Rural Respiratory Therapy
I work in a rural setting: a 25-bed, critical care access hospital that serves a population of between 5,000-6,000 people. We don't have an ICU, we have a SCU -- Special Care Unit -- where we would put a patient who is considered ICU status. We can't call it an ICU because of our critical care access status and we can't keep anyone in there longer than 72 hours. We don't ever have patients on vents longer than it takes to stabilize them until the transport team can take them away to a bigger hospital with more resources than our facility. So needless to say if there is some fancy new mode of ventilation or cutting edge respiratory modality, chances are I will read about it in a medical journal long before I will, if ever, get the chance to use it.
I spend a good deal of my time doing breathing treatments on the elderly, PFTs, EKGs in the ER and a whole slew of out-patient stress tests and cardiac and pulmonary rehab. I spend a lot of my time hoping for something big to hit so I can get that adrenalin rush that I assume is constant in a metropolitan medical facility ...
And then there are days like last Thursday....
Thursday started off with normal neb rounds, nothing too fancy: an old lady with the flu, a few pneumonias, and a few home meds who were in with no respiratory issues. And then came the stat page to OR for an emergency C-Section. I won't get into details, other than to say the kiddo was discharged a week later no worse for the wear, but one baby code blue and I had more than enough adrenalin to get through the day. I went to draw an ABG on a patient who had been admitted with suspected respiratory failure, a fact the ABGs would confirm. I put the patient on BiPAP and was then called to the ED for a stat gas on another suspected respiratory failure. The gas confirmed what her presentation indicated and we intubated and placed the patient on a vent until she was shipped. No sooner had she gone out the door then the patient we had earlier put on BiPAP coded and would eventually be intubated, put on a vent and shipped. This was all before lunch and I still had three PFTs to do, and a stress test.
Being a respiratory therapist in a rural setting definitely leaves something to be desired in terms of critical-patient volume and the latest and greatest in respiratory modalities, but it has it's share of excitement and has made me a more rounded RT.