sometimes i breathe : respiratory therapy blog

What I like about the floors

2009-11-06T05:04:00.003-05:00

The floors are known to be mundane for many therapists. Some hate it, some love it.

The case against it: We don't use our skills. The residents don't care about our opinions. I don't have to think as much.
The case for it: It's less stressful. There is more "down-time" than ICU. I don't have to think as much.

Our hospital makes us work the floors 50% and PICU 50% which ends up being a pretty good system in my opinion.

We provide useless and countless albuterol treatments for patients that don't need them. I've been told that there are many non-indicated albuterol treatments due to the fact that albuterol is cheap and safe while the phsyicians want to protect their butts.

The work load is usually split by how many treatments a floor recieves. If I were working floor 5 that has 12 treatments and floor 6 has 20, I'll probably take 4 of his treatments so we both have 16. By treatments, I just really mean albuterol. Sure we give other types of inhalation medication and provide other servies such patient education but those don't really matter in the system.

The Q2 (every 2 hours) albuterol treatments are pretty annoying simply because most of the time they are not indicated. Most kids end up on Q4 treatments which are usually done at 2000, 0, and 0400 "rounds."

We have a hour leyway too provide a treatment so for 2000, we have anywhere from 1930 to 2030 to get our job done. Each nebulizer treatment should take roughly 10 mintues if done correctly. That includes talking to the patient, vitals, finishing the neb, more vitals, and charting. The first rounds usually take longer just because we have to establish rapport with the parents, usually do addional BID (twice a day) treatments, and find the drugs.

We don't stack treatments here. Stacking refers to starting a nebulizer on patient 1, 2 and 3 and then coming back to 1 to take the nebulizer off. It saves time but that time should be used for patient educaiton. Also, some of these kids will rip that little mask off the moment you turn around.

There are two big things that I like about the floors more than PICU.

The kids are not as sick: This allows me to build a relationship, have fun, and joke around with the kids. And when there is "down-time," we could play video games.

Down time lasts longer: Down time is the time before the next rounds or any other responsibilities. If I finish my first round of treatment by 2030 and the next set of Q4 albuterols are due by 0000, I theoretically don't have anything to do for nearly three hours.

It does seem like a lot of the night shifters love the Facebook. Others will pick up a book or magazine. I try to expand my knowledge by talking to co-workers. I'll also snack a lot.

You'd think that there be more down time in the PICU since the nurses do the nebulizer treatments, but that's not true. Since the kids are definitely sick, we have to keep a careful watch. Our time is spent on discussing patient ventilator goals with the physicians and helping nurses with various tasks. More thinking is involved, but I sometimes don't mind turning off my brain.

Off orientation

2009-10-20T20:51:00.003-04:00

I've been off orientation and it's been going pretty well. Those three months were quick.

I visited home GA for a week and that was definitely fun. I remember back in college when $10 a meal was expensive. Now I could afford it which was definitely nice.

I also picked up five nights in a row of 12 hour shifts. That wasn't nice. Our scheduling system is almost similar to eBay. You have to work a minimum of 36 hours a week. If you plan it correctly, it's possible to work the three nights beginning of one week and three end of the next week. That's up to eight days off!

The only problem is that everybody tries to do that. The more days you work in a row, the more days you have off in a row. If the schedule opens up at 0900 and you log in at 0910, you will probably not get the perfect schedule you want. I logged in two days late because I did not know what I was doing.

They told me that new hires should probably only work 3-4 shifts in a row max. A poor performance could definitely drag the team down.

I was lucky. My five nights have been pretty tame. No codes and no unexpected patients. I was definitely tired after those nights and ended up sleeping for almost 12 hours afterward. It wasn't bad because I don't have any other responsibilities yet but I can't imagine the married who have kids that pick up these kind of hours.

Just because your babysitter is a RT doesn't make you one

2009-10-02T08:55:00.003-04:00

We had one of those moms the last night. "One of those moms" means that she's significant enough to warn my day shift counter parts during my report. She's not exactly rude or aggressive. She does something that annoys us even more; she's talkative and attentive.

A rude or aggressive mom could easily be handled by security. Yes, we've had those moms. I have found no defense against the talkative and attentive one. She does things that simply annoy the hell out of everyone.

My mistake was that I mistook her for a nurse when I first met her. The patient desat a little and needed some extra oxygen. I slapped him on 100% on the ventilator and observed. I asked what had happened. The mom continued on a long rant about her health care providers who did not provide quality health care and how babysitter is a RT that probably knew a lot more than the RTs here. Insulting one of my co-workers is basically insulting me. I'm proud to work here and I really didn't want to hear it from her.

She was one of those moms that wrote down everything you did, and would report you to the supervisor if she found your chest physiotherapy technique inadequate or something equally frivilous. Luckily, I had CPT with a round of Xopenex. I can't imagine all those drugs that the nurse had to push.

Since her babysitter is a RT, she decided to spew her respiratory knowledge about the ventilator on me. I admit that I was slightly impressed that she knew what PEEP was, but just because I know what a CT scan is doesn't mean I know how to interpret it.

I found it particularity amusing when brushed me off to get the isolation stethoscope. Did she know her breath sounds too? I also rember her requesting us to suction the left lower lobe through the endotracheal tube because it sounded a little chuckier to her.

I felt especially bad for the nurse when I left the room while pretending my pager was vibrating. Nurse lady's fake smile was starting to wane.

Then I found out that her babysitter came to the hospital the other night. She was a student that did not pass her boards yet. Some people just don't know their place.

Just because your babysitter is a RT doesn't make you one.

Better food = better performance

2009-09-25T09:22:00.003-04:00

I've come to realize that my performance at the hospital has a direct correlation to how much food is in my stomach.

I usually wake up around 5 PM. I'll eat a breakfast usually consisting of eggs, toast, cereal, and a bagel give or take. I'll take a quick nap before I leave at 6:20 PM. I get there by 6:45, get report, and then start my rounds. I usually don't eat "lunch" until 2 AM. I'm not putting any food in my stomach for almost 9 hours.

I've come to realize this when I would make stupid mistakes around midnight. I've done some pretty bad things from breaking a MDI to missing some elements while charting. My preceptor has caught this also.

So I started eating a apple before midnight. I'm still trying to wean myself off coffee with green tea...with minor success. My new thing is to bring oatmeal. Oatmeal and apples are great for waking one up.

It's not necessarily that I'm sleepy, it's just my stomach seems to drain the energy out of my brain.

2/3 done with orientation

2009-09-10T10:12:00.003-04:00

I'm 2/3 done with my orientation. My progress on the floors have been pretty good. I've learned to pretty much just follow orders and do what I'm told. It's good to question...questionable orders but there's also times where we have to accept it. I'm still not doing CPT on that sickle cell kid who is in pain.

I've been commended for my team efforts and my friendliness. I've been yelled at for making medical errors. It all comes with the job.

I'm not one to confront others when I feel like it won't make a difference. For example: one of my patients was on contact precautions. After my initial assessment and my ventilator check, I proceeded to take off my gown, gloves, and mask. I also noticed I forgot to reset the menu back to the main vent screen. One of the nurses just happens to catch me without my protection for that four seconds I wasn't wearing a gown.

Our hospital policy states that if the patient is on contact precautions, you only have to wear the gown if you touch the patient. Instead of printing out the policy and shoving it in her face...I decided to just take it with a "Yes mam." I think she was expecting some confrontation.

Now what would I solve if I confronted her? Sure I would get a since of satisfaction that I "beat" her but overall, I think the effects would be harmful. She would later develop a negative opinion on me. Rumors could get started very easily, and then I would be known as "that guy that never takes a shower" or something equally ridiculous.

Go team

2009-08-21T01:24:00.008-04:00

My patient in the ICU had copious dried, old blood-tinged secretions. He's on a conventional ventilator with some pretty high settings. What happened? The night before, I was weaning this patient from the oscillator.

His ridiculously low settings allowed him to come off the oscillator. Now he's on a vent with a audible leak, frank blood comes with every suction, and oxygen saturation drop to the 50's (97% is normal).

I spent a good second half of my shift bagging my patient to maintain his oxygen saturation above 80. My coworkers helped with my rounds.

After increasing settings and more suctioning, the patient continued to desat. We tried to put him back on the oscillator again but failed...twice.

Around shift change, the day shift attending arrived and finally decided to reintubate with a cuffed tube. The one we suggested when we heard the audible leak at the beginning of shift.

The copious amounts of blood made intubation nearly impossible so Doc decided to start ECMO. A rapid response was called and the room filled with people. It was my time to leave.

Apparently, starting ECMO takes a while. Most of the equipment was already set up but they needed blood. While the dayshift therapists managed the ECMO pump, our night shift crew decied to help and do first rounds for the dayshift. I could see the relief coming out of dayshift's arse.

Help your co-workers even if your shift is over, they'll return the favor one day.

The final lesson before PICU

2009-08-14T06:46:00.005-04:00

I've been on the floors for the past month. My badge finally works with the garages and I have access to all the doors now. I've had issues with a faulty badge that allowed access to only select doors. The emergency room door disliked me...which would be a big problem for a RT.

I've been quizzed relentlessly by my preceptor who is a very educated individual. He believes that I'm doing pretty well with my knowledge and time management. On my last night shift floor orientation, I had five cystic fibrosis patients and three "normal Q4 albuterol patients."

With cystic fibrosis, RT's have to run through a plethora of treatments usually starting with albuterol and ending usually with Tobramyacin. Usually, we'll start with a bronchodialtor and steroid, then go through hypertonic saline which will help these guys cough more. Pulmozyme is pretty common for CF and so is Tobi. Then there is the Vest (20-30 mintues of shaking) also. There are variations but each CF patient usually takes 30 mintues of care.

If my patient is due at 2000, then I have anywhere from 1930 to 2030 to make sure everything is done. So having five CF patients that take 20-30 minutes each that must be "done" within a hour really is not possible without "stacking" them.

Stacking is the process of running a treatment on someone and then leaving the room to work on another treatment. This is generally looked down upon in most hospitals but is still commonly practiced.

I did not mope but proceeded to start early. 30 minutes into it, I bowed my head in shame and asked for help.

After the initial rush, my preceptor commended me for asking for help. That was the lesson of the day. The hospitals policy actually stated that you are only allowed to have two CF patients per RT.

We all have a sense of pride and fear our co-workers will see us as "weak" when we ask for help but when it comes to our patients, quality care comes first. It's the same reasons why men hate asking for directions, but who cares?

The days vs nights rivalry

2009-08-01T18:40:00.006-04:00

This is a trend I noticed among the different hospitals I've been to: There has always been a rivalry between day-shift vs night-shift. I think it's healthy to have this natural rivalry. Night-shift is usually seen as incompetent. Day-shift is usually seen as up-tight.

I work during the nights so we naturally talk crap about the day-walkers. Fellow co-workers brought up instances where a day-shift therapist messed up somewhere and everybody on night-shift knows about it. Note to self: don't mess up.

We stopped for a second and wondered if any of them talk crap about our night staff. I know they do. I realized that its natural to defend your profession. Most of us chose night shift here whether due to the extra pay or schedule reasons.

It's also very one sided since we talk about other people that's not in our little circle. Then a nurse that works equal nights and days walked by and told us that she prefers our team more. "Days are too up-tight." That made more of a difference then all the smack we've been laying on each other.

I don't understand

2009-07-29T01:31:00.006-04:00

It's been two weeks. I'm making new friends and learning the hospital ways. I've found that I'm still very uneducated. I brought my Egan's Fundamentals of Respiratory Care (the RT bible) book up with me when I moved and decided to read for a hour a day until I finish the book (1263 more pages to go).

I was told that you are only a bad therapist when you stop learning.

There are still a lot of things I don't understand though, like why don't we have that many respiratory therapy driven protocols on the floor? I have a lot more "freedom" in the PICU and feel appreciated by the nurses and physicians but not so much on the floor.

The only protocol I saw on the floors was for CPT. I'm not doing CPT on that anemic kid writhing in pain. Seriously, do some of these physicians even see the patients?

Protocols have been proven to reduce costs.

I also don't understand don't all hospitals have the electronic patient id / drug scan system. Studies have shown they reduce costs and medical errors also. I don't think it would be that hard or costly to implement. Even if it was expensive at first, I think the hospital would see a return in their investment.

And when it comes to quality healthcare, it's all about money right?

Orientation 2

2009-07-14T21:09:00.002-04:00

Today's topic was on guest services, infection control, security, and JACHO. JACHO is now known as Joint Commission.

Joint Commission is a committee of 29 members who have a force of over a thousand surveyors. They come to the hospital and question you about safety procedures and etc. It use to be a planned once-every-3-years kind of thing. Now they come every 18-39 months. You'll get notified through email in the morning, but by the time you finish reading it those guys will be standing behind you and wondering why you aren't working.

We then watched a video on how to cough and sneeze properly. Do it into your sleeves and not your hands!

I also learned that as of July 1st, our hospital is not allowed to accept pens and trinkets from major pharmaceutical companies anymore. It may influence a patient's decision. Nooooooooooo!

Orientation 1

2009-07-13T16:38:00.004-04:00

Orientation was pretty standard fare: self-serve coffee and bagels, countless presentations on the hospital history, safety, sexual harassment, and of course HIPPA. There were at least a dozen speakers.

The VHS orientation tape with Harry Hush and HIPPA was a riot...

Apparently children over 10 can block their parents from seeing their medical records. The subject had something to do with STDs.

I met three other therapists. Two of them came from the south and were also new graduates so I don't feel so alone. There were about 30 other employees ranging from custodial to ER physician.

After lunch, the benefits were covered. I understood about 1/5 of it. I'm in a new city all by myself. It's time to call the parents and ask for advice.

It's been a month

2009-07-11T22:33:00.003-04:00

It's been more than a month since I updated this blog. I spent the last month celebrating. Yes...I spent the whole month celebrating. I squeezed the most fun out of my friends and family before I start work.

I came to Baltimore to look for apartments with my girlfriend a few weeks ago. We found one that's in a nice neighbor and close to the hospital; about 12 minutes. The only downside is that it cost $745/month. That's within my budget and all but I've been living for FREE the past 23 years.

The girlfriend is back in Georgia and the Mom drove up with me this time (12 hours in car with the Mom made want to drive off a cliff). She's teaching me how to do taxes and how to cook various tasty dishes. She'll be taking a flight back next week.

My orientation starts Monday and I'm a little nervous. I'm getting to know Baltimore a little more but I've never been without the parents for more than a week. I'm sheltered but I adjust well.

Unfortunately, I don't know anybody in Baltimore but I have a pretty neat computer and plethora of videogames to keep me occupied.

I just realized that I haven't done anything "respiratory" for the past 3 months. Uh-Oh.

I'm a Respiratory Thearpist

2009-05-28T09:36:00.008-04:00

The past month has been a little stressful. I've been struggling with the job hunt and inability in trying to avoid the sense of uselessness. My usual day consisted of applying for jobs, playing the harmonica, and getting nagged by parents about being jobless, therefore useless.

After 20+ applications, 3 interviews, and $300 spent on travels, I finally found a job.

I'll be moving to Maryland and starting in July. I can finally call myself a respiratory therapist.
My new life begins in July. For the month of June, I plan on just relaxing.

I'm going to move all the posts before this into a folder called RT school.
The new blog starts......now!

Stop watching CNN

2009-05-02T02:46:00.003-04:00

CNN lately has been nothing but bad news. Bad news brings depression. Simple solution: stop watching CNN.

If it's not the tanking economy then it's the swine flu. I recently saw someone where a mask near downtown Atlanta. Wearing masks are actually pretty common during allergy season in Georgia. Atlanta is pretty bad for asthmatics...but it's near summer. There was the first case of the swine flu in Georgia on April 30.

This one case of swine flu should not cause mass paranoia. Come on.

Was your hands.
Avoid unnecessary flights.

Be educated, not paranoid.

New grad seeking job

2009-04-21T05:43:00.003-04:00

About once a month I have trouble falling asleep. Maybe my internal clock is screwed up or all that stress I try to ignore. I don't know. Lately, I've finished my clinical rotations and on the lookout for a job.

I'm especially anxious about getting a job. This big hospital that I really like hired four students from our class already. Two of those students have masters degrees. They could be socially retarded amputees and still be hired. Master RT students make the hospital / department look so much better.

I was the last student to rotate through there and I'm entering the market at a bad time. It's not that my interview skills are really poor (I've read countless articles on how to prepare for interviews and practiced accordingly), it's that I'm not getting any interviews.

I think lacking real experience besides these clinical rotations is also a great difficulty I have to overcome.

I've applied to eight hospitals so far and I've received one interview and that only because I was rotating at the hospital. I know eight is not that much, but I get a little discourage when learned that these four students applied to only one place and it's their dream hospital.

I've been told that Georgia pumps out nearly 250 new respiratory therapy graduates every year. 50 of those are baccalaureate degrees or higher. Yahoo HotJobs posting lists 21 in Georgia. 11 of those are either looking for a fake background actors or a nurse.

Majority of big hospitals prefer to hire within / their extern students. It just happens that the last three big hospitals I have rotated through having hiring freezes for respiratory (I'm still hoping the big one will say yes).

My mom has been supportive in the start of the program but her patience is wearing thin. Dad didn't think I would pass the registry and decided that he doesn't want to go to my graduation because "Graudation is no big deal. Find a job."

I actually love my parents and get along with them just fine. They want me to live at home and work around Atlanta so I can save up to buy a house. I'd really prefer not to move out of state but I might not have a choice.

How to deal with night shift

2009-04-13T04:32:00.003-04:00

I've been rotating at this big hospital for the past month. It's keeping me busy, but I only have three nights left. Night shift is tough. There is the extra pay incentive, but most starting RT grads are being pushed into night shift. I really don't mind, but I know some fellow students who do.

Here are some tips I've gathered from fellow therapists about how to deal with having a schedule that's different than the rest of the world:

-A lot of articles say that taking a nap at work is essential for night shift. I think that will just get you into trouble. If you get sleepy, try splashing some cold water on your face.

-Keep your stomach happy. I keep enough fruits and snacks in my happy bag to feed the entire floor. My hospital is fortunate enough to have a grill that is open till 3 in the morning but most of the food is unhealthy...which leads to my next point.

-You know that feeling you get when you eat fried food for lunch and then feel sleepy afterward? It gets amplified on night shift.

-Some of the night shift staff told me that they sleep a whole eight hours before work and they have converted their lifestyle to a night shift model. Others tell me they still sleep at night and just take a few hours nap before work. Find what works for you. I prefer the sleep for eight hours before work model.

-When you get home from work, don't go straight to bed. You should wind down. Treat your night as if it's your day. If you normally sleep at 9 P.M., then you should try to sleep at 9 A.M.

-Sleep with no light during the day. Our bodies are accustomed to sleeping in the darkness. Block the sun with heavy drapes and wear sleep masks. I first thought sleep masks were stupid. "Why can't people just close their eyes?" I then realized that a quartered sized hole from the window can penetrate my eyelids.

-Coffee. I know it's bad for you, and I'm trying to wean myself off by drinking tea. But seriously, hospitals would be in a lot of trouble if they banned coffee.

Night shift may be difficult for parents or people that are married. It may be even more difficult for parents or the married if they are a new RT graduate. In this economy, we don't really have a choice.

First week externship impressions

2009-03-17T01:21:00.004-04:00

The hospital I'm doing my extern-ship at is a old and established hospital. It definitely has the funding since this is the hospital of choice for celebrities and sports stars. They even have upscale rooms with room service, nicer beds, and a good view.

The first week was pretty positive. They work you hard. Therapists have a lot of control and autonomy...which is what I'm looking for in a first job. I expect to gain as much experience as possible in my first job.

I really like their charting system; everything is digital. Giving out medication requires someone to carry a PDA: scan the drug bar code, then scan the patient's wrist. This system is excellent. It minimizes wrong dosing and drug errors. I just wish this hospital had a scrubs system where they offered free scrubs and a locker room to employees.

The scrubs system should be implemented by every hospital. I can't imagine it being expensive. You don't bring hospital germs back home and you don't bring home germs to the hospital.

My first week gave me a lot of ABG practice, chest compressions, assisting in a Swan-Ganz insertion, and broncospy assistance. I didn't really get a chance of power napping in the closet like some other hospitals.

The nurses were friendly and cute. The two therapists I followed had a plethora of information and felt comfortable with me. And that's what really matters; comfort. If you aren't comfortable with your co-workers, then you don't belong there.

Don't be a preceptor if you don't really enjoy it

2009-03-10T12:28:00.003-04:00

Yesterday was my first clinical day at my externship. I followed a older therapist that truly enjoyed the profession. He had strong opinions about healthcare, life, and respiratory care and voiced his opinion. I enjoyed following him.

I asked him if there was an incentive pay to accepting students for the therapists there.

"Why do I need a incentive?"
He told me that students helps him review forgotten knowledge and that he is obligated to share what he knows.

At my previous hospital, the therapist would receive an extra dollar to have a student follow them. I seriously think some therapist are just doing it for the extra dollar.

Being a preceptor does not only require extensive knowledge and experience, but also a good attitude. Even though I passed my RRT and I'm legally allowed to work as a therapist, I still consider myself a student. I still have plenty to learn, and I don't graduate until May 9th.

I'm not here to work. Don't give me half the patients so we can go to lunch earlier. Don't ask me; "Do you plan on doing something else then RT?"

I admit that at all of my previous rotations, these "rogue therapists" are rare. I've come to realize that I should have asked a superior if I could follow someone else.

Don't be afraid of your therapist. Ask questions. Don't work, learn.

sometimes i breathe : registered respiratory therapist

2009-03-06T16:40:00.005-05:00

I did it. I passed my registry. I spent the last week jamming 2.5 years worth of respiratory information down my throat. I'm excited. The clinical simulations were difficult.

Some tips about the test:

-I took the written and the clinical sims on the same day. Take them at the same day. It's better to deal with one day of stress than two days.

-The written has 115 questions. You have 120 minutes. Don't rush but keep in mind that you have a ~1 min per question. I finished with 3 minutes remaining.

-If you're a fast test taker like me, then recheck your answers. Utilize the red check box that allows you to skip back through them.

-I ate a full breakfast, took the written at 9 in the morning, finished at 11, took a lunch break, and then took the sims. Point: Keep your stomach happy.

-The clinical sims are a mind $#^@. Don't pee your pants when you see "Physician disagrees." I got 12 disagrees the second and third sims. I got really depressed throughout the whole test and thought I was going to fail.

-You have three hours to do 11 sims. Take your time. I took my time and I still had an hour and thirty minutes left. You get ~20 min for each sim.

-I have this bad habit of clicking, pulse, general appearance, etc for information gathering and then not reading the results. Read it.

-When you click get a physician disagree! Grab your arms and fold them! It'll prevent you from getting 12 disagrees in a row.

-And finally: Don't panic

I also received a e-mail from the big hospital that I applied to; I didn't get it. Whatever, I'm not going to let that drag me down for tonights monumental occasion. Tonight is going to be a fun night.

Simplifying Asthma Treatment by Holly McCarthy

2009-02-24T21:46:00.002-05:00

I located some of my inspiration for the following post in a UK publication, but I gathered their asthma was similar to ours. An article in Saturday's Globe and Mail entitled “Are common drugs a key to asthma relief?” discussed some promising results to found in a study in which asthma sufferers were given anti-fungal medications. Fascinating.

It seems patients with severe asthma noticed significant improvement in their symptoms after taking the anti-fungals. This means new, more toxic drugs may become a thing of the past as we look to more simplified treatments for this common – and often life altering – condition.

The study was also published in the American Journal of Respiratory Medicine (See? Told you asthma was the same there!) and is the first of its kind. Patients were tested for fungi (candida, aspergillus, and penicillium) allergies and, if it was found they had allergies to any of these, they were given itraconazole instead. The patients who got the drugs saw 60% more improvement of their symptoms as those who took placebos. Those results are nothing to wheeze at!

So, while this treatment won't help all asthma sufferers, those with fungi-specific allergies could see substantial relief. This is important due to the fact that so many asthma attacks are triggered by airborne allergens (fungal spores), especially mold. In some parts of the country, it can be almost impossible to avoid if they ever want to enjoy fresh air.

It should be noted that the anti-fungal medications are NOT a replacement for bronchodilators or medications that prevent airway constriction. However, these drugs can block common allergens and aid in decreasing the frequency and intensity of asthma attacks. More needs to be done, however, because there are so many people still suffering with asthma symptoms as current treatments fail them.

It's not a panacea and more research needs to be done but this is very promising for those in the respiratory therapy field who see the havoc asthma can wreak on patients. It can be very sad to watch—especially when children are suffering and nothing seems to work.

Nausea, dizziness and fatigue were some of the symptoms study patients complained about. But, when we are talking about the alternative (not breathing), these seem fairly mild in comparison.

By-line: This post was contributed by Holly McCarthy, who writes on the subject of the best sports management college. She invites your feedback at hollymccarthy12 at gmail dot com

I survived respiratory school.

2009-02-23T16:59:00.004-05:00

Today was the last day of class. It was sad, emotional, and a big relief. I passed my final. We ate, drank, ate some more. We did it people.

Sure I still have two papers to write, a RRT test to take, and 18 days of externship but I feel like a overwhelming sensation of euphoria is spreading over me.

Now this isn't the end. I will still attempt to keep in contact with some of my classmates and potential co-workers. I won't be seeing all the friends I made in RT school as much as before (at least three times a week), because everybody has their own story. I hope everybody finds what they are looking for in this economy. Remember: Don't panic.

The past 2.5 years have been quick. It started out slow and tedious, but this last semester seemed so quick. I'm a little sad because I'll miss my classmates, but I'm also excited.

This is the beginning of my career.

Starting soon: sometimes i breathe: newbie respiratory therapist blog

2nd interview

2009-02-16T20:07:00.003-05:00

My second interview at this anonymous hospital in GA was scary. I was nervous. I dressed the part and I came in with some common interview questions already answered in my head.

Tell me about yourself. I was born in China and I came to the United States when I was five years old. Like most college students, I had no idea what I wanted to do with my life. Biology was my default major because my mom is a biologist. A coworker informed me of respiratory school so I decided to give it a try. It was the best decision of my life. I was elected the respiratory club president because of my desire to unite the juniors and seniors. Our club became official this year and our main purpose is to discourage smoking on campus. I’m ACLS, BLS, NRP certified and I just applied for my CRT license. My customer service experience at Stone Mountain Park and MaxGroup developed my patience with people. In school, I rotated through a variety of different hospitals which has given me a versatile experience in the field.

What's your greatest strength? I was elected RT club president so that demonstrates my ability to lead and cooperate with my peers.

What's your greatest weakness? I feel like my voice is not loud enough sometimes. This may be a problem when I encounter older adults who have trouble hearing. I have been communicating more with hand signals and it seems to work more effectively for me.

Why do you want to work here? I chose this particular hospital as a potential career due to its patient population and reputation.

So why am I nervous? There were four position available. Two are taken by classmates. They have orientation starting in a few weeks. One speaks Spanish and the other is a Master RT.

It's not the end of the world if I don't get this job. I would just be severely upset.

Job outlook: not so great

2009-02-03T09:01:00.004-05:00

When I first entered the program, I assured my parents that finding a job will be effortless. Some of my fellow students entered the program solely due to the job outlook being great for respiratory. Now I'm getting a little worried.

Not only is respiratory therapy saturated in the southeast (We have many RT schools that pump out generous amount of students every year), but the economy seems to be getting worse everyday.

The two hospitals that I would've loved to worked for are on a hiring hold right now. The first one is building a new tower that would double their workload. All the therapists there told me that by the time I would graduate, that they would need at least double the therapists. The week before I left, the manager held a meeting. "We're actually going to open up the new tower slowly floor by floor. You guys aren't getting new therapists." What about the workload? "You'll get use to it."

Great.

The second hospital is a baby factory. I went to a meeting and they told us that they were on a hiring hold: 15 interviews within the past month and no hires. Their theroy is that people aren't having babies due to the economy and also a large part of the hispanic population (a large amount of their customers) have decided to move elsewhere. The manger looked at me and asked, "Are you sure you want to hear this right now?"

You know what? I would rather listen to the truth then be hidden under the shield of ignorance. They are cutting hours for respiratory and nurses. Even the nurses are on a temporary hiring hold. You know the economy is bad when a nurse can't find a job.

So now I'm fussing a little. I believe that healthcare is the best position to be in right now, but don't tell me that healthcare recession proof.

I passed the CRT!

2009-01-30T19:26:00.004-05:00

I was nervous when I got my score: 90. >75 is passing. I did better than I had expected. I celebrated and ate pizza. Next step: RRT.

The pros and cons about working with neonates

2009-01-13T16:51:00.003-05:00

I have been on the Resus (short for resuscitation) team for my clinical rotation, not the neonatal intensive care unit. It’s my first time watching a birth: 12 births on day one and 7 births on day two. I think I’ll start NICU next week. I present the pros and cons about working with neonates:

Pro: It’s easy.
Dry, stimulate, suction, heat, ausculate, give baby to mom or take it down to ICU.

Con: It could be boring.
Basically, you sit in a cubicle until you get a call. This hospital requires RTs to be at all c-sections.

Pro: Babies are cute.
…is the general consensus. Parents get excited. Pictures are taken. People laugh and smile.

Con: Watching a baby come out is not cute.

Pro: Only 5% of babies need a little help with oxygen and 1% need extensive care.
Con: That 1% can genuinely make you miserable.

Pro: Exercise.
Con: You walk a lot between your cubicle and the delivery rooms.

Pro: C-sections are usually quick. ~30 minutes.
Con: C-sections smell bad.
The physician uses a cutting tool that burns the flesh. I could never get use to the smell.

Pro: Some RTs believe that if an infant dies, then it’s ok. The baby never had a life to experience.
Con: Some believe that a dead infant is truly heartbreaking because it lost the chance to experience life.

Honestly, I'm not sure how I feel about the Resus team. I don't picture myself working at it all the time. This hospital rotates their employees through the department and that's a good thing.