Adrenalin Rush

respiratory therapists running to medical helicopter
Richard Mitchell, RRT, remembers his introduction to the world of transport RT like it was yesterday. He was working at a hospital in Shreveport, LA, back in the early 1980s and was asked to accompany a nurse to East Texas to pick up an infant with RDS.

“Instead of going left to the ambulance bay, we turned right and exited a door to a parking lot and there sat a Hughes 500 rotorcraft,” recalled the flight therapist at Dartmouth Hitchcock Medical Center in Lebanon, NH. “The RT sat in the front seat next to the pilot, making ventilator changes that required unbuckling, turning around on your knees, and from the ‘don’t make me come back there’ position, intervene.”

Respiratory care is full of exciting career opportunities, and of the top is the role of the transport RT. Whether they are rushing to pick up a patient in a helicopter like Mitchell did back in 1983, or in an ambulance or fixed wing aircraft, they bring a level of energy to the job that can’t be matched by even the most hectic day in the ICU.

It is not a role for everyone, but if you’re wondering if it is something you’d like to pursue, these transport therapists offer some great insights and advice.

Joshua Gillman, BSRC, RRT, RRT-ACCS, RRT-NPS
St. Thomas, U.S. Virgin Islands

How long he’s been a transport RT: I have been doing some form of transport for about 10 years. At first, the transport world chose me. We had multiple patients that required a higher level of care on transport. I could not stand by and watch an unsafe situation, so I took action and stepped up my game to help those in need get the interventions that would save their life.

What he most likes about the job: You really get to use all your skills; most importantly your problem-solving skills. You also get to know your patients and family on the long transports.

Characteristics he believes RTs must possess to work in this role: You have to have a logical and practical approach to complex things. That’s why I have to say, common sense all the way.

His top bits of advice for those interested in pursuing the area: Get exposure to all types of patients. Many think transport is all about trauma and critical care, but in reality there are multiple medical and surgical cases that need transport. You have to know how to manage all cases from simple to complex and brush up on your medications. Only knowing ACLS meds when you’re transporting a 29-year-old with a broken leg for surgical intervention is not going to be much help.

Matthew Anderson, RRT, RRT-NPS
Marshfield, WI
 

How long he’s been a transport RT: I have been a transport therapist for seven years. It was at my new student orientation when I realized I was meant to be a transport therapist. My clinical director at the time was a former transport therapist who mentioned the word “helicopter” and I was hooked.

What he most likes about the job: I really enjoy flying. I really enjoy taking care of sick babies. I really enjoy the variety of work we do in the transport environment and the autonomy we, as a team, have. Being a transport therapist makes me think and pushes the envelope of my problem-solving skills. It makes me strive to be a better therapist all the time. 

Characteristics he believes RTs must possess to work in this role: I believe a transport therapist must be able to adapt quickly to change. For example, you could be flying to pick up a 28-week baby with respiratory distress and then have to change mode of transport due to weather halfway to the referring hospital. There are so many variables, and you only have a set amount of resources available to you, so you need to learn how to adapt quickly to change.

His top bits of advice for those interested in pursuing the area: Make sure you know your limitations as far as physical workspace. We generally work in tight quarters with a lot of movement while in transit. I’ve known of several prospective therapists who didn’t complete the training or didn’t like the work environment once they tried riding in the helicopter or in the back of an ambulance. It is very different from riding in a car.

Monique Steffani MS, RRT, RRT-NPS, RRT-ACCS, C-NPT

Orange, CA

How long she’s been a transport RT: I have been a transport RT for three years in the neo-peds specialty. My transition to critical care transport came after being in management and education for a few years and being an RT at the bedside almost 18 years. I felt the need to go back to a specialty that allowed me the autonomy to practice at the highest capacity of our profession and license with my state. Also, working for the only hospital in Southern California with a helicopter on our roof gives us the ability to respond within minutes to a call.

What she most likes about the job: Without a doubt the autonomy of the role is what I like most. However, the level of autonomy also comes with a great deal of responsibility. Our team has a high level of trust in one another, and discussions are made in an efficient manner with our patients’ and teams’ safety in mind at all times. 

Characteristics she believes RTs must possess to work in this role: Have humility, be resilient, and be progressive.

Her top bits of advice for those interested in pursuing the area: Know the disease processes of the population you are managing. Advance your education, attain certifications, and gain as many years under your belt as possible in trauma and critical care areas. Be a humble team player; understand that there is always someone who knows more or better than you.

Jon C. Inkrott, RRT, RRT-ACCS

Orlando, FL

How long he’s been a transport RT: I have been on my current team for six years. I wanted to be a flight RT because of my love for flying and my passion for taking care of people. RTs don’t get many chances to be part of an adult transport team, so when I had that opportunity, I jumped at it, and I haven’t looked back since. It has been an amazing platform for me to share what we do with my RT friends around the country and even around the world.

What he most likes about the job: The thing I like most is I am truly living a dream! This is how I envisioned it would be; I never have to “go to work.” I like the challenges that we are presented as a two-person team. We transport some incredibly sick people, having the worst day of their life, and when we get to bedside, we make sure the patient or the patient’s family knows that we are going to take care of them like they are our family, and we will ensure their safe delivery to a waiting ICU or OR or cath lab or wherever their destination may be.

Characteristics he believes RTs must possess to work in this role: Effective communication, a positive attitude, and an unrelenting passion for what you do. These three components are what make you an attractive candidate for any team. Here’s why: we look for people with obvious experience over many years; at that point, we know you can, or should, be an excellent respiratory therapist. But bringing those skills into an aircraft with one other person and being able to succeed at the most critical moments in someone’s life, that’s the key to being successful. Anyone that comes in with a “know it all” approach will not be considered or will actually end up being dismissed as they inevitably shoot themselves in the foot.

His top bits of advice for those interested in pursuing the area: Get experience in all facets of what we do! ICU, PACU, ER, maybe even skilled nursing areas. Don’t be the person that says “that’s not my job.” If that’s you, you’re out. In transport, your job is everything!

Jenn Watts, BS, RRT, RRT-NPS, C-NPT

Elmhurst, IL

How long she’s been a transport RT: I have been a neonatal/pediatric transport RT for 14 years. I decided to move to this job for the autonomy and critical care applications it required.

What she most likes about the job: I love the partnership with my team and the ability to provide specialized care not able to be provided by outside hospitals. I love I am able to stabilize and treat patients based upon the standing protocols, with my physicians standing by (by way of a phone call) only if I need them.

Characteristics she believes RTs must possess to work in this role: Critical thinking, creative thinking, and excellent technical skills (troubleshooting, etc.).

Her top bits of advice for those interested in pursuing the area: Get as much critical care exposure as possible, with all patient populations possible. Also, learn about disease processes outside of the normal respiratory therapist’s wheelhouse.

Mark Medbery, RRT

Orlando, FL

How long he’s been a transport RT: I have been a transport therapist for four years now starting in the adult world and transitioning to the pediatric field. I took the job in the transport field because of my EMS background, as well as the challenging aspect of the job.

What he most likes about the job: No two shifts are the same. You go to different hospitals and you get to see a wide variety of patients, from a new onset DKA to post arrest or a major trauma. I love the autonomy I have with our medical director and she is allowing us to push the envelope of respiratory care with expanded scopes of practice and allowing RTs to create new protocols for the whole team.

Characteristics he believes RTs must possess to work in this role: You need to feel confident in your skills as an RT. You don’t have the backup out there like you do in the hospital. Many of the personnel on your team and in the outlying hospitals see you as the airway expert, so you need to feel comfortable intubating a wide variety of patients, from neonates to geriatrics. You must love to teach and reinforce the staff at the hospitals you go to, letting them know they are doing things right and showing them different ways to do things if they are not. Especially dealing with pediatrics, you need to be the calm one and help build them up so they will feel more confident the next time they have one.

His top bits of advice for those interested in pursuing the area: Get as much education as possible, take classes like PALS, ACLS, NRP, and get your specialized certifications like ACCS and NPS; they will only help you be a better clinician. Contact a transport team and see if you can do a ride along to make sure this is the area you want to specialize in before you invest the time. Look into requirements needed for the transport teams as well. Here in Florida, to transport neonates as an RRT you need 2000 hours in a level III NICU.

Steven Sittig, RRT, RRT-NPS, C-NPT, FAARC

Sioux Falls, SD

How long he’s been a transport RT: I’ve been a transport RT for 32 years and love flight, especially in helicopters.

What he most likes about the job: You can have a great deal of responsibility that in-house staff may not have the training for. No two days at work are really ever the same, as every patient may present differently, requiring different interventions

Characteristics he believes RTs must possess to work in this role: You need excellent communication skills as you interact with referring doctors, nurses, and most importantly, the patient’s family. You also need excellent assessment skills as the team is often comprised of a transport RN and the RRT. There is often no doctor right at bedside, and during transport it is your combined skills that make the difference. You also need to be adaptable as transport is a fluid environment. You are always watching the patient, monitor, and all equipment.

His top bits of advice for those interested in pursuing the area: Most transport programs use RTs for neonatal and pediatric transports. So get some good quality critical care in those areas. Most now too require the NBRC NPS credential or the NCC C-NPT credential in addition to the RRT.

Nick Widder, RRT, RRT-ACCS, RRT-NPS, CPFT, EMT-P

Los Angeles, CA

How long he’s been a transport RT: Full time transport, without unit responsibilities, 15 months. Prior to that, I provided transport services as needed, being pulled out of assignments, since 1990.

What he most likes about the job: It allows me to provide attention, full time, to the patient in front of me. I do not have competing demands of additional critical patients in other parts of the unit. I work with a small team of professionals, all of whom have significant levels of experience in critical care. We are able to communicate efficiently; we all speak on the “same page” and all of us trust the other members of the team. If we see something that would be “outside our lane” in the ICU, we are well within our lane on transport, and our opinions are not discounted by our professional title. I am allowed to work at the highest level of my scope of practice.

Characteristics he believes RTs must possess to work in this role: Must be able to “think on one’s feet” and realize that you might not have all the resources available in an ICU or ED. Must be able to make decisions and justify them later. Must know how the equipment you have works, and how to use the equipment to maintain or improve the patient’s condition.

His top bits of advice for those interested in pursuing the area: Get high quality experience at tertiary care centers. Learn how to communicate directly and professionally with members of other professions. Learn how to make patient assessments and plans for care based upon those assessments. Learn from mistakes you make or you have seen made by others.

Cindy Colley, BS, RRT, RRT-NPS

Tulsa, OK

How long she’s been a transport RT: Eighteen years at one hospital and 16 years at a second.

What she most likes about the job: You get the opportunity to utilize all your skill set—assessment, treatment, re-evaluate, teach referral hospitals, etc.

Characteristics she believes RTs must possess to work in this role: You have to be able to adapt to unique situations and think outside the box because it is a totally different environment when you are out on transport. You shouldn’t be a person that gets car sick or doesn’t like flying!

Her top bits of advice for those interested in pursuing the area: Do it sooner rather than later.

Wayne Takenaka, RRT, RRT-NPS

Mililani, HI

How long he’s been a transport RT: I’ve been on the team since 2008 as a dedicated member. But I’ve been doing transport since 1980.

What he most likes about the job: It started with the education course, where I learned to be more than an RT, doing advanced skills, including an “internship” like a medical resident. I like the teamwork and autonomy working with a nurse caring for the patient.

Characteristics he believes RTs must possess to work in this role: Open mindedness — it’s always a learning process and you must be able to think out of the box. Good actor — look calm under pressure, express confidence.

His top bits of advice for those interested in pursuing the area: Build a strong knowledge base — know your equipment, remember the basics. Be helpful in the unit you are working in, and not for just RT stuff. Be active in rounds.

Want to learn more about the transport setting and connect with AARC members like these who are already working there? Join the AARC’s Surface and Air Transport Specialty Section. All AARC members are welcome to join, whether they work in transport or not.