To share the views of an experienced RT for Respiratory Therapy Week, I reached out to Ms. Mieke Fraser. I first met Mieke when she was one of the supervising instructors for Ventilation Lab during my studies at The Michener Institute. I also ran into her at various professional development events including the latest Better Breathing and Canadian Network for Respiratory Care (CNRC) conferences. She is passionate, caring and an authentic RT. Her wisdom is built from years of experience, which includes but not limited to Mount Sinai Hospital and Bridgepoint Active Healthcare. She is also in the process of getting ready for her upcoming talk at the CNRC National Respiratory Care and Education Conference in Calgary. I asked Mieke what it means to her to be a respiratory therapist. This is what she shared with us:
I was working with an enthusiastic and engaging RT student yesterday that brought to front of mind what it means to me, to be an RT:
First, it’s the moment of connection with a patient and then if I’m lucky, the building of a therapeutic relationship with the patient and their family. We are fortunate to be able to treat patients across the health care system. I value being part of the team that helps patients with the most fundamental actions of life – their breathing.
Secondly, because I can make a human connection with them, and then help them with something as important as their breathing, I believe I can ease their suffering (maybe just a little or in some cases immensely).
We are a highly skilled and widely experienced profession. As a brief example: in a given week, I could be optimizing ventilation for a patient in ICU, helping to protect lungs from injury and allow healing, recovery, and growth in NICU; providing treatment in the ED for patient with acute exacerbation of their chronic respiratory disease; providing education and facilitating greater self-management to that patient with chronic respiratory disease; counselling a patient towards smoking cessation; and, helping facilitate a peaceful death.
And finally, as a RT with a few years of experience, I value being able to share my experiences, my approach, my wisdom, my perspective, my skills and knowledge to the next generation of RTs. Showing them how to assess a patient, to look at the details but also see the big picture, to make the differential list, to respectfully touch during assessment and treatments, to listen and connect with our patients, and so much more …
I am proud of the valuable role we have within a multi-disciplinary team, at times overshadowed by the larger-in-numbers presence of nursing and physicians. I would have to say that those individuals – the patients and families – with whom we make that moment of connection know we are different, and maybe just a little bit special, for we intimately assist them with the most precious piece of their life – their breath. For when you can’t breathe, nothing else matters.
Mieke Fraser, BSc RRT CRE
Thank you Mieke for taking the time to share your thoughts with us!
Happy RT Week!
Farzad ‘Raffi’ Refahi
Oct 25, 2017
Today in Canada, and the rest of the world, people are mourning and talking about the passing of Gord Downie of The Tragically Hip. While everyone was aware of his deteriorating health condition, this news is still difficult to process.
Directly or indirectly we may be involved with the palliative care of our patients. I have come across this interesting article by an ER Resident.
Farzad ‘Raffi’ Refahi
Last weekend, October 14th and 15th, I took part in the Pediatrics Advance Life Support (PALS) course. This is a challenging and satisfying certificate which I look forward to every few years. Completion of PALS involves review and demonstration of various knowledge and skills as both a team member and as the lead. There are many areas of individual growth in this certificate as health care providers (HCP) deal with a wide age range of patients, from neonatal to young adolescent. Also, the topics covered include, but are not limited to, Systematic Assessments, Respiratory Distress and Failure, Bradycardia, Tachycardia, Cardiac Arrest, Shock (Hypovolemic/Distributive/Cardiogenic/Obstructive), and Post-Resuscitation Care. Since many health concerns of children include respiratory components, PALS offers Respiratory Therapists a good chance to review their knowledge and skill-set.
Aside from the knowledge and hands on opportunities, there is a chance to work within inter-professional teams. PALS helps HCP’s see scenarios from different angles and roles. By better understanding the roles, team members can more effectively understand, anticipate and participate in the flow of patient care.
Reviewing the systematic approach in PALS is a mindset that can also be applied in adult populations and during Rapid Response Team assessments and interventions. As a new graduate, one of my biggest challenges was attending to Rapid Response Calls. The on-call Nurse and RT would reach the bed side first and would begin the quick assessment and at times, when appropriate, would initiate the required intervention even before the attending doctor would get there. This certificate allowed me to better identify, organize and classify the available information, better narrow down the plausible causes, and provide better interventional care.
When compared to ACLS and NRP, PALS is usually not a required certificate in job postings, thus new graduates can better stand out when equipped with this qualification. Even for RTs who have a few years of experience, completing this certificate can demonstrate a willingness and drive to learn and to improve.
This certificate is a useful asset and thus it is my personal recommendation to RTs and other HCPs to take their PALS.
Farzad Raffi Refahi
Oct 18, 2017
There are many individuals contributing to the field of respiratory therapy who I may not know about as I have been practicing in the field for only a few years. In my journey to learn more about this field and the people involved, I reached out to Mr. Andrew Wroblewski.
-YouTube (The CPAP Gentleman)
Andrew is a Respiratory Therapist and producer of a successful YouTube channel called ‘The CPAP Gentleman’. He has used his work experience of helping Obstructive Sleep Apnea, OSA, patients to create educational videos for patients. He has summarized and simplified relevant information into entertaining segments. The topics range from “What is Sleep Apnea?” to “Nasal Bridge Irritations”. His first YouTube video dates back to Feb 2016. He is a dedicated, driven and successful RT who is contributing to patient education and the growth of our field. He was kind enough to answer my questions.
1. How did you find out about the respiratory therapy field? What made you decide to become an RT?
I found out about the profession through a friend of my father’s. He graduated into the field about a year before I started, and currently works in the Hospital for Sick Children in Toronto.
I was one of those guys that had no idea what to do with his life upon finishing high school. My strengths and interests were in Biology and Physiology courses, so my parents and councillors suggested I go into healthcare. Respiratory Therapy seemed like an outgoing field with many different areas to work in.
2. a) Can you tell us a little bit about your YouTube channel? How did you come up with the idea? How did you get involved with it?
After many real-life encounters with actual patients diagnosed with sleep apnea, I grew to learn of the common issues people face with PAP therapy. Some were even fearful of the treatment, so I wanted to re-assure them and others in the world that sleep apnea was nothing to be scared about. The only way to do this was to educate them in a fun and informative way. And thus the character was born.
I believed that YouTube was the best option to communicate my message, and something that wasn’t being utilized to its fullest potential by other clinicians. I aimed to fill that void, and if I could help just one person by doing it, it would be worth it.
2. b) What are some of the challenges and satisfactions of making educational videos?
Time, time, time. Everything from coming up with script ideas, to video production, and post-editing takes up a lot of my free time. I don’t always produce in a noise-free environment either, so extra care needs to be taken to ensure videos come out in respectable quality. I hold myself to a certain standard, and strive to improve things whenever I can. The satisfaction comes directly from the people I help! I get a big smile on my face every time someone leaves a comment thanking me for my efforts. It also gives me the motivation to continue doing what I do.
2. c) How much time is required in making an educational video (roughly how much time is spent in research/script, recording of the videos, and editing)? Where do you find the time to do that in your already busy schedule?
It really depends on the topic I’m covering. Generally the research/script takes the most amount of time. If I’m very familiar with a particular topic, I can produce a script in a single day. If it’s something I’m not too sure about, it may take upwards of a week or more. Video production generally takes anywhere from 2-6 hours depending on the length of what I’m discussing. Video editing takes a similar amount of time. Sometimes I’m stubborn and I want things a certain way, so there’s been times where it’s taken days.
I don’t know where I find the time! I have many things going on right now from participating in multiple on-call programs to learning a new language. That’s probably why I’m only able to produce an average of one video per month. Hopefully my subscribers don’t mind!
2. d) Any thoughts/suggestions/comments for those who are thinking of starting their own educational related videos?
I would highly encourage others to participate in video production for the purposes of education. YouTube is a great avenue through which to do this, and also easily accessible through all hours of the day. I would recommend to start simple. Perhaps audio only, and images that relate to what you’re discussing. This way you don’t have to stress out about learning everything from proper lighting, sound production, and video quality. Not to mention, editing is a little more complicated when there’s a real person in front of the camera.
You’ll also save a lot of money! Cameras, lighting, microphones, backdrops…it all hurts the bank. But I’ve already healed from those wounds so it’s okay.
3. You work in the home oxygen and CPAP settings; Any advice or recommendations for RTs who are thinking of or may consider working with OSA patients (i.e. CPAP)?
Most OSA patients that you deal with, are for the most part, healthy. This is a far stretch from other environments respiratory therapists work in such as intensive care, emergency, and operative departments. This allows you a relatively stress-free environment where decisions do not have to be made quickly. You’re also able to communicate with your patients more effectively as they are fully alert and able to breathe on their own. I do recommend working on your customer service and interpersonal skills, as this will go a long way in developing a relationship of trust between you and your OSA patient.
4. You have vast knowledge and years of experience in improving the quality of sleep of your patients. Any advice for Healthcare Professionals (HCP) (i.e. How can they improve the quality of their sleep)?
Make sure you have good sleep hygiene. You should try to be consistent with bed times as often as possible. For some HCPs, this can understandably prove to be difficult due to varying shiftwork. Sleep duration is also important, and you should aim to get at least 7-8 hours of sleep per day. An average sleep cycle is around 1.5 hours, and you need five of them for the body to be ‘fully restored.’
Don’t drink coffee or workout too late! It can be difficult to fall asleep otherwise. And finally, if everything else is in check but you’re still feeling tired, make sure you get referred for a sleep study. You may have an undiagnosed sleep disorder that is effecting the quality of your sleep.
5. Any final thoughts or message you like to share with RRTs and HCP?
Do what interests you in your respective field. I know that seems sort of obvious, but many of us work in areas we don’t necessarily want to work in. This can be a result of the current job market and what’s available, or what others think is best for you. In the field of respiratory therapy, acute care is highly prioritized above all else. Home-care is sort of an after-thought. I personally had just two days to experience the home-care setting during my clinical rotations, but that was enough for me to make up my mind.
Don’t worry about passion, or lack thereof. Passion behind your work comes from experience, and a supportive environment. Work hard, play harder.
Thank you Andrew for sharing your views, recommendations and perspective. Keep up the great work!
Image credit: https://www.youtube.com/channel/UCO2DkdV_758nYdnuSc6wuLQ (accessed Sep 17, 2017 )
Farzad ‘Raffi’ Refahi
October 1nd 2017