Myths on Shift: Respiratory Therapy and the C.Y.A. Culture of Hospital Care


By Rachel Clevenger, RRT, ECG, CTP

Myth # 1:

“It’s always been done this way, so just do it.”

This mindset is extremely dangerous because it implies that change in healthcare should not happen because it has never happened. Think about the irony of that statement. There must always be those who vigorously challenge the status quo, for otherwise, the advances in medicine would fail to occur. We should always be looking for better ways to improve our jobs, and methods by which we do. Innovation is crucial.

Myth #2:

“Figure out just how hard you want to work and don’t worry about taking on anything else.”

This false narrative implies that you must make a decision early as to how much work you are willing to do, and then refuse to accept any changes to your load. This is not only wrong but very obstructive. Healthcare itself is dynamic and always changing, and there will always be adaptations to your daily routine. Refused to be locked into this mentality for it may one day cost you your livelihood.

Myth #3:

“Just leave that task for the next shift.”

This is the equivalent of “kicking the can down the road”. While it is true that a shift worker might not complete all of their tasks in an allotted time, do not simply leave the duty to the shift following yours. Request help from your team or supervisor, because the absence can leave a plethora of work incomplete; putting patients’ health in jeopardy.

Myth #4:

“Don’t make waves. It will just come back on you.”

Standing up to an issue or person may be nerve-wracking, but the importance of your integrity is well worth the risk. Often there is an individual or policy that desperately needs challenging, but everyone is too afraid of the repercussions in doing so. Be brave and complete your action with discretion, but never go against your conscience to keep things calm. You might very well save lives by opening your mouth.

Myth #5:

“You’ll understand when you have been here as long as I have.”

Veterans of shift work will have colorful wisdom to share, but this often comes with a big gulp of bias. While it’s true that work experience will shape your perspective but draw your own conclusions about co-workers and responsibilities. Refuse to let a personal vendetta from another person sway your decision about the same issue or person. Gossip is dangerous in the workplace and rarely leads to any positive outcomes.

Myth #6:

“That patient is just a habitual complainer.”

This myth may contain a small amount of truth, which is even more dangerous as a result. Every patient has the right to their own body. Every person has the right to voice his or her complaints about personal healthcare, and it should never be disregarded because it makes our job more inconvenient. Whether the claim is valid or not, we must remember that the patient is ill and out of sorts. How would the reaction be different if it was us lying in the hospital bed? If you hear this type of statement, first consider whether the person who made it was just too lazy to deal with the fallout. We may not always understand, but we can be understanding.

Myth # 7:

“You won’t have any support if you report it. No one will listen to you.”

This is nothing but a victim mentality and a false narrative in every way. Reporting a problem anonymously or with our own name keeps everyone safer. A whistle-blower statute is written into and protected under our legal system for the very purpose of opposing tyrannical leaders in positions of authority. If the individual that you inform does not take your claim seriously, document the event and contact the next person in your chain of command.

Myth # 8:

“That’s not part of your job. Just leave it.”

There are tasks that you will do every day that are not listed in your job description, and others that go beyond the scope of what you normally do. Leave your arrogance at the door, and adapt a mindset of the servant leader. Unless it is a duty that goes against your license or knowledge, be humble in the completion of an additional task. It does not belittle you, but rather speaks volumes about your character. Remember the story of the Lord who chose to wash the feet of his friends, like the lowest servant in the house?

Myth # 9:

“Someone always gets skipped.”

This statement can be true for many hospital shift workers, but should not be accepted by anyone. If you are given more work than you can do, it is your responsibility to delegate some of the tasks to another or ask for help from your superiors. Leaving it to the next shift or skipping it entirely is unacceptable and creates enormous liability. These are not packages that did not get delivered. These are therapies, treatments, medications, and procedures that directly impact the health of your patient. You may need to get creative to accomplish all of the tasks, but you have the ability to make it happen.

Myth # 10

“CYA, no matter what happens. Be sure you are covered.”

Documentation is king in the healthcare industry, due to the enormous amount of liability placed both on the workers and the hospital itself. But creative documentation to cover your *** will not save you from court proceedings if you continually fail to complete your job requirements. Auditing of employee charting is constantly occurring at hospitals, and it is conducted by those who know very well how to trick the system. Accurate filings and charting is always vital for every worker, but do not be under the impression that a few well placed/timed words written into the electronic hospital record is enough to excuse any incompetent behavior. Individuals under the impression that this is true will most likely be on the receiving end of a lawsuit one day.

For every exceptional therapist and nurse that does not buy into these myths, I give my full admiration. Healthcare shift work is not for the faint of heart, and doing it effectively may take all of your patience and discretion from day to day. But never was a job so rewarding that did not take such a great sacrifice to accomplish. Stand in the gap, and be that exception to the industry.

Rachel Clevenger, RRT, ECG, CTP is a respiratory therapist at Houston Methodist Hospital. She is a frequent blogger and passionate about lung health. Visit her website to learn more about her efforts to create a Vaping Lung Injury Specialist (RRT/VLI-S) certification. The views and opinions expressed in this article are those of the author and do not necessarily reflect the views of Houston Methodist Hospital.

1 Comment

  1. Great insights on how our cognitive bias affects our thoughts. You highlighted 10 opportunities where we can grow professionally.

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