Unsure? Get Tested!

A nasopharyngeal swab this past Friday followed the end of my deployment in acute care. A phone call from Markham-Stouffville Hospital confirmed a negative COVID-19 result. I endured 15 seconds of discomfort for a comfortable return to the PFT lab. It was a happy ending to being upfront.

Almost 4 months ago we stopped our pulmonary function testing. I was deployed to the acute care side of the respiratory therapy department. Helping in ICU, Emerg and wards. It was a quick refresher and a dive back to a side of respiratory care that I had not been involved with for almost 6 years.

While my exposure to COVID-19 patients and equipment were with proper PPE utilization, one could never be too sure. At the end of my rotations, and before seeing vulnerable patients in the PFT lab, I decided to get tested.
This is not the first time I have been tested over the last 3 months. With the start of spring, my seasonal allergies became evident. Mornings with red eyes and a runny nose were becoming the new norm for me. At the start of all this, and with these new symptoms, screeners and the occupational health department sent me for testing.

While I was relaxed, comfortable and calm about my recent, second test, the feeling about my first test was not the same. With my first test, I felt almost embarrassed and annoyed. Calling my manager and wondering what my colleagues would think about me being off due to COVID-19 was at the back of my mind. I didn’t want to be known as the person who didn’t use his PPE correctly or be known as the person who got deployed to be helping but now has become a vector. The only reason I am sharing my past false perception and beliefs is to share two points with you. Firstly, of course, you should do your best to follow proper hand hygiene, PPE, social distancing and other recommendations. Even if you have done all of the above correctly, it doesn’t mean that you are 100% protected. Secondly, there is no shame in getting COVID-19. Testing is becoming more readily available, so if you have any concerns that you might have contracted COVID-19, please get tested. It is important not only to look after yourself but also to protect others.

While I work in the healthcare field in Canada, this recommendation extends to all the frontline workers in the world. Thank you for your dedication and service. To those who have followed the recommendations and remained at home, thank you for your team effort. To those who have lost their jobs, became ill with this disease, or lost someone because of it, my heart goes out to you. 2019 and 2020 have been difficult but has shown me that we do great things when we come together. #StrongerTogether.

Farzad Refahi
June 13, 2020
www.respiratory.blog/unsure?-get-tested!/

Right After Getting The Swab

We Are In This Together

Post by Farzad Refahi. Photo by Tobias Mrzyk on Unsplash

Just like many of you, I have and will continue to go through changes during these challenging times.

My Journey So Far

Since our outpatient testing lab has closed, I have been deployed to assist the acute care respiratory therapy (RT) team. I have been working in Pulmonary Function Test (PFT) labs exclusively for the past 5 years.   This has made me re-assess my awareness of acute care practices. I pulled out old notes and textbooks, and have been studying daily to refresh my knowledge.  I had to reintroduce myself and get comfortable with specific ventilators and equipment (and get trained on some new ones).   Being back in acute care, even in a supporting role, has made me feel vulnerable.  I want to help the team in patient-care without being a burden to the team, without expressing false confidence, and without making mistakes that can impact patient care (and my licence to practice).

Continuous Support and Learning

Going forward, I will continue to help the acute care RTs in my hospital with steps that can make their lives easier which includes keeping an eye on the inventory, making ‘grab and go’ packages, circuiting vents, being the runner, and looking after simple respiratory assessments.  On my own time, I will continue to review my RT knowledge using available resources such as my textbooks, notes, online videos and courses, networks and colleagues.  I’ll be honest with myself and colleagues about my weaknesses and strengths, asking questions when needed, while trying to be mindful and aware of stress levels.

My Supportive Network

This transition has not been simple, but I am lucky to have a lot of support.  The RT team at Markham-Stouffville Hospital has been very supportive.  My fellow deployed RTs are amazing in team-work and supporting each other.  Thanks to all the acute care RTs, and other healthcare providers, for all your hard work.  I want to give a shoutout to the team at RTSO who have been understanding and supportive of my deployment.  Also, to RT’s like Thomas Piraino, who are contributing to knowledge sharing and best practices for Mechanical Ventilation in this crisis. Tom, I don’t know how you manage all this! Research, clinical work,  publications, family and still have time to do daily Mechanical Ventilation Q & A sessions (6 pm on his Facebook page https://www.facebook.com/respresource/ ). Your contribution to the RT profession is much appreciated!

Also, a big shoutout to my amazing wife, who supports me through all these challenging times.  I am lucky to have strong family support in my life!

Take Care of Yourself

Be honest with yourself about your strengths and weaknesses. Navigating a new environment, at work and in life, can be scary and it tests us.  Even though we may be trained, competent and capable, we all have doubts once in a while.   I know its hard to take a moment for yourself in a time of crisis, but we also need to be mindful of our own physical and mental health so we can help our patients as well. 

Final Thoughts

These are unique and challenging times.  We are in this together! I am going to finish this post with a quote from Brené Brown (Daring Greatly. 2012).

“Sometimes the bravest and most important thing you can do is just show up.”

Blog post by Farzad Refahi. Photo by TK Hammonds on Unsplash

Be safe,

Farzad Refahi
April 11, 2020
https://www.respiratory.blog/inthistogether/

Gratitude

During stressful times we tend to focus on the challenges and the struggles. It is important to not lose sight of the positive in our lives and to give gratitude.

Over the past few weeks, I have witnessed many amazing people stepping up to help everyone.  Thank you, Sue Jones and Kelly Hassall, for your ongoing dedication and leadership to help RTs through Respiratory Therapy Society of Ontario (RTSO).  Thank you, Gino Luigi De Pinto and Sue A., for keeping the RTSO website up to date with the latest resources.

   Thank you, Thomas Piraino, for putting together the great resource on your website, and answering questions live on social media. 

Also, a big thank you to Carolyn McCoyAndrew WestCarole Hamp and Kevin Taylor for your ongoing hard work in the background.

  Thank you to RT programs for lending your ventilator to hospitals, and taking your third-year students out of clinical rotations to keep them safe.

Farzad Refahi
March 23, 2020
www.Respiratory.Blog/gratitude/
[End]

Quiet First Day of Spring

Today is March 20th, 2020. The first day of spring. Happy Nowruz to all those who celebrate the new year. Iranians, among few other nations, have the first day of spring as their new year.

While new year celebrations involve visiting others and sharing delicious food, this year will be quiet. I hope it is quiet. Let’s continue the social isolation. Let’s continue to practice proper hand hygiene. Let’s self-isolate if you are feeling unwell. Let’s think about the vulnerable population and the elder members of the family.

My blog posts are usually meant for clinicians. This time, I am writing to every one, since dealing with COVID-19 is beyond the work of clinicians and healthcare system.

While you monitor your physical health, please don’t forget about your mental health. There are various electronic and video communication options that allow you to connect with others. Call the elderly to check-up on them. If you know someone in isolation, ask if they require groceries (being dropped behind their door).

Those who experienced SARS in 2003 may experience higher levels of anxiety around this time (especially clinicians). Make sure you connect with proper resources, support and intervention if required.

Give yourself mental breaks. Find a few trusted sources for news and COVID-19, and only review those. Constantly reading about it may induce increased anxiety. ( www.RTSO.ca is one of my trusted sources.)

Find appropriate stretches and exercises that can be safely done at home. Stay hydrated. Use this opportunity to stop smoking. Pick up that book that you always intended to read!

Don’t forget about the positive. Give gratitude for the good in your life. There are many great people who are doing their best to help out. A quick shout out to respiratory therapists and clinicians who continue to work to keep us healthy. Fatima Foster is creating a supportive online community for clinicians who are experiencing some anxiety around this time. John Meloche from Melotel Inc. is using the resources in his company to support communities and organizations who have non-for-profit COVID-19 support groups. There are many more examples if you look for them!

Have a happy, healthy, and quiet Nowruz!

Farzad Refahi
www.Respiratory.Blog/HappyHealthyQuietNowruz/

[End]

To Acute Care for Support?

Our Pulmonary Function Lab has been closed for the past two days to reduce the risk of transmission to patients, especially the vulnerable populations.  Things are changing daily, and there many unknowns. (To non-clinicians reading this, we do know proper hand hygiene and social distancing works!)

I have worked full time in a PFT setting over the past 5 years.  With PFT lab closed, and a chance for deployment to other units, I need to do some reviewing! 

The Essentials of Respiratory Care by Robert M. Kacmarek .Fourth Edition. 2005. Elsevier Mosby

The Essentials of Respiratory Care, Fourth Edition, by Robert M. Kacmarek, Steven Dimas and Craig W. Mach is one of my resources.  This textbook was not actually a resource during my studying, however, it was a recommendation by one of the instructors (shout out to Paul Smith at The Michener Institute). Since I have not been trained in the acute care setting of my hospital, I don’t know about many of the protocols, selection of equipment and policies.  I am still going to use this opportunity to review some respiratory care knowledge.

Do you have any up to date, open access and free resources to recommend?

Farzad Refahi
www.Respiratory.Blog/AcuteCareReview/

[End]

Thank you, Dan Pinard!

The other day I received a Pulmonary Function Testing question that I had not dealt with lately. I provided a short answer but did mention that I will connect with a trusted expert. Here is a quick shoutout to Dan Pinard from Novus Medical Inc. Thank you for the quick and comprehensive answer!

If you have read any of my annual Thank You posts, that I write during RT Week, Novus Medical Inc. is a recurrent name. Once again, they are supporting the PFT Symposium in Canada. This year, 2020, the symposium is on September 18th and 19th and takes place at Radisson Vancouver Airport Hotel.

From my understanding, more information will become available as soon as speakers have confirmed their invitations. For more information, you can visit https://www.cacpt.ca/conference/ . Also, to learn more about the great team at Novus Medical Inc. visit: https://www.novusmedical.ca/about-us .

I will let you know as I find out more about the event!

Farzad Refahi

Get Involved

There are various ways that you can get involved with your respiratory therapy organizations in Canada. Some take a minute to do, some five minutes, and some requiring a few hours a week on an ongoing basis. You can make a difference, and you should not take that lightly or for granted.

Fast and Easy Involvement

Takes a minute to find your respiratory therapy organizations on social media platforms. Follow them. It helps you stay up to date, and by sharing the relevant and important posts, you help with spreading the word, advocating and promoting the profession.

Takes a Few Minutes but You Will Help Shape Things On a Larger Scale

Our national organization, Canadian Society of Respiratory Therapists, is filling a few spots on the board of directors. Put aside 5 minutes to read the biographies and letters of intent. The voting process takes just a minute. Have your say, and help shape the future of our profession on the national level. Go to www.CSRT.com and vote! The deadline is tomorrow!

Have Some Time To Volunteer On An Ongoing Basis?

Have a desire to help and support your provincial organization? RTSO is recruiting for various position and roles. Visit www.RTSO.ca for more details. I have been volunteering with RTSO for more than 2 years, and have assisted with various projects. I have learned from many amazing volunteers over this time.

Together, We Are Stronger!

We can make a difference. Renew your national and provincial RT memberships!

Farzad Refahi

Cleaning Products

Exposure To Cleaning Products in Childhood

A few days ago I was listening to CBC radio, as I was driving to work, when I heard about a recent study that has shown an association between household cleanings products and increased risk of developing childhood asthma. I totally forgot about it until today when I noticed Mr. Noel Pendergast RRT sharing a link to the content on his Facebook page. My reaction when I first heard about this was: “Of course!”. We never actually think about it, but it sure makes sense.

A Known Concept?

It’s interesting that I can recall a childhood memory when during a family gathering, Dr. Nehzhat shared his concerns about bleach as a routine household cleaning solution. Side note, he is a chemist and one of the most wonderful people I have ever met. Back to the main point… “Please stop using bleach. Don’t breathe that in. Cannot imagine what that will do to your lungs”. Ongoing exposure to the fume, specially in a non vented area, could lead to respiratory changes for any individuals (regardless of the age).

Various Cleaning Chemicals

I worked as a lifeguard for few summers and even then I wondered how dealing with concentrated liquid chlorine may impact people’s breathing.

If I had to share my thoughts with my patients, I would recommend limiting exposure to harmful fumes and chemicals. Also, make sure that the area is well vented. I am not sure if I would be as comfort recommending masks as THE solution, as this false hope may lead to unnecessarily and higher and longer exposure periods. Side note- realistically, how many people are properly mask fitted and educated about the right mask for the right task?

Be Aware and …Clean

This is not to take away anything from proper hygiene, clean environment and limitation of irritants including known triggers.

Thoughts?

What are your thoughts on this?

Resoures

https://www.cmaj.ca/content/192/7/E164

A screenshot of the highlights from the article's abstract
For the full article please visit the following link:https://www.cmaj.ca/content/192/7/E164

A quick glance at your accomplishments!

Image by mohamed Hassan from Pixabay

Why you should take the time to update your portfolio?

The new year has begun, and hopefully, you are excited about it!  Documenting your achievements, awards and projects as you go along seems great but not always a convenient step.   Here is your chance to take a step back and document them. 

So why do this? 

We get busy and forget to document our achievements throughout the year. It will help you save time when it comes to updating your resume, filling out your annual employment review, realizing your areas of strength, and help with your goal setting and career planning.

Stepping back and looking at your achievements with a quick glance can help you practice gratitude and build confidence.

It is also a good reminder for certification deadlines and professional organization renewal dates. 

Where you can document your progress

At the end or beginning of the year, set aside time to update your portfolio.  By portfolio, I refer to whatever system you have in place to organize your resume, professional documents, and continuing education files.  Once you establish a system, updating it should become much easier, more rewarding and less frustrating. 

Personally, I use a cloud system that is free and easily accessible from any electronic system that can connect to the internet.  I personally use Google Documents because it works for me.

I already have existing folders and documents which help me track my continuing education activities.   Creating a new document or adding to the bottom of your year-end page, you can update your accomplishments.

Questions to help you track your accomplishments

To simplify things here, think about these three areas:  Projects, courses or certificates, and skillsets.

What were some projects that you were part of (employment or volunteering)?

Which courses or certificates have you completed or renewed?

What new skills you have learned or strengthened?  

(Optional: Publications, Test Scores, Awards, Languages, Patents and other relevant categories)

Start Now!

Access your existing paper portfolio or your secure and accessible cloud/online folder.  Answer the three questions mentioned in the previous section.   

Bonus: Think about your upcoming year personal or career goals to see if your accomplishments support your goals.  What are some activities that support you in your path?  The answer to these questions can help you set goals for your upcoming year!  

Tell me about your process?  What has helped you?  Also, what are some of your memorable accomplishments over the past 12 months?  What are you looking forward to accomplishing?

Thank you

It was a few years ago during Respiratory Therapy Week that I started a tradition for myself.  During RT Week I would reflect and write a note to recognize and thank individuals who have directly or indirectly made an impact in my respiratory therapy practice over the past year. 

Over the past 2 years, I have been spending a lot of my spare time on RTSO activities.  I get to witness an amazing work by a great group of people. First and foremost, thank you, Nancy Garvey!  She continues to contribute to this field without asking for anything in return. Gino De Pinto, thank you for the energy you have brought back to this organization.   Sue Martin, thank you for your ongoing care for RTSO. I appreciate your courage to look after an area of organization that requires the most amount of attention. Sue Jones, thanks for your efficient and effective leadership approach.  Hope you can save us one more time. Shawna MacDonald, thank you for continuing to do wonderful work with Airwaves despite having limited resources. Kelly Hassall, I look forward to working on more projects with you! David Offengenden, your support of Nancy is vital to the operation of this organization (thank you for ongoing dedication).  Rob Bryan, you may have stepped down to give space to the new team, however, your years of service at this organization is clear and still noticeable and appreciated. Dilshad Moosa, you were given a difficult assignment and you still took the challenge (thanks for your dedication and contributions). To all the members of RTSO who have renewed your membership, thank you!  As Sue Jones clearly described at the 2019 Leadership Summit and Inspire Conference, if we don’t have the majority of RTs supporting the organization, why would the government listen to our voice of concern and advocacy? Thanks for supporting RTSO. We advocate for our patients on a day to day basis, advocating for our profession should be as important. 

Making a transition from provincial to the national.  CSRT. Thanks to the board of directors, president, CEO, administrative team, and volunteers!  A special thank you to

Carolyn McCoy for her contributions to CSRT, and on a personal note, on her ongoing guidance and mentorship.  A thank you to Carly Brockington for her patience with me (as a novice peer reviewer). A quick thanks to a retired member of CSRT, Christiane Menard.  Your interest and support of my blog fueled my interest in supporting the RT organization. Thank you.  

Through CSRT, I have met many wonderful individuals and I would like to give a quick shoutout and thanks for their ongoing support of my online presence: Brandon D’Souza, Sebastien Tessier,  Christina Dolgowicz, Marco Zaccagnini, Thomas Piraino, Noel Pendergast, Frank Fiorenza, Dave Wall, Greg Donde, Mika Nonoyama, Dave Sahadeo, Lynard Higoy, Kuljit Minhas, Katherine Nollet, Christina Sperling, Patrick Nellis, Karl Weiss  and many more (my apologies if I have missed your name).

Moving to a global level.  Thank you to Bernad Ho (Bsc, RCPT),  Thomas Piraino, Mika Nonoyama, Eric O Cheng, Frank Fiorenza, and  Andrew West for your involvement and advancement of RT practice and image on a global level.  

On a corporate level,  thank you to John Meloche (Melotel Inc.) for supporting my online presence.  Just like Christiane Menard, you have been one of my first followers/supporters.  

Also, thank you to the Novus Medical Inc. for their huge role in the support and growth of the diagnostic side of respiratory care in Canada. 

Congratulations to Tony Kajnar on receiving the Pinnacle Award from the RTSO.  Despite all the resistance and barriers in your way, you have not given up and continue to advance and grow the diagnostic side of our profession.  I also appreciate your mentorship over the years. 

To my mentors,  a huge thank you to Carolyn McCoy, Thomas Piraino, Christina Sperling, Nancy Garvey, Mika Nonoyama, Mieke Fraser, Kathleen Olden-Powell and  Noel Pendergast (I am sure that I am missing some names here). 

Carole Hamp and Kevin Taylor, I may not have direct contact with you, but I do recognize and appreciate your hard work at CRTO.   

Kari White and Madonna Ferrone, I may not really know you two but keep up the great work!

RT schools, I have noticed and appreciate your increased online involvement.  More online presence, a higher RT representation!      

Dave Wall and Greg Donde, thanks for starting an RT podcast.  Seb Tessier, Dave Sahadeo and I had previously spoken about this void and glad you guys started RTAudio. 

A quick shoutout to my Markham Stouffville Hospital RTs that help me stay sane at this crazy fast-paced PFT lab:  Carolyn Greer, Kim Dixon, Perrin Michael and Sheery Tse.

A special thank you to my amazing wife, Jessica Morgan, who despite having an ongoing busy schedule, makes time to support and encourage my RT involvement.   

As I type this thank you post, I become increasingly nervous and worried about the names that may have escaped my mind.    

If you have read this far, I am very impressed and thankful.  On that note, a huge thank you to my followers. I know that I have not been as active.  That is not due to lost motivation or interest. For the last 2 years, I have been volunteering with RTSO, assisting in various projects and goals.  As I become more efficient at my roles, I will redirect more time into my blog and online activities.  

Thanks,

Farzad ‘Raffi’ Refahi
Oct. 26, 2019
http://www.respiratory.blog/rtweek2019/