1.0 Free ASHA CEUs for Speech Therapists

This course also offers Free CEUs for Respiratory Therapists

2.0 Free CRCE  for Respiratory Therapists

Expires 12/31/12

So I have a whole new and different set of challenges, and oddly enough, several of these have nothing to do with the functioning of a neonate. I have personal challenges. Issues that reverberate to my very soul. And suddenly hardcore, no-nonsense Andi isn’t so tough. So here is my little list. My confessions.

1. That moment when I am called. There is a 30-weeker being delivered by crash c-section and I am needed in the OR, Stat. My heart still skips a beat and I still wonder if I am good enough. Will I know enough? Will I be able to help? What am I walking into?

2. That moment? You know the one, right? Where a new mom is born. And the room quiets except for one little cry. And my emotions are fricken traitors and my eyes get moist. Because to cry is to be healthy. And isn’t that what the parents wanted? And there is a new person in the room. It is absolutely awesome, whether that new person entered via guts and determination of the mother, or whether there was a surgical incision involved. It’s still the same to me. It should be to all of us. And I have just taught myself a lesson: to let go of the issues I have with the way my boys came into the world. They came into the world. That’s all I need.

3. If you name your child something stupid, I will make fun of you behind your back. Sorry, but you kind of deserve it. If we tell you your chosen name for your baby is “interesting”, that means we think it is the most ridiculous thing we have ever heard.

4. I got attached this past spring. I was there for 4 days straight. I was called to the OR for the delivery of a mom who almost died from blood loss. And she could’t see her baby for days. I resuscitated the baby. I kept him alive. I worked my ass off for four days straight. When he was crying because he was hungry, but he couldn’t eat. When he just wanted to be held, but any disruption made his heart rate plummet too low and his oxygen saturation bottom out. And his mommy was too sick to be there. So I leaned over him, with my hand on his little diapered butt and the other hand on the top of his head. Gentle pressure so he felt like he was being held without being held. So he could have some comfort without coding on me. And I was off for awhile. When I returned, I worked with adults. He was gone. He went home. He and mom both recovered. I had done a good job. And it affected me so profoundly that I cannot put it into words. And I still wonder what happened to them. So now I am distant. Forgive me for that. I have to be.

5. Last night, I resuscitated a 33 weeker. Zach’s gestational age. I wanted to tell the scared parents that it would be ok. That before they know it, there will be a robust toddler destroying their home. But I can’t do it. Because every baby is different. And just because it was all ok for us doesn’t mean it will be for them. Their baby came out not breathing. About half of Zach’s size. A heartrate low enough that we had to perform chest compressions. And then I start to wonder. Why us? Why them? And I see Zach’s face and I fight, fight, fight. I become over-invested. Because, while our efforts worked last night, there will be times when they do not. Last night could’ve been one of those times, and I know that my soul would’ve been crushed.

6. There are ugly babies. I’m sorry, but there really are. All that matters is the parents think they are amazingly beautiful. I just don’t tell them the truth.

7. We judge you parents. If you are pieces of shit, we know it. When you go out for “fresh air” and come back to your sick baby, covered in the residue of smoke. When you come back positive for drugs. When baby looks nothing like Baby Daddy but mysteriously like Neighbor, who is Baby Daddy’s BFF. When you are overbearing and, though you mean well, you try too hard and impede the necessary medical treatment of your very sick kid. Secretly, I want to take the baby home with me. I want to tell you that you are a piece of shit. But I cannot. We don’t leave the door to the room open so we can “hear alarms”. Those alarms sound throughout the whole unit. We leave the door open to supervise your ass.

That’s all for now. I have to get ready to go to work. NICU again tonight. More later.

Actually, I should be specific.

A week and a half into clinical, and I’m sort of wishing there was some better pre-clinical briefing. I mean we had orientation, we were given a scavenger hunt to “acquaint” ourselves with the hospital, some lectures on how to do things et cetera, but I think what I would personally have appreciated is a little bit of a heads up. Like “hey, heads up… 80 percent of your patients aren’t going to make it”.

I first started volunteering in a hospital when I was around 14, working in the continuing care unit. I didn’t know at the time, but that was pretty much a palliative unit, for patients who weren’t going to get any better. I didn’t particularly enjoy it, because shit, it was effing depressing. But I didn’t want to be known as the downer emotionally unequipped volunteer, so I told myself I was making some sort of positive impact by visiting patients. There was one in particular, and although we didn’t usually talk much, I still enjoyed her company and usually gravitated towards her each shift. On one of our Sunday walks, she opened up about her granddaughter while buying her a gift. She was happy, I was happy, everyone wins. Except, I told the nurse about our day only to find out she rarely gets family visits, and her granddaughter usually doesn’t show up either. I couldn’t help but wonder how many other well-intended items collected dust in her personal locker. Whether it was the following week, or the week after, I don’t exactly remember (and really, it isn’t all that important); but I came back for my shift to find her bed empty. I knew death was inevitable, I mean that was the very nature of the unit I volunteered in. I wasn’t in a gift shop; I was in the palliative care unit. But that was my first real exposure to death, and being young and unaware, I never came back.

Fast forward ten years, I’ve just come back from a third world country, and have just finished two years in school preparing to be integrated into a hospital. You would think that I have more emotional depth compared to my more youthful self. I’m all crazy excited, reviewing pathologies because my poor study habits have rendered me unprepared and worried, and ready to jump at every opportunity that gets thrown at me. Being placed at a teaching hospital means that I have the advantage of seeing some really interesting things, but also means that I will be constantly competing to practice essential skills, as I will be vying for learning moments against medical students, nurses and residents. What this really means is – I say yes to everything.

Which brings me to my next exposure. I probably should have said no, I probably should have known that something like this was just a touch too heavy of a gig for a first week. But somehow, I ended the last shift of my first week standing in the room of a 20 something patient watching her die. I literally watched her until she died. She was suffering from a terminal disease, and the decision was to remove her supports. The entire time, I told myself I didn’t really know the patient, that I didn’t have a right to cry, or feel sad. Her parents and aunt were in the room, her mom was lying with her crying, her family saying their final words, nurses that had been with her the past few months were crying; and then it hit me. The entire situation hit me in the face, and I realized later that I wasn’t really aware of what was happening. After a certain point, I just drifted. The fragility of life hit me. Just one week ago, just one second ago, this person was a person and all of a sudden it was over. Forty minutes earlier, this girl had a heartbeat.

I came back this week, to find that two patients had died, three patients have deteriorated, and one most likely will not be there when I show up tomorrow morning. The partner of the patient assigned to me asks me about the direness of the situation, and I don’t even know what to say. I wish someone had really told me how hard it was going to be to get to know the families of our patients, or to get to know our patients and know that they aren’t going to get better or that their path to recovery was going to be hard and painful. I wish we had spent a little bit more time in school really realizing and emphasizing that situations like this were a reality, versus spending time on crappy courses on stupid shit like how to be a leader.

Our preceptor had asked us at the beginning what we thought the mortality percentage was in a Canadian ICU, and with all of our teeny little one digit number guesses, knowing that over half never leave was actually quite shocking. Not everyone can be helped, and I guess I just didn’t pay enough attention to the fine print.

Maybe it’s just the intensive care unit, maybe it’s this profession or maybe I really am just emotionally unequipped. But I do know that one week in, and I feel like the fourteen year old volunteer. One week in, and I already want to quit.

Sorry for this depressing post… but this is going to be a long year.

Here are some tips.

 Relaxation

There are many ways on how you can relax. It really depends on what makes you feel relaxed. For some people, finding time to do meditation is relaxing. It also gives them a chance to just get rid of all the negativities in their minds. Other people find fun activities relaxing, such as swimming or dancing to good music. It’s a way to express oneself without inhibitions.

 Relaxation does not take a whole day. If you could spend fifteen minutes of your day to do something comforting or relaxing, that will take a big load of stress from your back. Simply close your eyes and shut the world out for a few minutes and you will definitely see wonders.

 Keep yourself hydrated.

A lot of nurses forget to drink water. Or some nurses prefer not to drink water because it will only give them more reasons to stop working and go the washroom to pee. This is completely unhealthy and will make your skin dry and old. The more hydrated you are, the better skin you are going to have. With a younger, more beautiful skin, you can look at yourself and feel better that you don’t look stressful.  Drink at least six glasses  of water a day and you will definitely see changes in your skin and body.

 Eat healthy

The thing with nurses is that due to their hectic schedule, they simply opt to buy junk food and drink. They want to have the energy to survive the night shift  so they take energy drinks and eat chocolate. While this is okay when taken in moderation, doing it habitually will not do good things to the body.

Change this by switching to a better lifestyle. There are many websites and books out there that can inspire you to change your diet.

Basically, respiratory therapists give evaluations and assessments to patients before they are being treated. They check the patient’s lung capacity with the use of several medical tools and equipment. They also take into consideration the patient’s age, height, sex and weight. Machines like blood gas analyzers are used in this evaluation.

Respiratory therapists can perform chest physiotherapies on patients who have too much mucus in their lungs. This helps patients breathe better and have clearer lungs.

Respiratory therapists work hand in hand with doctors. Being knowledgeable in the area of respiratory diseases and treatments, therapists give advice on the best treatment for the patient.

The reason why respiratory therapists are now venturing into the nursing field is because both fields are interconnected. By holding degrees in both professions, they get more career opportunities. They are able to work in a variety of facilities and with different medical practitioners.

I wish I had been able to take the opportunity to reflect on the trip earlier, but wanting to spend as much time there as possible, I had planned the trip to span from the first second I had a free moment to the last. Literally three days after I landed back home, I started my clinical orientation – jet lagged, and flu ridden. In fact, everything has been happening so fast, I am still currently living out of boxes. At this point, I feel like I have packed and unpacked so much, that unpacking would just be a trivial time consuming feat that would inevitably end up with me still somehow living out of boxes anyways. Either way, I am not unpacked, and still living out of cardboard boxes.

Being the end of the long weekend and all, and of course being the insomniac that I am, I have decided that I would take this lovely 2:09am moment to both reminisce and let go of my Nepali obsession.

What do I miss most about Nepal?

- The people: In all my years of life, I have never met a kinder and more welcoming group of people. I am sad to say that in my attempts to integrate back into my normal Canadian routine, I haven’t had a chance to contact all the new friends I’ve made as promised. Note to self: get on that soon. But seriously, I have met some truly amazing people and without them the trip wouldn’t have been the same.

- The traffic: Even though I pretty much shat my pants the first time I stepped out into traffic, I had grown accustom to it, and I miss all the crazy throngs of people and the cars. Never knowing if you were going to get hit by a rickshaw, a motor bike or just step in a muddy pile of poo water… it was like a daily adventure. I miss adventure.

- The cows: You don’t find random cows in alleyways back in Toronto. Boring.

- Live bands: If you are a music junkie, then Nepal is definitely for you. Despite the fact that all the bands began playing the exact same music by the end of the five weeks, pretty much the entire Guitar Hero 3 set list, it was still an large pool of amazing talent. I miss walking down the street at 8pm and just hearing live music blaring from every corner. I’m glad to say they did us proud with their Alanis Morissette and Bryan Adams’ covers.

- The mountains: Being that Nepal is pretty overcrowded with lots of cars and bikes, going even twenty minutes up the mountain meant feeling the difference in fresh air. It was clean, it was sweet, it was fresh. Never before did I appreciate the fresh air the way I did when I was there. There was something awesome about the view, about knowing you were travelling vertical kilometres above everything.

- The clouds: There’s something about Nepalese clouds, but they are always so fluffy. The mixture of constantly fluffy clouds and gorgeous mountainous backdrop pretty much meant a beautiful view wherever I went. I could live with that kind of beauty indefinitely, for sure.

This list could pretty much go on forever, because I pretty much just miss Nepal. I miss everything about it, I miss the stray dogs, I miss the food, I miss the humid warmth, I miss the rainy weather (I am inherently morbid), I miss the food, I miss the egg and ramen noodle soup from the restaurant across from my hotel (aka Lotus), I miss momos (Tibetan dumplings, oh how I miss thee), I miss the hospital, I miss the little street kids, I miss rolling roti. I miss driving along the country side, watching people live their lives. I miss the seeing family and friends just gather, enjoying each other’s company like nothing else mattered. Although 5 weeks is really not that long in the grand scheme of things, I still managed to feel like it was long enough that I had established a routine, a second home. I had my own little band of misfits, a mixture of fellow Torontonians and newly friended locals, and it was just fun.

I could continue this with discussions of all the life lessons Nepal has imparted on me, but I’m going to go out on a whim and say that it’s both irrelevant and boring. So instead, pictures! (But I will throw out a warning: if the option ever arises to spend the night in an airport, or get a hotel.. take the hotel. I’m pretty sure my back will never be the same.)

And this isn’t even a busy day.

Goodluck finding parking.

Toronto street wires on steroids.

Not uncommon – stray napping in the heat.

I called this the River of Garbage. The water was so thick with pollution, it seemed to be viscous in flow. Despite the hovering rain cloud, the clouds were still fluffy, just dark.

Home is what you make of it

The Monkey Temple gang of dogs. I imagine that they keep the monkeys at bay and from wreaking havoc.

Homelessness is everywhere. Awareness is key.

Colorful Buddhist flags. Each colour representing something different that contributes to balance in our lives.

After all, it is monsoon season.

Playing in the courtyard, photocreds of one of the girls at the orphanage during our time volunteering.

Bottled Fish. Ran into some kids using a small hook, string, worm and their bare hands.

He taught me the method to his madness.

Sunset at Durbar square, beginnings of the formation of the lineup for Curry without Worry

View before I jumped off a bridge.

View after I jumped off a bridge.

Told you clouds were fluffy.

Himalayan mountains

Sitting higher than a cloud = best seat in the house.

I might have cultivated the rice you are currently eating.

Thanks to everyone who made this trip what it was, my fellow RTWB members etc. Cliched as it is, but this trip has motivated me to do more, and this isn’t the end. I am inspired.

“It doesn’t matter how slow you go, so long as you don’t stop” – Confucius

Being an RRT and RN holder, one can work in many different areas. Respiratory therapists can only focus on the ventilator support for patients, but nurses can assist patients in many different ways. The role of the nurse therefore has more autonomy and flexibility compared to being a respiratory therapist.  If you want to give total care and assistance to your patients, enrolling at an RT to RN would be a wise decision.

While the RT to RN transition may not be so easy, it also doesn’t mean it’s not achievable. For RTs, the program’s trainings are very familiar and can be easy to learn. RTs and RNs work at almost the same facilities so situations that are written in books or given in lectures are very much relatable.

Respiratory Therapist Salary

The country’s average income for a regular respiratory therapist is close to $27.05 per hour (or $56,260 each year). The lower 10% obtained less than $40,660, while,  the upper 10% earn over $74,400 per year. Beginning incomes for this profession vary from $16.29 an hour to $21.58. Remember that larger sized organizations normally fork out steeper earnings when compared with their lesser counterparts. Taking into account advantages such as healthcare, vacation/sick time, education assistance, and incentives can enhance your salary by 30%, to a average pay of $67,700. The most important variables that will establish your salary are region, knowledge/degree of instruction, qualifications/areas of expertise, and practice.

To negotiate a nice salary, be confident and advertise your talents and experience to the job interviewer. Attempt to get as many alternatives for yourself as possible, but interviewing at numerous several potential employers like educational institutions, non-public corporations, private hospitals, non-public treatment centers, and government wellness agencies at a city, state, or national level. Institutions, universities, and professional organizations are the kinds of respiratory therapist jobs that pay out the best typical hourly salaries.

As you obtain know-how as a respiratory therapist, you will stumble on several prospects to grow and build up your career. For example, in time one can be elevated to a administrative position and watch over a team of respiratory technicians. Although practical experience is a major variable here, completing a bachelor’s or master’s college degree will probably help speed up this process. You can learn to become a specialist in essential therapy for other organs (for instance the heart or kidney) or associated discipline such as prescription or health care machines. If you do obtain a college degree, you have the potential to teach others in respiratory therapy courses at respiratory therapist schools. Lastly, becoming a advisor is a feasible and potentially profitable possibility.

There are many options available at more advanced respiratory therapy tiers. Actions you can take while you labor to advance in your career or expand your respiratory therapy salary: Get certifications, get an associate’s or bachelor’s degree in the niche from an credited program, finish additional instruction and acquire extra abilities.

The respiratory therapist job description states that they’re health professionals who assist individuals (of all ages) who suffer from long-term inhaling, or pulmonary, issues. These include respiratory ailments like bronchitis, emphysema, and asthma. For toddlers, a respiratory therapist’s experience is useful in the treatment of underdeveloped lungs. A common therapist will administer and evaluate diagnostic studies, perform applicable checkups, regulate blood-oxygen concentrations, and set up and incorporate cardiopulmonary tools to assist or monitor the patients’ breathing. They are also known to provide emergency care to people affected by shock, heart stroke, drowning, or heart attacks. The bulk of respiratory therapist jobs are located in nursing homes, but there are quite a few therapists who function in home care or nursing care locations. Respiratory therapy jobs almost always require an Associate’s degree or instruction from a respiratory therapist school. Most perform full-time, but since hospitals are continuously open, some can expect to perform evening and saturday or sunday hours. Keep on reading for further info regarding the standard respiratory therapist salary.

SHP is ecstatic that three of our own will be presenting at the international conference. Shawna Strickland PhD RRT-NPS AE-C FAARC, Kathy Moss MEd RRT, and adjunct instructor Ronda Bradley MS RRT are all giving presentations to many of their most prestigious peers. 

Congratulations and good luck ladies!

Stay tuned for a more detailed story in this semester’s Touchstone. 

I’ve been assigned my disease for the semester.  I have to present, with a fellow classmate, on asthma.  Others are presenting on different diseases as well.

I’ve purchased a bunch of 3×5 cards and am going to start making flash cards for the coming weeks so I can hopefully ace all my tests and proceed in the program.

Tomorrow is day three of A&P and home for the weekend.

Today we began learning about pulmonary anatomy briefly covered a few historical points, talked a bit about the RT profession, RT organizations and protocols.

In A&P we started discussing body systems and major organs in the most general of terms.  I’ll have to pick up some index cards for A&P.

Have to determine what I need to read for the lab tomorrow.  Thankfully on Thursday I’ll only have to be there from 8 ’til 12.  On Friday I have class from 11 to 12.  Then I’m done except for the studying for the weekend.  On the bright side I’ll be able to truly get ahead of the curve on the reading for next week this weekend.

1.0 Free CEUs for Sleep Technicians

This course also offers Free CEUs for Respiratory Therapists