Respiratory Therapy or Nursing School?
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fma08
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Which one are you more interested in?
Sasha
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Go for respiratory therapy.
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If you are undecided, I would say go into nursing. To enter a specialized field like RT, one usually has a reason that attracted them to that area. If you are just tossing darts in the college catalog, nursing will give you more options. RT has many options but they are primarily focused around the Cardiopulmonary and critical care areas. If you do not care for doing a lot of teaching nursing will be your better option although that profession consists of a tremendous amount of patient/family teaching. With both professions you will have the responsibility of many patients with little down time. RNs in an ICU generally have 2-3 patients and RRTs will have 6 - 10 patients. Med-surg RNs will average 10 patients and the RRTs will have around 20 - 60 patients. The same for the busy EDs with RNs averaging 6 patients at any given time and easily over 20 per shift and the RRT sees around 20 - 50 in a busy ED.
Thinking about going back to school. Had looked at nursing and respiratory therapist. Not sure what one is the best option. Any thoughts or guidance would be appreciated. Thanks
OOOO..why settle? Do both! Which first...hmm?? Which are you most interested in doing soon? I like running around the hospital better than being in one unit for example...RT would be more interesting to me in that context.
Good luck to you no matter what the final decision is.
OOOO..why settle? Do both! Which first...hmm?? Which are you most interested in doing soon? I like running around the hospital better than being in one unit for example...RT would be more interesting to me in that context.
Good luck to you no matter what the final decision is.
RTs are generally assigned to an area like the ICU, PFT lab, HBO, ED or a med-surg floor. For therapy, they no longer hang a treatment and then run around looking for coffee but rather they must stay the entire documented time with the patient. They also do not leave the unit except for the one who is assigned the code beeper. There are a few exceptions but generally when you are working in one of those hospitals you are literally RUNNING your entire shift with no breaks and a beeper that will make you crazy with 30 - 60 calls per 8 or 12 hours.
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Sounds like a good day!
Do you as a Paramedic assess 30 - 60 patients in 12 hours every shift?
My job isn't a 10 minute per task job so of course not...
Are you trying to be insulting?
If you are you need to understand some regulations then like what Medicare considers as treatments. The shortest being a 15 minute procedure with our longest being up to 6 hours depending on the dive in the HBO chamber.
How is your agency paid for your EMS "tasks"? At what level does Medicare reimburse you for the central line insertion, A-line insertion or intubation? Are you able to charge for 30 minutes of patient education while giving that albuterol treatment on a professional scale? Can you get reimbursed on an independent provider scale for outpatient? Consultant?
Yes, raising the standard for education allowed both nursing and RT to move to a different scale and recognition for procedures done.
However, I do know some EMT(P)s that believe 10 minutes is way to long to spend with a patient which is why they run a speedy taxi service complete with L&S to the ED. Some have their beds, computers or TV shows to get back to.
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usafmedic45
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+1. Nursing school without question simply because RT is a niche field and the opportunities with someone with a nursing background keep expanding.
Do it for a couple of years and that will wear off just like anything else. After a point, it has all of the interest and excitement of being a med/surg nurse. Most RTs I know freely admit they like their job but the fact that we are well paid has a lot to do with that.
...or you work at a hospital small enough where there is a single therapist for the entire hospital at night and have to basically triage 20-30 calls in 12 hours from five different departments (ED, ICU, med/surg, medical rehab and long term care). The advantage to that is the fact the night flies by although you go "I am not being paid enough to put up with all of this crap". Then there are nights where you do (in a more normal sized hospital and not the large academic medical center setting that VentMedic works in and in the similar settings I previously worked in ICU and PICU in) pretty much nothing and the night drags by and you find yourself going "They aren't paying me enough to stay awake".
It's a balancing act. RT can be a rewarding job and/or a great stepping stone to bigger things. It's not something I will ever stand up and solely sing the praises of, because the field has a LOT of problems and it isn't for everyone.
Vent, I don't think that was his intention.
Do it for a couple of years and that will wear off just like anything else. After a point, it has all of the interest and excitement of being a med/surg nurse. Most RTs I know freely admit they like their job but the fact that we are well paid has a lot to do with that.
...or you work at a hospital small enough where there is a single therapist for the entire hospital at night and have to basically triage 20-30 calls in 12 hours from five different departments (ED, ICU, med/surg, medical rehab and long term care). The advantage to that is the fact the night flies by although you go "I am not being paid enough to put up with all of this crap". Then there are nights where you do (in a more normal sized hospital and not the large academic medical center setting that VentMedic works in and in the similar settings I previously worked in ICU and PICU in) pretty much nothing and the night drags by and you find yourself going "They aren't paying me enough to stay awake".
It's a balancing act. RT can be a rewarding job and/or a great stepping stone to bigger things. It's not something I will ever stand up and solely sing the praises of, because the field has a LOT of problems and it isn't for everyone.
Vent, I don't think that was his intention.
Lifeguards For Life
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don't mean to sound rude, but why do the RN's not do the same things RT's do in most circumstances? I recently had a RRT clinical for paramedic school, and the only task we did was give breathing treatments. They were atrovent and albuterol. Why do the nurses wait for respiratory for theese seemingly simple procedures? what else is entailed of a RT?
Respiratory Therapists are specialized in the area of cardiopulmonary treatments. They have much more detailed training in that area, and can provide a much wider variety of treatment options. Nurses on the other hand have a broader range of knowledge, but don't go as deeply, and don't specialize in the specific treatments for breathing difficulties, artificial ventilation, etc. Nurses don't intubate - heck, most doctors don't, and would prefer Respiratory or an Anasthesiologist do it.
So, yes, any boob could hand a patient a nebulizer and say, "Breathe this in." But RTs have the training to educate the patient, to evaluate the treatment, to monitor the patient's progress, etc. It's their particular speciality, whereas nurses are basically generalists who specialize in the broad field of nursing.
Also, RTs don't shy away from a patient's secretions like nurses do.
I'm sure Vent or someone else can give a much better answer to this question, so I'll leave it to the experts.
LOL, Life...RT's do more than simple breathing treatments. You should be hearing from the gallery soon!
Lifeguards For Life
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I'm sure they do, i just know i got a dud respiratory clinical, folllowwed around a RRT for 8 hours doing breathing treatments, that the nurse or a tech could of done. very boring. very repetitive
firecoins
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my only comment to that is an RT does not have to drive to their patients. If I could stay in the hospital, I too could assess 30 - 60 patients. There are only so many patients I can see when it takes 10 minutes just to get to them and than i got to take them to the hospital.
That being said RTs do alot more than hang treatments.
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He's not being insulting, he's regurgitating what you just told him. You say between 30 and 60 patients in a 12 hour period. Assuming you have no breaks or downtime between patients, at 30 patients that is 24 minutes per patient. At 60 patients that is 12 minutes per patient. On average. So while 10 minutes may be a bit low, most of the assessment are probably just that if you're going to be up to 60 in a 12 hour shift. If you are spending 6 hours of the day with one treatment, then you're taking care of that one patient and ensuring that he/she gets their appropriate treatment. And that's not wrong, it's just different from EMS and to compare them is not appropriate. It would be like comparing patient contacts in the cath lab to those in the ICU.
And to the original poster, my advice would be this:
If you are already in EMS take the time to ask around at the hospital. Talk to nursing supervisors, Respiratory techs and supervisors. Maybe see if you can't shadow some of these individuals and learn a bit more about what they do. Even if you spend 8 or 12 hours following a Resp Tech around and decide you could never do it, you're probably still gonna learn some valuable information in that time period. And if you don't have access to these individuals, set up an appointment with a counselor and see what other resources you have to make an educated decision.
Jeremy89
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I was caught in the same dillemma. An RT at my hospital told me "dude, go for the RN. They can pretty much do everything we can, plus much much more". You could always be an RN on a pulmonary floor, or an ICU where most pt's are on vents.
The pay is slightly more for an RN, but an RT whose been working 10 years will easily earn more than a new grad RN.
Hope that helps!!
I also encourage so to go into nursing and if that is the language the RT used, he may have his reasons for saying the RN is the way to go for you.
Medicare doesn't reimburse for txs done by RNs since they are not considered therapists for a specialty. This is true in all therapies. Hospitals do lose money if an RN gives a treatment since he/she can not stay at beside for the duration of the treatment. They also do not fill out the required assessment each and every time a neb is given. Thus, any monkey can hand a neb to a patient but the assessment and education is a little different.
Also, in most states there are restrictions for RNs messing with ventilators and their education must be verified to be specific for mechanical ventilation in an ICU situation. Most hospitals also have very stringent policies about RNs or even MDs touching equipment they have not been properly educated for. JCAHO will ask for the policies. For lower level ventilators such as those used in transport, home care or sub acutes, RNs can manage those.
For the "simple" stuff, ask a Paramedic or RN to name 5 different asthma medications or to do a simple scoring to determine which med and how much for both short term in an emergency and long term. Ask them about the difference in administration between HFA and CFC. How many would pass the Asthma Educator cert test which basically consists of all the information needed for properly assessing, treating and educating a patient in the ED?
http://www.naecb.org/
http://www.naecb.org/
Yes it is a little more involved than handing some one a neb or as some in EMS do, hang a mask treatment and continue with you paper work. Then check the little "treatment" given box.
As an EMT or EMT-P what else are you going to do in prehospital? You will not be managing ICU ventilators or even those little ATVs until later. You will not be drawing arterial blood or inserting or monitoring chest tubes. You will not be inserting UVC/UAC lines. You will not be giving surfactant. You will not be giving flolan or nitric oxide or even heliox. You won't be shooting cardiac outputs. Hemodynamics are barely covered in Paramedic school. You won't be running an asthma clinic. You won't be doing cardiopulmonary stress testing. You won't be doing HBO. You won't be doing ECMO. You probably will not work in a cath lab. And, until you get some type of critical care training as a Paramedic you will not baby sit an IABP on transport.
You will be giving albuterol treatments and you really should have paid attention to the assessment and education of each patient. Of course, since most RRTs know that "giving a neb" is boring to EMT(P)s, few are going to put much effort into making your day enjoyable especially when they see the criticism on the EMS forums about their chosen profession by those who have absolutely no experience as an RT or even in the hospital. If you don't care enough about helping a patient out who can not breathe or see the importance of a "boring" nebulizer then any training or education will be a waste of time on you and it will be the patient that suffers because you feel they are too boring if a nebulizer is all it takes to help them out of a bad situation.
For many of the things done in the hospital, EMT(P)s view it as boring and rarely pay attention to it when they are participating in a transport of that patient so why waste time showing them anything other than what they will be doing on an ambulance. People in EMS whine all the time about boring BS transfer calls to specialty areas or tests. Yet few take the opportunity to know what that area is all about. I did happen to notice which is why I chose RT to advance my education from a Paramedic degree and to achieve many more opportunities in clinical and transport situations.
RT has two levels and generally the certified which also requires a 2 year degree will do nebulizer treatments on the med-surg floors. The average load is between 36 - 40 treatments for a 12 hour shift. Of course there will be unscheduled treatments and PRNs that may have to be worked in. If you miss lunch, you fill out an exception form and get paid for that time. Some treatments will be missed and the proper paperwork will have to be filled out for the various accrediting agencies. Too many missed treatments can reflect poorly on the CRT or RRT's time management or on the facilities lack of staffing. Generally when the treatment load becomes ridiculous the RTs can protocol out unnecessary treatments or make any changes they see appropriate for that patient.
Now for RRTs on transport, besides the skills they can do on a regular basis in the hospital such as PICC, A-line, IV, UAC/UVC insertion and intubation, they can also do:
Rapid Sequence Intubation
Needle and surgical cricothyrotomies
Femoral and external jugular IV insertion
Needle chest decompression and/or chest tube insertion
External pacing and monitoring of Internal pacing
Intraosseous placement
Intra Aortic Balloon Counterpulsation
Ventricular Assist Devices
Needle and surgical cricothyrotomies
Femoral and external jugular IV insertion
Needle chest decompression and/or chest tube insertion
External pacing and monitoring of Internal pacing
Intraosseous placement
Intra Aortic Balloon Counterpulsation
Ventricular Assist Devices
These meds are also within their scope on transport if they are part of their job description. Of course there is a long list of meds that normally fall uner the scope of an RT. As well, if on a specialty team or working with ECMO, other medications and medical gases will apply.
Adenosine
Amiodarone
Anectine
Ativan
Atropine
Benadryl
Calium chloride
Clonidine
Demerol
Dextrose
Dilantin
Dobutamine
Epinephrine
Esmolol
Etomidate
Furosemide
Haldol
Ibuprofen
Labetalol
Lidocaine
Magnesium sulfate
Morphine
Narcan
Nitroglycerine
Nitroprusside
Norcuron
Procainamide
Procardia
Sodium bicarbonate
Succinylcholine
Tylenol
Valium
Verapamil
Versed
Amiodarone
Anectine
Ativan
Atropine
Benadryl
Calium chloride
Clonidine
Demerol
Dextrose
Dilantin
Dobutamine
Epinephrine
Esmolol
Etomidate
Furosemide
Haldol
Ibuprofen
Labetalol
Lidocaine
Magnesium sulfate
Morphine
Narcan
Nitroglycerine
Nitroprusside
Norcuron
Procainamide
Procardia
Sodium bicarbonate
Succinylcholine
Tylenol
Valium
Verapamil
Versed
Just like EMS, where you can choose to work for a transport company doing ALS transfers and never intubate or start an IV or initiate any med for years, as an RT you can work in a sleepy little hospital that does very little like the one usafmedic45 had chosen to work in. Or, you can work toward becoming part of a specialty unit and take your career to the fullest. That can be said of nursing also. One can work in a quiet doctor's office or work in a fast paced ED or ICU with many standing orders and protocols to initiate as well as becoming part of a CCT or Flight team.