Respiratory Care Practitioner (ADULT)

Respiratory Care Practitioner

Under general supervision, performs respiratory care related procedures. Adheres to standards set forth in Respiratory Therapy driven protocols. Assesses patient condition, administers prescribed therapy and aerosolized medications, provides airway and ventilator management, performs respiratory related diagnostic tests, and records patient response to therapy modalities. Special duties may include provision of basic and advanced respiratory care to neonatal and pediatric patients in the intensive care unit and during transport, which frequently requires making rapid decisions and assisting physicians to respond to status changes in neonatal and pediatric patients. Working with physicians to create breathing management strategies. Treating breathing disorders, some sleep disorders, severe allergies, and other lung conditions. Provides airway and ventilator management, place, monitor and maintain advanced airways, and documents patient response to therapy modalities. Special duties may include performance of a variety of diagnostic tests of the cardiopulmonary system and to determine the effect of disease and treatment on that system.

Education: Completion of an approved and accredited respiratory programGraduate from a respiratory care education program supported by CoARC or accredited by NBRC (National Board for Respiratory Care), with a minimum of 62 semester hours of college credit, including a background in the basic sciences, or baccalaureate degree in an area other than respiratory care or Associates of Arts or Science degree

Licensures/Certifications:

• Current Maryland license as a respiratory care practitioner
• Healthcare Provider (CPR Certification)
• Neonatal Resuscitation for NICU respiratory care practitioners

Skills:

• Knowledge of respiratory therapy theory, practice and techniques
• Skill in using computers and a variety of personal productivity applications
• Skill in oral and written communication
• Skill in providing customer service
• Knowledge of laboratory and regulatory requirements relating to patient care

Principal Duties and Responsibilities:

Assesses oxygenation and recommends/initiates, administers, evaluates, and documents response to oxygen therapy, medical gas therapies including Heliox, Vapotherm, Nitric Oxide (NICU)

Assesses need for, recommends/initiates, administers and evaluates/documents response to inhaled medications by assessing response to inhaled medications, follows appropriate procedures and protocols for medication reconciliation and patient identification as guided by clinical practice, and records and communicated missed medications. Adheres to the Bronchodilator/Common Cannister protocol and progresses patients to MDI therapy. Scans all medications. Calls physician to obtain appropriate changes to medication orders

Assesses need for, recommends/initiates, administers and evaluates/documents response to therapies directed toward secretion mobilization and airway clearance by performing endotracheal suctioning, assessing response to chest physiotherapy (cough and breathing retraining, PEP therapy, postural drainage and percussion) and expansion therapies (Incentive Spirometry)

Performs safe and effective cardiopulmonary resuscitation, including airway management techniques. Maintains all airway management competencies including Endotracheal intubation. Attends as assigned mock codes

Assesses need for, recommends/initiates, sets-up/maintains and evaluates/documents response to mechanical ventilation, ventilator and weaning protocols, routine airway care, appropriate clinical alarm limits and documentation. Performs wake up and wean screens daily. Maintains Blood Gas Lab/C.A.P. standards for clinical laboratories

Recommends, performs, and interprets diagnostic tests including FVC/NIF, portable spirometry, continuous pulse oximetry,overnight pulse oximetry, end-tidal CO2 monitoring per protocol and/or when ordered, transcutaneous monitoring in NICU,and laboratory tests

Instructs patient, family, and significant others in the rationale and methodology or respiratory care procedures to facilitate patient/family cooperation, understanding and efficacy of care, including reassessment of care. Documents daily patienteducation, re-evaluations. Assesses prn medications for need

Performs the following support activities: decontaminates and sets and up equipment, provides equipment and cylinders when requested, secures rental equipment appropriately, daily oxygen rounds, troubleshooting and appropriate labeling ofmalfunctioning equipment, communicates opportunity for rental equipment return

When assigned to the NICU and is able to demonstrate competence, performs the following duties: neonatal resuscitation; setsup, manages, and troubleshoots high frequency oscillatory ventilation, neonatal mechanical ventilation and CPAP devices;Assesses, initiates/recommends, administers, and evaluates response to nebulized medications, administers surfactant, oxygentherapy, chest physiotherapy, endotracheal suctioning, arterial, capillary, and cord blood gases; Sets up and monitorsventilator humidification systems; recommends/sets up Transcutaneous monitor where appropriate.

Documents on Pediatric Asthma Pathway and all Information Systems and paper documents accurately and completely. Communicates and documents functional concerns to the Help Desk and to relief therapist. Documents according to regulatoryblood gas lab requirements. Relays accurate information to oncoming shift. Maintains patient orders, transitions therapies, and maintains work assignments accurately, responsibly and fairly among staff

Maintains and completes competencies in a timely fashion. Applies Bronchodilator Protocol, Wake up and Wean and Common Cannister protocols consistently. Interprets patient care in accordance with these protocols

Selects, reviews, obtains and interprets data: Reads and evaluates physician's orders, clarifying as needed. Accurately transcribes physician orders to electronic charting system or departmental patient master. Reviews patient information including history, lab data, radiologic studies, progress notes, respiratory and cardiovascular monitoring data and performs assessment/data collection in systematic manner

Determines modifications to physician orders, which optimize patient, care and makes recommendations to physician. Recommends procedures to obtain additional data including radiographs, bronchoscopy, Gram stain and C&S, spirometry, blood gas analysis, lung mechanics, work of breathing, EKG, noninvasive monitoring. Performs diagnostic modalities: Performs procedures and interprets results: ABG sampling and analysis, co-oximetry, spirometry, pressure-volume and flow-volume loops, cuff pressure, sputum induction. May perform pulmonary function, and sleep diagnostic tests

Conducts patient education and disease management. Performs cardiopulmonary resuscitation according to resuscitation guidelines. May assist with or perform intubation. May assist the physician when performing bronchoscopy, thoracentesis, tracheostomy, cardioversion, and intubation.

May participate in land/air critical care transport. May assist with high risk deliveries. May assist with surfactant replacement in neonates. May participate in pulmonary rehabilitation, home care. May assist with discharge planning. May assist with community outreach. May initiate and implement therapist driven protocols.

Supervision and Administration: May assign, organize and coordinate the work of assigned Respiratory Care Practitioners. May demonstrate respiratory care procedures to trainees and other health care personnel. May train assigned practitioners and complete assigned practitioner competency reviews.

Assesses priorities for delivery of patient care and redistributes resources as necessary throughout shift. Protects data from intentional or unintentional destruction, modification, or disclosure

Participates in continuing education for professional development in Respiratory Care and related fields. May serve on hospital committees. May participate in professional organizations

Supervision and Administration: May assign, organize and coordinate the work of assigned Respiratory Care Practitioners. May demonstrate respiratory care procedures to trainees and other health care personnel. May train assigned practitioners and complete assigned practitioner competency reviews.

All roles must demonstrate GBMC Values:

Respect

• Treats others with fairness, kindness, and respect for personal dignity and privacy

• Listens and responds appropriately to others' needs, feelings, and capabilities

Excellence

• Meets and/or exceeds customer expectations
• Actively pursues learning and self-development
• Pays attention to detail; follows through

Accountability

• Sets a positive, professional example for others
• Takes ownership of problems and does what is needed to solve them
• Appropriately plans and utilizes required resources for various job duties
• Reports to work regularly and on time

Teamwork

• Works cooperatively and collaboratively with others for the success of the team
• Addresses and resolves conflict in a positive way
• Seeks out the ideas of others to reach the best solutions
• Acknowledges and celebrates the contribution of others

Ethical Behavior

• Demonstrates honesty, integrity and good judgment
• Respects the cultural, psychosocial, and spiritual needs of patients/families/coworkers

Results