Half my staff lives 90 minutes to three hours away from this facility and at least three-quarters of them have three hospitals within 10-20 minutes from their homes. Why do they choose to drive a long distance to work here? I would like to say that it because of my wonderful personality and pleasing disposition, but that is not the reason.

It starts with the creation of a pleasant work environment from the board of directors and the CEO and trickles on down to each department. During my initial interview with prospective employees, I will often tell them that if they are looking for a fantastic salary, this is not the place. I can't compete with much larger facilities, but I can offer them a challenging position where they can use their education, knowledge, training, experience, and the skills of their profession.

People want to work where they feel they are needed. Managers often overlook their staff when it comes to expressing their appreciation for all that they do; often, the only time they see or hear from their manager is when there is a problem. Managers should take the time to have a private conversation with all employees as well as give them a written letter, with a copy for their personnel file, regarding their contribution to the department, the hospital, and our patients.

Several months ago, I had the manager of the medical/surgical department call me to compliment several members of my staff and she mentioned each individual by name and then added a very sincere compliment about each person. I mentioned this to the entire staff at our next meeting. You can imagine the delight in the faces and countenance of these individuals when they learned of these comments and realized that people are watching them.

Recently, the manager of our emergency department told me about several members of my staff and how pleased her department staff and physicians were to have them working in her department. Again, she mentioned each individual by name and gave a very specific compliment or attribute about each individual and his or her professional behavior.

Receiving comments from other department managers about your staff and the wonderful work they are doing is an awesome experience, not only for the manager, but for each individual. All of us enjoy receiving compliments when we are doing good work. It makes us feels needed, wanted, and appreciated. Compliments are the food that nourishes and edifies the soul.

• 55 percent of our impact on people is determined by body language -- postures, gestures, and eye contact 
• 38 percent of our impact on people is determined by the tone of our voice
  
• 7 percent of our impact on people is determined by the content or the words used in the communication process.

Ninety-three percent of our communications with one another is based on something other than words. Therefore, if my goal is to improve the work environment or to build a solid team of professionals, I need to do more and say less. As the old saying goes, "Actions speak louder then words."

As managers, we sometimes begin to slip by arriving late for work or leaving early. In a recent employee satisfaction survey, several staff members noted this behavior in their manager and felt that he ought to set the standard and arrive at work at the start of the shift and stay until the end of their shift. There are numerous times when my assignments or schedule could appear to my staff that I'm not setting a good example. One of the things I try to do is to let people know that I'm leaving to attend a meeting or I have another assignment and I will be gone the rest of the day. My staff is also aware that it is not unusual for me to have a 50-plus hour week, as one or more of my staff will stop by my office and say something like, "Are you still here?"

In addition, managers need to set the example regarding their demeanor as it can affect a whole department. A grumpy old boss does little to inspire those individuals that look to their manager for direction. However, a manager who is cheerful, optimistic, smiling, positive, applauds his staff's achievements, and involves them in the decision-making process will experience a staff that is willing to make those little sacrifices that mean so much in our daily challenges to excel.

Managers also can set the example by being active in their state and national professional organizations, read professional journals, attend seminars and state and national conventions and then report back to their staff on what they have learned. Another avenue managers can travel is obtaining additional education and higher degrees or credentials.

We cannot expect our staff to seek these things if we're not willing to do the same. We need to set the standard and raise the bar to where you want your staff to be.

A few months ago, I shared predictions that my department made about how our profession will look in 2025. Technology is moving forward at light speed and I suspect that there will be things happening in the next few years that even our imaginations hadn't considered. Because of new technology, I predict we will be providing treatments in the next few years that we have yet to conceive as being possible.

Here are a few more predictions:

There is no doubt that our population is growing older and we will be seeing chronic pulmonary diseases like COPD, asthma, and others in greater numbers. Because of new technology, there will be increased accuracy in diagnosing these patients. We will see more and more of these patients treated on an outpatient basis and avoiding hospitalizations as much as possible. 

I think we will see a greater emphasis on promoting "wellness" rather then treating illnesses. And we will also see a more aggressive as well as progressive move from providing acute care in the hospital to providing care in the patient's home. Hospitals will still provide the cutting-edge respiratory life-support technology, but sub-acute and home care providers will play an increasing role.  About 75 percent of RT's today work in an acute care hospital setting, but I believe in the future we will see more and more RT's working in home care and physician's offices.

There is no doubt in my mind that RT's will be required to have more than an entry level educational associate's degree in the near future because of advancing new technology and use of protocols. More sophisticated mechanical ventilators with new modes of ventilation and greater clinical monitoring capabilities will demand a more highly educated and sophisticated RT to care for these patients. There will be more use of evidence-based protocols and biomedical innovation that will require the RT of the future to master these new innovations. 

Within a few years, a bachelor's degree will be required as a minimum. Additional knowledge and understanding will be required in physiology, genetics and biochemistry to name just a few. These advances will require RT's to make decisions regarding patient care or treatment that we do not have the ability to even comprehend today. The big challenge here is that a vast majority of RT Programs today are located in community colleges that do not offer baccalaureate or masters degree programs. Somehow, we are going to have to make a shift in the way we educate RT's. 

New improved aerosol delivery devices are already here. More will be coming that will improve the efficiency and delivery of medications to the lung parenchyma, increasing effectiveness and reducing costs. It was also predicted in a lecture I attended that in the near future physicians would be prescribing medications based on the patient's genetic profile. The future looks absolutely brilliant for RT's that are willing to make the sacrifices that will be required to keep up with the myriad of medical advances that are taking place right before our eyes today.

There will be new advances in aerosolized or inhaled medications that will enable them to be used for a much broader group of diseases, e.g. heparin for fibrosis and asthma, furosomide and opioids for dyspnea, insulin for diabetes, calcitonin for osteoporosis, luteinizing hormone and follicle-stimulating hormone for infertility, human growth hormone for growth and interferons for hepatitis.  There is also research going on for developing an inhaled gene-replacement agent for genetic diseases such as alpha-1 antitrypsin deficiency and cystic fibrosis.

The RT of the near future will need to understand the scientific evidence and to be able to analyze various studies to determine if the findings are appropriate for their practice.  These new aerosol therapies will require a broader knowledge of physiology, general medicine and pharmacology.

Unless the predicted shortage of physicians is resolved there will be an increasing need for RT's to lead out in the management of pulmonary diseases.  The RT's scope of knowledge and skills will need to expand and RT's will need to refine their critical thinking and communication skills, and increase their ability to analyze the medical literature.

Your thoughts?

‘Twas the night before Christmas, when all through the hospital not a respiratory therapist was sleeping not even a nurse.

The hospital was decorated so beautifully with colorful lights and wreaths in hopes that St. Nick would soon make a visit.

The patients were nestled all snug in their beds while the nurses, CEO, CFO, and the DON had visions of wonderful days ahead dancing in their heads.

I had just settled down for a long winter's nap when out in the parking lot there arose such a clatter that I sprang from my chair to see what was the matter.

Away to the window I flew like a flash, tore open the blinds and immediately called a Code Blue in the parking lot.

The full moon was showing brightly giving a luster to the events going on in the parking lot below.

When, what to my wondering eyes should appear, but a little old physician so lively and quick that I knew in a moment that it must be Dr. St. Nicholas.

More rapid than eagles he came. He whistled and shouted his orders he called. Now Nancy! Now Angela, Now Frances and Diane, Come Connie, Come Betty and Peggy to the ER we must go, so dash away, dash away, dash away all.

Off to the ER his coursers they flew with a gurney in hand and Dr. St. Nicholas too.

And then in a twinkling of an eye, I heard the coughing and breathing of a patient revived.

As I drew in my head and was turning around, down the hallway I saw Dr. St. Nicholas coming with a bound.

He was dress all in scrubs and a lab coat too, a bundle of joy his countenance did show.

His eyes how they twinkled, his dimples how merry, his cheeks were like roses, his nose like a cherry, his droll little mouth was drawn up in a smile and his beard was as white as the snow.

His smiling face and a little round belly shook when he laughed like a bowl of jelly

A wink of his eye and a twist of his head soon gave me to know that I had nothing to dread as he said not a word but went straight to his laptop to finish his charting

He was a right jolly old doc, and I laughed when I saw him in spite of myself,

With a wave of his hand and a smile on this face I heard him exclaim ‘ere be walked out of sight

Merry Christmas to all and to all a good night!

In Huntsman's talk, he said have faith in yourself, believe in what you are doing, and most importantly, be a person of integrity. It is totally up to you and no one else how your life evolves. I don't believe we are here to fail; we're here to succeed in whatever we desire to do. He went on to say what we become, who we are, and the footprint we will leave in life is based entirely on our own determination, hard work, education, and sacrifice.

Huntsman continued to admonish his audience to work hard and show integrity in all aspects of their life, regardless of prosperous or hard times. Never cut corners, demean other people, or waste time hanging out. Decide who you are and what your goals entail -- then go for the roses.

Follow your own dreams, no matter the obstacles or difficulty of the task. Making dreams become a reality will require great sacrifice and determination. Most people are content to just coast along. Many really don't like to apply their talents and abilities or to put in long hours of work. But to achieve any dream and to make something truly remarkable happen in our lives, we must face adversity head on and we must overcome all of the obstacles in our pathway. The world today is filled with significant obstacles everywhere. These obstacles appear in various forms and disguises and plague society, making some feel as though they cannot fulfill their dreams, but these are only momentary setbacks.

Another challenge facing people today is the economy, and some of the problems include losing your job or even your home. Despite the setback, there is much to be learned during times of adversity. Many of us are going through one of these valleys of life today, or we will someday experience one of those challenges or moments of adversity. These experiences in life are intended to make us better -- not bitter. Always keep in mind nothing meaningful can come your way without integrity, and integrity is often challenged by adversity. Also, remember that adversity determines our character.

Huntsman related a story about the time he agreed with a simple handshake to sell 40 percent of his business at a particularly difficult time in his life. But by the time the final legal papers were drawn up six months later, his business increased in value five times. The buyer was willing to pay hundreds of millions of dollars more as a result. "No, a deal is a deal and a handshake is my bond," Huntsman said. That is character!

Huntsman said that we must be creative, work hard, and surround ourselves with bright, honest people. Be a straight shooter and follow your dreams. But above all else, believe in yourself and in what you are doing and your dreams can and will come true. When pursuing your dreams, never forget we are only caretakers or custodians for all that we have, and sharing our wealth, our dreams, and aspirations will encourage and motive others to follow their own dreams.

Thanksgiving is the one holiday when my large family plans to be together to celebrate this national day for expressing our thanks and gratitude for all and for the wonderful blessings we've received throughout the year.

I was thinking about this upcoming event and had a few thoughts and put pen to paper and came up with the following:

T'was the Night Before Thanksgiving

T'was the night before Thanksgiving and the wonderful smells of delicious crescent rolls and pumpkin pies cooking in the oven tickled our olfactory senses with a wonderful and exciting aroma. 

Mom and I in our aprons had just settled down after a wonderful day of preparing for our national day of Thanksgiving. We sipped eggnog and dreamed of feasting on our traditional golden brown Thanksgiving turkey stuffed with my wife's secret dressing recipe (secret, because she has never written it down and it has never been the same twice) with mash potatoes, gravy, sweet potatoes, cranberries, our fourth generation Berg Family Snow Salad.

We topped it off with those wonderful pumpkin pies piled high with whipped cream and our traditional eggnog, secure in our belief that this has indeed been a year to remember and to take this opportunity to especially give thanks for the blessings of a wonderful year. 

We have been blessed this year with the marriage of one granddaughter, the birth of another grandson and two great-granddaughters and if Mother Nature and our daughter can get together, we may have another grandson born before the end of 2009.

I hope your year has been as wonderful and exciting as ours and that as we look forward to the traditional holiday season and a new year that the future will be wonderful beyond your imagination.  Happy Thanksgiving!

I started this wonderful and exciting week with a visit to the RT Students at Victor Valley College, Victorville, CA. I presented what I hope were some valuable words of wisdom as they begin a new career and profession-- as well as a few gifts welcoming them to our exciting profession. 

I also brought with me a recent RT graduate who gave them some suggestions on the difference between being a student and being a licensed RCP and what they really needed to concentrate on before they graduated. 

The highlight of this activity was introducing them to the President of the California Society for Respiratory Care and allowing the students to interact and ask questions.

At the hospital, we had two wonderful and delicious catered lunches for both the day and night shifts. Our CEO attended one of those lunches and suggested that we ought to have a catered lunch everyday during RC Week in the future.  That sounded like a direct order and we shall comply.  

In addition to the delicious food, we also had gifts of appreciation for everyone as well as "Certificates of Recognition," Certificates of Excellence," and "Certificates of Leadership" that recognized something "special" about each staff member.  One of the gifts given to everyone (including our administration) was a scrub top with a picture of a rib cage and lungs.  Most of my staff wore them every day during RC Week.

We did something different this year and sponsored a hospital-wide chili cook-off with prizes for the three top winning recipes.  We had so many people wanting to enter their "award-winning" recipes that we had to finally stop taking entries.  We even had a couple of medical staff physicians enter!

It was an excellent activity that brought visibility to the Respiratory Care Department. We had a wonderful turn-out and served about a third of the hospital staff with some of the best chili I've ever eaten.  We also served delicious cornbread and a soda with each bowl of chili. 

One large crock pot of chili that went very quickly was the one made with buffalo meat.  We also had chili made with elk meat and we had rumors that someone was going to bring chili made with rattlesnake meat, but that didn't materialize. 

Everyone had an opportunity to sample any chili they wanted and then they voted for the one they thought was the best.  It was a huge success and our CEO suggested that we do it on a monthly basis.  I don't think we will, but we might make this an annual event. 

The highlight of the week, of course, was recognizing and announcing the individual that received the Respiratory Care Practitioner of the Year Award.  This individual has work at our facility for 25 years, graduated at the top of his RT Class, and has received both the "Employee of the Quarter Award" as well as the "Meritorious Award" from the hospital in the past.  He is a very knowledgeable, highly skilled, and well-trained respiratory therapist.  It was our privilege to honor him with this prestigious award.

Because Halloween came at the end of our official Respiratory Care Week this year, we joined a crescendo of other hospital activities that climaxed a wonderful week with a craft fair, costume awards (I got to wear my "Cat in the Hat" costume), scary decorations, good food, and lots of fun and excitement. We had unexpected visit from our CEO to our department who personally handed each employee an unexpected and surprising bonus check. 

What a week! I hope your Respiratory Care Week was as successful with as much fun and excitement as ours.

We all know that our profession can and is very stressful at times.  This Respiratory Care Week, you might want to give your staff the Respiratory Care Survival Kit:

RESPIRATORY CARE SURVIVAL KIT

1 Lifesaver - to thank you for the lives you save every day

1 Paper clip - to help you hold things together

1 Tootsie roll - to remind you of the important "roll" you play in patient care

1 Mint - to remind you we share in your commit"mint"

1 Rubberband - to remind you to stay flexible, especially on the days you are stretched to the limit

1 Tea bag - to remind you to relax; you're doing a "tea"riffic job

1 Crayon - to color your world and the world around you

1 Band-aid - for all the aid you provide

2 Pennies - so you will always be able to put in your 2 cents

I hope that each of you will have a fantastic Respiratory Care Week with great fun and wonderful memories.

A colleague of mine made these predictions:

In the year 2025:
 
Small volume nebs will no longer be given due to increased risk of infection from air-born diseases. DPI takes the lead with MDI following.
 
Ventilators will have biofeedback from the patient. Patient's base line blood gas will be entered in. Through non-invasive technology, the ventilator continuously monitors and adjusts settings for target goal.
 
After an attempt to re-establish negative pressure ventilation, pressure ventilation becomes the standard with new modes that sense patient demands and makes changes for those demands or to meet preset goals.
 
The last function IPPB machine dies, and RCPs remember it as the first positive pressure ventilator.
 
Due to drug-resistant bacteria, universal precautions have advanced. All patient rooms are negative pressure rooms. A new affordable biohazard suit is introduced. PAPR has a new look and seal that prevents leaks improving RCP safety.
 
Korea discovers that the large smoking population of past years is now raising the cost of healthcare. However, stem cell research has enabled scientists in Korea to grow individualized hearts and lungs. The newly grown lungs are surprisingly affordable-more affordable than paying for chronic illness.
 
How's that for imagination?

What will the innovations of today look like to our colleagues in 2025? In 2008, we assembled a time capsule for Respiratory Care Week to be opened by colleagues at our facility in 2025. Here is a list of items we included in our time capsule:

• List of currently used respiratory therapy medications
• Copies of our current protocols
• Copies of our policy and procedures
• List of the Respiratory Care Week Committee members and recipients of the prestigious "Respiratory Care Practitioner of the Year Award"
• Picture and list of current RC Staff
• List of currently in use equipment
• Pictures of our current equipment

This might be a fun activity Respiratory Care Week activity for your department. Perhaps you might even include in the time capsule some equipment such as nasal cannulas, oxygen masks, nebulizers, BAN (Breath Activated Nebulizer), self-inflating bags, flow-inflation bags, endotracheal tubes, LMA (Laryngeal Mask Airway), laryngoscope and blades, disposable optical laryngoscope, ABG kits, arterial line insertion kit, incentive spirometer, PEP, acapella, peak flow meter, etc.

If you decide to create your own time capsule, I hope you are around in 15, 20 or 25 years to open it and revel with your colleagues in the things of yesteryears.

Respiratory Care Practitioners are like Ford - they have better ideas.

Respiratory Care Practitioners are like Coca-Cola - they're the real thing.

Respiratory Care Practitioners are like Dial Soap - they care more, don't you wish everybody did.

Respiratory Care Practitioners are like VO5 hair spray - their goodness holds in all kinds of weather.

Respiratory Care Practitioners are like Standard Oil - you expect more and get it.

Respiratory Care Practitioners are like Frosted Flakes - they're Grrrreeeeeeeeeeeaaaaat!!!!!!!!!!!

But most of all, Respiratory Care Practitioners are like Hallmark Cards - they care enough to give the very best!

HAPPY RESPIRATORY CARE WEEK!

Each year, we form a Respiratory Care Week Committee to take charge of this celebration. This year, the committee decided to do a couple activities that I thought might interest others. 

First, we purchased scrub tops for everyone. The committee found a picture of a rib cage with lungs and a heart and they are going to have that picture silk-screened on the back of the scrub tops. They will give the scrub tops to everyone in the department, including our administration and medical director. 

They also decided to have two catered lunches for both the day shift people as well as the night shift instead of just one for each group. 

For a finale, we have invited the entire hospital staff (including the medical staff) to participate in a Respiratory Care Week Chili Cook-Off by either entering their favorite chili recipe or just coming and enjoying a wonderful and delightful epicurean extravaganza of chili, cornbread, and sodas. An impartial unbiased panel of judges (respiratory care practitioners, of course) will award prizes for the best judged chili recipes. 

Like us, you have probably also noticed that Halloween comes at the end of Respiratory Care Week this year. This awesome committee decided to end our week of celebration with everyone dressing up as a Dr. Seuss characters.  I was selected to be the "Cat in the Hat" and a very talented lady is working very hard to make my costume for me.  Of course, there will be more delicious food and the department will be decorated appropriately for the occasion - that part has already been completed.

What fun things are you doing to celebrate this auspicious occasion of Respiratory Care Week - 2009?

One of my sons-in-law told me the reason the years seem to fly by faster as we grow older is that when you are 5 years old, one year represents 20 percent of your life, but when you are 40 years old, one year represents 2.5 percent. At age 70, one year represents only 1.4 percent of your life. Each year goes by faster because each year represents less and less time of your life.

I don't know whether that's true or not, but the years do seem to go by more quickly as we get older.

In five weeks we will celebrate Respiratory Care Week 2009. Although I believe we should show our appreciation to our staff throughout the year, this is the one week we can pay special tribute to our therapists who serve our patients so well throughout the year.

We make an effort here to have a least two catered luncheons during this special week. In addition, we recognize one individual as our very own "Respiratory Care Practitioner of the Year" and award that individual with a special trophy, a basket of goodies, a gift certificate to a fine dinning place, a name engraved on a permanent plaque that hangs in the main hallway of our department and an all-expense paid trip to the state respiratory care convention each year.

There also is a nice write-up in our local hospital newsletter. In addition, we have gifts of appreciation and awards for everyone, and our local newspapers print nice articles in their papers about respiratory care.

I think all of us are interested in what other departments do to celebrate Respiratory Care Week, and I hope you will be willing to share those activities with all of us.

It wasn't from one of my staff or a respiratory therapy colleague from some exotic region of world, but from my second oldest daughter, a mother of five children and a grandmother to 2.  She has been an interior designer for nearly three decades and works with clients who have million dollar homes in southern California. 

From time to time I share some of my articles with my family and several months ago I gave them the address for my blog. Unbeknown to me this particular daughter actually read that series of articles I had written on one's Saturday-Night Essence.

While she enjoyed being an interior designer, she felt that there was more she could and needed to do to fulfill her dreams.  She made a list of all the things she enjoys doing, especially in her free time, but nothing seemed to be her Saturday-Night Essence.

One of the things she does extremely well is floral arrangements--with most of her arrangements selling for $150 to $500--so she decided to give that a try. She created floral arrangements for several wedding and, although she enjoyed doing them, it wasn't something she wanted to do forever and make into a career. 

Again, she read and reread Finding Your Saturday-Night Essence, Discovering Your Saturday-Night Essence, Pursuing Your Saturday-Night Essence and Goals For Your Saturday-Night Essence and she continued to ponder these blog posts for days to determine what her Saturday-Night Essence might be. 

About a week before she called me, she received an unexpected telephone call from an executive in New York City from a company that has numerous interior design center showrooms across the country. He wanted to know if my daughter would be interested in a new position that was open for a design center manager.

Initially, she was overwhelmed by this invitation and asked for more information regarding the open position.  She was given a very generic description of the job--which would be like someone calling one of us and asking us if we wanted a job as a respiratory therapist. 

Since she had been reading my blog and pondering her Saturday Night Essence for several weeks, she decided to accept his invitation for an interview. Afterwards, she called me to ask about the do's and don'ts to consider during a job interview as she hadn't been to a job interview in about 30 years. At this point I was unaware that she had read my blog and I simply told her to be herself. Be honest and let the individual conducting the interview know of her dreams and aspirations, I said.

The day of the interview came and everything appeared to have gone very well. She called me two days later to tell me everything that had happened since we last talked.  She told me that once again she spent hours reading and rereading the articles on Pursuing Your Saturday-Night Essence and setting Goals for Your Saturday-Night Essence.

Then she reviewed for me a most exciting part of this adventure. During the interview, she felt extremely comfortable and very much at ease.  She said that a strange thing had happened during the interview: she heard words flowing effortlessly from her about her dreams and aspirations that she had never shared with anyone before. She wondered who was talking, because they didn't seem to be words that she would express.  I suggested that she had connected with her Saturday-Night Essence and that her thoughts and ability to express herself came easily to her at that point.

As the interview came to a conclusion the executive from New York began to elaborate more fully on the exact details of what the job entailed and it was much more then just a manager of a design center showroom.  It was my daughter's dream, her Saturday-Night Essence.  Within a few hours, she was offered the job and what had only been a dream had turned into reality.  The executive told her as he extended the job offer to her, "We've been looking for you a very long time." 

So often I write articles and never know if anyone ever reads them let alone actually puts them into practice, but this is one series of articles that did have an effect on at least one individual and it appears to have helped her pursue her dream and to find her Saturday-Night Essence. 

I would love to hear if anyone else has a success story to share.

Delegating responsibility is a challenging and sometimes difficult thing to do for many department managers, supervisors or lead therapists. One of the major reasons for this challenge is the assumption that "I can do it better."

Some leaders belive that for a job to be done right, they must do it themselves. But how are other leaders going to be developed if the manager does it all himself all the time? It is the job of the leader to make those under his direction into better executives or managers than he himself is and prepare not just one but many who can take over his responsibilities if he is no longer available.

On Andrew Carnegie's tombstone is written: "Here lies a man who knew how to enlist in his service better men than himself." Theodore Roosevelt once said that the best executive is the one who has sense enough to pick good men to do what he wants done and self-restraint enough to keep from meddling with them while they do it.

Delegation is not abdication. A leader does not lose his authority or his responsibility when he delegates. He must still remain primarily responsible and must guarantee the success of the one to whom the responsibility is delegated. He cannot delegate and then turn his back on what occurs afterward.

It is the responsibility of the one who has delegated the authority to see that the assignment is understood, accepted and fully performed. He must inspect; he must train; he must encourage; he must supervise the one to whom the responsibility has been given. No one can delegate away his responsibility. He delegates his responsibility without losing it. Delegation without control is irresponsibility.

There is no real delegation if the responsibility has not been fully accepted. But just as delegation is not abdication, neither does the acceptance of responsibility mean usurpation. The importance of acceptance cannot be overemphasized. If there is full acceptance, then the delegation should be made without reservation. The leader should delegate the whole job with all of its satisfactions, prestige and rewards. This offers a challenge worthy of the highest dedication to both the one making and the one accepting the delegation.

The art of delegation involves some of the greatest administrative skills. We ought to give it constant, complete and continual study and then back up our study with practice.

Where will our profession of respiratory therapy be in 5 to 10 years? What will the educational requirements be at that time? I've been reading and attending meetings last winter and again this summer where the subject has been the future of respiratory therapy.

There seems to be many more questions than answers available at this time. However, there seems to be a general agreement that new therapies, new and more sophisticated equipment and new advances in pharmacology will require respiratory care practitioners to have no less then a bachelor's degree with master's and doctorate degrees on the horizon. 

I find this very exciting and look forward to seeing what will transpire and develop in the next decade within our profession.  Each day is a new adventure for me and I have the same feeling of excitement that I had as a young teenager. Each day becomes more exciting than the last.

Now is the time that we need to begin to prepare the next generation of respiratory care professionals by providing them with the education and tools they will need to provide the most appropriate and the best possible care for our patients.

Every day seems to bring forth new knowledge, new technology, new ways of caring for our patients, new therapies, new medications, new equipment, and new ways to help us do our job more efficiently and more effectively. 

As a teenager, I never imagined that many of the things that I've witnessed would ever happen in my lifetime. I am doing things today that were unheard of just a decade or two ago. In fact, we are using equipment today that didn't exist 5 years ago as well as medications and procedures that have all been created within the last several years. 

What will the next decade bring to our grasp?  I don't know, but I sure hope I'm around to see what it is and to do things I haven't even imagined yet.  Can you imagine what our children, grandchildren and great-grandchildren will witness and what an adventure they will experience?  I hope I'm around to enjoy it with them.