Trau·ma  Junk· ie  ( 'trau-m&  'j&[ng]-kE) n. Slang
  1. One who has an insatiable interest, devotion or addiction to responding and assisting people with serious injury or shock to the body, as from violence or an accident.

An Interview with Keepbreathing

I thought I'd change things up a bit and post something outside of the norm for Surviving RT School (if there is such a thing...) So, here is an interview I conducted with the Anonymous Therapist sometimes known as "Keepbreathing" of Respiratory Therapy 101: Just Keep Breathing.

By the way, the picture above is us in the studio. Since we both like to blog under a pseudonym, the producers at CNN thought it would be best if they just edited out our bodies as well. Then since there was a bunch of talking and no bodies on the set, they decided I should just post in on my blog. It almost got picked up by PBS, but even they didn't want it. So, here goes:

1. How long have you been involved in blogging, and what got you started?
I've been involved with blogging in one form or another for years. I started eons ago in high school, back when only total nerds had anything to do with this newfangled internet...I ran personal blogs to entertain myself and my friends, and continued that way until I started RT 101 about a year and a half ago. This is the only widely-read (and that's generous) blog I've participated in.

2. When did you first know you wanted to be a respiratory therapist? How long have you been in the field?

Actually, when I was growing up I always wanted to be an airline pilot. My plan was to go to Daniel Webster College and get an aviation degree, but then 9/11 happened and the job market bottomed out. I was working at a hospital at the time and noticed that the RTs seemed to have a more fun job than anybody else around, so I job shadowed an RT for a day and decided I liked it well enough to go to school for it. Any doubts I had were eliminated one day as I traversed a hallway, wondering whether to do RT school or not, and I literally saw a sign for Champlain colleges now-defunct RT program that said BE A RESPIRATORY THERAPIST.

I started working as an RT as a student in 2003, and got a provisional license in May of 2004. Since then I've worked every shift in in four states and five hospitals, which has given me a lot of interesting experiences.

3. Tell us about your experiences in respiratory therapy school.

Believe it or not I was the Token Slacker. I'm one of those people who is good at taking tests but who is really lazy, so I tended to do as much work as possible in class to avoid it on my days off. Sometimes that meant sneaking the CardioPulmonary Anatomy book into Mechanial Vent I, sometimes it meant trying to cram Neo-Peds while sitting in O2 delivery.

Despite being a lazy slacker I managed to pull respectable grades and made the "deans list" four out of five semesters. Good slacker story: I once showed up for my Physics In The Health Professions class and noticed that everybody seemed really concerned with something. I put my coffee down and asked the guy next to me why everybody was so worried, and he gave me The Look and said "Dude. It's the final today." I managed to shrug off the panic and pulled a 90 on the exam. I'm lucky.

4. If you weren't a respiratory therapist, what would you be?

Pilot, hands down. I'd give up everything to be a pilot of the opportunity presented itself. I took flying lessons a number of years ago and absolutely loved it; because of financial pressure I haven't been able to go aloft in a few years now. I miss it. It makes me sad sometimes.

5. What is your favorite book of all time?

My favorite book of all time would have to be the Hitchhiker's Guide to the Galaxy, all five books in the trilogy, by Douglas Adams. I read and reread those books as a kid and they actually have a lot of solid points and decent advice in them if you know how to take it. Best advice I've ever gotten comes from that book; it's the two-word phrase Don't Panic. Simple, concise, and darn good advice.
6. What are some your favorite TV shows?

I like nerdy TV. I watch the Mythbusters and Iron Chef America; I also watch some of the slaughter-ye-sacred-cows shows like Family Guy and South Park. I have to admit that even though it can be a little dramatic I do enjoy watching Trauma: Life in the ER. I've seen people I know on there. As staff, not patients.

7. What is the most embarrasing song on your playlist?

Um, there are a number to choose from. For a married straight guy I have some questionable tunes; I like Norah Jones because she has an excellent voice, and an ex-girlfriend of mine from many years ago bought me a Kristy MacColl CD which will pop up on the playlist now and then. Picking a specific song would be challenging...

8. What sparked your interest in the medical field?

I was working in a hospital in a clerical position and got to see what went on in the hospital that way. My mother was a psyche and then administrative nurse, but I never really developed an interest in nursing.

9. What is a typical shift like for you?

I show up, clock in around 6:30 AM and wait for our assignments to be passed out by the charge therapist. Report usually takes 15 to 20 minutes, and then depending on my load and whether I remembered to bring coffee from home I'll either start first rounds or get coffee. First rounds are almost always done by 8:30 or 9, unless something crazy happens or I have a massive assignment. Second rounds are at 11, third at 3. Each round consists of ventilator checks, miscellaneous therapy like chest PT or nebulizers, and the odd jobs that surround ICU care like retaping ET tubes, drawing ABGs, or inserting A-lines. The time between rounds is usually taken up with filler: road trips to CT scan or the vascular lab, bedside traches, intubations, bronchoscopies, and so on. Some days I also am on codes and so I get to go if somebody decides to try to die. Between scheduled treatments and the filler stuff, most of my days are pretty busy.

10. Do you remember the first medical blog you read?

Musings of a Highly Trained Monkey. MonkeyGirl is awesome.

11. What's your favorite holiday, and why?

I usually like thanksgiving. You get the family togetherness without the commercialism of Christmas. You also have an excuse to gorge yourself and eat until your stomach bursts, at which point it's empty so you have room for pie. Christmas is nice, but the stress surrounding it can be a little overwhelming.

12. What is the best part of your job? The worst?
The best part of this job for me is problem solving. I love it when I am presented with a problem that I can identify and fix. Troubleshooting a ventilator patient, giving one of those extremely rare treatments that are actually indicated and will actually help, or successfully getting a blood gas that nobody else could are all high points for me. Seeing a patient that I cared for get better is always satisfying but it doesn't happen that often; it seems that a huge percentage of our ICU patients here are either full-blown Gomers or they're on the slow path to death.

The worst part of the job for me is dealing with family members. Some families I like: they're smart, inquisitive in a good way, and they listen. But most families seem to be hostile, confrontational, ignorant and obstructionist and I really don't like them to be around the patients. I used to have a lot of trouble terminally extubating patients or dealing with death, but I've gotten used to it now. The only ones that bother me any more are the young ones who didn't deserve it.

13. A lot of Respiratory Therapists complain about the burnout factor. How do you avoid it?

I don't know if I've avoided it or made a lifestyle out of it. =)

Seriously though, burnout happens when you work too hard and put too much of yourself into the job and you don't get enough back. The key to avoiding burnout is to know what matters and what doesn't, because in respiratory about 60 or 70% of what we do is either unindicated and done for the psychological edge of "we're giving a treatment so we must be doing something!" or it's just plain unneccesary. You have to do it but you don't have to throw yourself into it. Focusing too much on that stuff will drive you insane and burn you out. Focus on the 30 or 40% of what you do that actually matters and you'll be okay.

In a phrase: learn to separate the wheat from the chaff.

14. Most people think respiratory therapists work solely in hospitals, "playing with sputum," but that's just not true. If you weren't working in a hospital as an RT, where would you work?
Either in a pulmonary office as an outpatient RT, or in homecare. Nursing homes apparently used to be easy money but I would hate that. Working in a pulmonary office and doing assessments, ABGs, PFTs and so on would be a good setting to work in. Homecare has its ups and downs, but it wouldn't be all bad to do. Additionally, some therapists work in outpatient PFT labs or in sleep labs.

Having said that: I love my in-house work, and I really love the ICU work.

15. Aside from blogging, what do you do in your free time?

I read, I cook, and I run. I just started running again with the goal of not being the 45-year old STEMI alert who comes in and dies in the ER because he never cared for his heart. I cook because I like food and I read because it entertains me.

16. Do you have a favorite quote?
"Forgive me, oh Lord, my many little jokes on thee and I'll forgive you thy great big one on me." ~Robert Frost

17. This or that... Football or baseball?
Football, although I don't watch many sports.
Beer or liquor?
Both! I like sampling different beers. They're like children: all unique in their own special way. I also like liquor because it makes me laugh until I fall down. Gin, whiskey, rum...it's all good.
Coke or pepsi?
I can't tell the difference, really. Coke's maybe a little sweeter?
Reality TV or sitcoms?
Sitcoms. Reality TV makes me want to puke.

18. Clear up one misconception you believe the general public has about respiratory therapists, and one misconception you believe other medical professionals (doctors, nurses, CNA's, etc.) have about RTs.

The general public has no idea we exist. When they hear about us it's on "Trauma: Life in the ER" when some resident is screaming WHERE'S RESPIRATORY? However, when I do get asked questions from the general public, it tends to be along the lines of "So...you just give these treatments all day?" I think that when the public is aware of us, they see us mostly as neb pushers and those weird people who occasionally draw blood that hurts more than usual.

The truth is, we do give a lot of nebs, but we also do a lot more. We assess, act as the extra eyes and ears for physicians (which is why I suspect a lot of treatments get ordered, the MD knows someone will be in to assess the patient every few hours.) We titrate oxygen, analyze blood, know intimately the interplay of body systems that can affect respiration. We run life support. We do a lot more than just pushing nebs.

Where I work now, Respiratory gets a lot of respect by and large. The ICU people especially respect us and understand what we do and how valuable we can be to the team. But I've worked at hospitals where other medical professionals tend to see us as low-level lackeys...until something goes wrong, at which point it's all "WHERE'S RESPIRATORY?" and "OH GOD WE NEED RESPIRATORY!"

19. You have so many blogs in your blogroll. Which ones do you
enjoying reading the most?

Oooh, don't make me pick...they're all good. I guess if I had to pick a couple of favorites, Madness: Life in the ER, Musings of a Highly Trained Monkey, Ambulance Driver, the Anesthesioboist, and the RT Cave are some of my favorites...but I like them all. It's why they're on the blogroll!

20. Do you have any advice for current RT students? What about those already in the field?

Current RT students: Don't give up. Respiratory Therapy is a good field to be in. As much as I might complain, it's important to remember that there are a lot of positives in this field. You will gain lots of knowledge and be treated to a unique perspective on life and living if you just take the time to learn the lessons that this field as to offer you.

And those of you already in the field: try to focus on the positive. There are problems in the field, but there are problems in any career and in any workplace. Be happy to have a job. Separate the wheat from the chaff, don't stress the little stuff, and just try to take it easy.

The best advice I can give to anybody is the best advice I mentioned in question 5: Don't Panic. And just keep breathing.

Well, there you have it.

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