Working as an RT – Mieke Fraser

  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
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
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Influential People In Respiratory Therapy: Andrew Wroblewski

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

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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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