Respiratory therapists across the country have been feeling the staff shortage in their field for months. Prioritization of patients has often been a necessity during the pandemic, taking a heavy toll on caregivers who see COVID-19 patients at their worst.
This was particularly the case on November 14 – “hands down the worst day” of Anna Carmean’s career.
The 28-year-old respiratory therapist received more than 25 calls and texts from colleagues who needed his help while on shift at Spectrum Health. Unable to be everywhere at once, she had to choose who to help and who to move on to the next available therapist.
“I held a man’s hand while he had one last conversation with his wife on the phone because he was on a ventilator and didn’t know if he was going to be okay,” the caregiver said. Spectrum Health, 28 years old. recalled. “This man has had no other medical complications. He was also the same age as my father. And as easily as he could have been mine, he could have been yours.
Carmean is not alone. Hospitals across the state need more primary caregivers, and respiratory therapists are no exception, according to the Michigan Health & Hospital Association.
The hospital association did not have data to quantify the need, but an Indeed.com search for respiratory therapist jobs in Michigan generated more than 230 jobs, including 68 posted in the past 14 days. Several jobs included the note: “emergency hiring”.
At Beaumont Health in Dearborn, Cathy-Jo Ponzi is the Director of Respiratory Care. She said the shortage has existed “in recent years,” although the respiratory nature of the COVID-19 pandemic has only widened the need and increased awareness of what respiratory therapists are doing.
“A lot of the two-year healthcare fields aren’t getting the publicity they deserve,” Ponzi said. “They sort of came to the fore because all treatment for this virus is a type of intervention that a respiratory therapist does.”
During his 38 years in the field, Ponzi has witnessed a cycle from abundance of workers to shortages. Now, as a respiratory virus has infected more than 454,956 Michiganders and killed at least 11,274 residents, the shortage has struck at an inopportune time.
In Beaumont, Ponzi said there were 29 openings for respiratory therapists. Friends from different health systems across the state have reported similar shortages.
“Every site pretty much has openings and one of the issues is making sure your pay rates are competitive,” Ponzi said. “If you recruit, you have to fly elsewhere.”
With numbers strained, respiratory therapists are often asked to take extra shifts. A typical week may include three 12- or 12.5-hour shifts, but some therapists have reported taking 2-3 extra shifts, or around 60-72 hours in total per week.
Hospitals have benefited from itinerant caregivers, but they are not cheap. Ponzi said a hospital could hire a traveling therapist for $ 60 to $ 70 an hour for a 2-3 week assignment under normal circumstances. These days, that price has doubled.
“Unlike nursing, we can’t control the number of patients entering a facility (by limiting bed fill), so we have to find a way to deal with the volume of patients regardless of staffing,” said Ponzi. “We just have to try and suck it up and see if you have some people who want to work more overtime and do your best to sort your work out with unstable patients who really need your expertise first.
Anna Carmean wasn’t sure what career she wanted to pursue when she attended Muskegon Community College, but she knew she wanted to help people. She turned to respiratory care after attending a career fair and found she could enter the field faster than nursing.
Respiratory therapists specialize in the respiratory and pulmonary systems, which involve all aspects of breathing. They manage patients with various forms of oxygen therapy, including both invasive machines like ventilators and non-invasive machines like BiPAPs. They also monitor sedated patients and help with blood draws and patient transport to and from procedures.
“We call ourselves the Batman of healthcare,” Carmean joked. “We go to a patient room, do our job and leave, but they never know our names. We are not always at the bedside, so we don’t know them as doctors or nurses. We do a lot of things that people don’t know. “
With COVID-19, the virus attacks the way oxygen molecules disperse in hemoglobin, which is the protein molecule in red blood cells that carries oxygen from the lungs to body tissues. A patient’s difficulty is not with ventilation, but with oxygenation, Ponzi explained.
“It’s like going into Colorado (at high elevation) and you can bring the air in and out, breathing isn’t the problem,” Ponzi said. “You can’t get enough oxygen in your lungs and then you get short of breath. This is the same thing we are seeing with this virus. “
“We are throwing everything we have in our respiratory toolkit to these patients and often that is still not enough.”
Over the past nine months, health workers have had to learn new ways to treat and care for patients with COVID-19. They incorporated new therapies and practices such as pronation or placing patients on their stomachs to improve breathing.
Ponzi said the biggest challenge during this second wave of COVID-19 cases was the emotional toll he put on respiratory therapists.
“You are afraid for the patients, afraid for yourself of getting infected and taking it home to your family,” she said.
This ringed true for Carmean, who lives and cares for his 85-year-old grandmother. In the first months of the pandemic, she hopped on the couch at a few friends’ house to avoid infecting her grandmother. Now she is confident enough in her sanitation routine to go home, but even so, the worry remains on her mind.
“It’s stressful,” she says. “There’s always a chance she can get it, but we’ve come to the conclusion that it’s better to both be together than to try to deal with things like we did in the spring.
“We were very lucky and I am grateful for that.”
What is the solution?
In order to meet the needs of the industry, Ponzi said doctors, medical assistants and nurses in the medical field need to be more educated at the high school level about alternative career options. There are programs in place for students to follow respiratory therapists to learn more about the job.
Schooling to be a respiratory therapist typically requires a two-year associate’s degree. Michigan has 11 colleges and universities with accredited respiratory care programs, some of which are in partnership with healthcare systems during clinical hours.
Ponzi said the program is difficult, and the programs typically accept 22 to 28 students. Upon graduation, the class could be reduced to around 18 students entering the field.
Between year # 1 and # 2, students can get a job in a hospital as a respiratory assistant. Good assistants are often hired before the end of their program so that they can start working after graduation.
“What I like about a respiratory therapist as opposed to a nurse is that you are an expert in respiratory and lung disease,” Ponzi said. “Unlike a nurse, where you know a little about a lot, respiratory therapists know a lot about the respiratory and pulmonary systems.”
For Carmean, her favorite thing about a Respiratory Therapist is the variety of jobs she has to do and where she can move around the healthcare system.
“When you enter nursing, you are hired on a certain floor or area of the hospital,” she says. “We go everywhere. I could go to the emergency room or intensive care and then float around to organize things and move patients here and there. You are not bored and you are still standing and helping people. “
One downside, however, is that she doesn’t always know the fate of the patients she helps. Like the COVID-19 patient whose hand she held on November 14 as he fell asleep to be put on a ventilator.
“Unfortunately, we don’t stick around so sometimes we don’t know the end of a story,” Carmean said. “This is another burden that we carry … but we will overcome it. We would love to see the numbers drop. “
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