Respect of Respiratory Therapist, where has it gone??

By Pamela Jenkins, RRT, CPFT posted 02-03-2011 13:29

Hello Respiratory community, I am addressing a topic that I believe to be on the minds of many respiratory therapist, who are curious to wonder what happened to the respect of Respiratory Therapists in the healthcare world. I work with many RNs and physicians, and from my education knowledge, we were taught to be proud of our profession and to know what we know and to practice our profession with the highest quality of knowledge and confidence. But in my experience of performing my job, I have come to realize that as a therapist, RTs are looked over in the medical field. Now dont miconstrue the situation, this may not go on in all medical places, but I think that when there is a ventilator patient involved, and there is a RN, a physician, and a RT standing in the room discussing this pt, I feel that respiratory should be included in that conversation, rather than the RN and physician standing there and talking about what they want done for the patient on a respiratory standpoint, and not including the RT, who is standing there being an onlooker. SO what do we as respiratory therapist do? How did such an an important profession lose respect? Is this normal. Or how about when u offer your evidence based opinion about the well being of a patient, your medical opinion falls on deaf ears. It has been a concern of mines, and I just wonder why this is so. I look to hear any comments to help me understand why this is so.



Most of the time I think it's a value added situation:When the 'RT' is discussing the patient, are they ready to discuss (argue) the blood gas based on the anion gap, strong ion difference or the henderson-hasselbach equation (how many of your RT's actually carry a calculator in their pockets?)
Can the RT argue vent changes based on the graphics on the ventilator? Based on the pathology of the patient? Can they discuss the need for nutritional stabilization, do they assess caloric needs?
Even though "We're the professionals!", most RT's don't know more about respiratory than the Doctors do. We use oxygen all the time, but how many RT's know what 02 does at the cellular level and the evolving nature of reactive oxygen species?
The Profession begins and maintains it's people at the Associate degree level. (It is still an interesting and entertaining discussion when someone jumps up in any group of RT's and says " RRT's are better than CRT's".) I would bet half the nurses in your facility have their bachelors degrees, are working toward them or their Masters. Just as I would bet that most RT;s are sitting happily on the credential they earned, and on their collective associate degrees.
My experience is most Doctors are nice enough to involve RT (not because they actually learn something but to help promote a team effort), but sometimes they don't have the time.
Know more about respiratory than the Doctors you work with, become a resource.
Even then, sometimes it won't matter. It's the nature of people and the nature of medicine.
Mike (30 years experience, 1 1/2 masters degrees, 7 credentials, and still arguing with CRT's,RNs and MDs. :))
I can only echo the responses already given. I do understand your frustration. Many RTs are at their job to do as little as they can and get paid as much as they can. These are also the same RTs that complain about how bad they have it. It is true that without Directors assistance it is difficult for a line employee to drive improvement from the bottom up. As far as getting staff to attend education sessions you might try developing a topic and work to get CE approval from your state or national Associations. The staff will show up for free CEs.
As far as gaining respect I follow the concept that no one can disrespect me unless I allow them to. So you can always at least control the respect given to you by your actions. But respect is more difficult to achieve department wide. It takes a long time and comes not from a few big efforts but from a million little efforts done every day. Such as every RT in the hospital going to the cafeteria for meals and leaving the entire hospital uncovered looses respect. Or complaining when a nurse calls with a new order or request for help. As far as the Dr, be there before he shows with the chart in your hand with suggestions for patient improvement. Sure it will be scary at first, but it gets easier each time you speak up for your patient. Another tactic might be helping your partner nurse when she needs you for patient care that doesn’t directly involve you. When you offer to help her, you are saying you understand her job is important enough for you to spend time assisting, as any good partner would. Eventually she will do the same for you Often I find that it us, against the nurses. In reality my partner nurse is more important to me in delivering good patient care than my fellow RTs. I have always believed that a good RT with a good partner nurse is really the most important team in the hospital when it comes to saving lives.
I take heart in concerns since it shows that you know what right should looks like even if you don’t see it every day at your job. Recognizing the problem is half the battle. Keep trying. Even if you fall flat on your face, that’s a forward direction.

02-04-2011 11:21

I am curious about the comment "the RT standing there as an onlooker". Who made the RT the onlooker and not the participant, it was surely not the physician or the RN. RT's do not lose respect , we give it away simply because respect is not " given freely" it is much earned. As a supervisor I observe some therapists who are very forceful, opiniated in Multidisciplinary Rounds. They will not let the RN speak about their patients, others just stand in the line. No one made them the onlooker there. If you offer EBP to your medical director and it is ignored why do you feel it is a slight to our profession? The solution is offer more , we must educate ourselves on how to research the best practice and how to speak to physicians on that level. When callling about patients, use proper SBAR for any changes we may want. More importantly all RT programs should move towards RCP protocols - train our therapists to be critical thinkers and the make the decision. One of my pulmonologists told me that all he wants is an "RT who knows what they are talking about to tell him what to do". Join hospital committees that do not only involve RT, attend those nursing meetings, learn, learn and learn some more. In today's new healthcare world never has it been so important to recognize the "team" approach but at the same time recognize the expertise of each member of that team. In my 30 years as an RT I have never had to ask for respect from anyone I work with. I truly hope that I earn that respect with my work ethic. Finally by joining AARC and utilizing all of it's many resources , the training is in the very organization you are asking the question. Respect yourself and your profession first and the rest will follow. My Thoughts, Sharon
"Respect is not for free, we have to earn it with knowledge". Since working for an Staffing Agency got the chance to work at many diferent facilities and with many different RT. I've seen the very good ones and the ones that sometimes I wonder how could they get their licenses.... We always have some conflict of power with RNs or LVNs and that is the root of many issues cause instead if being arguing we should realize that we are on the same boat and row together respecting each others position and area of expertise.
I've seen people that really like and enjoy the profession and that people gives us respect and worries about keeping themselves always updated with the latest technologies and strategies. Other goes to work cause it is easy money...come on giving an HHN is not such a challenge...that people really suck, seen people going to work dressing unprofessionally...people that don't care more than about themselves "read mi blog post about the workload I had to face..."
What I can tell you for sure is that RN and patients know swho is the good RT and who is the one that really suck...when an RN knows that you are good they respect you cause they know that with you by their side nothing bad gonna hapen and if it does you will solve it.
Also we need to get more credentials, nowadays you can graduate in a year and half form a private school when we should be required at least a Bachelors degree !!!
After 40 years in this business we have evolved from oxygen orderlies to our current state of practice. I realize there are many frustrating moments as a Respiratory Therapist but to specifically address your observations is a very complex answer so I am going to give a simplified answer. Respect is earned through many avenues. We sometimes are our own worst enemies. As a professional we first need to live by our own code of ethics and conduct which can be found on the AARC web site by a simple search. I wonder how many RT's even knows this exists much less review on an annual basis? Diversify your skills and be involved in the profession on many levels, network with health care professionals, be involved on hospital committes, grand rounds, discharge planning, in-service presentations to the physicians, nursing staff and the list goes on. This is how we EARN respect!