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The Seven Deadly Sins of Respiratory Care: Fear

By Mike Hess posted 10-20-2016 15:45

  

In 2015, I wrote a series of blog posts covering what I saw were the major issues facing our profession.  Now, a year later, I'm revisiting these posts and sharing them with a new audience, because they appear to be as relevant today as they were two summers ago.  I welcome any and all feedback!

"Fear is the path to the Dark Side.  Fear leads to anger.  Anger leads to hate.  Hate leads to suffering."

                    --Jedi Master Yoda

We're afraid.

It's not something we want to hear as therapists, but it's time for some tough talk about the future of respiratory care.  Fear seems to stalk the background of much of what we do as a profession.  We're afraid of alienating other professions, so we don't fight for stronger license protections.  We're afraid of alienating small pockets of old-school, on-the-job trained therapists, so we drag our feet when it comes to fixing our desperately broken credentialing system.  We're often afraid of pushing back against physicians who order things we know are inappropriate, or nurses who demand things that are unnecessary.  We certainly seem to be afraid of leaving the shelter of our relative anonymity, and instead are content to lurk in the shadows of healthcare where nobody knows our name.  

Why? 

We know that we improve outcomes and efficiency when our expertise and knowledge are put to use.  Whether it's in the inpatient space or the outpatient world, our services have never been shown to be anything but a tremendous asset to healthcare systems that deploy us appropriately.  So how is it we're still essentially unknown and uncelebrated?  In any other industry, a profession that routinely saves organizations tens (sometimes even hundreds) of millions of dollars annually over the course of decades would be publicly hailed as game-changers, paradigm-shifters, or any of a dozen other praiseworthy buzzwords.  So how is it that huge parts of the health and hospital industry barely knows we exist?

Some of it seems to be rooted in the darker parts of the profession that we don't like to talk about, like those parts where treatments are given because it's too much trouble to go against a nurse or doctor who orders unnecessary aerosols.  It's so much easier to just go with the flow.  Who needs to have their day or night ruined with conflict  Better to not rock the boat, and just blow some albuterol that (probably) won't hurt.  Unfortunately, while this fear doesn't necessarily lead to anger or hate, it has most certainly led to suffering, because conflict avoidance has become an ingrained part of our professional culture.  If we don't want to make one nurse mad by questioning their suggestion, we sure don't want to make ALL of them mad by declaring certain therapies off-limits, right?  

It doesn't take a Jedi master to see how this mindset holds us back.  Many of our licenses are relatively toothless, allowing nurses, EMTs and other disciplines to take jobs away from respiratory therapists and relegating us to afterthought clinicians in when it comes time for "system redesigns" and other cost-cutting measures.  Even in cases where RCPs aren't overtly eliminated, our timidity and reluctance to step out of our comfort zone prevents us from taking our rightful seat at the administrative table, and mutes our voice.  It's also yet another barrier standing in the way of us making bigger strides in the outpatient sector, where our next opportunity for growth truly lies.  Our fear may jeopardize this opportunity, much as our apathy has led us to largely miss the boat on tobacco cessation (despite Sam Giordano's prescient warning a decade and a half ago)

We need to start working right now to cast aside fear and embrace our inner Jedi Knight.  We must stand courageous in the face of adversity, and not shy away from (respectful) conflicts with our fellow clinicians.  Nobody is going to give us the things we want and need to survive as a profession, so let act boldly, and let fortune favor the bold.

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03-29-2017 18:15

Very good read especially for a new grad like myself.

10-21-2016 03:34

Mike,

That's about the truth! I'm an older RRT-NPS with a MSRT degree that I acquired last year and over 35 years in the field. I still believe in learning and furthering the RT field. However, most of my staff would rather sit on their butts, than do anything for the patient. (RT, get ice, water or empty urinals). Granted some are CRTT's with 20 years experience (one said I don't want to do ABG's and I refuse an in-service) others are younger and believe they know everything, but are afraid to put any effort in learning more or helping patients. 

Thanks!!

David