Sunday, March 20, 2011

A Letter to the Respiratory Therapist

Dearest RT,

I have often said that we are the red headed step children of the health care industry. Not yet able to enjoy the respect that comes with longevity of similar careers like nursing, we are still after decades of existence a bit of an enigma to everyday people. Some might have noticed our name yelled during episodes of their favorite hospital drama. After all the business of saving lives is complete the heroic MD yells with deep conviction

"Call respiratory and tell them to bring a vent!"

As he clutches an endotracheal tube that is nowhere near secure in a patient that isn't even being bagged. As if we're off somewhere slamming down doughnuts as we wait for vents to be called for.

What everyday man often doesn't know is we would have been there from the word go. Nor do they know that in many cases it us who often secures the airway , initiates "life support", and then asks that the MD get called so we can tell them what we did. Little does the everyday man know how hard we work to cover anywhere between 10-25 patients per therapists per shift while having to be prepared to drop it all and see about the emergencies (and quasi emergencies whenever summoned.) We are often unappreciated, misunderstood, and unfortunately mistreated by those whose team we're supposed to be on. Yes, red headed step children.

Notice I said "often" not always, as there are those times, hospitals, and situations where all the stars align and therapists are truly made to feel a part of the team. Our experience and knowledge are valued. People actually know our names instead of yelling "RESPIRATORY!" down the hallway behind us. I have been fortunate in my now almost 12 year career to have enjoyed these circumstances and I'm truly grateful for these times.

When it's bad though, it's really really bad. I have worked in places where therapists have been reduced to the role of nothing more than a button pusher or knob turner having their clinical skills and knowledge completely disregarded by people who often don't fully understand the purpose and action of therapies they're requesting then being told or shown by their own management that we have to "take one for the team." To understand this I have to go back to the point that the general public and alas some healthcare professionals have no clue, or worse, no respect for what we do. I don't pretend to know how to change this other than to keep doing what we're doing. Do it well. Do it consistently, stay educated in the field and stand our ground in the face of adversity and ignorance. Combat ignorance with education and open dialogue, and maybe...just maybe, things will change.

I write this letter from a place of appreciation and love for everything this career has done for my life and the many wonderful people it has placed in it. My patients! The reason why I can do what I do in the first place. The good ones, the mean ones, the in-between ones, but especially the pleasantly confused ones whose shenanigans make my night whiz by. The nursing staff who I've saved lives side by side with, cried with in tragedy, and even laughed with in tragedy (cause you gotta laugh to keep from cryin' right?). The MDs, who don't let their egos get in the way of what is best for a patient, who once they understood that I knew what I was doing allowed me to DO MY JOB! The unit secretaries, radiology, lab techs, pharmacy, environmental, hospital security without you guys there is no us, because we are ALL critical to lives of the patients we care for whether we know, or are told that or not.

I'm in the process of stepping back from this career that has been a defining part of my life since I was pregnant with my son and into one as a writer. Eventually, (if all goes well) I won't be practicing much if at all. However, everything I learned while a therapist will carry me in to the tough business of the written word. After all what can thicken your skin or grow you as a person more than dealing with life, death, and every manifestation of the human being on a daily/nightly basis? I promise to one day write our story that people may continue to come to better know and understand who we are. I promise to tell our story to the best of my rotten ability!

To all my fellow RTs:

Your name is NOT "respiratory". Your knowledge and experience matter even when those around you would make you feel that it doesn't. Go forth, give nebs, save lives, be as BRILLIANT as you are, and smile because you are somebody!

With Love,

Stacey Rose RRT, RCP

Wednesday, March 16, 2011

A Dog's Day Afternoon...and Evening

We tend to think that getting mauled to death by pitbulls could never happen to us. It's a story for the 11 o'clock news or one you mention in passing while picking up your buttered roll and coffee from your local bodega.

"Hey d'ja here about that kid that got mauled to death by pitbulls?!"

"Yeah, that's a damn shame! Could'ja add two more sugars?"

Well gentles, I'm here to tell you that I stared a maulin' in it's eyes...excuse me, eye (more in a sec)...and lived to tell the tail. I mean tale. I was doing my usual deal, dropping by the homes of the sick and shut-in to spread joy and drop off respiratory equipment when I pull into the shared driveway of two houses that looked to have just smashed down from Kansas. I check my surroundings because if my pristine ghetto upbringing taught me nothing it was to know whats up when I arrive on any set.

Upon checking the set, I see to my right a porch that looked to belong to a family of garden gnomes. This was cool as this was the gnome...patient I'd come to see. In front of me, I spied a large German Sheperd with a gleam of curiosity in his eye, but a high rising gate to his front. This gave me a fleeting sense of security so I attempted to open the door and exit my vehicle. My automobile's sticky electric locks are the only reason I sit here writing with all ten fingers in tact.

It could have been a scene from one of those really bad "gangsta" films. This would have been the part where the wicked street boss finally got what was comin' to him. There was a slo-mo pan to my left that revealed: The Den of Death. Three 7'5" 90lb pitbulls* with jowls that drug the ground leaving frothy spittle in their wake were looking at my plump brown toasted caramel physique with wanton longing. Their powder white bodies twitched with anticipation of pouncing on me (either that or they'd been denied food for so long they were having some sort of neuro-muscular tics). One, whom I'll choose to call "Righty" because his absent left eye (I think he and the others shared it for lunch), never let his disabled glare leave me. He was the reaper, incarnate.

I thought screaming to be unwise at this point being the hell dogs were standing in a doorway obstructed only by an uninstalled child safety gate (dern thing must have come a loose with the house landed!) and I didn't want to rile them any further. I pondered driving away and never coming back, but then realized that I'd quit my other job (shit!). "Okay." I thought, "I'll call work and then runaway!" Just as I was making my frantic phone calls: one to my patient to let him know he'd have to hold his breath one more day, and another to my office to let them know about my impending escape; A miracle occurred.

A man, let's call him "Bo", appeared and gazed outside of the gaping door of the makeshift shack. Two of the hounds of hell retired to the inside of the abode, leaving Righty still fixated on my now rolled up tinted window. Bo stood behind Righty, gave a loving tap to his back as a mother would an infant, and Righty the blue eyed cyclops turned and entered the home. The door was shut, and my living nightmare was over.

How I wish I could say my dogged dilemma ended here. Alas Non. There were more patients to be seen, more dogs to be encountered. I was challenged by Chocolate the dachshund with balls of cast iron steel, and Dixie the...well I don't know what the hell kinda dog she was but she was huge, made a hell of a lot of noise, and sniffed my ass.

By day's end I was emotionally spent. I was dog tired after having worked my fingers to the bone. Then, the the final blow: The passing of Nate Dog! I was howling at this point. How much could one endure in one day. At last, I arrived home, a wasted heap where I was greeted (not really) by my cats with lackadaisical side eyes, yawns, and soft silent farts. Cats, you see, are just the way I like my animals (and men unfortunately); quiet, distant, and emotionally unavailable.



*I swear those dogs were that damn big I don't care what you say!

Wednesday, March 9, 2011

The Zion Chronicles: Eatin' Lightenin' Crappin' Thunda!

I remember my elementary school guidance counselor Ms. Kenney. She was a short black woman with a warm smile, a compassionate temperament, and a no shit taking attitude. I remember loving the way her office smelled. I also remember spending hours on end there in 6th grade. You see, 6th grade was a tough one for me. I was some how elected whipping girl for that year and as such was picked on ad nauseum.

During my time in the fetal position on Ms. Kenney's couch, eyes damn near swollen shut from crying, I would fix my cloudy gaze on this one "inspirational" poster on her wall. It was the cutest, puffiest, cuddliest kitten clawing for dear life to a rope with a knot on the end. It read: "When you're at the end of your rope, tie a knot and hang on." Inspirational posters, I've found, are wasted on children. At the time, I had no idea what the poster meant. I didn't know that I was that damn kitten and that Ms. Kenney was trying her best to help me hang on.

It frightens me to think of what would happen if my story had been set now. With all the suicides among kids due to bullying, I'm sure I would have been another headline. It doesn't seem rational to the lucid adult mind why a child would want to kill themselves, but being THAT kid in the 6th grade I do. The pain! There was an incredible amount of pain and self hatred. It hung heavy over me like a dank cloud every morning I woke up. I'd wake up hating the fact that I did. I'd wake up wishing I were somewhere, somebody, or something else. Weekends were hallowed times where I could retreat into me, read, watch television and eat until I damn near popped. Monday's dropped me off at the gates of hell again. I cried every one. If I looked it up I probably had about 45 days out of school that year.

This past summer when I knew I was sending Zion off to the 6th grade all those old feelings came rushing back. "Would his 6th grade year be like mine?" "Maybe I shouldn't send him. " were thoughts that raced through my mind from July all the way through August and occasionally still do. Thankfully Zion's social adjustment has gone remarkably well. Maybe it's the school. Going to a school full of artsy fartsy mainly free thinking kids must be pretty cool...I guess. Maybe he's cooler than I was. :/ Anyway, Zion's major obstacles have come where I least expected them with academics, and in many ways his 6th grade year has been just as rough as mine was.

I'm happy to report that things have improved dramatically. It's taking a full on team effort with his teachers, his EC facilitator and myself, but I'm definitely seeing some turn around. What I'm most proud of is my improving patience which has resulted in our improving relationship. It took me accepting that my expectations of him were unrealistic. He is not the student I was. He does not like to read like I did. He is not me. To think I bosted how I was never going to be the parent that tried to relive their existence through there child, but there I was doing just that. I wanted his 6th grade year to be better than mine. I wanted to save him from what happened to me, to see him succeed and in his success he would some how redeem my 6th grade year. To my dismay, none of that shit was based in any sort of reality.

Fact is, the 6th grade/middle school is a huge transition for all children it can and often is awkward and painful. I have to hang in there with him and be the knot that he's hanging on to when he's at the end of his rope (and some time that knot is my mom. That's okay too). I strive to be attentive without smothering. I try to discipline without being a dictator. It's a tricky balance especially being a single parent, but we do just fine most days. When I read about kids who've killed themselves because of the sheer pressure of being a kid in this day and age, it scares the hell out of me. I ask Zion a million questions. He answers two. He seems okay. I try to have faith that he is.

I have visited his guidance counselor's office and didn't off hand notice any inspirational posters. She, while quite pleasant, lacks Ms. Kenney's certain I-don't-know-what. She's a new generation of guidance counselor. Maybe it's the sheer number of children and variety of issues she has to deal with on a daily basis. Her office is not the cozy nook that I remember Ms. Kenney's being. It was quite dark with a slit for a window and had cement walls. No leather settee like Ms. Kenney's. I have empathy for her plight though, and wish that I could pop in and hang just one inspirational poster on her wall. While I didn't really understand what it meant, it was comforting to see that little kitten when I went to her office. Say! I'd always been rather fond of Mick the trainer from Rocky. Maybe he oughta have done a series of posters. They would have looked something like this...

...I so would have gotten this one. Yep, me and Zi will just keep eatin' lightenin' and crappin' thunda until we get through it. Together.