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Does your department have it, and overall how do you maintain it? I have been an RRT for ten years now, and I am finding myself burnt out with the younger generation in the workforce coming on up. I blame this partly on the age of these newer folks (20's), weak management (little accountability), and a lack of work ethic. Your responses are appreciated. Thanks
 
Posts: 2 | Registered: August 03, 2011Reply With QuoteReport This Post
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Autonomy is something granted us by the docs we work with. It can be granted individually by individual docs for the staff or for an individual therapist, or it can be granted by a group of docs or all docs for a staff or individual. It comes with trust. Some docs never trust the RTs for whatever reason. Most will when the trust is earned. It may take years, but with consistent competency and creativity it usually comes. For a staff to gain autonomy it usually takes a planned programmed approach by department directorship of hiring clinically strong managers and supervisors and mentoring the less experienced in critical thinking, decision making, communication, work ethic, etc. until the RT staff gains the trust of the medical and yes the nursing staff. Few things are as effective for employee satisfaction and retention or patient outcomes as a truly competent proactive RT staff being allowed to do what needs to be done when it needs to be done for the patients. For the management this is a worthwhile, but truly difficult goal to reach. There are so many potentials for setbacks. These younger therapists (not always the younger, just the less dedicated)often for some reason have no clue that their ADD world is often not compatible with the focus needed for good patient care. For example perhaps you were offered a "wean as tolerated order" and you got the ball rolling well with a series of successful SBTs during your days to work, then another therapist is assigned the same patient while you are off and the pulmonologist that trusted you enough to give you the order rounds and finds the patient loaded with secretions, hyperpnic and hypoxemic at one end of the unit while just having observed your young or just unfocused peer at the other end of the unit exchanging text messages or playing games on their phone. Your trust/autonomy factor for everyone even those that can be trusted falls way off with that doc, and probably even his partners and perhaps most of the medical staff. There are many potential examples of trust busters. We have to hold each other to high standards.

Everywhere I have worked, I have wound up playing the roles of educator, motivator and holding my peers to higher standards, leading by example even if I was not hired into these roles, and on reflection it was partly because I am so passionate about getting the best possible results for my patients, but it may also have been because I so enjoy that high trust relationship with my docs and the autonomy that comes with it.

Individually you can do the best you can at all times. Leaps in trust occur in my experience with those most challenging docs when they have run out of ideas. If you always know your patient and have a plan ready when asked or offer it at the appropriate time you will be surprised how far that can get you when your plan succeeds. You have to be present in the situation, keep your head in the game, but if you really want autonomy on a day to day basis, you have to work to bring your whole staff up to a level that warrants trust. Volunteer to give inservices, sharpen your skills at every opportunity, take the lead when you can and help people to realize that their greatest paycheck is in seeing the patients do well and enjoying the process of being a part of that positive result. Celebrate successes with the team. This may sound a bit corny, but I have been at this a while and have always managed to work my way into trust relationships with the docs so that I could enjoy what you are seeking. It is not easy, but in a nutshell, it comes from trust and trust must be earned and you are not the only therapist that trust must be earned for to really enjoy the autonomy you want. Hang in there, it is way worth it.
 
Posts: 147 | Location: Buckeye Az | Registered: January 27, 2006Reply With QuoteReport This Post
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