Stand for the Change You'd Like to See

As we steadily move into the new year and a new decade, we've already seen many changes in the face of medicine. But the changes that are to come, the ones we as providers control, are the changes that will be most defining for our profession.

Keep in mind that I'm both an EMT student and a respiratory student, so this post may be geared toward one profession or the other at times, but in a nutshell-- it's all health care, and here is my small contribution.

What can we do to bring about change? There are several things:

Be a diagnostician, not a technician

In RT school, one of my favorite instructors of all time often told us that we should think like therapists, not technicians. In EMT school, I have learned that BLS skills are crucial, but aside from Basic assessment, decision-making skills are key.

We like to follow a simple model for patient care in both professions: Assessment -> Decision Making/Critical thinking -> Intervention -> Follow-up. Often times, this is overlooked in practice. So many providers are used to doing a very focused assessment based on the complaints the patient presents and immediately moving to the protocol/standing orders or phoning the physician for advice with their initial (and very simple) findings. Following this, a decision is often made for treatment hastily and without regard to other possible causes.

It is important for both RTs and EMS providers to remember that while we aren't physicians, we are taught this process for a reason. Many of us would like more autonomy and a larger part in the overall care of our patients, but in order to do so, we must act and think critically, not as if we are working out of a cookbook or basing everything we do off of an algorithm.

I can't speak on behalf of EMTs yet, but I know in recent years that respiratory therapists have made a move toward being a more crucial part of the team. Professional organizations (the AARC, NBRC, etc.) are working for us as professionals, but it is our duty to show everyone what we are truly capable of doing.

Don't settle for being a neb jockey or a button pusher. If something doesn't seem right, question it in a professional manner. Be prepared to offer an alternative method or treatment to the physician, but also be prepared to defend your case with proven research, which brings me to my next point.

Never stop learning

As either an EMT, Paramedic, or Respiratory Therapist, we have an obligation to our patients to never stop learning. Every day, new modalities, new drugs, and new equipment are in the making. You may have went through the toughest program in the United States, graduated with flying colors, and passed your boards the first time around, but it doesn't stop there. Trust me.

I'm not talking about just meeting the required number of CEU's that you need to renew your license or certification. I'm talking about taking an active role in educating yourself for the benefit of your patients, as well as being able to share this knowledge with your co-workers.

As well all know, the internet is an amazing thing. Use it as a tool to learn about current trends

so that you can be the best provider you can be. Stay-up-to date on your knowledge and skills. This will take you a long way, and eventually, you will be able to make great strides in your field.

But also, remember to stay humble. Some of the best advice can't be found in a research article, a textbook, or a policy manual. This is why we must...

Never stop listening

You are never too good at what you do, nor will you ever have seen and done so much, that taking a moment to listen to another, more experienced (or even less experienced) co-worker's stories or advice will ever be beyond you. It is safe to say that we have all experienced moments in our careers that we haven't known how to react to a situation. Emotional situations often come to mind.

Again, absorb it all. Listen to your partner's story about a rough call he had, and listen from an outside perspective. Often times, the best providers have an even better colleague that they look up to.

Social media is wonderful. Twitter, podcasts and blogging can easily revolutionize medicine as we know it. Read and listen to all that you can. (That's another post for another time, I promise.)

And last but not least?

Be the change you want to see

Everyone has their own ideas for how we can reform the health professions. We're all individuals, and while we see eye-t0-eye on the issues that require change, we may envision going about these changes different-- and that is completely fine.

Your job is to be the change that you want to see. Go about this change how you want to go about it. Bounce your ideas off of your fellow health care workers, your supervisors, and others in the medical community. One person can make a difference, but all in all, many people are required to enact a change.

Support your own efforts and the efforts of others. In 2010, and in years to come, we can improve health care.

Are you in?

How 2009 Changed Me

...alternatively titled "How I Became a Better Caregiver and a Better Person in '09."

Dear 2009,

You have changed me. It's true. You were a hard and sometimes trying year, but I have no regrets and I'm glad you were a part of my life.

For all of my readers, here's a quick recap of my year, as far as school goes:

Spring 2009
-Respiratory Care Fundamentals II
-Cardiopulmonary Disease Processes: A Case Study Approach
-Respiratory Care Fundamentals II Lab
-Clinical I: Respiratory Therapy Tech
As this was my first semester of clinicals, I learned two important lessons: Regarding patient care, you should always trust yourself, and always ask questions. Becoming a good caregiver is a combination of both of these. If you are ever unsure of yourself, or your knowledge on a certain topic, don't be afraid to ask. No one will look down on you for asking.

Summer 2009
-Respiratory Care Procedures II
-Clinical II: Respiratory Therapy Tech
-Respiratory Care Procedures II Lab
Summer was a trying semester. None of us wanted to be there in the first place (What?! No break AT ALL???) and we covered a lot of ground. We learned some non-invasive procedures (CPAP, BiPAP), but it was also in this semester that everything really tied together and we learned some of the more complex things.

It wasn't long after being signed off on intubation in school that I lost my virginity, and since then I've successfully dropped almost 25 ETT's, only missing once (I went back in a 2nd time and got it.) I grew a lot this semester, as a lot of pressure was placed upon the students. (Read more on what I'm talking about here.)

Fall 2009
-Mechanical Ventilation
-Pulmonary Diagnostics
-Advanced Respiratory Patient Assessment
-Mechanical Ventilation Lab
-Clinical III: Respiratory Therapy Tech
Fall semester of 2009, you kicked my butt. However, it was also in this semester that I learned to find support in the people who care about you the most-- one of the more valuable lessons learned during my course of schooling thus far.

I witnessed my first pediatric code, and I learned that it's okay to be emotional. I also learned that you have to be able to find a balance between the stresses of your job and "real life." As much as it is okay to be raw and let your emotions show, you can't let the things you see burden you.

But the most important lesson learned in Fall of 2009? Working in this field isn't about being a hero, or about saving lives...not all the time. More-so, it is about being there for your patient and their family. Sometimes you don't bring them back, and sometimes you don't even have the chance. At many times in such a career, you are going to be faced with doing things that are extremely difficult for you...but you have to remember that you're in it for the patient.

As many of you know, though, school isn't my life, and my life isn't school. Outside of school, I have a job as a CNA/telemetry tech/Unit Clerk at the local hospital. I learned a lot on the job this year:

I realized when I first became a trauma junkie, and why I love what I do. If you don't love what you're doing, you should be doing something else...and I spent a great part of 2009 trying to figure out why healthcare is the right job for me.

I witnessed my first save, and learned that cardiac arrests don't always end badly. It was also in this same day that I discovered how important it is to truly connect with your patient's family. Medicine is fascinating, and the advances are great, but if you don't have bedside manner, you won't get far...and bedside manner doesn't stop at the bedside.

Outside of work and school, other important things were learned along the way:

-I learned to keep your friends close. Good friends are hard to come by, and when you find them, you should cherish the friendship completely. Never take what you have for granted.

-I learned to find comfort in silence. When everything is so busy and you feel so incredibly weighted down from the events in your life, I learned how to turn it off. I learned how to relax and make time for myself. Sometimes, clearing your mind is just as important as checking off everything on your to-do list for the day...and both should be something you do daily.

-I learned to be my own person. Seems simple enough, but it was a difficult lesson to learn. You don't have to be perfect, nor do you have to embrace everything that everyone thinks you should do. You don't always need the support of others, especially if you know in heart that what you are doing is what is best for you.

So, here's to 2010. A belated Happy New Year to all of my readers!

I intended to write this post with resolutions on what I plan to change in the New Year, but I don't make any promises at this point. 2009 has taught me a lot, and I guess my main goal for the New Year is to relax and expand on the lessons learned in 2009...to continue to grow, and become better at all aspects of my life, one step at a time.

I'm certain 2010 is full of many exciting changes and new chapters in my life, but I don't know what those are just yet, and that's okay.

One breath at a time, right?