Top Gun is, of course, one of the quintessential '80s movies. Tom Cruise plays Maverick, a young Navy pilot with boundless self-confidence and a fair bit of charisma (some argue that he is, in fact, playing Tom Cruise). After causing some havoc aboard his home-base aircraft carrier, Maverick and his best friend/radio intercept officer Goose (Anthony Edwards) are sent off to the Navy Fighter Weapons School, also called Top Gun, for advanced training against some of the best pilots in the world.
Eager (some might say desperate) to demonstrate his prowess, Maverick flies right at the edge of the performance envelope. This earns him the awe of some and the ire of others, notably rival pilot Iceman and the Top Gun instructors themselves. Despite being called arrogant and dangerous, Maverick continues to push harder and harder, even to the point of bending/breaking the rules to prove just how great a pilot he is.
He keeps pushing right up to the point disaster strikes. Wanting to get a "kill" on one the Top Gun instructors, Maverick impatiently pressures Iceman to get out of his way, and in his haste, flies too close to Iceman's jet exhaust. This causes one of his engines to stall and his jet to go into an unrecoverable spin. Maverick and Goose eject, but Goose collides with the F-14's canopy, breaking his neck and killing him.
Much like Maverick, respiratory therapists tend to have a pretty high degree of confidence in ourselves and our abilities. Indeed, to a certain degree, this confidence is warranted; we receive highly specialized training, which often goes under-utilized and unnoticed by others, so it can be a self-protective measure as well. But we cannot lose sight of the fact that we are still a part of a team. We should not be afraid to stand up for ourselves, but we also must be cautious to stay in our own lane, too.
Recently, a fellow RT told me a story about working in a very small, rural hospital with an attached skilled nursing facility (SNF) that serviced a particular patient population. (Yes, I'm keeping this rather vague. Feel free to consider it a hypothetical, if you want.) This SNF had a standing unofficial policy to decline any patient with a tracheotomy, as it had no respiratory therapy department of its own and hospital's RTs, by policy, only responded to emergencies there. However, a trach patient who was otherwise an ideal candidate came up for admission. Some of the administrators asked the RT department if they could handle the patient, despite neither the SNF nor the hospital having worked with one to any degree for the past several years. The RT leadership decided to jump on board, and over the objections of the nursing staff and their administrative team, the patient was accepted.
This failure of cooperation led to a variety of miscommunications, blame assignments, coordination and logistics issues, and outright anger on all sides. The RTs were asked to see this patient in the SNF, against hospital policy. The nurses had little to no experience or comfort with trachs, and all of their established competencies had lapsed. Because this patient was admitted quickly, there was no time to review policies, procedures, or competencies prior to admission, and because nursing administration was unhappy about the process, they dragged their feet getting the nurses trained and checkoffs completed. The hospital RT department had no real competency checks for suctioning or equipment, and many of the RTs didn't feel comfortable providing care without any refresher or training. Despite these concerns, the RTs were told simply, "We're respiratory therapists. You were taught this in school. You'll be fine."
Fortunately, this decision did not have any long-term effects on the patient, although the inexperience of one therapist did result in unnecessary testing and days of patient discomfort, as their trach tube cuff was inflated for days with no apparent indication as debate continued about the proper course of treatment. However, the arrogance of accepting a patient over the concerns of many stakeholders and with insufficient preparation simply because "we're respiratory therapists" could have resulted in disaster, as it did for Maverick. The department was quite fortunate to have escaped with only bruised feelings and not a significant incident, or possibly even a sentinel event due to poor communication or education failure.
We must remember, above all else, that no matter what our training and skills are, we are still part of a healthcare team. We do need a certain degree of confidence in order to do our jobs, but we cannot let that confidence blind us to the needs and concerns of our interdisciplinary colleagues. Failing to do this absolutely destroys our credibility and any regard those colleagues have for us. Similarly, we MUST stop tearing down other disciplines in break rooms and Facebook groups when they misapply an oxygen mask or connect tubing in a strange way. These are teachable moments, not mockable ones, and taking a moment to be a teammate will go a long way to help our causes later on.
In the end, after a crisis of confidence and some additional experience, Maverick learns to temper his pride and rely more upon the skills of others in order to win the day. He turns his former adversary Iceman into an ally, bickering about who's the lead and who's the wingman, is invited back to Top Gun as an instructor, and gets the girl. We need to make sure we get ourselves on this trajectory, before our collective mouth starts writing checks our profession can't cash.