Independent PFT lab

Lessons learned from Universal Pulmonary Function Lab.

I began working at Universal Pulmonary Function Lab slightly more than 2 years ago.  The lab was without a technician or RT for weeks before I was hired (to work as once a week [sole] operator.  The learning came from the challenges of working without having a prior training to their equipment, protocols and patient flow.  Here are my top learnings from that experience:

1.    Becoming resourceful.
Regardless of the amount of training you receive at the beginning of your job, the RT/Technician/Operator has no option than to quickly seek and utilize resources.  I stayed in touch with the amazing lead respirologists, Dr. A. Born.  I sought the advice of my PFT mentor Mr. Bernie Ho.  I discussed my issues with colleagues at the other PFT lab I was working at the time (Ms. Sylvia).  I accessed printed manual for the equipment and the online guidelines at ATS/CTC/ERS websites.   When put in situations like this, we have our school notes, textbook, previous instructors/preceptors, online guidelines, conferences and forums.   I am proud to say that under the supervision of Dr. A. Born, this lab holds and operates at a very high standard.


2.    The power of Body Language
Toronto is a great city painted with multiculturalism.  On regular basis, I would have elder individuals who could not understand English.  The ability to simplify and summarize instructions and to deliver it verbally, vocally and through body language is a useful skill I had to develop.   While PFT involves many small steps with many technical aspects, learn to simplify it for your patients.  It will require more attention and care but your patients will notice your effort and will appreciate it! It is all about patient-focused care after all.

3.    Independence
As a sole operator of a lab, there is only the RT/Tech, the patient and the secretary.  Doing PFTs in hospitals includes a variety of healthcare providers who you rely on or call on, if needed.   Monitor your patients throughout the test.  Some patient are not good evaluators of their symptoms.  Identify early signs of fatigue, dyspnea and vertigo.  Be aware and be prepared.

I leave this independent lab knowing that my replacement is also a dedicated and driven individual who will look at the lab and the patients.


Farzad Raffi Refahi RRT


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Marijuana sale in Ontario

“The Ontario government has announced a framework to manage the sale and use of marijuana…”- CBC News

I am posting this not to support nor to oppose this topic but to simply share the latest developments. Soon, it may be easier or more acceptaple to ask about patients’ cannabis use along with the [tobacco] smoking history.  

For the full news article please visit: http://www.cbc.ca/1.4280484

-Farzad

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Presenting At CSRT

In 2016, I gave a talk at the annual Canadian Society of Respiratory Therapists, CSRT, Conference.   At that time I was working six days a week, running a blog, and was trying my best to prepare for the presentation.  I was excited, nervous and driven.  My presentation was far from perfect, however, I learned a lot in the process and from the self-reflection after it was completed.

Here are my top three pieces of advice for first time presenters at CSRT:

  1. Quality.
    Know more about the topic than most people in the room. Do your research but don’t invest all your time on the research component.  There will always be individuals who would know more about the topic than you would, however gather enough information so your talk would be beneficial to most people in the room.  Presenting at CSRT requires quality and professionalism.  Do your research, deliver the quality, but don’t spend the whole time sharing your research.
  2. Keep It Simple.
    Collect all the relevant information, process it and present it in few key points.  A 45 minutes long talk is a short time to discuss all your findings.  It is best to summarize or select only 3 to 5 key ideas/points, and then focus on the delivery of those points.  Keep it simple.  Present the key points without relying too much on technology.  There seems to be always some technical issue during talks (happened during mine).
  3. Practice… Practice… Practice.
    Get to know your material. I would encourage practicing enough to memorize. Practice in front of friends and individuals in the field.   Use the feedback from the practice runs and modify your presentation until it is smooth and simple while delivering the main ideas.  I videotaped my practice runs so I would identify areas that required more attention.  Don’t be afraid to connect with your audience. Get to the room that your will be presenting early or during breaks. Stand where you will be presenting, look around and get to know the room.  During your presentation don’t forget to breathe.

  Here is the link to CSRT’s  Call For Presenter’s page: 

http://conference.csrt.com/call-for-presenters

Good luck!

Farzad ‘Raffi’ Refahi HBSc RRT CRE

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Pulmonary Function Testing Symposium

Back in 2016, I was working as the Lead Respiratory Therapist, or Chief Technologist, at a Toronto based respirology clinic.  I was responsible for diagnostic testing, training and supervision of staff, quality assurance and technical operation of the clinic (PFTs, MCTs, 6 MWTs, CPETs and Cap. Gas and ABGs).  One of our suppliers, Novus Medical Inc, informed me of an upcoming conference that focused on pulmonary function testing by Canadian Association of Cardio-Pulmonary Technologists (CACPT).  The 2016 Pulmonary Function Testing Symposium was a two-day event of talks, workshops and networking opportunities by experienced technologists, respiratory therapists, respirologists and other healthcare professionals.  Attendees were like minded individuals who were driven and dedicated to the field.  This conference allowed me to expand my knowledge, to learn from the wisdom of technologists, and to connect with individuals from across Canada (some whom I am still in touch with).

This year’s Symposium is on September 22nd and 23rd.  I am looking forward to talks by Laura Seed RCPT, Dr. Gottschalk, Lori Davis RCPT, Dr. Stanbrook, Angela Thomas RN, Dr. Allan Coates, Andrea White-Markham RRT, Dr. Myrna Dolovich, Tony Kajnar RRT, and workshops by Ontario Lung Association, Susan Blonshine RRT, Jane Schneiderman PhD, Susan Lori RKin and Tony Kajnar RRT!

This conference is organized by Laura Seed, Murray Beaton and Tony Kajnar.  To find out more about the conference I got in touch with CACPT.   I was lucky enough to have a conversation with Ms. Laura Seed, the VP of CACPT.   This is what she had to share.

The Canadian Association of Cardio-Pulmonary Technologists (CACPT) has always provided an education forum for its members.  For years the Pulmonary and Cardiovascular members of the CACPT across Canada came together at the annual Canadian Cardiovascular Conference (CCC).  Respiratory Sessions were included at this cardiovascular venue.  Attendance to the CCC unfortunately decreased dramatically in the last 5-7 years.  The Canadian Respiratory Conference (CRC) was then considered by the CACPT to provide an alternative education forum for the Pulmonary members.  The Pulmonary members did not attend this conference due high registration fees and not enough content on Pulmonary Function topics. 

In 2015, I as Education Chair, organized a 1 day PFT Symposium in Toronto at the Hospital for Sick Children.  This was very successful.  With feedback from the delegates pointing to the need of this type of symposium it was expanded to 2 days, to include not just lectures but also workshops.   At this time Murray Beaton of Novus Medical expressed interest in promoting this education forum.  This partnership has resulted in workshops that provide hands on experience in PFT testing. 

The PFT Symposium is unique as all topics for lectures and workshops pertain directly to aspects of a Pulmonary Function Lab.  It allows CACPT members, Respiratory Therapists and anyone else who work in the PFT lab to come together and learn from each other’s experiences.  What is particularly challenging is providing topics for the “diverse” experienced technologists that attend.  Basic topics such as learning to perform quality Spirometry to the more challenging topic of Methacholine Challenges are included in the program.  All employers of Pulmonary Function Labs, independent or hospital based, would greatly benefit in supporting their PFT technologists to attend the Symposium.  It speaks to the quality of care and patient safety that is provided when diagnosing, treating, and monitoring  patients with respiratory disease

The 2017 PFT Symposium will be on September 22 and 23 in Toronto at the International Living Learning  Center, Ryerson University.  Registration Link is available on the CACPT website (www.cacpt.ca).  The program can be viewed on the link as well.  There are plans underway to organize the 2018 PFT Symposium in Alberta (Edmonton or Calgary).

I also got in touch with Mr. Bernard Ho.  He was my PFT clinical preceptor at Women’s College.  I consider him as my mentor and, to this day, I seek his opinion, advice and suggestions.  I asked Bernie about his thoughts on this symposium, and this is what he had to share:

PFT Symposium by the CACPT (Canadian Association of Cardiopulmonary Technologists) is the only comprehensive annual educational seminar in Pulmonary Function Testing in Canada.  It provides up-to-date standards and recommendations of the American Thoracic and European Respiratory Societies.  More importantly, there is opportunity of networking among the colleagues and discussing test procedures and policies from various PF Laboratories.  PFT Symposium is accredited for 13 hours of continuing education (CE) /professional development (PD) credits by the CSRT and CACPT.    It is a great opportunity for PF Lab from the Independent Health Facility in Ontario to earn the required PFT professional development credits.

 

I am really excited to attend this year’s conference.  Hope to see you there!

Farzad ‘Raffi’ Refahi HBSc RRT CRE
September 01, 2017

References:
-Image : http://www.cacpt.ca/PFT-Symposium-Programme-2017.pdf
-Thank you to Laura Seed, Murray Beaton, Tony Kajnar and Bernard Ho.

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Merci Christiane

Ms. Christiane Menard is retiring from her position as the Executive Director of Canadian Society of Respiratory Therapists, after almost a decade of service (9 years).  As a thank you for her contributions to the respiratory therapy field, this blog post is dedicated to her.

The first time I met Christiane was at the 2016 Ottawa Conference.  Even as a relatively new respiratory therapist and a novice blogger, I was greeted with a big smile and a hug.  She is full of energy, passionate and is very driven.

From a quick glance at her career accomplishments you can see that Christiane’s dedication to excellence is evident.  Besides the position of Executive Director of CSRT, she held other positions such as the Communications Coordinator for Merck, Director with Society of Obstetricians and Gynecologists of Canada (overseeing Communications, Government Relations and Partnerships), and Director of Communications for the Canadian Association of Medical Radiation Technologists.

In 2017, she was the Honorary Lifetime Membership Recipient from CSRT.

I reached out to CSRT’s president, Mr. Jeff Dionne.  This is what he had to share about her:

When I think of Christiane, I think of a true visionary.  She took on the role as Executive Director for the Canadian Society of Respiratory Therapists during a time when things were quite unstable.  Our profession was going through an identity transformation; our membership numbers were steadily dropping, our impact within the RT community was dwindling, and our image as a national organization was blurry at best.  During her time as ED, we have witnessed numerous success stories emerge; from the Blueprint for Action for our profession in 2014, to our role in private practice, to the Anesthesia Assistant certification process, the CSRT is now a nationally recognized leader in the realm of professional association.  Not only have we seen our student memberships double, but we are also proud to say that we have well over 4,000 members in our association.  It has been through her tireless commitment and dedication for our profession that has placed us in such a positive situation for the years to come.  Thank you, Christiane.

 

I will share with you the brief conversation I had with Chriastiane.

  1. Looking back over the years as the Executive Director, what are some of the memorable moments that come to your mind that you can share with us?I have so many memorable moments and in each of these moments, it is the passion of the RT profession that was front and center.  Whenever I went to provincial meetings, I always tried to find out about RTs and to learn more about what they did and the projects in their region.  The most memorable moment was in 2014, I was in Vancouver for several meetings and on my way to the airport I accepted an invitation to visit the PROP program in Vancouver.  A young and most passionate RT named Esther Khor gave me the grand tour of her organization and it was the most amazing set up I have ever seen.  It was the first time, after working 40 years in the health care sector, that I saw an organization actually put in place a truly effective “patient centered approach” to care.  I immediately invited her and her patients to speak at the 2015 conference and I feel this was one of the most memorable presentation at a CSRT conference. 
  2. How has the RT field changed from your point of view?I see a profession that has gained a lot of confidence in their knowledge and clinical skills.  More and more RTs are working in less traditional roles like research, quality assurance, patient transport.  I am very proud of all the RTs who continue their education and keep building on their RT skills and knowledge.  Nine years ago, critical care was the most important area of practice.  Now we see more and more RTs working in community and home care.  Many RTs have entered a growing area of the health care that is most important – patient safety.  The profession constantly shows its versatility and ability to adapt to the changes required in the health care sector.  I have no doubt that RTs will continue to look for new applications of their skills and knowledge than any other profession. 
  3. What is next for you?I am retiring from being an Executive Director, but I love working.  I just feel I am no longer able to work at the Executive Director level and knew it was time to take a step back.  I plan to stay at CSRT in a lesser capacity for a number of months to support the transition of the new CEO.  I will then find some part-time work where I can still use my knowledge and skills.  As I will no longer travel for meetings, I look forward to attending more cultural events in Ottawa and going to the pool and gym more often. 
  4. What were some of the goals you set for yourself when you began as Executive Director and do you think you accomplished them?I had many objectives when I started – increase the CSRT membership, increase the number of participants at the CSRT conference, increase the income from sponsorship – and then I soon realized that none of these objectives could be achieved if we were not able to show the value of CSRT to our members and to our industry partners.  So I think we have achieved those objectives by showing value.  The most difficult objective to achieve had to do with the financial viability of the CSRT.  When I started in August 2009 we had absolutely no money in the bank … no money for rent, no money for payroll.  That was so overwhelming and I struggled with this for many years.  It took nine years, and inch by inch, we increased our financial stability.  This year is the first year that I feel we are on solid financial ground and that we do not have to borrow on the line of credit or on next year`s income to meet our financial commitments. 
  5. What are some words of advice for people in the industry who want to get more involved?Find something that is missing, something where you can make a difference, something that can be done better, and just do it!   If I look back at who has done just that I think of Jason Nickerson, who got involved in international health, not because of the money, but because there was a need and he knew he could make a difference.  Tom Piraino is another RT who saw a void in RT education with regards to the clinical applications of ventilation and he got involved in increasing knowledge and understanding in his institution, at the provincial level, at the national level and at the international level.  It just takes effort, constant effort, and you can achieve everything by doing an inch at a time, one step at a time.  The secret is to not get discouraged by hurdles … anyone can build a mountain one spoonful at a time! 
  6. What are some of the challenges you see in the future for RT’s and how can we as practicing RT’s prepare for those challenges?
    The biggest challenge for the RT profession is keeping up with the complexity of the health care sector.  As the health care sector always seems to be in transition, the RT profession will also continue to be in a transition and there is no way to go but forward and learn more complex clinical applications.  I do feel that the RT profession has been very quick to adapt to changes that have occurred in the past and I have no doubt that RTs will continue to increase their knowledge and clinical skills. RTs will surpass any challenge and will move forward where they are most needed and where they can make the most difference in the respiratory care of their patients.
     
  7.  Any final thoughts?
    My final thoughts ….I am so grateful that my last full time job was with the CSRT and that I had the privilege to have the trust and support of the RT profession who so generously shared their passion with me.   I can brag that my last job, after working in the health care sector for over 45 years, was the best ever!  Not many people brag about their job when they retire, but I do !

I want to thank Christiane for her dedication to our industry and for taking the time to speak with me.

 

Resources:
-Image: https://www.linkedin.com/in/christiane-menard-3946a140/detail/photo/

-Thank you to Carolyn McCoy and Jeff Dionne for taking the time to help me  with this article.

Farzad ‘Raffi’ Refahi HBSc RRT

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