The PediaRTritian is born

Pediatrics are an interesting bunch, sometimes they receive treatments like adults and others times they are treated totally differently. Either way we all know pediatric patients do cause some nervousness with certain people.

I like to think that I have quite a bit of experience with pediatric patients. Lets see I worked in a level 3 NICU which I was also on the neonatal transport team where a RN and RT would fly or drive babies born with problems, normally respiratory problems. I have also worked in a Pediatric ICU along with different peds units. On top of all of that I also have 4, yes I said 4 kids at home. I've been around the peds population a bit.

So you ask where am I going with this? Well it has to do with the small town hospital I work at currently. Now this is a small town hospital that really doesn't get a lot of pediatric patients at all.

It is that time of the year for evaluations and I was called into the supervisor's office to do a little evaluating of me for the past year which I had just started working at this hospital. So I'm going through the Blah Blah Blah, your doing fine, Blah Blah Blah, what can you improve on, etc etc and this comes out.

Supervisor - "A RN wrote you up some months ago about not feeling comfortable with you as the RT of a peds patient, but was comfortable with your other night shift cohort."

Look on my face: WTF? I do remember this patient.

Me - "How so, I took great care of this patient."

Super - "Well this was a new nurse and she said that you didn't help her very much."

Me - "Help her with what, I did my RT stuff and the patient was in no distress."

Super - "She was just new and nervous and wished that your were more around to help her be comfortable with a respiratory peds patient."

Me - "Really? But isn't she a nurse who went through school? I'm not sure I understand what she was getting at, but I guess where I come from there are nurses who are pediatric nurses."


OK so after chatting a little while it basically came down to the supervisor, who is also the floor's supervisor, letting me know she want's us more involved in the care of peds patients with respiratory problems. Just help our more because the RN's don't get a lot of peds patients and get a little nervous around them.

Correct me if I'm wrong but do we not get the same amount of respiratory peds patients as the RN's do as inpatients? Granted I probably have more experience that most of the nurses on that floor with peds but still, what more can I do besides educate those RN's who are not comfortable with respiratory issues, I will not sit there and hold their hand. I guess I just don't quite get it.

Once again another added responsibility of what the RT can do is added to the list, the PediaRTritian is born. Tonight it also just so happens that there is a peds patient on the floor for us to see and besides just doing my nebs and RT stuff, I am stopping down about every 2 hours to check with the RN to see how she thinks the baby is doing, what else can I do. This just frustrated me a bit that I was told that a nurse wasn't comfortable with me and now we are wanted to be MORE involved with peds patients, but I am not going out of my scope of practice.

Now that RN who wrote me up, well she quit soon after that because that peds patient stressed her out to much and took a job at a clinic where she doesn't deal with peds patient. Now was it me or just a new RN freaking out a little to much and not being comfortable with her own training. I've also been informed that there are RN's here who flat our refuse to take peds patients even to the point of calling off work if there is that possiblity. Amazing.


Pretty soon RT's will run the hospitals.

Keep it up RT's and drive on.

Whoa It's been awhile, people are still nuts.

OK so I have to apologize for not posting for like 2 months now, I became a little busy with life and this was put on the back burner. My hospital started blocking personal (BLOGS) sites from viewing on the internet so I wasn't able to log onto Blogger here and post anything because I usually did it from work. Home has been a bit busy and there just wasn't enough hours in the day to do much posting.

So here I am posting again, my hospital set up a WIFI network for patient and others to use so I bring my laptop into work now and can have some time to post again. So stick with my I'm able to do this again.


Now on to more pressing matters, OK so it's only what I think is a funny little story about a patient at work who really either had no clue, or she just wanted to be difficult and not have to the my therapy.

We RT's here at my little hospital have to start and do Incentive Spirometers with every surgical patient for 4 times to make sure they are doing it correctly and acheiving 50% of there predicted volume, which I personally think should be 50% of their PRE-surgical volume they were able to acheive and not the predicted. Some people have trouble getting 50% of predicted without the surgery. So anyways if the patient cannot get 50% of predicted we start EZPAP until they can acheive this goal. OK now off to my story.

I walk into Mrs. White's room to do round 2 of her I.S. and it goes like this:

"Hello Mrs. White I'm with Respiratory Therapy and I'm here to work with your I.S."
"OK, hand it here and I will do it."

I hand her the I.S. and she of course blows as hard as she can into the mouthpiece and of course nothing moves.

"Umm your doing this wrong, you need to suck in on the mouthpiece to make it move"
"Oh OK I remember."

Now mind you she has been previously instructed on this, I'm there for round 2. She goes ahead and blows on it.

"No remember suck in on it like you would when drinking from a straw."
"I can't, I hate using straws, I don't use them."
"Ok well have you ever used them, while drinking some pop or soda?"
"Nope I have always hated them and have NEVER used one."
"Well how do you know you hate them then."
"I just know I do."
"Well lets try breathing on this again, OK"

So off she goes blowing in and out on the I.S. and it's doing nothing.

"Mrs. White, try to take a deep breath through the tube like you would if you were going to go swimming under the water."
"I don't know how to swim, I don't swim."
"Umm, you have never gone swimming or wading in a pool?"
"No, I'm from the Southwest there are no pools there."
"I used to live in the Southwest for a couple years there were pools there, it's hot and people have to cool off."
"Well not in my time there were no pools in the Southwest."
"OK, I see, lets try sucking in on this tube again."

So now she is like panting on the tube, quick short breaths.

"Now take the tube out of your mouth and put your hand in front of your mouth and blow out."

She does

"Did you feel the air on your hand?"
"Yes."
"OK do the opposite of that, ya got it"
"OK I see."

Back with the I.S. she if breathing deeper in and out of it.

"Did you see it move up there?"
"Yes I did."
"OK now do what you did to make it move up only do it bigger!"

FINALLY SUCCESS, she hit 1500 ml's on the I.S. and her predicted is only 2000 ml's so she is over the 50%, NO EZPAP, whoo hoo.


The next day I come to work and find out the day shift was having the same issues that I did with this patient, so like I said she either has:

A) No Clue
or
B) She is jacking with us.

Either way I didn't have to see her again. You can always find humor in this job. Actually I think you have to have a sense of humor to work this job.


Thanks for reading.