Respiratory Therapist - PRN

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Job Summary

This position performs duties necessary to treat patients in accordance with the physician's order and departmental policy. Works independently in all Intensive Care units and critical care settings.

Consults with physicians and other personnel and makes recommendations on treatment as appropriate. Must possess skills necessary to treat patients of all ages to include infants, pediatric, adolescent, adult, and geriatric patients.

Accountabilities

• Patient Assessment: Collect and review all appropriate patient related information and data in patient's medical record.
  
  Collect and evaluate additional clinical information by inspection, palpation, percussion, auscultation and patient interview. Inspect chest x-ray or review x-ray results to determine presence of or changes in consolidation, atelectasis, pneumothorax, opacification, position of tracheal tube and other conditions. Determine appropriateness of prescribed therapy and goals for identified pathophysiological state, appropriate for patient age, size and limitations.
  
  Recommend the collection of additional pertinent data through chest x-ray, blood gas analysis, pulmonary function studies, and other laboratory tests. Explain planned therapy, medications (including typical effects, side effects and frequency of use) and goals to patient and/or family. Evaluate and monitor patients' response to therapy.
  
  Modify treatment techniques based on patient response and assess priorities for delivery of patient care. Ensure interdisciplinary communication tools and plan of care are timely and accurately completed.

• Airway Care and Suctioning: Select, assemble and check equipment for proper function, calibration to include correction of any malfunction.
  
  Ensures all VAP Bundle elements are completed. Perform naso-tracheal and artificial airway suctioning with and without inline suction device. Preparation of patient as indicated to include provision of oxygen as required and evaluation of patient with treatment modification as indicated.
  
  Placement of airway support devices to include nasal and oral airways. Tracheostomy tube maintenance/cleaning; assist with tracheostomy tube change/placement; application of other tracheal airway devices to include assistive speech devices. Assist with endotracheal intubations as directed.
  
  Performs repositioning of endotracheal tube, monitoring of cuff pressures to maintain minimal occlusive volumes, and extubation procedures either by physician order or as indicated using pre-established protocols for ventilator weaning or liberation. Completes assigned airway care procedures and documents timely and accurately in the electronic medical record according to GHS UMC RCS standards

• Bronchial hygiene activities intended to improve distribution of ventilation, facilitate removal of secretions from airways and/or delivery of medications to the airways. Able to perform CPT (percussion/vibration/postural drainage), small volume nebulizer therapy, MDI orally or through ventilator, IPPB, PEP, IS and flutter valve.
  
  Provides patient instruction before, during and after therapy, to include the use of teaching aids. Ensures proper positioning of patient prior to start of therapy and uses proper equipment. Maximizes patient comfort and effectiveness by modifying techniques throughout therapy and coaches coughing at conclusion of treatments.
  
  Practitioner remains at bedside throughout therapy. Complete assigned therapies and document timely and accurately in electronic medical record according to GHS UMC, GHS RCS and other relevant regulatory agencies standards. Communicate timely and accurately patient information to other members of the healthcare team using interdisciplinary education and plan of care tools

• Perform diagnostic testing and monitoring to include: arterial blood gas sampling either percutaneously or through indwelling catheter or other indwelling line; end tidal CO2; pulse oximetry including stand-alone, patient assessment, nocturnal and de-saturation prior to discharge; transcutaneous PO2/PCO2; bedside pulmonary mechanics; EKG; Indirect Calorimetry and other tests as indicated by GHS UMC RCS policy and procedure. Checks equipment for proper function and assesses patient response, modifying technique as indicated.
  
  Performs test within GHS UMC RCS standards for requested status e.g. Daily, AM, Stat, QxH, etc. Documents results timely and accurately in electronic medical record or other designated method, contacting physicians as indicated according to GHS UMC RCS standards. Critical values reporting documented accurately and timely according to GHS UMC RCS standards

• Performs continuous aerosol and supplemental/transport oxygen therapy to include setup and application; assessment of patient response; assessment of proper equipment /delivery system performance including proper oxygen concentration, flow and temperature; modification of therapy as indicated; equipment change as indicated or required by GHS UMC RCS policy. Minimize wasted supplies and/or software by utilizing available tools to ensure correct selection of patient sized software.
  
  Ensure timely and accurate documentation in electronic medical record or other approved method according to GHS UMC and GHS UMC RCS policy or procedure. Complete assigned procedures according to GHS UMC RCS standards.

• Perform mechanical ventilation both invasive and non-invasive (including CPAP and BiPAP). Selects, assembles and ensures proper function of all devices. Demonstrates detailed knowledge of different modes of ventilation both pressure and volume; graphics interpretation and appropriate application to patient requirements.
  
  Monitor equipment to ensure conformance with physician orders to include but not limited to: oxygen concentration, volume/pressure settings, rate and flow. Assesses patient response and makes appropriate recommendations and/or utilizes protocol to secure orders for and make modification of settings to maximize patient comfort/synchronicity and ventilation/oxygenation needs. Ensures VAP bundle items are completed to attain system VAP goals.
  
  Attend physician rounds and inform physician of any changes in patient conditions. Maintain physical presence in assigned unit(s) and notifies appropriate nursing personnel of contact information if necessary to leave area unattended. Ensure accurate, timely documentation in electronic medical record and completes assigned rounds according to GHS UMC RCS standards

• Alternative gas therapy to include: Nitric Oxide, Heliox and other specialty gases as ordered.
  
  Setup; analysis to include adjustment of analyzing equipment; monitoring to include technical function of equipment; change of equipment/cylinders and modification of therapy. Timely and accurate documentation in electronic medical record or other approved method according to GHS UMC and GHS UMC RCS policy or procedure

• Support activities to improve delivery of respiratory care services. Performs appropriate cleaning/disinfection and sterilization of equipment between patient use as indicated by equipment type and patient isolation status.
  
  Returns to re-processing area or notifies appropriate personnel to pick-up used equipment. Performs appropriate breakdown of used equipment with appropriate disposal of single patient use items/software while retaining all re-usable items for re-processing. Remove from service all malfunctioning or questionable performance equipment. Accurately completes RCS Technical Services documentation on all equipment removed from service.

• Maintain professional standards, by completing assigned and unassigned job responsibilities with all appropriate documentation. Effectively utilizes abilities to efficiently achieve results without direct supervision, maintaining adequate quality, speed and volume.
  
  Presents example of efficiency for peers and routinely makes expertise available to assist other members of the healthcare team. Presents positive role model when assisting with orientation of new staff members; clinical education and mentoring of students. Ensures documentation of all therapies and results complies with GHS UMC, GHS RCS and regulatory agencies standards, to include multi-disciplinary documentation, plan of care and real time electronic medical record documentation.
  
  Communicate timely patient information to appropriate members of the health care team. Attend meetings and utilize available resources and communications to maintain up to date knowledge of system and department processes and improvements.

Supervisory/Management Responsibility

This is a non-management job that will report to a supervisor, manager, director, or executive.

Minimum Requirements

Associate's Degree - Commission on Accreditation for Respiratory Care (CoARC) approved RC program

Required Certifications/Registrations/Licenses

• Registered Respiratory Therapist (RRT) National Board for Respiratory Care (Lawson Code CRRT)
• Temporary or Permanent Respiratory Care Practitioner (RCP) SC State License (Lawson Code LRCP)

In Lieu Of The Above Minimum Requirements

National Board for Respiratory Care (NBRC) RRT associate degree equivalent hours

Team members employed in this job prior to July 1, 2020 are grandfathered under prior educational and experience requirements. In addition, team members must be certification eligible and will have one year to obtain required certification.

Other Required Skills and Experience

2-3 years clinical experience preferred

Work Shift

Night (United States of America)

Location

Greenville Memorial Med Campus

Facility

1008 Greenville Memorial Hospital

Department

10087143 Childrens Hospital-Respiratory

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