Getting Your Dream Job

image of highway sign with Dream Job Next Exit written on it

Lots of people start out in respiratory care with an ultimate career goal in mind. Maybe you want to manage a department one day. Maybe you see yourself working with tiny babies in the NICU. Maybe you crave the adrenalin rush that comes with air medical transport.

Generally, we don’t get our dream job right off the bat, though. And those who have ended up with theirs will be the first to tell you it takes much more than just the passage of time. It takes lots of hard work and determination as well.

Don’t take no for an answer

LeeAnn Kiesel, BS, RRT, RPSGT, RST, graduated with her RT degree in 1995 and worked in a range of settings over the years, including nine years in sleep medicine.

But what she really wanted to do was work more closely with COPD patients, educating them about their disease and helping them get the care they need to maintain their quality of life. After several rejections and many years of work experience, plus earning a bachelor’s degree in health sciences, she’s finally there.

“I am currently working my dream job, as a COPD navigator/educator,” said the Indiana therapist.

She loves being able to spend enough time with her patients to develop a rapport with them and finds that getting to know them on more than just a clinical basis is highly rewarding.

Her manager has made the job a real pleasure too.

“He gives me the independence I desire in doing my work,” she said.

And the schedule isn’t bad either. While Kiesel emphasizes she regularly puts in 40-45 hours per week, there is enough flexibility built into the schedule to allow time for the other things she needs to get done in life.

LeeAnn Kiesel’s dream job advice: If rejected do not give up! Brush yourself off and stand back up. If you need to, talk with someone who you respect who has been rejected. Also, while working toward your ideal job, strive to make yourself more marketable. Try different specialties within the RT field. Lastly, I cannot emphasize enough the importance of education!

The long and winding road

Nick Widder, RRT, RRT-NPS, RRT-ACCS, C-NPT, NRP, got into respiratory care back in the days when you could start out as an on the job trainee. With a background in EMS and EKGs, he had what it took to step into the role and soon found himself enrolled in his local respiratory therapy program.

“By the time I graduated I had been working regularly in the ICU, NICU, and ED,” he said. “I was sent to the OR to learn to intubate, and sent to the PACU, where I was able to practice management of airways after extubation but before the patient became fully conscious.”

Since he was working in a hospital with a high-Level II NICU, he also ran into neonatal transport teams and was intrigued by the role.

Widder got the chance to experience pediatric transport firsthand at his next facility.

“I enjoyed going out of the hospital, attending to one sick patient at a time, and being allowed to use my assessment and treatment skills, long before the idea of official ‘Assess and Treat’ protocols had made their way into mainstream respiratory care,” Widder said.

But RTs were just occasional members of the transport team there. When he learned about another team where RTs were full-time team members, he decided that was the job for him.

It was not to be.

“I was stymied by two issues,” said the California therapist. “First, I did not have any neonatal intubation experience, as it was not permitted at any of the hospitals I had worked at. And second, I was not a known quantity, coming from outside the area.”

So, it was on to another job, which as it turned out was at a tertiary referral center with a Level III NICU and other sophisticated services requiring a dedicated RT on the transport team. When the time seemed right, he applied for the position and thought he had it wrapped up — the medical director had even unofficially congratulated him on getting the job — only to find out that the adult team configuration was changing to two nurses and the neo-peds team was full.

The adult team did return to the RN/RT model, but the opportunity for him to step into the role never resurfaced.

Widder forged ahead with his career, anyway, taking on several other jobs and serving as chair of the AARC’s Adult Acute Care Specialty Section. When his role there ended he decided to join his local rescue squad. He regained his EMS certifications and eventually became a paramedic in the hopes that those moves would make him a more attractive candidate for an RT position on a transport team.

Then one day he saw a post on the AARC Transport Section discussion list seeking applicants for an RT transport position at a hospital across the country from where he was living at the time.

“As it turns out, it was the same team I had first learned about so many years before,” Widder said. “My children were grown and out of the house, and I had fewer ties to the area. On a whim, I contacted the author of the posting, later applied for the position, and I have been here for six months, living the dream.”

Nick Widder’s dream job advice: Perseverance, experience, and expertise in a chosen area are all necessary. Additionally, flexibility, and the willingness to jump through the hoops that are required, including licenses and certifications. I have been working in respiratory since 1981. I have been applying to different transport teams since 1991. I finally got here in 2018, 27 years later. It has been worth the wait.

Serendipity

Shawna Murray, MEd, RRT, had no idea her dream job even existed until one day she ended up getting it.

“I didn’t even know that a respiratory clinical educator was an option,” said the Utah therapist. “Personal growth opportunities have allowed me to grow in this position and it is more fun and fulfilling than I ever thought it would be.”

As a clinical educator, she has a place at the table when discussions about new or upcoming initiatives take place and she has the chance to weigh in on how respiratory therapy can assist, represent, or contribute early on.

“It is truly exciting to be able to be a patient advocate, clinician, educator, and professional all in one role,” she said.

Her specific job title is Learning Business Partner, and she supports not just respiratory care but several other disciplines as well. She says just about every initiative undertaken by the organization requires information and education, so clinical education is a big part of the process throughout.

Murray got where she is today through hard work and increasing her educational credentials. She earned a master’s degree in instructional design and is now pursuing a doctorate in education, health sciences.

“A conscious decision to take advantage of and support education initiatives in the local department, facility, region, and now system level has helped me grow my skills in clinical education,” she said. “Experience and training in education theory, principles, and practice added to my respiratory credentials has enabled a different and valuable perspective.”

Now she’s paying that forward by working to support master’s level programs for clinicians across the board so that they too can add clinical education knowledge and skills to their arsenal. “It is my desire to positively impact patient care by ensuring that ongoing clinical education is the best it can be,” Murray said.

Shawna Murray’s dream job advice: Stay open to possibilities and get a strong foundation of solid bedside care. Identify clinicians that are potential mentors in areas that you are interested and ask them to mentor you. You may be surprised how many professionals would be more than willing mentor and open opportunities for you if they know you are interested in growing and willing to do the associated work. Be part of the professional organization and work to support and grow your profession. Work to grow your communication skills. Excellence in verbal and written communication is essential to success! Be continually aware that every interaction you have with others represents you and your profession. Make every interaction count. Show up. Be kind. Work hard.

Fleeting dream?

Judy Kochmanski, RRT, believes strongly that every home care patient with a respiratory ailment or respiratory medications should be able to see and work with a respiratory therapist so they can get a respiratory disease management plan that will work for them.

The New York therapist feels fortunate to be working in that role today but, given the reimbursement climate in home care, she fears that her dream job may one day float away.

“Respiratory visits are not considered a true service visit like PT, OT, or nursing, so it is hard justifying my position,” she said.

She believes she’s still on the job because outcomes have improved with the delivery of her services.

“Our readmission rates are staying down, so that is why they keep me,” Kochmanski said. “Ideally we should work out of an insurance group to prevent declines in respiratory status and keep patients at the top of their game.

Judy Kochmanski’s dream job advice: Always stay on top of current respiratory education — AARC resources, GINA, COPD, GOLD, ALA, ALS, etc. And pray about it. Watch for opportunity, and once you get it, continue to strive to be at the top of your respiratory game. New things are coming each day; idiopathic pulmonary fibrosis is moving quickly now. How can we help slow the decline?

What goes around, comes around

James Cleaves, RRT, CPFT, is living proof that you’re never too old to seek out your dream job — or change your mind about what a dream job even looks like.

He is currently serving as a director of respiratory care at a Level I inner city trauma center in New Jersey, and for many people in the profession who aspire to leadership positions, that would pretty much seem like a dream come true.

Not so for Cleaves.

“My dream job at this point is to get back to the bedside,” he said.

At this point in his career he longs to get back to basics, and while he may or may not actually go there, it is, as they say, always nice to dream!

“At 60 years of age, I no longer have any interest in titles, roles, or additional letters at the end of my name,” Cleaves said.

Jim Cleaves’ three-pronged dream job advice: If your dream job is to be the best possible RT, never complain about your assignment. The patient is in worse shape than you are. Work everywhere you can and in every environment you can. LEARN EVERYTHING. Even if it has absolutely nothing to do with respiratory care, someday it may. Don’t be afraid to fail. You learn more from mistakes than from successes. And above all else, remember you work for the patient; the hospital or institution just happens to pay you.

If your dream job is to be in a leadership role, remember the view from the top isn’t what you think it is from the bottom. A leader to me means that you are not in a “leadership position,” you are creating actions and examples that others follow.

If your dream job is outside of our profession, read, learn, question, review. But do it with conviction. For someone to believe in you, you first must believe in yourself.