That is a dumb thing to say

Student Respiratory Therapist: I got into this because I wanted to be a nurse but I didn't want to deal with poop.
Registered Respiratory Therapist: Oh, well, you're in for a rude awakening.  Also, I hate you.

I don't really have a lot to say.  I have applied to Graduate schools for Nurse Practitioner (non-nurse to NP pathways) and Medical Schools.  We will see what happens and honestly, I am comfortable doing either path and I am really leaning toward the holistic NP coursework.  It is very much in the vein of the DO approach, but there are no DO programs anywhere close to me at all.

Chest Radiograph Explained Very Well

I did not make this but I found it and thought it was amazing so I would share it.  It's unedited so hopefully the signature in the lower right is the proper credit.

Education Tool

Feel free to take my drawing and use it to help teach others.  Obviously not anatomically correct, but its an excellent way to explain to a beginner how blood paths in a neonate.

Students, Every group is worse than the group before.

Quick Tips for Students.

1. Take Report, if you don't have a census sheet, suck it up, start scribbling on a blank sheet of paper.
2. Write down words you don't know and look them up later.
3. If the RT you're with doesn't know the answer, that doesn't mean you don't have to know the answer, look it up later.
4. Be proactive, many RT departments don't have the preception structure nurses do so you're with someone who probably hasn't been officially trained to know how to use you.  They're nervous about being wrong or a bad teacher or teaching you all the things you already know.  Be up front, tell them you don't know anything even if you think you do and follow them like a duckling.  Even the ones who act bitchy about you doing that will talk about how good you were when you are gone.  The "cool" students (the ones who relax and laugh the whole day with the RTs instead of learning) are always the ones most complained about.
5. Even if you don't want to work at that hospital, act like you do.  When you graduate your teachers send out recommendations to hospitals and they'll sometimes be too real about your skills and personality.  RT departments also all tend to know eachother.  Its a small society and being a douchebag will get you blackballed from a hospital you've never even been to.
6. Get at LEAST 1 year, more preferably 3 years of ICU experience right out of school.  Doing anything else destroys your resume.  3 years of ICU experience, then open your oxygen supply company.  Your life-goals will thank you.
7. Get your Bachelor of Science in Respiratory Care.  Get it asap.  Boise State has an online completion program and KU has one.  I prefer KU.  Its going to be mandatory soon and while you'll be allowed to practice with an associates it will be hard to get a job.  Physicians Assistants used to be Associate Degrees and the PAs who didn't get a higher degree find it very difficult to get a job, even with experience.

It was ordered 7 days ago and no one remembers why.

When I argue about the necessity of a treatment I am not trying to be lazy.  Stop looking at me with that sassy face.

It has taken me 4 times as long now to argue with you about it than to have just given it and I can't charge the patient for arguing with you.  

Quick Case

1200g 25wk, week 3 of life, week 3 on jet ventilator (HFV-P)

Capillary Blood Gas at 6am

7.60 / 42 / -- / +16

Vent: HFV-P  29/10 f240 (Backup Rate of 8)

ServoP: ~4.0

ETT: 3.0mm @ 7cm (2.5mm Jet Adapter)

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Capillary Blood Gas at 9pm the night before

7.39 / 70 / -- / +10

Vent: HFV-P  29/10 f240 (Backup Rate of 8)

ServoP: ~2.5

ETT: 3.0mm @ 7cm (3.5mm Jet Adapter)

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Polydactyly

When a neonate I pick up from a referring facility has 6 or 7 fingers normal people make faces and comments about how weird it is.  As a Neonatal Respiratory Therapist I only care that this neonate has more fingers to grip their ETT with.

Plus its kind of cute that when its reaching for its pacifier it looks like its waving at everyone with its many fingers.

HeRO®

HeRO® is an FDA cleared medical device for the identification of transient decelerations and reduced baseline variability in heart rate.

•	HeRO generates an hourly numeric score that quantifies the prevalence of abnormal patterns in each patient's heart rate.
•	HeRO continuously acquires, records, measures and analyzes heart rate characteristics.
•	HeRO provides real time display of the HeRO Score at multiple viewing stations located throughout the NICU.
•	HeRO is non-invasive and requires no applied parts or new patient leads.
•	HeRO interfaces with any make off existing ECG monitoring systems.
•	HeRO provides secure remote monitoring capabilities.
•	HeRO allows covered entities to remain HIPAA compliant.

Advocacy

Patient advocacy is exhausting.  I might "just" be a Respiratory Therapist but since its within my scope of practice to interpret chest radiographs, I am going to.

I won't move an ETT without personally reviewing the film, I will notify you when I see free-air or "bowel shaped aeration above the diaphragm" and I expect you to accept that.  I don't "joust" or anything and I try my damndest to communicate with you one-on-one to save your ego but its not always possible.

Next time though, when a Respiratory Therapist tells you they're concerned about a patient's cardio-pulmonary status, listen to them like you would listen to an expert on the topic.

Not just because we're colleagues or friends, but because we are actually experts on the topic.