How to Wreck a Respiratory Department

Ahhh, enlightenment. . .

I've blogged about the attitudes in our department. I had a chance to work with some of our PFT lab folks, who have been RTs at our hospital for many a year, and they were able to explain a little history to me.

In the 70s, the hospital restructured. Without any advance notice, the therapists were notified that they would be dissolved as a department, and placed under nursing. The house therapists were placed under the nursing direction of the pulmonary floor, NICU under NICU nursing, PICU under PICU nursing. Everyone in a middle or upper management job had to reapply for the job. In the opinions of the historians, the person that was chosen to manage the actual staff members was, out of 8 candidates, the least qualified to be managing respiratory therapists.

I don't know how long that situation lasted--I'll have to do some follow up. But eventually, Respiratory was returned to it's own department. With a wonderfully kind, but very weak manager, and a medical director who is basically absent, an "approachable" guy who never stands up for respiratory.

So now I get it, so much of what makes our department the most dysfunctional respiratory department I've ever worked in.

The house and the units never work as a team. They are in competition, at odds, disrespectful of each other. When there are staffing needs, the discussion isn't aimed at teamwork, it's aimed at who is more important, who is going to get shit on.

The staff rebels against the management. The various clinical specialist and managers work very hard and speak loudly and often about how important they as individuals are, how indispensable. They are competitive with each other, and undermine each other's efforts and those of the staff to advance in any way.

And the doctors and nurses piss on us. This could be a whole other post, how we are not backed up, only the experts when there's an airway problem, the rest of the time we are peons to be written up every time someone doesn't get suctioned or a treatment is a half and hour late.

This may sound like a whine. Maybe it is. But I've worked in three different states, and something like seven different hospitals, and I've never, ever, worked with RTs who are so contemptuous of each other. The senior people with all sorts of knowledge, silent, getting their jobs done, waiting to retire.

So to all of you administrative types, here's your recipe for destroying the morale and quality of your respiratory department.