HI - RESPIRATORY Therapist

**TRAVELER MUST HAVE HAWAII RT LICENSES**


*****PLEASE RESEARCH HOUSING BEFORE APPLYING FOR THIS ***This position works in the respiratory therapy unit of a hospital and exercises considerable independent clinical judgment in applying scientific knowledge and theory to practical respiratory care problems in accordance with physicians' orders. The position is responsible for independently administering respiratory tests and treatment to patients with respiratory diseases and disorders including cases involving critically ill, pediatric, and neonatal patients. The position may be required to work on shifts, including evenings, and weekends and holidays.

Key Duties and Responsibilities

1. Life Support Systems: Initiate, monitor and maintain volume and pressure cycled respiration units for patients requiring continuous ventilation as a life support measure as determined by a physician. Such work includes emergency intubation; initial setting of ventilator controls; performing arterial punctures; evaluating laboratory results and making ventilator adjustments to maintain arterial blood gases within normal limits; and consulting with physicians to determine the mode of therapy to be used (e.g., Intermittent Mandatory Ventilation (IMV), Intermittent Demand Ventilation (IDV), Positive End Expiratory Pressure (PEEP), Continuous Positive Airway Pressure (CPAP), and Bi Directional Positive Airway Pressure (BiBAP).

Consult with physician regarding proper method and scheduling of weaning patients off respirators; provide continuous airway management and maintenance to include establishment (placement of an oral or nasal endotracheal tube), securing tube and maintaining proper pilot balloon pressures, suctioning of secretions when necessary, changing of tracheostomy tubes and endotracheal tubes on a regular basis and removing same when no longer needed.

2. Participate in administering and initiating cardiopulmonary resuscitation as part of the resuscitation team which includes airway maintenance and/or establishment with an endotracheal tube, manual ventilation via mouth to mouth, ambu-bag and mask or bag to tube; perform arterial punctures for blood gas analysis; ventilate patients during transfer to Intensive Care Unit and initiate mechanical ventilation when indicated.

3. Provide consultation and patient evaluations:

Assess and evaluate patients with respiratory disorders as requested by the primary physician, i.e., clinical status, history, laboratory results, chest x rays, vital signs, etc.

Use the principles of growth and development to assess each patient's age-specific needs.

Recommend methods of treatment, i.e., mode of therapy, medications, type of equipment, duration and frequency of treatments, additional lab work, pulmonary function studies, etc., directly to physician.

4. Administer treatments:

Provide age-specific treatment and care.

Communicate and interact with patients and families in a positive and courteous manner.

Read prescriptions prepared by physicians to determine requirements for treatment ordered, such as type and duration of therapy, medications and dosages ordered; is familiar with and has a working knowledge of all medications used, to include proper dosage, actions, precautions necessary, and expected side effects, if any. Determine most suitable method of administering treatments, precautions to be observed, and modifications to work procedures which may be necessary.

Examine patients' charts to determine diagnosis, physical conditions, chest x-ray report, medical history, vital signs and to determine if any condition exists which may contra-indicate the type of treatment ordered. If a contra-indication exists, contact, confer with and advise physician concerning treatment modality.

Gather materials and equipment required for therapy and transport to patient's bedside. Confer with patient when possible, explain treatment to allay fears and anxieties associated with equipment and procedure and to elicit cooperation during therapy.

Prepare medication ordered, insert into micro nebulizer and proceed with treatment; observe patient and adjust machine controls to elicit most beneficial results; monitor patients' tidal volume, pulse rate and breath sounds during treatment; chart results on treatment record. Note any adverse reactions and report same to nursing personnel and if necessary, the attending physician.

Perform chest physiotherapy treatments to include postural drainage, percussion and vibration; review chest x-ray reports to determine area affected and position patient to facilitate drainage; chart results of treatment in patient's treatment record; observe patient closely during treatment for any adverse reactions, i.e., dyspnea, cyanosis, etc., and position accordingly.

5. Pulmonary Function Testing:

Operate pulmonary function testing equipment to obtain data relative to patient's respiratory process to include vital capacity, forced vital capacity and maximum inspiratory flow rate and all expiratory flow rates. Provide all results for use by physician in diagnosing and treating respiratory disorders.

Use simple screening devices to screen patients for early indication of respiratory disorders and pre-op screening.

6. Pulse Oximetry: Operate pulse oximetry monitors for spot checking SP02. Able to identify stable wave forms to insure reliable results. Basic maintenance of equipment as necessary.

7. Patient Education: Able to instruct patient and family on treatments provided by Respiratory Therapy in accordance with the hospital patient/family education policies and procedures.

8. Provide initial instruction to outpatients at the hospital or in the home (re: aerosol treatment, breathing exercises, and postural drainage exercises).

9. Adhere to safety/infection control policies and procedures. Report unsafe equipment.

10. Maintain a clean, well-stocked, safe environment for patients and staff. Keep patient care and utility areas neat and clean.

11. Maintain the strictest confidentiality of all facility and facility-related employee information.

12. Cardiopulmonary Rehabilitation: This is a service that involves extensive patient teaching concerning disease processes, instructing the patient to do peak flows, monitor medications, ABG interpretation, and exercises for oxygen conservation.

13. Electroencephalogram: Placement of electrodes to monitor electrical conductivity of the brain essential for clinical decisions. This includes taking measurements of the head, placement of electrodes, acquisition of data, monitoring of vital signs. This information is prepared for physician interpretation.

14. Polysomnography as performed in Sleep Studies.

Other Duties

In addition to the key duties and responsibilities, this position may be assigned to:

Clean and cold sterilize non-disposable respiratory therapy equipment and supplies; adjust, maintain, and make minor repairs to equipment; perform routine record keeping and filing; participate in training and educational programs; and perform other related duties as assigned.

I. EDUCATION, EXPERIENCE, CERTIFICATION, LICENSURE

Desirable Qualifications: Registered Respiratory Therapist (RRT) recognized by the National Board of Respiratory Care or Certified Respiratory Therapist (CRTT) recognized by the National Board of Respiratory Care.