Day in the Life of a Respiratory Therapist
I am a respiratory therapist. I work in the hospital setting. If you come to the hospital I will probably be one of the first caregivers at your bedside. Chances are that I’ll give you a breathing treatment and entertain you with some conversation. And then you might think that this is all I do. Yet there is so much more.
I usually get up before my kids do. My kids are pretty neat in that they get up right away when you wake them, eat, and get dressed. Not always, but most of the time, they are excited to go to school. They are good kids. My wife usually drives them to school, and soon thereafter I’m off to work. I only live a mile and a half from work, so the drive is not long at all.
Reviewing patient reports
I arrive at work, punch in, and get a report from the night shift therapist. We have a list of patients, most of whom are scheduled for breathing treatments every four hours or so. I might click on the Internet if time allows and sift through the news. Or, as is often the case, my beeper goes off and I’m called to duty.
I work at a small, 64-bed hospital in Ludington, Michigan. About a mile and a half to the west of is Lake Michigan. About a mile and a half northwest is my home. There are about 8,040 people living in Ludington, and about 60,497 people living in Mason county. Ludington sits kind of in the middle, so we have quite a big area. I think we even draw people in from surrounding counties, so we are kind of centrally located in a large area. So, for a small hospital, we can get kind of busy sometimes.
Getting to know my patients
About 7-9% of Michigan residents have a diagnosis of COPD, so I’ll assume the COPD prevalence for our area is about the same. Most are able to manage their COPD at home, while others will visit our hospital from time to time. Believe it or not, working in a hospital is sort of like working at a grocery store, where you have your regular customers, many of whom are COPDers. Sometimes we get to know people quite well.
In a way, I think working for a small town hospital is nice this way, as we often get to know our regulars, and what works best for them. It must be nice for them too, as coming to our hospital means you are not among strangers but familiar faces. That has to make being a patient easier, especially when you have a chronic disease like COPD, and especially when you can’t breathe.
I’m a severe asthmatic myself, so I know what it’s like not to be able to catch your breath. I know what it’s like living with a lung disease. I have also been doing this for 20 years now, so I’ve met thousands of COPDers. I’ve been doing this long enough that when I see you I will probably be able to tell that you have COPD without you even saying anything.
Breathing treatments and machines
I will probably give you a breathing treatment, and the medicine of choice here is Duoneb. I will probably start one up before you even see a doctor. I will do this because I (we) don’t want you to have to wait to get your breath back. If the treatment works, great. If not, then we will get a doctor fast. You will become our top priority. Well, you are already a top priority.
If you need it, we also set up CPAP and BiPAP machines. In case you don’t know, these are machines that apply pressure to your airway using a mask that goes over your nose and mouth. The pressure helps to keep your airways open and assists with breathing. It can make breathing easier until the doctor can work his magic and get you fixed.
Intubation and ventilators
We have other machines too, such as ventilators. If a CPAP or BiPAP isn’t enough to help a person, then we can place a tube into their airway in a process called intubation. This is then secured and hooked up to the ventilator, which provides positive pressure breaths. If the person has a lot of secretions blocking airways, this allows us an easy means to clear airways to make breathing easier.
Ventilators are usually temporary and are used short term to allow a person to rest while doctors and nurses work their magic. And when this is done the person is usually given a sedative to take the edge off. Usually, these create a sense of amnesia, which means the person won’t remember it, which is good. And once the problem that put the person on the ventilator is resolved, the tube is pulled out and the ventilator discontinued. Usually, this takes a day or two, although sometimes it takes a while longer.
If someone were to stop breathing, we are also called to the scene. We secure the airway, assist with intubation, and set up ventilators. Sometimes we assist with chest compressions to help circulate blood. In doing this we are a significant part of the code team, and what we’re doing here is giving the person a fighting chance. Our main job, though, is managing the airway.
Most of the time you see me I'm giving breathing treatments. I give lots of breathing treatments here at this small town hospital. And I also encourage people who smoke to quit, and I give smoking cessation advice. I educate people about their diseases, whether it be heart failure, pneumonia, asthma, or COPD. And, of course, I spend a lot of time just chumming with my patients, talking about politics, God, history, or whatever else interests you.
Ending the day and returning home
Being a small hospital, it can get horribly busy, and it can also get irritatingly slow. Sometimes it’s slow enough that we can pull out a book and read a good story. Sometimes I do this, write stories, like the day in the life of a respiratory therapist, and share them with you.
Then I go home. My youngest is 6, and he’s usually excited to see me. The same with Laney, who is 8. I call them the littles. My 13-year-old is more independent, and sometimes I see her and sometimes not. Chances are she’s across the street playing with her friend, or in her room doing her homework. Or, more likely, playing some game on the Internet. My oldest is off to college at the University of Michigan, so I don't see him much these days.
The Littles usually want me to entertain them, and, especially after a long day of work, I’m eager to oblige. Myles loves his legos, and he might need some help creating a village, or making a plane or truck. He loves learning, so perhaps he’ll bring me his flashcards. Or, since he’s learning to read, he might want me to read a book with him. Laney often joins in too. Or, perhaps we go outdoors to kick a soccer ball around or play a game of Hoot Owl Hoot. To end the day, perhaps I'll watch some TV with my wife.
The most common patients I see are people who have COPD. I hope your breathing stays easy. However, should you need need us to help you breathe easier, one of us is available at a hospital near you 24/7.
Do you live with any sleep disorders (eg. insomnia, RLS, sleep apnea) in addition to COPD?