This photo was taken on the man's deathbed, and says it all. You can find the story Here.
I guess the photo won't save, so I hope you can view it on flickr.
Tuesday, April 22, 2008
Wednesday, April 9, 2008
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.
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.
Wednesday, April 2, 2008
EPIC Next Session
We are validating our respiratory content. It's quite a tedious process, but I think we are building a fairly decent ClinDoc for our department. Of course I expect everyone else to think I'm wrong on that.
There is actually a lot of work that could get done in our department, at this time, as well as in the future. I'm exploring an article in this month's Journal of the American Medical Informatics Association, on Computerized Whiteboard System for an ED. I think it could present an excellent solution for how we manage our treatments and assignments.
Another project I have is to help my Department Head create a business case for hiring "someone"--hopefully me--to be a respiratory informaticist. I want to develop this into a paper worthy of Respiratory Care.
So we'll see what I can accomplish. I'm also poking away at html. This week we are in the validation sessions, but my boss has taken me out of the clinical role for at least the next schedule, so I can work on this transition.
How lucky am I?
There is actually a lot of work that could get done in our department, at this time, as well as in the future. I'm exploring an article in this month's Journal of the American Medical Informatics Association, on Computerized Whiteboard System for an ED. I think it could present an excellent solution for how we manage our treatments and assignments.
Another project I have is to help my Department Head create a business case for hiring "someone"--hopefully me--to be a respiratory informaticist. I want to develop this into a paper worthy of Respiratory Care.
So we'll see what I can accomplish. I'm also poking away at html. This week we are in the validation sessions, but my boss has taken me out of the clinical role for at least the next schedule, so I can work on this transition.
How lucky am I?
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