Advancing the profession of respiratory therapy: from “tank jockey” to highly skilled clinician in 60 years
Submitted by Christopher Gagnon, Professional Practice Leader, Respiratory Therapy
"Advancing the Profession" is this year’s theme for national Respiratory Therapy Week, which takes place from October 21 - 27. Respiratory Therapists at Providence Health Care (PHC), both past and present, have been at the forefront of advancing the profession from its humble beginnings to where it is today.
The health care professionals we know as Respiratory Therapists first emerged on the scene as inhalation assistants in the 1950’s and were little more than “tank jockeys”, responsible for the delivery, set-up and exchange of oxygen cylinders throughout the hospital. Over the next 60 years the field has progressed rapidly with knowledge and technology, into a profession that patients and health care providers rely on every day.
Today’s Respiratory Therapists are valued as integral members of the health care team, with an advanced and specialized body of knowledge, plus a unique and adaptable skill set. They work in all aspects of the health care spectrum -- from critical care to chronic disease management to end of life care, and serving all age groups, ranging from neonates to the elderly. Respiratory Therapists provide expert pulmonary and airway support, ventilation management, diagnostic assessments, and patient education.
At PHC there are two distinct teams of Respiratory Therapists: those who work in Acute Care and those who work in Diagnostics/Community.
The Acute Care Respiratory Team
The Acute Care respiratory team is comprised of approximately 50 therapists working to provide care across all areas of the patient journey. Often the first point of contact is in critical care areas such as Emergency and ICU where Respiratory Therapists provide care to the sickest patients with complex respiratory and cardiac issues. Respiratory Therapists play an integral role in weaning patients from the mechanical ventilation that they often require during critical care, and they also provide ongoing care to these patients as they transition from critical care to the hospital ward. Respiratory Therapists who work on the medical and surgical wards collaborate with multidisciplinary team members to support a seamless transition to the community when patients are healthy enough to return home. Respiratory Therapists also work in the Bronchoscopy Suite, where they assist the Respirologist in providing diagnostic, therapeutic and advanced interventional bronchoscopy services, including endobronchial ultrasound guided bronchoscopy as well as the placement of airway stents in the OR.
The Diagnostics/Community Respiratory Team
The Diagnostics/Community respiratory team is a diverse and active group of 12 therapists specializing in pulmonary diagnostics and disease prevention. They perform the full range of diagnostic testing from basic spirometry to body box plethysmography, cardiopulmonary exercise assessments and altitude testing. Also associated with this team is the Respiratory Patient Educator who provides ongoing education and follow-up with patients on a variety of diseases including asthma, COPD and interstitial lung disease. The Respiratory Patient Educator plays an important role in promoting self-management, preventing disease flare-ups and reducing hospital admissions.
The role that Respiratory Therapists play in evidence-based research has evolved considerably, with therapists advancing beyond their traditional participation as research assistants to primary investigators with their own research teams. At PHC, Respiratory Therapists have led and also been a part of teams in several Research Challenge cohorts. Partnership with other research groups, such as physician-led projects in Respirology and in Critical Care, allow front-line Respiratory Therapists to be at the forefront of advances in respiratory care and their profession.
Thoughts on Advancing the Profession from The PHC Respiratory Therapy Leadership Team:
- “Sometimes Respiratory Therapists are their own worst enemy when it comes to advancing the profession. As a small and relatively young, lesser-known profession, we often struggle to find our place in the health care system and may question the value that we offer. Yet if we just take a moment to pause and look around at each of our RT colleagues in action we see just how untrue that really is. Respiratory Therapists offer great value to the system, and the contributions Respiratory Therapists make towards improving health care are immeasurable. This is what advances the profession.” -- Christopher Gagnon, Professional Practice Leader, Respiratory Therapy
- "One of the most rewarding parts of my role is the opportunity to help facilitate the transition from hospital to the community setting for patients with complex respiratory needs. I think RTs have a unique role and responsibility in supporting the evolution of our health care system from one that is centered around acute care service delivery to one that promotes living well at home. Adopting this vision across the spectrum in which we practice as Respiratory Therapists is one of the most valuable ways we are advancing our profession." -- Lena Farina, Respiratory Therapy Site Leader
- “I started my career 28 years ago when vacuum tubes and bellows were a major part of a ventilator; everything is now microprocessors with capabilities that would have blown my mind in 1990. Medical science has been accelerating in both knowledge and technique so rapidly that ongoing education for frontline staff to stay current is essential to keep advancing the profession.” -- Dave Sima, Respiratory Therapy Research, Education & Practice Coordinator
- “Traditionally the work of diagnostic RTs had been more technician-like, but I believe as therapists, we have so much more to offer. I see it in the brief interventions we have with patients that really matters: speaking to someone about the risks of vaping, how to reduce symptoms associated with forest fire smoke, or recognizing the signs and symptoms of an exacerbation. As the model for health care delivery shifts to a focus for health promotion and disease prevention, I am really excited for the possibilities for our profession to take part in that.” -- Maria Li, Pulmonary Diagnostics Coordinator
- “St. Paul’s is a clinical site for student Respiratory Therapists which provides our staff the opportunity to guide the next generation of respiratory therapists. Having students year round makes education a constant component to our department. Our front line staff are always challenged to be at the cutting edge of best practice and they are always willing to learn and grow in how we provide care to our patients.” -- Hannah Tighe, Clinical Site Coordinator
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