Respiratory Therapists

Transcription

1 SOC : Assess, treat, and care for patients with breathing disorders. Assume primary responsibility for all respiratory care modalities, including the supervision of respiratory therapy technicians. Introduction Respiratory care workers called respiratory care practitioners, certified respiratory therapists, or registered respiratory therapists, depending upon their qualifications evaluate, treat, and provide education to patients who have chronic illnesses, are receiving surgery, or are unable to breathe on their own and are permanently reliant upon breathing apparatuses or life support. In addition to assessing patients vital signs and responses to therapy, respiratory care workers must monitor lung capacity, work to prevent respiratory infections, and maintain artificial airways such as tracheotomies and intubation tubes. Gathering, analyzing and interpreting chest X-rays and sputum samples and other tests is a regular part of the occupation, as is analyzing blood specimens to determine oxygen and carbon dioxide levels. Nature of the Work Respiratory care workers work under the direction of a physician to manage the care of their patients, from diagnosing and evaluating needs to treating, educating, and participating in the rehabilitation of patients. Their scope of practice includes providing care for incidents of asthma, pulmonary edema, emphysema, and other conditions, as well as emergency care and resuscitation for those who have experienced heart failure, stroke, asphyxiation, drowning, and various forms of shock. Treatments include providing patients with mechanical ventilation, administering aerosol medications, and operating and maintaining highly complex ventilation equipment. Those in respiratory care must be able to solve basic mathematical problems and be able to compute medication dosages and calculate gas concentrations. Intensive care unit respiratory care workers may have three to six patients to care for per shift, while practitioners in non-acute departments may have five to fifteen patients on their caseload. Home healthcare respiratory care workers have caseloads of patients for whom they create a plan of care. They set up in-home ventilators and train patients and family members in patient care and maintenance of a ventilator or other equipment. Respiratory care workers meet with patients as advisors, instructors, and hands-on therapists. They do a great deal of teaching families how to care for their loved ones. Some teach respiratory education and smoking prevention courses to patients in medical facilities or the community. Respiratory care workers are needed around the clock due to the ongoing nature of urgent patient care. Most hospital respiratory care workers work three 12-hour shifts per week, but others work variations on a 35- to 40-hour per week schedule. Shifts may be scheduled for day, evening, or night. Many home healthcare workers work a 40-hour, Monday-through-Friday schedule. Some respiratory care workers work part time, while others choose to work per diem shifts at one or more hospitals, which may pay better in lieu of a lack of benefits packages. A fair number of workers who have permanent, full-time jobs will also pick up a regular per diem shift with another medical facility or work on an on-call basis to supplement their income. The vast majority of respiratory care workers work in hospital departments. Others work in clinics, doctors offices, nursing homes, research centers, sleep-study laboratories, and home healthcare settings. Some also work for respiratory equipment companies as advisors, sales representatives, or providers of technical support and education. Job Requirements Skills/Characteristics Since respiratory care workers, along with nurses, are the most common healthcare providers working directly at patients bedsides, they must have a love of helping people and a compassionate man- 125

2 Knowledge, Skills & Abilities ner. Respiratory care workers become advocates for patients care. They need to be able to work with patients with severe medical disabilities and their emotional families, and experience the death of their patients at times. Most feel that it is important for respiratory care workers to see themselves as healers and be fully invested in their work as more than simply a job. Because they often work in a small team comprised of a doctor and a nurse for acute patient needs, they must have the ability to make compromises and possess strong interpersonal skills. They work independently as well, so must be able to manage their time and tasks. Excellent respiratory care workers take the initiative, are highly motivated, disciplined, have attention to detail, are comfortable using computers and equipment, and are able to make decisions quickly in often highly stressful situations. Respiratory care workers must stay apprised of new developments and relevant case studies that will improve their skills and knowledge for optimum patient care. Training/Experience This occupation is in demand not only by employers, but also by those wanting to enter the field. Training providers are not able to matriculate as many students as apply to their programs, so it is essential for candidates to be persistent, obtain the necessary prerequisites, and be well prepared for the rigorous education and training program. In order to enter this field, one must complete an associate s degree along with a state-approved respiratory care training program. Programs generally consist of college semester units of education, including science and mathematics. In addition to classroom training, students will learn in a laboratory and clinical setting. Courses specific to respiratory care include technical education related to therapeutic and diagnostic procedures and ventilation equipment, patient assessment, cardiopulmonary resuscitation (CPR), cardiac and pulmonary rehabilitation, respiratory health promotion, casework, and medical recordkeeping. In order to get a state license, students must complete their prerequisites and respiratory care curriculum with at least a C average, although those with better overall academic performance are more likely to pass the licensing exam. In order to practice in a particular specialty, respiratory care practitioners must seek out advanced certification through the National Board for Respiratory Care. 100% 80% 60% 40% 20% 0% Knowledge Medicine and dentistry Customer and personal services Education and training Psychology English language Biology Skills Active listening Instructing Reading comprehension Critical thinking Monitoring Time management Abilities Oral comprehension Oral expression Problem sensitivity Speech clarity Speech recognition Inductive reasoning Top Employing Industries (California) 126

3 Employment Recruitment/Hiring The existing vacancy rate of respiratory care workers will increase in the coming years as many currently employed in this occupation approach retirement. In addition, the number of seniors in the U.S. in the coming years is expected to be the greatest than at any time in the nation s history, which will increase the long-term need for respiratory services. While this occupation is predominantly female, there is a higher percentage of male respiratory care workers than for several other allied healthcare occupations. Recruitment occurs in a number of ways medical facilities post job announcements online on job-search Web sites and in local periodicals, have booths at career fairs, and have direct contact with training providers. Because of the great demand in California, most respiratory care workers are hired just as they complete their training and gain licensure, and some receive job offers while they are completing their clinical education. Many medical facilities offer sign-on bonuses as an incentive to newly hired respiratory care workers. Licensure/Certification Upon completion of the education and training program, graduates are eligible to take the license examination with the Respiratory Care Board of California to become a respiratory care practitioner (RCP). Should an RCP wish to gain national certification, they are eligible to take a voluntary exam with the National Board for Respiratory Care (NBRC) for a certified respiratory therapist (CRT) credential. Both of these classifications are considered entry level. If an RCP/CRT would like to advance their career, they can take the Advanced Level Practitioner Examination with the NBRC to become a registered respiratory therapist (RRT). Preparation for the RRT exam involves either completing an advanced training program or combining work experience with additional education. California licenses must be renewed every two years. Continuing education requirements include 15 units to be completed with a live instructor (as opposed to distance-learning formats). Some medical facilities provide additional on-site training in new respiratory care developments, as many as 40 hours of paid training per year. Benefits & Challenges Respiratory care workers can sometimes work under highly stressful conditions, particularly in the emergency room or intensive care. Due to the gravity caused by breathing problems, they may encounter situations in which they have to think and act very quickly in order to save a patient s life. Respiratory care workers inevitably lose patients at times. Like other healthcare providers, respiratory care workers learn over time to compartmentalize their emotions while they help other patients and continue their work. Physical concerns include quite a bit of standing and walking during work. Respiratory care workers use high-pressure oxygen and other gas tanks, which can be hazardous. These workers are trained in strict safety protocols, including precautions to prevent contracting infectious diseases. Other challenges include the impact on schedules and caseloads due to staffing shortages. Because those in this occupation are important members of critical care teams, they often have to do triage to prioritize patient needs. The shortages lead to increased wait times for patients and reduce the amount of time respiratory care workers are able to spend with them, thus reducing the quality of care. One benefit to the shortage of workers in this field is that there may be opportunities for sign-on bonuses and overtime work. Respiratory care workers believe that their work is a powerful contribution to the healthcare field. They get great satisfaction from providing healing services to patients. Over time, they often develop friendships with their patients and their families. However, some patients with acute needs are cared for in the emergency room and then are discharged from the hospital, which doesn t allow for an ongoing healthcare provider-patient relationship. Home healthcare respiratory care workers sometimes enjoy having an ongoing relationship with a patient and their family, though this familiarity can cause the death of a patient to be even more painful. 127

4 The hours can be great in terms of having time off those who work three 12-hour shifts have four days in the week to spend with their families or to hold other jobs. Education Distribution Career Ladders & Lattices Most respiratory care workers begin working in general care and then advance to working with critical patients who have multiple medical problems. If a respiratory care worker advances their credentials to become a registered respiratory therapist (RRT), they can seek employment as a respiratory supervisor, though some dedicated respiratory care workers will successfully become supervisors without this credential. Respiratory managers are a level above supervisors, and one should be an RRT to seek employment for this position. Those with four-year college degrees will have the best chances to become respiratory managers. Clinical coordinators must be RRTs and possess a bachelor s degree. Some respiratory care workers with special qualifications become student or clinical educators. Greater opportunities may exist for those with experience in cardiopulmonary care or working in neonatal settings. Because some hospitals and medical facilities are beginning to cross train their healthcare staff, other opportunities may arise as practitioners gain experience. Some respiratory care workers transition to other healthcare occupations, such as nurses or physicians assistants. $60 $50 $40 $30 $20 Occupational Wages $10 $0 $60 $50 $40 $30 $20 $10 $0 128

5 1. Please tell us about your current position and how you arrived there. I knew I wanted to get in the medical field when I was in college, but I didn t want to go through all of the training to become a doctor. My college counselor suggested I look into respiratory therapy work. I then went to Foothill College for an associate degree in respiratory therapy. I began working as a respiratory therapist, and after some time I became a shift supervisor. Because of my interest in management, I earned a BS in Business at San José State University. Following my university work, I worked as a respiratory therapy manager. I then worked in administration in respiratory home care and as a surveyor for home care accreditation. I have been the director of this hospital s Respiratory Care Department since May Please describe your typical workday so that a job seeker might get a sense of what you actually do. Work in respiratory therapy varies quite a bit. A respiratory therapist might work with medication aerosols, ventilators, and with code teams groups of physicians in the ER (emergency room). There is a lot of teaching families how to care for their children and loved ones. A respiratory therapist acts as an advisor, instructor, and a hands-on therapist. We see different kinds of patients throughout the day and consult with physicians on a daily basis. Michael Henry, BS, RRT, RCP Director, Respiratory Care Department 3. Which aspects of your education and/or training made you more capable or marketable in this field? Having an AS degree in respiratory therapy is required for work in this field. It is much less common to have a bachelor s degree in the respiratory therapy field. Having a BS in business helped me move into the management level for respiratory care. Training is adequate preparation for working in pediatrics, which is the focus of my current employer. 4. What are the most exciting aspects of your job? What do you like most about your job? I enjoy working as part of a team that includes a physician, a registered nurse, and a respiratory therapist. This core group works together for acute patient needs. I like the breadth of job skills needed in order to perform the work well. 5. What do you dislike or find challenging about your job? Short-staffing impacts respiratory care quite a bit. The shortage of respiratory therapists can really impact the ability of respiratory therapists to help patients. It requires that they prioritize what they are able to get done in a shorter amount of time. 6. What advice would you give to a person seeking a job in your field? For those wanting to get into a career in respiratory care, you need to be able to deal with people with severe medical disabilities, distressed family members, and at times, the death of patients. This work can be highly stressful. There is a personal impact of the work because it can be emotional you must be able to compartmentalize work and home life. You cannot take work home; you really need to be detached from patients even though you are working with them and providing for their care. 129

6 7. What qualities make someone a star performer in this occupation? The qualities that make someone a star performer in respiratory therapy include both skills and knowledge. You must be interested in staying current in medical advances and technology, as it is very easy to fall behind in what is current in the field, especially in a university training environment. You must be self motivated and disciplined. It is also important to work well in a team, have the ability to compromise, and have good interpersonal skills. In addition, a star performer must have compassion for patients and family, and be willing to become an advocate for patients premium care. 130

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