What does a Respiratory Therapist Do That An RN Can't?

[steve0123]

Hi All-

I was just wondering what education/etc one needs to become a Respiratory Therapist, and what their role is in the ICU? In Australia, Registered Nurses manage almost all aspects of day to day to care in the ICU, including ventilators (obviously in collaboration with physiotherapists and intensivists). Are RT's common in US ICU's, and if so how is their contribution to the patient more beneficial/cost effective/whatever than that provided by an RN? I'm not having a go at RT's, was just curious as I'm reading about all these diverse roles being undertaken by non-nursing staff in the US that are usually carried out by RN's in other countries (staff such as RT's, Anaesthesia Assistants, Surgical Technicians, etc etc etc).

Thanks,

Steve

[RN Randy]

i thought it goes like this excuse me if im wrong okay RT see his pt ,RT reports to the doc about the pt, doc writes order for patient, RN follow the order

Wow, excuse me if *I'm* wrong, but your post seems to suggest that RT is the driving force behind the physician for the pt's pulmonary care??

Sorry but as said before, here in the USA RT's are not qualified to practice medicine. [Read the label on the back of your vent.. "This device restricted to use by qualified, trained personnel under the direction of a physician."]

Sorry, no RT or RN in that.

Practicing medicine is the doc's job, and apologies if I offend, but that post is an example of the entire problem.

It goes more like this:

Doc sees patient, everyone else follows the orders, and collaborates with suggestions for the best pt outcome.

"Patient" being the center of concern, not who is trying to take anything away from whom.

And one other point; it isn't "your" patient, it's "ours". And if anyone; it's the physician's.

Those nasty possessive pronouns seem to be the irritants that start the inflammation.

As with DFK, you are trying to create a 'chain of command' that does not, and cannot exist. It isn't about rank and file, it's about liability and responsibility. [aka, the legal system], not who's better, or knows more about a single subject.

And as Mandy noted, too much 'me/mine' and not enough 'us/ours' from every department is where we're all wrong... ya know?

Peace, :-)

rb

[JoanieRT2b]

I really didnt mean to offend anyone and I do agree with you a RN's job is just as important as a RRT's .Acually everyone's job in the hospital field is important from the dietary department,housekeeping on up.

[dfk, RN, CRNA]

As with DFK, you are trying to create a 'chain of command' that does not, and cannot exist. It isn't about rank and file, it's about liability and responsibility. [aka, the legal system], not who's better, or knows more about a single subject.

i guess it's my turn now to defend, er umm, express myself..

rm, if u look from the beginning where all this 'junk' got started, you'll clearly see that what you propose others have said are getting quite slanderous. i wasn't personally saying what you implied, MERELY stating that RNs do NOT have the same training as RTs and that RTs training makes them more qualified than RNs at 'running' the vent according to pt status (and yes, dr.s orders as well) and their physiology education. some RNs feel they can "do" the same job as RTs, and to a degree, yes.. but the point is, is the scope and education are different, and for a reason.. again, i DON'T agree NOR condone RNs taking those matters into their own hands.. i WILL tell you that i have met and worked with MANY RTs and would trust their judgement over SEVERAL physicians.. any day.. period !

just because one has a medical degree does not make you an expert (pulmonologist notwithstanding) ~

so, go on and enjoy your grand-sounding day and we will go on continuing to strive for best pt outcome....

thanks for listening.

[RN Randy]

Ok... one mo' time....

Here is a bit from the OP:

Are RT's common in US ICU's, and if so how is their contribution to the patient more beneficial/cost effective/whatever than that provided by an RN? I'm not having a go at RT's, was just curious as I'm reading about all these diverse roles being undertaken by non-nursing staff in the US that are usually carried out by RN's in other countries (staff such as RT's, Anaesthesia Assistants, Surgical Technicians, etc etc etc).

Looks like a pretty innocent and sincere question about a field he is unfamiliar with.

Now lets talk about the semantics of the title, aka: the reason this post continues.

DFK, before I say anything, let me say that your defensive and aggressive approach is indeed an example of the issue both here and in the field. The OP is in another country [not much private insurance to fund a hundred specialties] and the disagreement here has risen from his unintentionally poor choice of words in the topic title. Nothing more.

Now, my point:

That fact standing, I then submit that the few RT's here took offense to it and immediately jumped on it to preach about who has more rights where, and that my friend, is exactly why this thread lingers, and exactly why issues arise in the field. It's about personality and turf or rank and file. Period. If you can't see that your previous statement reads as "RN's aren't trained in RT and until they are, should not adjust a setting, etc." then you should now.

That's my only disagreement. RN's at my facility take 8 hours on vent class, 8 hours on a balloon pump class, and 8 hours on a CRRT class. Want to argue whether RN's should be handling IABP or CRRT? I'm guessing not.

Now in your last post quoting Jesa, you restate your position saying RN's may be capable of operating the machine. Fine, now we're on the same page and I agree with you. Pick a stance, don't wander.

Originally, Jesa posted trying to display his RT prowess and knowledge in order to defend RT from Nursing, then summed it up by saying fluid isn't affected by the laws of motion, and gas is unaffected by gravity, and suggested I try and grasp the concept. I didn't even reach for it. [Obviously, that silly statement killed any point Jesa may have had, plus; that kind of attitude only adds fuel to the fire.] You then, post in general agreement to his view and toss more gasoline with opinions about how some RT's are better than physicians. [i.e. coming off as personality or individual issues, which aren't being debated here.]

Then you say a medical degree doesn't make one an expert.

Well.... neither does an RT or RN degree, but you never say that, nor does it matter. The doc is in charge, specialist or not.

Then you sum it up by implying my position fails to take the pt's best interest into account. DFK are you reading my posts at all?

Either way; Tell me what any of that has to do with this discussion?

Now; going back, Jesa did say a chimp can operate a vent, but an RT is better suited for assistance in management. [Now THAT makes sense, and is indeed my only point as well.]

I'm not, nor was I ever discussing management. I'm discussing equipment operation under the direct supervision of a physician.

You and others continue to argue management in the face of my operation opinions, and it's a senseless debate. There's nothing to er, defend yourself from, bro. You're simply on the wrong page.

So let's just let it pass and start over, shall we? :-)

The short of it from rb's point of view:

The title of this post is an irritant to RT's and has been misinterpreted.

RT's manage vents better than RN's in most all cases.

RN's making ordered vent changes should, in no way, offend an RT.

RT [Allied Health as a whole] is not in charge, or liable for the patient's overall care.

Nursing is not in charge, but is liable for the patient's overall care.

The doc is the only one in charge.

Any issues with that?

Geez, I hope not.... lol.

Finally,

To answer your side topic, I'd advise you to look up the definition of slander vs libel, and also defamation. None have been committed. Worst case is misinterpretation on my part; and if it's happened, I apologize to whomever may have been offended.

Y'all need to relax a bit, no one is attacking you or your turf.

Goin' on with my "grand sounding day"!

:-)

rb

[augigi, CNS]

We don't have RTs in Australia, so we do all our own ventilator changes, weaning, suctioning, ABG interpretation etc.

[she_devil128]

In my hospital, we make RT notes that physicians look up before they do/order something for the patient. What I am saying is that, RT is more of a specific field in medicine. RT's can make suggestions to physicians regarding the patients pulmonary status, make physicians pulmo jobs easier, etc. Well that happens in my hospital, i dont know about what other hospitals' RT does. I am an RN too and i feel more confident handling the vents and all compared to other nurses.

And to answer to the thread question, it depends on the institution's policy on the RT/RN job description. Ofcourse nurses can do most whatever RT's can do, if its about turning the knob or not, suctioning, pulmo rehab, etc. But an RN cant make RT's notes, nor an RT can make nurses notes. RT's also do more pulmonary analysis than RN's and that's why i agreed with what DFK said about the "physiology of it all", and sorry if i offended anyone with my post. Actually, the job is to assess and evaluate pulmo status, treat, and do rehab. We can suggest how many liters of O2 to be delivered and so with the vent numbers(and btw, ABG analysis is one of our majors in school). Be careful when you read the word "suggest" and not "order". Usually that is included in the RT's plan of care, which is later on ordered by the physician. The suggestions RT's make are found on the RT's notes where we also do assessment, diagnosis, and evaluation, which is more of medical compared to nursing diagnoses.

Now im working as an RN, and i am just glad that i am an RT too, it helps in the team to be dual, and yeah cost efficient. But working as an RN will not allow me to write RT's notes on the chart now.

As for my opinion, it's ok if a hospital won't have an RT, sure nurses can do the job, but with RT's on board, pulmonary care would be much easier, not just with the intervention, but with pulmonary planning, rehab, and follow ups.

And just to make it clear, im talking about Respiratory Therapists and not respiratory technicians. Or to make it even more clearer with what RT's do, pls refer to this link: Respiratory therapists or Respiratory Therapist

Hope this info helps. Peace to all!

[RN Randy]

And everyone said....

Amen.

:-)

rb

[dfk, RN, CRNA]

And everyone said....

Amen.

:-)

rb

amen is right.

alright rm, perhaps i jump around on some issues, but issues and comments are ongoing. and perhaps i invoke a bit here and there, but hey, that's me. and i can assure you it is no reflection of my ability or professionalism.. i do however feel one can have any view they choose.

i understand what you are saying, all of it, believe me, and i am aware of the OP. given the title of this thread, one has to expect a little latitude. and perhaps relax a bit. with all this speak, that's why i ended a previous post with ending the 'drivel'.. this is plain example.. i just don't think there will ever be an over-all acceptance of a common theme here..

cut me some slack "bro" ~

[RN Randy]

amen is right.

alright rm, perhaps i jump around on some issues, but issues and comments are ongoing. and perhaps i invoke a bit here and there, but hey, that's me. and i can assure you it is no reflection of my ability or professionalism.. i do however feel one can have any view they choose.

i understand what you are saying, all of it, believe me, and i am aware of the OP. given the title of this thread, one has to expect a little latitude. and perhaps relax a bit. with all this speak, that's why i ended a previous post with ending the 'drivel'.. this is plain example.. i just don't think there will ever be an over-all acceptance of a common theme here..

cut me some slack "bro" ~

Hey, consider it cut, I've no qualms, just debating.

Also,

You're right, there is a lot of speak and this is a hot topic for me, due to my particular place of employ, so maybe I'm guilty of ill feelings too.

I'll sit down and shut up a while, lol.

But I do wonder how the Aussies get by without RT...

:lol_hitti

rb

[dfk, RN, CRNA]

Hey, consider it cut, I've no qualms, just debating.

Also,

You're right, there is a lot of speak and this is a hot topic for me, due to my particular place of employ, so maybe I'm guilty of ill feelings too.

I'll sit down and shut up a while, lol.

But I do wonder how the Aussies get by without RT...

:lol_hitti

rb

i think they tell them upon employment to....take a deep breath.. :rotfl: :rotfl: :rotfl: :rotfl: :rotfl:

[RN Randy]

LOL, no doubt....

[cowboyRN]

I work with a RT in the ICU that can run a sub 3 hour marathon, and I have never been able to finish in faster than 3:30. He's a wiz and rebuilding a vent in a pinch too.