By Rachel Clevenger, RRT, ECG, CTP
Streets are empty of traffic as the silent commute is made to hospitals and clinics. The bars were not open last night, nor was the doughnut shop this morning. We arrive by car, bus, shuttle, train, and foot without any pleasant conversation. Surgical masks across our faces with scrub hats covering our salon free roots, we line up 6 feet apart outside the building; acknowledging one another with a tired nod. A temperature screening at the entry point, we then shuffle our aching feet towards the department before being given report from the last shift.
Hopefully, our patients did not deteriorate or code while we were off the clock. Check your email, because there were ten policy changes to ventilator equipment and procedures in the last five hours. Extra PPE requirements, n-95s, PAPRs, and isolation gowns are gathered as we triage our assignment; searching for a viable starting point. Don’t forget the extra cert pager and phone. We then disperse to the ICUs, MICUs, ER, floors, PFT labs, clinics, and assigned areas to start the shift. Better be ready to hustle and flow, because you won’t have time to take a break today. Wipe everything down, and treat every new case as if it could be COVID-19. Mandatory testing for employees on Monday.
This new reality of COVID-19 normal is penetrating the resilience of even the most durable therapists in the field. Respiratory therapists by nature inhale stress with a calm demeanor set apart from the rest of healthcare workers. Initially, the fast and furious pace of the pandemic had our profession chasing a whirlwind catch up with the virus. History was being made every day, and respiratory care is in the center of the hub.
Newly created procedures, experimental treatments, and cutting edge medication trials are setting a steep learning curve for all. But after months of the constant drone, the ever needed vigilance has become too much for any clinician to shoulder in a healthy way. The newness of the novel virus has worn off, and the profession is getting tired of the media’s constant panic without effective results.
Respiratory therapists are blessed with assessment skills like no other, and are readily expected to advocate on behalf of their patients; many of whom cannot have any visitors due to the COVID-19 containment rules. But how can the RT fulfill this task of the heart when we can barely keep our heads above water? How can we save lives when we are ignoring our own health warning signs? How can we be deemed essential, and yet feel so fragile at the same time?
The fear of contracting COVID-19 is an obstacle to patient care; and many respiratory therapists are terrified of this very fact. The face of treating COVID-19 in the healthcare profession comes with a large amount of PPE, and this image is impeding efforts to advocate.
If I don’t wish to waste PPE to enter a room, how can I comfort a widow who has not seen a family member since she arrived?
If I am too afraid of contracting the virus to act, how will I effectively manage a difficult intubation in the emergency room?
If I am too concerned that my family and children will be affected by the virus, how can I perform my daily tasks without breaking down in a panic attack?
The truth is a sober one. Respiratory therapists know our role, and we must summon all our efforts to practice effectively without dissolving into a fear-driven waste of skills. We may be weary, but we are still willing. RTs treat many dangerous diseases, and the COVID-19 pandemic is no exception.
But we are not excused from our duty for the purpose of being afraid. Life is filled with risks, and respiratory care is not for those without a little steel in their blood. Do not give in to the staggering apathy that is palpable in our hospitals from every angle. Titrate that ventilator and help your patient improve, even if it takes more time than you can spare. Use your assessment skills to spot symptoms others may have missed, because it might give a clue to the treatment options. Offer solutions to members of the care team, who are also searching for a patient plan. Give hope to your patients that are purposely ignored by so many hiding behind face shields. Leave it all out there on the field, and remember why you chose this field.
The real healthcare heroes are always in this state of mind, because one day the patient wristband will read their name and date of birth. Be the patient advocate you would want to speak on your own behalf, or silence will be your just reward.
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 lunghelp.net 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.