People: Respiratory Therapists
The extraordinary unsung heroes of the Covid world…
Air hungry…
I believe that the Respiratory Therapist deserves at least a few minutes of reflection to tell their story.
Respiratory Therapists are one of many unsung heroes in the medical world, essentially unrecognized and invisible to the outside world. They were one of the shinning stars in the Covid years. They are a group of highly skilled clinicians whose work focuses on the management of maintaining and supporting the changing breathing demands of all patients, of all ages, who struggle to breathe normally and/or independently due to a myriad of challenges.
In the COVID years, a time of great fear, stress, uncertainty and acute demands for medical intervention, there were increasing demands for the expertise of the Respiratory Therapist, who provided highly specialized and lifesaving pulmonary treatment and management. Respiratory Therapists were mostly unknown to those outside of the medical setting, even though they often worked laboriously side by side with a mixed team of Nurses, Nurse Practitioners, Physician Assistants, Doctors, Hospitalists, Critical Care Specialists and Surgeons working in collaboration with one another, integrating their specialized knowledge to provide life saving pulmonary outcomes.
Respiratory Therapists as pulmonary clinical specialists have expert level skills in the treatment and complex management of all things pulmonary. In the larger tertiary medical centers they may choose to work in multidisciplinary teams delivering directed specialist care in only one area, such as pediatrics or neonatology. In the smaller community hospitals they offer care wherever needed, which at times may include patient transport to the larger more complex and specialized medical centers. They are omni-present in the health care setting. They are an integral member of clinical teams working collaboratively, with Physician oversight to manage, triage, monitor and report the levels of needed intervention for all breathing issues.
The need for the Respiratory Therapists intervention is always pulmonary related. It can include management and treatment of a new developing pulmonary infection or disease process which may include but are not limited to: COVID related infections; chronic pulmonary disease that is worsening (like Asthma, COPD/Emphysema); a premature birth with critically undeveloped lung function; and traumas brought on by unforeseen accidents of nature and self. If there is a critical pulmonary injury, a problematic birth, a neonatal emergency, an asthmatic starving for air, a COPD patient tiring, exhausted and ready to collapse, you will find a Respiratory Therapist at the bedside. They are present in the ER following a suicidal attempt, overdose, trauma cases and all scenarios that can compromise adequate breathing function requiring breathing support. You will find them in the ICU’s, OR’s, pediatric units, neonatal intensive care nurseries, in adult and geriatric care units, oncology units, out-patient rehabilitation, in Pulmonary Function Testing labs, on ECMO teams, on lung transplant teams, on hemodynamic teams, on patient trauma transport teams (in helicopters and on ambulances), in the home care setting, in the Pulmonologist office and in educational institutions. Phew…and even with all that said, I may have even missed some venues where the Respiratory Therapists are being called upon for pulmonary support, the core of their clinical practice. Again, unfortunately, outside of the medical setting, they remain mostly unrecognized for their knowledge, experience, expertise, and worth.
Thinking back to the crazy Covid reality that we all inhabited not so long ago, there were many who required hospitalization and critical intervention due to rapid and unanticipated viral downward spirals leading to decreasing oxygenation, hypoxemia and pulmonary emergencies. In these scenarios Respiratory Therapists and the entire medical team worked together to make decisions in providing life saving breathing support via both non mechanical and mechanical ventilation. These intensive supportive strategies were tantamount to patient survival during the COVID pandemic. The Respiratory Therapist was one of the critical drivers of this management as well as follow up care. Yet how often did you hear of the Respiratory Therapist as one of the front line clinicians providing care? How often, if at all, did we hear of them in the news, in the papers, on the Internet, on the TV, radio, or during the many Covid updates by the State and Government?
Today Respiratory Therapists continue to work in this highly specialized arena of medicine. They love their work, and are dedicated to contribute and labor for positive outcomes, improved functioning and life. It is as simple as that. They are not there for the money, because there is very poor monetary compensation when compared to their colleagues. They are not there for the glory, because obviously that does not currently exist, as only a few outside of the medical setting know who they are and what they do. They are not there for the perks, for no traditional perks exist in the not-for-profit work world. I think it would be fair to say that their perks are deeply embedded in the pure joy of realizing good outcomes, simply and pure. They remain working for us, all of us, young and old alike, doing their work daily, unsung.
This is a case of the extraordinary and beautifully ordinary unsung in our world today.
