For millions of people with asthma, chronic obstructive pulmonary disease (COPD), other smoking-related illnesses and some sleep disorders, the simple act of breathing can become a life-or-death struggle. Respiratory therapists (RTs) help provide immediate care, ongoing rehabilitation and patient education so patients can live as normally as possible.
RTs, Please, for Asthma
For asthmatics in an acute phase, RTs restore normal breathing through use of handheld inhalers, nebulizers and, if necessary, injections. These therapists really shine as they teach patients how to manage their disease.
Research shows that RTs are the best qualified medical professionals to teach the nation's approximately 20 million asthma sufferers how to correctly use their breathing equipment, says respiratory therapist Thomas J. Kallstrom, RRT, FAARC, director of respiratory care and echo/vascular services at Fairview Hospital in Cleveland.
"Asthma is our disease," says Kallstrom, a certified asthma educator. "We provide essential information to help patients recuperate and to prepare them to never see us again. If they take their medication properly, they should never have to come to an emergency room."
Learning to Adapt
Cigarette smoking causes most cases of COPD, the fourth leading cause of death in the US. RTs treat hospitalized COPD patients by administering supplemental oxygen or initiating breathing treatment. Once their condition has become stable, COPD patients often enter pulmonary rehabilitation.
Irreversible lung damage makes breathing difficult for COPD patients, so RTs help patients cope with chronic shortness of breath. "The focus may be on adaptation, rather than rehabilitation, because patients may never fully resume their previous activities," says Gretchen Lawrence, RRT, FAARC, program associate for the National Lung Health Education Program.
Besides teaching proper medication use and breathing exercises such as effective cough techniques, RTs may also develop personalized exercise programs and encourage smokers to quit.
RTs who staff pulmonary rehab units frequently have earned specialized credentials in pulmonary function technology from the National Board for Respiratory Care.
Help for Smokers
In hospitals, RTs assess patients' tobacco use, encourage them to quit and refer them to treatment programs. They also help patients deal with hospital "no smoking" policies by developing nicotine replacement therapies. Many RTs staff hospital outpatient smoking-cessation programs due to the large percentage of pulmonary diseases caused by smoking.
Working with smokers requires passion, patience, consistency and an understanding of addiction, says Gaylene Mooney, MEd, RRT-NPS, director of clinical education for the respiratory care department at the University of Arkansas for Medical Sciences Area Health Education Center-Southwest.
The Mayo Clinic in Rochester, Minnesota, the University of Massachusetts Medical School, and the University of Medicine and Dentistry of New Jersey all offer tobacco dependency treatment programs for RTs who want to specialize in this area.
RTs Put Sleep Disorders to Rest
Millions of Americans suffer from sleep disorders such as sleep apnea, night tremors, insomnia and sleepwalking. Sleep disorder clinics are flourishing, creating more opportunities for RTs.
With their knowledge of anatomy, physiology, the heart, lungs and breathing-related disorders, RTs have a solid basis for learning about sleep disorders, says Karen Schell, RT, sleep lab manager at Newman Regional Health, and a registered polysomnographic technologist (RPSGT).
RTs aspiring to work in a sleep lab should participate in a three- to six-week training session at an accredited sleep school, Schell says. (For a list of accredited programs, contact the American Academy of Sleep Medicine.) To advance, RTs should consider becoming an RPSGT, she adds.
Unlike other areas in chronic care, RTs treating sleep patients often see instant results. "Many patients don't realize how long it's been since they've had a good night's sleep," Schell explains. "When they wake up feeling refreshed, they are thrilled."
While 75 percent of all RTs work in hospitals, home healthcare agencies employ many of them. More primary-care physicians and pulmonologists are hiring RTs, often part-time, to assist with diagnosis, patient education, smoking cessation and consulting, Lawrence says.
"Given the tremendous rise of asthma and the prevalence of [COPD], pulmonologists see the value of an RT as a physician extender," Kallstrom says.
Treating chronic conditions may lack the drama and urgency of working with critical- or intensive-care patients, but Lawrence and other RTs enjoy a deep satisfaction watching their patients achieve even small victories.