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Ray

RT staffing

Census driven for nursing service. But RT has to be Acuity driven. This means that adminstrators don't care about patients that only need medication therapy. They only care about how many Ventilators and/or Bipaps are in use in order to staff accordingly.

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Abdulrahman AlshamraniPermalink Reply by Abdulrahman Alshamrani on December 28, 2008 at 10:52pm
If you notice that most of the management programs are part of Business colleges which has an influence on the graduate in any field.
RayPermalink Reply by Ray on December 29, 2008 at 5:28am
True, and the person that suffers from these decisions is the patient.
ric mandanasPermalink Reply by ric mandanas on December 29, 2008 at 6:02pm
sad truth. makes you angry. you know in one way or another we or our loved ones can be a patient. sad picture.
Brett OettingPermalink Reply by Brett Oetting on December 31, 2008 at 12:41am
Hospitals are primarily staffed by census and heavily influenced by nursing ratios. Ancillary departments are comparatively small and lack patient care ratios, as is the case with respiratory care. This situation leaves RTs unprotected and overworked when the incidence of respiratory disease increases, which is nearly year round in this area but still a little more impacted during the winter months. Recently, a JACHO visit to our county hospital resulted in the abolishment of concurrent therapy. Of course, concurrent therapy has been a hot topic with the AARC since 2001 but it seems JACHO is finally putting it in motion. We may never get patient care ratios but getting rid of concurrent therapy is a step in the right direction.
RayPermalink Reply by Ray on December 31, 2008 at 3:06pm
Help me understand about the term CONCURRENT THERAPY,
Brett OettingPermalink Reply by Brett Oetting on December 31, 2008 at 8:44pm
"Concurrent Therapy" is performing more than one therapy at a time. Usually, the therapy in question is a medicated nebulizer treatment. With common shortages in staffing due to the lack of patient care ratios for respiratory therapists, medicated nebs are often "stacked" and multiple treatments are performed at the same time to meet the productivity requirement of the hospital/organization. The 2001 AARC white papers on the subject encourage 1-to-1 therapy, and it seems JACHO surveyors are encouraging 1-to-1 therapy locally. It's a positive move toward professionalism and patient safety, and it relieves those situations where therapists are encouraged to perform 40, 50, 60, or more procedures in a 12-hour shift. Been there, done that!
RayPermalink Reply by Ray on January 1, 2009 at 9:35pm
Thanks for the explaination on concurrent therapy. We have had to leap frog some therapy, but not several in a row. That is encouraging about JACHO. I knew the AARC has never been in favor of concurrent therapy.
Garry W. KauffmanPermalink Reply by Garry W. Kauffman on January 2, 2009 at 7:14pm
A quick note about concurrent therapy (AKA 'STACKING') from a country boy RT. Aside from the fact that I believe this is unethical from the standpoint of not providing the care to the best of one's ability, I think another issue is one of marginalizing the role and value of the Respiratory Therapist.
Proving multiple unmonitored therapy from my perspective, and more importantly from the perspective of a CEO looking to cut costs, is a sure way to communicate that 'anyone can do it'. I don't see other professionals doing this and I think we all need to take a stand on behalf of the patients we serve and our RT colleagues, and put a plan in place to cease this practice.

How do you do that, you ask?
I'll stay tuned for comments.

Garry Kauffman, RRT
RayPermalink Reply by Ray on January 10, 2009 at 7:04am
You are totally correct. Thank you for your support of what is right for our patients and our profession.
RayPermalink Reply by Ray on January 3, 2009 at 6:03pm
I wonder why the AARC hasn't addressed this issue and developed an ethical and safe treatment load matrix per 8 hour shift, for us.The more treatments you attempt, the more administration thinks that they can provide with less personnel. That mindset has been around for a long time with management. We have to draw a line in the sand at some point and not cross it. Our credibility as a profession is at stake.
ric mandanasPermalink Reply by ric mandanas on January 4, 2009 at 8:25am
Interesting discussion Ray, and as it gets meatier this reality in almost all RT settings will not be resolved in the near future. ( I do hope I am wrong). Meanwhile, we are either forced or constantly seeking inspiration in giving our patients the best treatment, the same way we want to be treated.
Ronald TaylorPermalink Reply by Ronald Taylor on January 4, 2009 at 4:10pm
I totally agree with you but what I am doing at the moment is to do critical incidence whereby nursing staff administer medication but do not monitor those patients. But with NiV and other vent strategies our nurses only reduce Fi02 as they have not been assessed on ventilatory management incuding respiratory physiology the management would like me to do this but as I am only one RT I do not have the time which is a good thing from my point of view, We tried a Nurse led NiV service because they did not want to employ another RT and that has been a failure so now hopefuly in the next few months I should have another RT on board.

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