I'm sorry, I am obviously one of the ten states that does not have radiology liscensure. For the ones that do I would question what their scope of practice is if they are performing procedures just because a NP orders it to be done. Thanks Ventjock I learned something today.
Posts: 104 | Location: Springfield, MO | Registered: March 08, 2004
My hospital has their therapists running 4 to 5 vents per therapist. On the floors about 35 - 40 tx per therapist. Very doable, but our aquity is pretty high.
When we intubate patients we are expected to issue the initial vent orders for the doctors to sign off on. There are exceptions when the doctor will give us initial settings, but about 80 - 90% of the time we choose the initial settings.This message has been edited. Last edited by: KC Cook,
I work in a 250 bed hospital. An average 12 hour day shift on the floor would be around 24 treatments per RT for the entire shift, along with MDI's and incentives. normally 1 vent running, its "busy" when there is more than 3. Day shift is full of RT's that have been here for at least 10 years, three of which have been here over 20. I work nights with a tx load of anywhere between 15-24 tx in a 12 hour shift. Been here 5 years outta college.
Its your typical old school hospital where change takes forever and a typical answer to a "why do we do this this way" question is "because we've always done it that way". We run no protocols and basically never think for ourselves. It was ground breaking and earth shattering when we actually had an 02 protocol started last year. We just went from Q hour vent changes to Q2 my second year here.
Our pulmonologist is ooooooooold school, still believes aerosols filled with albuterol and mucomyst hooked inline with USN's are the next best thing since sliced bread when it comes to secretions. Oh yeah he's the one that wrote me up for putting one of his patients on a non-rebreather when he wrote a titration order to keep SAT >90 and his ordered cool aerosol mask wasn't cutting it.
All in all its where RT skills come to die, I try to keep sharp and keep up with new stuff the best i can. Only reason I stay is because Its the best paying hospital within an hour of where I live.
Hey guys. New here.I just found this forum and have enjoyed what I've read so far.
I work nights at an 800+ bed hospital with 7 different ICUs I’m a senior therapist in our medical ICU. Most of the ICUs have 12 to 16 beds and the MICU usually has a minimum of 8 vents running all the time. We are hired to days or nights and a specific service area, i.e. TCV, Neuro, MICU, Peds, Neo, SICU, CCU, etc. Acute care is organized by floor and pt population. A Medicine RT will usually do txs for a medicine pt. So say the surgical ICU is on the 4th floor, so will be the surgical acute care pts. We usually have 30 or so “interventions” per acute care RT for a 12 hour shift and 3 to 6 vents per ICU RT. The ICUs use therapist driven protocols and we are responsible for everything from intubation through post extubation. As long as we keep the Docs informed of our progress we are free to wean as tolerated and make vent adjustments, extubate, do ABGs, order txs, and place A-lines as necessary. We work closely with our RNs as far as pt care decision making goes. There is a real feeling of “Team effort” most all the time. I think we get away with a little bit more in the MICU than elsewhere due to the fact that almost all medicine pts either are or will become a pulmonary pt at some point during their MICU stay. I have to say I love my job and the freedom I have to practice my profession. New Docs take a while to adjust, but once they get to see it in action it’s just one less thing they have to worry about. I recently had a Doc from a small community hospital tell me that he couldn’t trust the RTs where he had come from with the few vents they had because 3/4 of them couldn’t even interpret the vent waveforms. Scary stuff… If your not allowed to use it you’re sure bound to loose it….. I guess…
I work as an RT in Ontario Canada, I work in a large hospital, we have a very advanced role, including intubating all patient populations from infant to adult, including all difficult airways. We attend all high risk deliveries for airway management of the newborn for neonatal resuscitation and intubation for meconium aspiration or ventilation if needed. We place all arterial lines in the ICU or ER. We are do all trach tube changes and operate the bronch for all percutaneous trachs. As for workload though, I feel we are overworked as there is only 1 RT in the ICU(30 plus beds), 1 RT for the floors + NICU (they are very busy but we do not do any breathing treatments or mundane stuff as RT's do in the USA, or so I've been told from a former American RT) and 1 RT in the ER. We also do lots of patient transports to other hospitals in the area as our hospital is full lots of the time. If anyone wants to practice all the skills an RT should do and then some, Canada is the place for you....This message has been edited. Last edited by: AC,
not all canadian RTs have a bachelor degree, a lot do and a lot do not, there are 3 yr diploma programs and 4 yr bachelor programs. its all a mater of personal choice. as for working here in Canada you can, here in ontario you have to register whith the college of respiratory therapists of ontario (CRTO-wwww.crto.on.ca) and complete a proir learning assessment(PLA) and then challenge the exam. the CRTO can give you more information.