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Rick Frea interveiws Rick Frea 2012 style

To commemorate the fourth anniversary of the Respiratory Therapy Cave, I recently sat down with myself in the comfy confines of my own mind and interviewed myself.

(begin transcript)

Me: Well, here we are in year number four.  Can you believe it?

Myself:  No.  It's amazing how time flies.

Me:  How much has changed since you started this?  I mean in your life?  How much has changed?

Myself:  My life is a ton busier as I've added two kids to make it four total, and I now work mainly day shift.

Me:  So you probably can't blog when you work days.

Myself:  Not really.  When I work days I usually have to do real work.  And when I'm not doing real work I have to hide out.  So writing while working is a real challenge. Yet I'm exposed to a lot more during the day.  My patients are awake and I get into some really awesome discussions, and many times these translate into good writing material. 

Me:  And the bosses and doctors are all there during the day, so they make work busier?

Myself:  Yes, doctors make work busier.  They write good doctor orders and stupid doctor orders.  The stupid ones usually translate into good posts.  When I come up with an idea I jot it on the back of my worksheet I carry on my clipboard. 

Me:  Do any of the bosses there help you come up with ideas?

Myself:  Oh yes.  There's one boss who is tense and he hates his job.  I'm relaxed and easy going most of the time, and he hates it.  He's anal retentive, and I'm phlegmatic.  Everything is urgent and important to him, and I excel at prioritizing.  So you can see we might not blend well together.  He hates me, and his goal -- I think - is to anger me so he can report me to my boss.  Yet I enjoy it when he gets angry at me.  Every time he gets angry it gives me a post idea.  I hate dealing with people like that, yet if I can bear it my blog is the beneficiary.

Me:  So you're saying days is a little harder?

Myself:  No, I'm saying days is a lot harder than nights.  I'd much rather work nights.  Yet so long as I have kids I'll stick with days.  It works best.  However, I do work a night once a week.  That's usually the day of work I look forward to each week.

Me:  So you don't like working days?

Myself:  Oh, I like working days.  It's just a lot busier and a lot more stress. And I'm not much of a socializer and I don't do well with crowds.  One on one with a patient is where I excel, and as far as patients are concerned days and nights work as well.  Yet when it comes to stupid doctor orders, nights work better. 

Me:  You don't have to do stupid stuff at night?

Myself:  You do, but not so much.  At night you can get away with letting a patient sleep.  At night doctors sleep and aren't writing orders unless a patient is sick or the nurse is bored. 

Me:  Do you still like working in a hospital?

Myself:  Yes.

Me.  What do you like best and least?

Myself:  I like the people best.  I like my patients.  I love helping people who can't breathe breathe better.  I love conversations with my patients.  I love doing actual RT stuff.  On the other hand, I hate hospital politics.  I hate doing breathing treatments because a doctor has no clue what they do or because a nurse thinks they cure all annoying lung sounds. 

Me:  If you could make one change to make the job of RT better, what would you do?

Myself:  I would have Congress pass a law making respiratory therapy a recognized profession like nursing is, and allow RTs to start their own outpatient clinics under the direction of a physician.  Doctors could have all patients with lung diseases come to our clinics and allow us to educate the patient, help the patient manage his disease, and monitor the patient's progress.  We could do the same in the hospital.  We are respiratory experts, and I wish doctors would appreciate our expertise by giving us more autonomy to care for the patient.  If this ever happened you'd see an end to annoying doctor calls at 2 in the morning.  Doctors would be happier and so would You'd see an end of respiratory apathy and passivism.

Me:  You think RT apathy is quite a problem among RTs?

Myself:  It is of RTs who've been working greater than five years.  I don't want to get into respiratory therapy apathy too much because I wrote several posts about it, but it's not the same as burnout.  Burnout is the result of working too much.  RT Apathy is the result of too many calls for stupid things.  Apathy results when you get called too much to do breathing treatments STAT that aren't even needed.  Apathy results when you do 40 breathing treatments in a day and only 2 are needed.  You're running around like a chicken with its head cut off when you don't need too. 

Me:  Would protocols cure RT apathy?

Myself:  If they did several larger hospitals wouldn't have RTs who are still apathetic.  Yet I think protocols can be a major help if doctors appreciate protocols.  Yet I think a lot of useless breathing treatments are not the result of doctor ignorance so much as meeting criteria.

Me:  What do you mean by meet criteria?

Myself:  These are things that need to be done so that CMS (that's Medicare and Medicaid) recognize that patient needed to be admitted.  If you don't do certain things (such as a breathing treatment) for certain diagnosis's, then CMS can use that as an excuse not to reimburse the hospital for that patient's visit.

Me:  Well, we're running short of time here.  I just want to thank you for four years of your great blog. 

Myself:  I'd love to thank all my readers.  I couldn't do this without all of you.  You guys inspire me to keep writing. 

Me: Why do you keep writing.  I mean, gosh, you write a ton.  Why?  I mean, what do you have to gain?

Myself:  Writing is my psychologist.  I write to get it off my chest. My readers, I guess, are the beneficiaries of me talking to my subconscious.  Thanks. 

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