be named in order to get an answer.

[Ruby Vee, BSN]

Regardless of what you THINK I was doing, I was not trying to throw them under the bus. I was not going to name anyone specifically, just ask a generalized question. As I said, I'm just trying to gain a better understanding. There is nothing wrong with asking questions. No one has to be named in order to get an answer.

If you call down to RT with a question like that, the first thing the RT charge is going to want to know is who was the RT you overheard. If you don't tell him, he'll look it up on the assignment roster. And then, depending upon the charge, the RT would be referred to the manager or asked by the charge to explain himself. Whether or not you INTENDED to cause him problems, you would have done so.

[Alfi_srq]

You need to speak to your supervisor or next in the chain of command on topics like that before calling the board. Each institution has a chain of command and their own policies. But before you start calling the board speak with people in your own institution.

[KRVRN, BSN, RN]

It sounded like the OP "called the board" to inquire about the scope of practice. Usually we hear something along the lines of "call the board" and we think someone's in deep doodoo. Not wrong in my opinion.

[1RN4Christ]

If you call down to RT with a question like that, the first thing the RT charge is going to want to know is who was the RT you overheard. If you don't tell him, he'll look it up on the assignment roster. And then, depending upon the charge, the RT would be referred to the manager or asked by the charge to explain himself. Whether or not you INTENDED to cause him problems, you would have done so.

I understand what you're saying, but you don't get that the RT charge is at a separate extension altogether (their office). I called the dept. extension expecting to get the RT that was working on the floor. Let's not make assumptions or project into the future. I just wanted an answer to a question, not get somebody in trouble, which is why no one was mentioned, or the patient, or the day. It was a generalized question that I wanted an answer for, and in turn, give that RT the benefit of a doubt before I took things a step further (if even necessary).

[1RN4Christ]

Before I called the board (to ask the question, not report anyone), I did look at our policies (which were incredibly vague). Maybe I should have asked my manager first. At any rate, I was trying to become more informed on the situation before proceeding further. It would have been better to ask the RT directly but if you only have one for your small hospital (other than the charge), I am not going to pull her away from ER/ICU, whatever, to ask. I can find her another day. I don't see any issue in doing my own research.

[iluvgusgus]

I have had RT's discuss the results of ABGs with pts and what that meant as far as how they best would be oxygenated...I guess if some lab values pertain to something respiratory then I dont see why they couldnt discuss it, sometimes the RT knows a lot more than the MD regarding ABGs , etc.

[iluvgusgus]

Also, I think that their conversation with the pt, although we are on the same "team", it is more the business of the pt and the RT. I would stop worrying about what other health professionals are saying and just worry about yourself and whether you are practicing in your scope. I am sure you wouldnt want the RT to have over heard a conversation you had with your pt and then make a big fuss over whether you made a comment outside your scope. Who has time for it? Just let them do their nebs and let them move on.

[Nola009]

Well hun, talk to your boss. Not us. Sorry your toes got smooshed a bit, but you didnt even tell us how long "they" have been working in health care. Im quite sure RTs are intelligent enough to interpret a few labs. The level of chem the RTs take (and continually use) would probably blow your lil mind.

My Dad has been a RRT for over 25 yrs and I am a new grad RN. Im smart enough to realize that he (and many others) knows a thing or two more than me! Get off your high horse!