Editor's Notes      Michelle Porter

Speaker's Report      Jonathan Lee

Speaker-elect's Report      Ruth Krueger

Past Speaker's Report      Ken Thigpen

Leadership Luncheon Report      Anna Parkman

Secretary's Report      LaDawn Neary

Treasurer's Report      Barbara Fedak

Delegate Assistance Committee      David Gourley/Kathy Rye

Elections Committee      Tom Striplin

P & T Committee Report      Jacque Coons

Delegate Report      Steve Kessinger

Delegate Report      Bob Fluck

Delegate Report      John Steinmetz

2002 Committee Assignments      Ruth Krueger

Membership Figures

What Have You Done For Me Lately?
I thought this title was appropriate due to some recent events. First, I attended the Janet Jackson concert last week; it was a great show. Then thinking back to the horrific events of September 11, and the changes we have seen and will see in what our country has done for us lately reminded me of this saying. The armed guards at the airport, the new security of our homeland administrator appointed by President Bush and our troops being deployed to the Middle East. It is an amazing thing to drive down any street and see flags displayed everywhere, as well as other symbols of our American pride and freedom. I am thankful and proud to be an American.

So, what have you done for me lately, AARC? I was asked this question again the other day by a co-worker. Well, how can I start this one; there are so many things we are working on as a professional organization that it is difficult to name them all. Improving our professional image by requiring degrees, recredentialing or mandating continuing education, the Muse study, not to mention the hard work that goes on daily behind the scenes as our lobbyists fight for us in Washington. All of these things and many more show the dedication of the AARC and the respiratory profession to change for the better.

Currently at the facility where I work, we are having some turf issues with the new ECMO program. There are several nurse administrators who don't see the need for respiratory therapists to be involved. With help from ELSO and contacts across the country, we have been able to prove our worth and show that RTs can be a valuable player on the ECMO team. Our licensure act that does not limit the abilities of a respiratory care practitioner has been a great tool. Without the help of the AARC and the networking that occurs by being a part of this great organization we might not have a leg to stand on. I am thankful and proud to be a member of the AARC.

So, the next time you hear the song or the phrase, "What have you done for me lately?" in reference to the AARC, be prepared with some strong answers. I did this just last week with a co-worker and I caught him a little off guard. We all should be proud to be members of this quality organization, and especially honored to be in the leadership of the AARC. [Top]

Organizational Alignment
If ever there has been a time for all respiratory care professionals to pull together, it is now. We all need to be moving forward together in the same direction, towards the same destination for our mutual success.

How do we get everyone else to pull with us?

It's true, there exists some real challenges for us all, from the Executive Office to the Chartered Affiliates to the individual RT. How can we all consistently align ourselves with a common goal, purpose and mission while creating a "win-win" outcome for individuals, State Societies and the AARC?

When the AARC goes to Washington DC, we need to have the strength and resources of every RT, 112,000 strong, behind us for action, not only the 35,000 AARC members. When the AARC Times or Respiratory Care journals price advertising this is based on circulation, read: members. What is the real cost of this division? Close your eyes for a moment and just imagine what could be accomplished if all 112,000 were members, aligned & focused Goosebumps, yep...

Current reality describes a delicate balance scale, rather than a coiled catapult of resources and energy we just envisioned. Literally, the few carry the many, and as services are supported by fewer individuals these members must "pitch in" or pay even more in the way of dues and volunteerism for the same benefits. Some may be disenfranchised by this, "I can't afford it", "I don't have the time" the real question is, "Can you afford not to support/participate with the AARC?" & "Aren't you proud of your profession?" Where would our profession, let alone our careers, be without the landmark work delivered by the AARC.

We need to take a long, hard and honest look at ourselves in the mirror, asking ourselves:

• Individually, are we pitching in, paying our "dues" for the multitude of benefits derived from the work of a few? Every RT, member or not, prospers from the toils of the AARC: development of CPGs, Uniform Reporting Manuals, position statements, the Muse study, the million dollar research program, the Blue Ribbon Panel on RT Value and Recognition, the work done with HCFA on classification and reimbursement, recognition by the Armed Forces, on and on...

If this work is not noticed by our own, what kind of catastrophe will it take to get everyone's attention? What will it take to have a single unified spirit and energy behind the efforts of our own professional association?

• State Societies/ Chartered Affiliates, are we in a reciprocal, mutually beneficial relationship with our parent organization?

"Wait just a minute, I thought the AARC was here for us?" Yes, we get CEUs from the AARC to attract conference attendees, members or not, revenue sharing from local membership, input on direction of our professional association, delegate financial assistance to ensure representation at the House of Delegates meetings, free listing of our conferences in the AARC Times, guidance and insight on the latest developments nationwide and internationally relating to a broad scope of issues pertinent to our profession, legislation, education, research, and practice, disaster relief funds. We can even get a loan for a licensure drive. On and on... yet, how are we supporting the AARC with our choices? Are we holding member drives, are we advertising our job openings with our own organization, are we encouraging AARC membership with a registration discount for our state conferences equal to the price of membership and enrolling those non members in the AARC, do we engage state members over membership with our AARC, with every business choice, are we taking actions that promote, encourage and reinforce the ongoing work and efforts of our AARC for our benefit. Or do we dilute our potential and our future?

• As an Association, are we pursuing the valued, wanted and needed outcomes and benefits of our efforts for the members and customers we serve?

We have invested in research and scientific validation of our skills application, marketed the profession to decision makers, and as a career for the future, restructured our organization for improved efficiency and effectiveness, we have planted the flag of Respiratory Care on the mount of Index Medicus, we have adopted new methods and practices to keep costs to a minimum, we enlist and solicit input of members and affiliates for our direction and future, we have retained notable and respected leaders in our field to help guide and direct our progress. What is our next horizon? The eyes and ears of this association are open, ready and invite a singular unity for recognition of the great work done by RTs across the globe. It cannot be achieved in a vacuum -- we must all pull together

The AARC, members and chartered affiliates all must exist in a climate that fosters unity and collective success, symbiosis and synergy. Without one, the others cannot prosper. United we'll stand tall; divided we'll continue our struggle. It is and will be a climate of our own making. RTs are a unique breed. Innovation and resourcefulness are our nature. Adaptability, skillfulness and ingenuity are our calling cards. The time to reflect is now. The time for unity, integrity and action is upon us to align our collective behaviors. As a body of collegial professionals with the same interests and goals, we will strive to produce the very best we can produce as individuals, as a profession for ourselves, and ultimately our patients and students. [Top]

2002 Yikes
This is such a contemplative time for me. Living completely alone for the first time in my whole life, watching the horror explode on the screen with the Attack on America, and questioning my ability to be the person I want to be, all have factored into a strange new me that I'm not sure I know. With that preface, I want to share some thoughts about where I'd like to see the HOD go next year. (Have I got ya scared yet that you may not have elected the right person for this job?)

2001 has been a year of extreme growth both professionally and personally for me. The early challenge of the speaker role (filling in for Jonathan) taught me some great things. It was both a blessing, in the form of a foot up for next year, and an eye opener as I once again realized my failings. The speaker role is a challenge!!

Challenges excite me. The wisdom and energy in the House excites me. There is so much potential in each one of you and my goal for 2002 is to find a way to let that potential shine. President Elect, Peg Traband, just shared with me her desire to find a way to incorporate the will and hot points of the House into her charges for 2002. We both feel the need to only do what makes sense and to eliminate redundancy and bring forth the important stuff.

So with that, here are a couple of my thoughts for 2002 HOD goals.

Develop a strong push from the House, with the help of committee charges, to eliminate the things at the state level that aren't aligned with promoting the AARC and our profession.

Ask each delegate "What can we, as representatives of our states, do better for the profession of RT?" and along with that, identify how many hospitals nationwide are using protocols and how we can move that number up.

If you have thoughts about where this illustrious group should go and ways to streamline what we do, please share them with me. As you receive your committee assignments for next year, please look at the charges closely and help me align them with where you think your committee's strengths are. Earl, a poet in the Roman Empire once said, "We become what we think about most." Let's think longest and hardest on what we can do better.

All these contemplations I have recently experienced have reinforced what my good friend KT told me long ago - what doesn't break you makes you stronger! I personally am turning into Paul Bunyan's ox! See you in SA. [Top]

Where do we start? So much has happened since Naples that it's hard to know exactly where to begin. . . Our nation has just received a wake-up call unlike any other experienced in most of our life times. Our leaders have responded admirably and honorably with an over-riding sense of doing the right thing at the right pace for the right reasons. It is more gratifying to be an American right now than at any other time in memory for me. I am thankful that we have a God-fearing Commander-in-Chief who seeks His guidance in one of our country's darkest hours. The events of the past few weeks have certainly refocused most, if not all our energies and priorities to some degree. It is extremely gratifying to see America making some attempt to once again become "One Nation Under God" and speak openly about Divine Guidance and prayer. I believe that our return to God offers the greatest hope for our future. The comments from you on the listserv have been heartwarming as well. I appreciate the efforts of several of you in helping us find and maintain some sense of balance and perspective from different viewpoints. Isn't it great to be in America, folks?

I guess I should move from my soapbox and on to House business, huh? That transition is a little more difficult at this point than before but important, nonetheless. It may be somewhat more of a struggle than in the past knowing this will likely be the last article for this publication I will submit for some time. The House represents the "heart" of the AARC and it has been a distinct privilege to be associated with this body for most of the past twelve years or so. It's great to be around the cream of the crop and experience the reminders of why we became involved in the first place. . .

I would like to share a recap of the Board action on our resolutions from the Summer Meeting in Naples:

HR 16-01-01 - "Resolved that the AARC include e-mail addresses as a separate field in the database of members provided to state societies monthly."
Board Action - Referred to Executive Office.

HR 11-01-03 - "Resolved that the AARC/HOD encourage the Chartered Affiliates to lengthen the term served on committees such as the Membership, Legislative-PACT, and Education- Program Committee. A 3-year commitment is needed for each member."
Board Action - Accepted for information only.

HR25-01-02 - "Resolved that the AARC appoint a taskforce to develop a standard protocol for therapists transporting patients across lines where each state has licensure requirements."
Board Action - Referred to Executive Office.

HR 01-01-04 - "Resolved that the AARC offer multi-year memberships at discounted rates to its membership beginning in January, 2002 {e.g. 3-year membership - $250 ($83/yr); 5- year membership - $400 ($80/yr)}."
Board Action - Referred to Executive Office.

HR 43-01-05 - "Resolved that the AARC produce a film showing testimonies of AARC accomplishments, therapists' passion for their profession and patients appreciation for the therapist and profession that takes care of them. This film is to be made available to each of the Affiliates to encourage new members to join the AARC."
Board Action - Referred to President-Elect.

HR 14-01-06 - "Resolved that the AARC exhaust all other measures to improve our financial condition (dues increases, expense reductions, etc.) prior to considering reductions or elimination of revenue sharing."
Board Action - Accepted for information only.

HR 06-01-07 - "Resolved that the AARC implement a program which recognizes healthcare facilities providing exceptional respiratory care services."
Board Action - Referred to Management Section Chair, Karen Stewart, to form an ad hoc committee to investigate feasibility and report back at the December meeting.

The other two resolutions considered by the House were defeated within the House and therefore did not require Board action.

Finally, a special thanks to all of you for the efforts and spirit you exhibited during our focus group session in Naples. Anna Parkman has done a wonderful job of collating these comments and developing a document which will be shared with you a little later as well as providing an overview of these comments in this issue of The Record. It can really be therapeutic just talking about the issues at times. I've said dozens of times over the past several years that the answers to most of the problems faced by our profession may be answered by the folks within this body. This document is living proof! Anna, a special thanks to you for your hard work and to all of you for sharing these thoughts and comments. Well, San Antonio will be here before you know it. Let's get ready for yet another good meeting!

Peace [Top]

The Leadership Challenge
This is an era of great challenge for the health care industry and respiratory care. As in any turbulent time, individuals look to those in leadership positions for inspiration, guidance and a sense of clear direction. Those in leadership positions in turn, look for individuals to join the work and begin to question where the leaders of tomorrow are going to come from. Perhaps more than ever, we in respiratory care are seeking a better understanding of what it is we need to do to foster, develop and support leadership in our field.

In response to this desire to better understand leadership issues within our organization, members of the HOD and BOD were asked to consider several questions in break out groups during the leadership luncheon at the HOD Meeting in Florida. Rick Ballard and I had the pleasure of pulling the information together for submission to the leadership committee and Ken asked me to summarize the information from those break out sessions.

The first question was direct and clear: What are the obstacles that make it difficult for us to develop new leaders? As a group we generated over 60 responses. I was able to group the comments into six categories. These included issues related to balancing work and family commitments, those issues related to time, workforce dynamics and cost, a host of issues related to our general thoughts on "the masses " and a number of things we recognized as "missing links" in the leadership development category.

Question two asked us to consider how we might remove or alleviate the obstacles we recognized. Many suggestions were offered with regard to pulling in students, educating our colleagues and ourselves. Communication and personal contact was a strong theme as was an increased emphasis on recognition, rewards and simply saying thanks. Suggestions were made on how we might better work with managers, educators and employers to facilitate leadership development with specific focus on what the AARC and the Affiliates might do to increase leadership capacity in our organization. Here again, the small groups were prolific with over 50 responses.

Perhaps one of the more challenging questions we faced, asked us to consider what we might be doing that would discourage participation and leadership growth. Never a group to avoid reflection, the BOD/HOD members again offered numerous responses. The break out groups identified potential problem areas; focusing in on loss of potential leaders through lack of follow-up with individuals nominated and slated for elections, the perception of the clique mentality, and leadership practices that might be nonproductive. Additionally, the groups identified some things we might all need to be mindful of in our interactions with members and non-members.

Next we were asked to speculate on what we might do to make leadership growth more inclusive. The answers here were very specific and easily categorized into suggestions for that the AARC, the AARC/HOD, and the affiliates might be able to implement to foster leadership growth. The groups offer for consideration the development of a leadership and mentoring tool kit. Suggestions were made to implement leadership programs on both the state and national level. Here again, rewards and recognition for service was a common theme followed by a strong emphasis on pulling in more people by every possible method.

The challenge of getting new people involved and re-energizing the experienced contributors was addressed in question 5. Ideas for re-energizing the experienced contributors included, increasing recognition, finding additional support, sharing accomplishments, using these people as consultants, and finding ways to recognize early contributors at the affiliate level as a method to bring them back in. The groups offered that the new people might need encouragement, mentoring, concrete task assignments, the opportunity to co-chair, and continual cheerleading. Several suggestions were listed that would be supportive of both groups such as rotation of committee responsibilities, a personal thank you, remembering to play to the individual's strengths and again, a little recognition for contributions.

The groups next took up the task of providing short and long-term suggestions in the final phase of the discussion in Naples. The short-term tactics fell into four main categories: work out, reach out, recognize and take action. The "work out" section includes suggestions for streamlining communication and looking at processes to get the "work out" to ease the burden of leadership. Comments related to communication, contact, and developing relationships with potential leaders was categorized as reach out. Those suggested actions that might be taken quickly included developing a leadership conference, focusing on the student members, and the development of leadership & mentoring packets for affiliates to utilize. Long-term suggestions asked for consideration of leadership curriculum design, continued support in saving our schools, looking for ways to enhance the student membership to include specialty sections, a track at the national meetings and perhaps a student specialty section. Several ideas were offered for the affiliates and the AARC to consider all of which require a certain degree of time to consider, evaluate and implement. These include leadership conferences or forums to be offered at the affiliate level, development of a leadership road show, scholarship programs, mentoring initiatives and continued emphasis on the development of the RCP as a professional.

The summary, bulleted document of our work totals some 9 pages. I believe that each HOD/BOD member will want to review the document and have the time to discuss "next steps". I have submitted the material to Ken and I am sure that the appropriate means for disbursement will be established. My sense is that we all felt so pleased to have the opportunity to share our thoughts and mutual concerns with regard to enhancing the leadership capacity in our profession. I for one was energized by the discussion. I know I saw the same reaction in many of my colleagues. It is great to be back in the house! This one is important, let's make things happen! [Top]

From the Secretary's Desk
How ironic that over the past couple weeks I've been involved in a couple of pretty intense discussions over e-mail with both the HOD and KSRC while at the same time studying communications for small groups in my course work.

As Secretary for the HOD, a majority of my job responsibilities include some form of communication, either verbal or written. Personally, I prefer face-to-face verbal communication because I am a people person and like to pick up on "nonverbal signals". Besides, it is easier to ask questions and get your concerns and questions clarified almost immediately.

Unfortunately, we are in a position where we only see each other a couple times/year, so most of our contact is written correspondence and mostly through e-mail. While it allows us to discuss issues of concern between our two, usually busy, meetings, it certainly isn't the same as a face-to-face conversation.

In reviewing my reading material for class there were several definitions from Stewart Tubbs "A Systems Approach to Small Group Interaction" (pp. 43-44) that jumped out at me:
Bypassing-"a misunderstanding that occurs when the 'sender...and the receiver...miss each other with their meaning'."
Group Task Roles-"identifiable behaviors that are directed toward accomplishing the group's objective."
Intentional-Unintentional Communication-"Intentional communication occurs when we communicate what we mean to. Unintentional communication occurs when we communicate something different from what we intend, as when we accidentally offend someone."
Polarizing-"exaggeration that occurs when people attempt to make a point."

So, in our quest of "Group Task Roles", if you find me "Polarizing" with my "Intention-Unintentional Communication" and a "Bypassing" occurs, please stop me and steer me in the right direction.

On a side note, we received a total of 7 resolutions for review at our fall HOD meeting. They should be emailed to you around the end of October. I'm assuming this system worked well for the summer meeting, as I did not receive any negative feedback. Please make sure you contact either Pat Lee or myself if you have not received the resolutions by November 15. [Top]

This is the time of year that the Speaker-Elect, Ruth Krueger, and I have the responsibility of developing next year's budget for the HOD. As I thought about this and reviewed the latest financial statement I have received from the AARC, I considered what the report showed and what impact that might have on the budget that we develop for the HOD.

The report I received is through July, showing 7 months of this current budget for the AARC. Monthly total revenues are 27% lower than budget for the month and 21% below budget for the year to date. The first reason for this is that membership dues are 15% below budget for year to date. Total members were budgeted to be approximately 34,000 and actual membership is about 31,000. The second reason is that total publication revenues are 27% less than budget for the year caused by fewer ads in our publications.

Fortunately expenses continue to be below budget providing a favorable 16% variance. The executive office continues to do all it can to keep expenses in control in addition to the other cost-saving measures instituted last year. As you remember the reduction of the HOD meetings to two days is one example of the attempt to keep expenses down and that in itself has reduced expenses for the AARC.

Because there has been no gain in membership I feel that the HOD can do something more to share in cost-saving measures and be more cost-effective by presenting a budget that is more in line with our actual expenses. I have reviewed the 2001 budget for all committees and my findings are as follows:

Upon reviewing financial reports for 1999 and 2000 it would appear that we have, in most cases, over-budgeted our committees. I would propose that Ruth and I, with input from the committee chairs, put together a budget that is based on our financial history. I believe that the use of the list serve and e-mail communication is partly responsible for the decrease in expenses over the past 2 years and that we have not previously factored that into our previous budgets. I feel that it is my responsibility as Treasurer, to urge that the HOD continue to do its share to trim expenses, where possible, so that the AARC can continue to operate and provide the services we have all grown to expect from our professional organization. Ruth and I will plan to report on the final budget for the HOD at the meeting in San Antonio. Jonathan's article points out the need for all respiratory therapy professionals to pull together and make a commitment to support our professional organization. The AARC has proven time and again to be at the forefront of healthcare issues and working for the benefit of all respiratory therapists whether they are members or not. All of us need to educate, enlighten, and yes, sometimes nag our fellow RCPs to understand the importance of a united, cohesive profession. We cannot not move forward unless we grow our membership to provide the financial resources for the AARC to continue to work for us and benefit us. [Top]

The Delegate Assistance Committee approved funding for the Alaska Society for Respiratory Care and the Nevada Society for Respiratory Care to assist them in sending a delegate to the summer House of Delegates Meeting in Naples, Florida in July.

The committee's budget has a balance of $4,150 remaining and available for states with financial constraints that may prevent them from sending a delegate to the fall Meeting in San Antonio, Texas.

Each state president and delegate should have received an application for delegate assistance from Pat Lee. The committee encourages any society experiencing any financial difficulties to evaluate their budget and finances and review the HOD guidelines for delegate assistance. The application needs to be completed and forwarded to the Executive Office. Feel free to contact any member of the committee with any questions. [Top]

Our next meeting in San Antonio is quickly coming upon us. The elections committee is gearing up for conducting the House elections at this meeting. As we strive to cope with the National Tragedy that our nation is facing, it is hard to focus on professional issues such as elections. We must however, move forward and do our best as citizens and professionals to return to our lives as best we can.

The complete list of candidates is included in this copy of the record. I believe we should give a big hand to all the candidates for considering the commitment to run for a House position. I would like to thank all the members of the elections committee for their help and support. Most of our work is ahead of us. I look forward to seeing everyone in San Antonio!

The slate of candidates is:

Bylaws Committee
Laura Lucas (SC)
Roy Wagner (TX)

Secretary
Rick Ballard (WV)
Michelle Porter (UT)
Bob Fluck (NY)
Laura Lucas (SC)

Elections Committee
Al Moss (MI)
John Hempkens (MO)

Speaker-elect
LaDawn Neary (KY)
Karen Boyer (ME)
Al Moss (MI)

Treasurer
Randy Gorres (IA)
Reynaldo Rivera (PR)
Tom Wagner (CA)
John Wheeler (MN)
Barbara Fedak (CO)

On behalf of the Progress and Transition Committee, I am submitting a report of the HOD Effectiveness Survey Results. Our committee received 84 surveys back at the meeting in Naples. Thank you again for your help in filling out the surveys and returning them. The questions and averaged number responses as well as comments are listed below. If you have any questions, please contact Jacque Coons, the P & T Committee chair.

4 - Strongly Agree
3 - Somewhat Agree
2 - Somewhat Disagree
1 - Strongly Disagree

1. The AARC House of Delegates is an appropriate forum for comprehensive reporting of AARC activities. 3.92
2. The leadership of the House of Delegates consistently attempts to promote involvement of the chartered affiliates. 3.88
3. Communication between the AARC HOD and BOD is generally effective and continues to improve. 3.64
4. The resolution process is an effective means of promoting changes within the AARC. 3.61
5. The "Open Microphone" session provides an effective means of introducing new ideas and fostering cohesiveness. 3.73
6. The resolution process allows for timely input into AARC strategic planning. 3.50
7. The format of the AARC HOD provides good opportunities for both formal and informal networking. 3.71
8. The HOD Committee system promotes affiliate involvement in planning and impacting the direction of the HOD and the AARC. 3.49
9. The HOD is an effective means of addressing key affiliate issues through existing AARC structure. 3.60

• The meeting/presentation running concurrently next to the HOD was quite loud and distracting.
• Due to long hours of the meetings, snacks should be provided.
• The two-day format does not allow for enough discussion. Would it be possible to hold orientation the afternoon prior to the HOD convening so that we could have two full days for House business?
• Good meeting.
• Need more time for networking.
• Two-day format greatly reduces time for networking.
• Effective meeting. Little time wasted.
• Shortening meeting has significantly impacted networking opportunities.
• I believe we still need an avenue to help new delegates (especially shy) inter-mingle with other state delegates and more explanation (possibly at orientation) about committees.
• I think it's time the HOD forum/structure is re-evaluated for effectiveness. We are going into a time of crisis. This is a great opportunity with all the states convened. What are other associations doing with their delegate structure, role and responsibilities? Ruth did a great job. Ad Hoc Committee on HOD Resolutions--please give HOD members a hard copy of this report. Current written reports should not "refer to previous reports". The example is Ad Hoc Disaster Response report. Please include all details.
• The Ad Hoc Committee on HOD resolutions report was an excellent addition to info provided the HOD. I still appreciate the two-day format. Would have liked written reports from Pres & Pres-elect...even summaries would do. It makes taking info back to state affiliates much easier. I also believe we need to keep the dress code as business casual rather than business attire. It makes for a more comfortable and less stuffy meeting. Please get everyone to use list serve correctly--answer a direct question back to the person directly and not clog up list serve. Thanks.
• Some of the resolutions seem to not be appropriate or have a significant impact.
• I have seen this body improve in efficiency over the year. Kudos to our leaders for streamlining the process.
• Could improve format by holding more focus groups. People are usually here at least a day earlier than meetings--possibly some informal focus group could meet.
• Great interaction between BOD and Exec Office. Very informative
• The House must devote at least some time to direct promotion of the practitioner and the practice of respiratory care. It seems the House is spending 100% of their time on BOD items.
• Clarify what are current issues vs. open microphone. People were using current issues time as open mic.

Nevada Obtains Licensure
On May 24th, 2001 Governor Kenny Quinn signed into law Senate Bill 91. This bill contained language adding Respiratory Care Practitioners to the Nevada Board of Medical Examiners (BME). This replaces NRS 640B, a bill that required minimum passage of an NBRC entry level or Registry exam.

Three members of the NSRC have been appointed by the Governor to act as advisors to the BME. They are Mike Garcia, current President of the NSRC, Don Wright, Vice- President, both from Las Vegas and Steve Kessinger, Delegate, from Fallon, Nevada.

Meetings have already taken place to establish regulations. These will be presented to the full medical board in mid August and then undergo public review. According to the time line all therapists practicing in Nevada must have a license by January 1, 2002.

Nevada began its efforts in 1985 and has worked off and on for 14 years before achieving its first goal of a Work Practice Act in 1995. The state legislature is somewhat unique as it only meets every two years for a maximum of 120 days. It has over 1100 bills introduced each time and only 500-600 are actually seen through each committee and finally sent to the Governor for his review.

We were fortunate to have a very strong ally this session. Senate Majority Leader William Raggio worked "behind the scenes" lobbying for the successful passage of this bill. His crusade is personal. His wife Dotty, was a patient in two Reno hospitals in 1994. She required mechanical ventilation at both and Senator Raggio spent hours at her bedside observing and watching RCPs take care of her pulmonary needs. The professionalism shown by these therapists impressed him enough that he not only championed our efforts this time, but also gave a very impassioned speech on the senate floor in 1995 to pass our work practice act. Sitting in the gallery, I could see many other senators and visitors wipe tears from their eyes.

RCPs play a great role in healthcare. We've known that for many years, and now the politicians know it. With licensure, we will take our rightful place along side other health care professionals, and join the ranks of other states that paved the way.

Professionalism is a state of mind that includes pride in what one has accomplished and knowledge gained through experience. The combination of the two is undefeatable. Hook us together with other healthcare professionals and you achieve synergy at its best.

Nevada appreciates the support of all who helped us achieve our goal! [Top]

Disaster List Serve I am Chairman of the AARC Ad Hoc Committee on Disaster Response. Until the Monday after the terrorist attacks on New York City and the Pentagon, there was a disaster response list serve which allowed discussion among those who I had enrolled initially or those who self-enrolled based on notices which appeared in AARC publications and the web site. I had hoped that this list serve, (after the events of September 11) would allow discussion about the response to these disasters. We also have a respiratory therapist on MA-2, which has nothing to do with that ill-advised ventilator. I had also hoped that we would receive "live" field reports from this therapist. (As it turns out, that probably was a pipe dream, as anything of that nature needs to be filtered through the unit's PIO- Public Information Officer.) MA-2 is a Level 1 DMAT based, as you may imagine by its name, in Massachusetts. DMAT stands for Disaster Medical Assistance Team. The team is comprised of various medical professionals, including physicians, nurses, paramedics, and respiratory therapists. Each team has at least 75 members so that when the team is called up at least 35 members will be able to respond. A Level 1 team is self-sufficient for at least 48 hours, needing nothing from the outside (including electrical power) with the capability to treat 250 patients. When the team is activated, team members become federal employees, so that their malpractice insurance is covered and there are no considerations of state licensure. The DMATs are part of FEMA (Federal Emergency Management Agency), a subsection of the Department of Health and Human Services. At the time of the terrorist attacks, there were 3 Level 1 DMATs on standby East of the Mississippi and 3 West. This is called a push pack, which, with three teams, can then operate a treatment site 24 hours a day. To learn more about DMATs, visit the website at http://ndms.dhhs.gov/NDMS/About_Teams/about_teams.html (Normally this works, but I just went there, as I have the site book marked, and got nothing.) If you want to learn more about DMATs and the National Disaster Medical System, I will be speaking at 8:30 AM on Tuesday, December 4 about DMATs and how to get involved.

Back to the list serve (you thought I forgot!). You all may remember the early days of the HOD list serve. There was definitely a learning curve, especially with that "Reply" feature, which many e-mail programs will send to the list serve and not necessarily to the person who originated the message. I identified three (what turned out to be) fatal flaws: 1) people were naive and didn't really understand the nature of a list serve (as evidenced by messages such as "I received this message meant for so-and-so - it must have been a mistake"; 2) people didn't know that "Reply" went to the whole list serve; and 3) one member went nuclear when the child protective software objected to something on the web site; this person went into a tirade (and was subsequently joined by several others) without actually having visited the allegedly offending web site. (If you have not already guessed, it was a software false positive- I visited this web site and there was nothing even remotely objectionable in it.) I am hopeful that long before you read this, this list serve will have been reactivated. I definitely think the need is there for those interested in disaster response to have a discussion forum. Keep your eyes peeled for notices about resuscitation (reactivation?) of the list serve. [Top]

Is there a relationship between education, professionalism, and professional membership? I hope I don't bore you too much with my thoughts on education, professionalism and professional membership. I am not a man of many words and applying these words to paper in cohesive sentences and phrases that actually make sense and mean something becomes a chore; a chore which I procrastinate or avoid. As an MBA graduate and a health care manager, I have become fond of "bullet points", incomplete sentences, and action plan formats.

First, I along with everyone else was horrified by the events of September 11. I am saddened by the terrible loss that many have suffered and at the same time in awe of the bravery and courage that have been displayed. The patriotism and unity that is now being exhibited throughout this country should invoke pride in all of us.

As some of you may remember, at the last House of Delegates meeting in Naples I stated that I thought membership may be related to the level of education necessary to practice in a profession. I felt my theory was in someway supported by the fact that higher levels of membership by Speech, Physical, and Occupational Therapists in their national organizations may be directly related to the fact that Speech Therapy and Physical Therapy requires a Masters degrees and that Occupational Therapist require a Bachelors degree. I also felt that as individuals become more educated, they become more committed to their profession and join professional organizations as part of the process. I still believe that there is some truth in this and that a higher level of education does contribute to professionalism and hence membership in one's professional organization but there are other factors that I was not aware nor considered.

Working in a rehabilitation hospital allows me greater access to speech, physical, and occupational therapists than I have had in past jobs. Through this association I have tried to get a better understanding of them vs. us in regards to professional membership. I will admit that this is far from being anything close to a scientific study but it may generate enough interest to investigate the topic more thoroughly.

Speech Therapy or Speech Language Pathology requires an annual credentialing process through their national organization that is included in their annual dues. In order to complete the credentialing process you pay a credentialing fee that approximates the annual membership fee so the logic is, why not pay the membership fee and get the benefits of membership along with the credential. That's a "Slam Dunk", "No Brainer". I understand why their membership is 90%+.

Physical and Occupational Therapists are very similar and have a membership rate of 50 to 60%. Unfortunately, the membership rate for the therapists in my organization does not approach these numbers but the therapists (members and non-members) almost unanimously said that representation in Washington is a principal reason to belong. I think the reason that representation in Washington is so important to these folks (including Speech Therapy) is that most of their income is related to the phrase "licensed and/or skilled therapy" and that much of this is performed in independently owned, freestanding clinics. These therapists are trained to evaluate and treat patients independently and are well respected by physicians. I am sometimes truly amazed when I listen to discussions by a speech therapist, physical therapist, or occupational therapist regarding physiology, pathophysiology, theory or other aspects of their practice and feel that as a respiratory therapist my training was inadequate. Also, continuing education for these people is accepted as part of their professional responsibility and not as another chore to fulfill some bureaucratic requirement as I have heard many RTs say.

Respiratory Therapy has not gotten to this point yet and only a relatively few of us are looking outside of the box and dreaming of the possibilities. Most of us in the HOD realize the importance of being professionally recognized in official state and federal governmental regulations but unfortunately most of the practicing therapists don't understand. The vast majority of Respiratory Therapists, Respiratory Care Practitioners or whatever title you are most comfortable with, practice within the walls of a hospital and under medical direction. The safety and security of the hospital and medical direction is disabling to many and becomes an easy crutch. This prevents many from attaining or wanting to attain a professional status and eventually independence as professional practitioners. I think this is where education, professionalism and membership come together.

I am one of the few that believes a four-degree should be required to become a respiratory therapist. Maybe a bachelor's degree vs. an associate's degree should be the difference between RRT and CRT, similar to PT vs. PTA or OT vs. COTA, but that's another story. I believe as we become more educated and trained in our profession, we become more accepted as experts and that people, medical professionals and laymen, will seek us out because of this expertise. Education not only increases our knowledge but also gives us the confidence to intelligently present information and ideas, analyze facts and formulate thought for future advancement. Through these processes one begins to achieve increasing levels of independence and a spirit of professionalism that leads to a need for collaborative association with other professional peers best accomplished through membership in ones professional organization.

So much for being a man of few words, but I hope this stimulates some thought and discussion regarding the future of our profession. I do think that we can increase our membership numbers slightly in the short term but I also think for our numbers to reach the levels of physical therapy or occupational therapy we must consider bachelor level or even advanced degrees in respiratory or cardiopulmonary studies. [Top]

Thank you to the 50 delegates that turned in their committee requests for 2002. I was excited to have that many until I remembered there are 100 delegates -- 50 states :-> Some of you may be awaiting election results from your affiliate and if so, feel free to send your request after your election. If you have not given me your committee request and would like to be assigned, you still have time. Contact me and I will email you another request if you no longer have one. I would like to have the assignments completed so I can name the chairs in San Antonio and give out the hard copies for your assignment. So-o-o you other 50 people, please think about where you would like to serve and get your request to me before November 1. Thank you for all you do to make our profession GREAT! [Top]

Active -- 23,575
Foreign -- 270
Honorary -- 24
Industrial -- 2,042
Life -- 52
Physician -- 215
Student -- 4,146
Special -- 489

TOTAL -- 30,813