Everyday Wisdom Applied to Respiratory Care
Carolyn Small, BSRC, RRT-NPS, CPFT 8-21-2024
I recently retired from full-time work as a respiratory care practitioner. With approximately 40 years of experience, I have found that lessons I learned in my youth could be applied to respiratory care as well. Here are five just for starters. I challenge you to apply your own homegrown lessons.
- Check the lid before you shake the orange juice. AKA “Did you check your connections/equipment?”
My dad used to LOVE orange juice, but it had to be the not-from-concentrate variety. The stuff with the pulp. He could drink a 64 ounce jug every day if we had it. As you may know, the juice with pulp requires several good shakes before pouring. I seldom drank it because I prefer to eat my calories.
One day I decided to indulge and have a tall glass of that nectar sweet liquid. I grabbed it from the frig and gave it a big shake. Juice went everywhere. The lid flew across the kitchen and landed in the sink. I was so mad at my dad for not screwing the lid on. I was mad at myself for wasting all that good juice. I was also mad because now I had to clean up that mess. Once I calmed down, I realized I had learned a very valuable lesson. I never made the same mistake again.
How does this translate to the world of respiratory care?
Always check your equipment. Screw the nebulizer together before adding Albuterol. Check the light bulb on your laryngoscope. Make sure your ventilator circuit connections are tight before your pre-use check. Turn the stopcock to the off or on position depending on the situation. Basic stuff, but often overlooked.
2. Make sure it’s sugar before you pour it in your coffee. AKA “Read your label, verify your orders.”
I love a good cup of coffee to start my day. A full body roast, or a bold bean in a cappuccino. I have to limit myself to one cup a day of one or the other because I “season” my java well with a teaspoon or two of sugar and a generous serving of half and half. I enjoy the aroma of the fresh ground beans and the smell of it brewing as it wafts up to my olfactory organ. However, at work, when the sugar and salt packets are right next to each other on the condiment rack, a quick distracted reach could potentially lead to a coffee disaster (and a grumpy RT).
In respiratory care, we may need to use normal saline, 7% hypertonic saline, 3% sodium chloride, or sterile water. What medication is ordered? Albuterol, Atrovent, Duoneb? Regular dose, double dose? Check your orders. Read the labels. It is almost dummy proof now with electronic health records and bar code scanning, but errors still happen.
3. Don’t forget your jacket! AKA “Do you have your PPE?”
I grew up in Minnesota, so this was something I heard a lot. The days would be beautiful and sunny, but as the sun set, the nights would get cold. Even if we were just going to the grocery store, my mom would always call out for us to bring a jacket. As teenagers, we would roll our eyes and scoff. Nevertheless, it was good advice. She really was just teaching us to be prepared.
In practice, that translates into always having personal protective equipment on hand and available. Wearing gloves should be second nature. We don them for all patient encounters. During the COVID pandemic, we were mandated to wear masks. Prior to COVID, I had believed that masks should be standard precautions in the emergency department as respiratory care practitioners. I have contracted RSV every winter in the Peds ED by exposure during treatments given to coughing kids.
Our job involves asking people to deep breathe and cough. This should not be a political issue. It is simply common sense. Reducing exposure to any bacteria or virus is good for you and your family. Keep a mask in your pocket.
4. Follow the directions. AKA “What’s the next step?”
Whether you’re making cupcakes, working on model airplanes, or putting together an Ikea shelf, directions are there for a reason. Follow them step by step. Shortcuts lead to mistakes and frustration. The result can be flat cupcakes, an abandoned project, or crooked shelves.
In health care, shortcuts can cause harm and are potentially life threatening. Do the Allen’s test prior to an ABG. Perform a pre-use check on your ventilators. Do the leak test. Calibrate your equipment. I am not ashamed to admit that I have referred to operators’ manuals when setting up equipment that I have not used in a while. I have also downloaded manuals onto my phone for quick reference. There are YouTubes for literally everything. Many equipment manufacturers have apps for quick reference.
5. Bloom where you’re planted. AKA “Be your best self.”
This is something my grandmother would tell me. My grandparents lived in the country. Their garden fed them all year. They ate fresh produce in the summer and canned goods throughout the winter. They also raised chickens and milk cows for their subsistence. They worked hard but always seemed content. I wondered if they ever wished for a more comfortable life.
I have worked in hospitals in Minnesota, Iowa, the East Coast, and finally settled in Las Vegas, Nevada. I never planned on staying in Las Vegas beyond a couple years. I have now been here for over twenty. I have pondered this saying many times over the past 20 years. When I became restless, wishing for change, I thought of my grandmother. I chose to bloom where I was planted. My job became the ground for my root system. I bloomed with my work family. I chose to keep current on the latest research and best practice, incorporating it into my job as I was able.
Wherever you are, be the best respiratory therapist you can be. Grow in whatever environment you find yourself. Even a desert has life. You must be that thriving stalk with a strong root system of knowledge. You will gain new branches with each passing year. That does not mean you have to feel stuck in your job, just thrive wherever you find yourself.
