Monday Congress Gazette
Congress attendees who gathered for yesterday’s AARC Business Meeting learned all about our major achievements in 2007 and plans for 2008 from AARC President Toni Rodriguez, EdD, RRT.
President Rodriguez particularly noted the major victory we achieved with the inclusion of registered respiratory therapists with bachelor’s degrees in the Therapist Category of the U.S. Public Health Service—a move that means qualified therapists may now achieve officer status in the PHS—and the recent introduction of H.R. 3968, our Respiratory Therapy Initiative, in the U.S. House of Representatives, which would open the door to greater access to certain qualified RTs in physicians' offices and other alternate sites of care.
“On our 60th anniversary we stand on the brink of some of our greatest accomplishments as a profession,” says President Rodriguez. “When the right time and the right circumstances fuse, you must be ready to act.”
She says our objectives for 2008 position us for success as well. As we enter the new year, she will move forward with plans to:
- Introduce the Senate companion bill for H.R. 3968 and promote grassroots respiratory therapist support for its passage.
- Conduct the first of a series of conferences that will lead to the identification of the roles and responsibilities of respiratory therapists in 2012 and beyond.
- Continue to build relationships with our patient and professional partners and increase public awareness of the profession.
- Increase and enhance educational offerings for our members at all levels to prepare them for future professional directives.
- Continue to promote and grow our international presence.
“The next 60 years will be years of challenge and change for our profession. If we know who we are as a profession and remain committed to acting in like manner, we will succeed and make the most of all the opportunity currently coming our way,” emphasizes Dr. Rodriguez. “If we fail, we will cheat the patient of needed respiratory care services both now and in the future. Now is our time. The future of our profession is in our hands.”
Richard M. Ford, RRT
J. Randle Curtis delivers the 2007 Egan Lecture to a packed house.
J. Randal Curtis, MD, MPH, of Seattle, WA, presented the 34th Donald F. Egan Scientific Memorial Lecture yesterday morning at the AARC International Respiratory Congress. The presentation was titled “Caring for Patients with Life-Threatening Illness and for Their Families: The Value of the Integrated Clinical Team.”
He shared that one in five individuals will die in an ICU and that most patients in the ICU are at risk of dying, which is why a focus on palliative care is so important. In addition, there exists significant variability in practice in regards to withholding or withdrawing life support. Clearly, the opportunity exists to improve palliative care.
Doing so must involve not only the caregiver’s interactions with the patient but with the family. Dr. Curtis discussed how most families value communication to an equal or greater degree than the clinical care being provided. Family satisfaction is directly linked to both communication and the degree to which families are able to directly participate in decisions about the treatment their family member receives.
Dr. Curtis introduced us to a program called IPACC, Integrating Palliative and Critical Care. This program incorporates a multifaceted/multidisciplinary approach in which caregivers receive special training and internal champions are designated in each ICU to create a new focus on palliative care. Respiratory therapists can make a difference as part of a collaborative, multidisciplinary approach to integrate palliative and ICU care.
Not only did Dr. Curtis discuss the opportunity we have to improve the experience of patients and their families, but provided us with the patient’s point of view. The patient’s perspective was shared through a video clip, which reminded us all that regardless of the patient’s state of consciousness, we need to communicate and consider how our actions, discussion, and the ICU environment may create anxiety and/or fear for these patients.
For more information about IPACC, program tools, and the patient video you can log on to: http://depts.washington.edu/eolcare/.
What are attendees learning at the Congress? These key lectures provide a great example of the cutting edge topics covered during the meeting—
- This year’s Journal Symposium, “The Institutional Review Board and You,” features everything anyone would ever need to know to get a clinical study approved by their organization’s IRB. The symposium kicks off tomorrow morning with great lectures by leading researchers who will demystify this important topic for people just getting started in clinical investigation.
- Few conditions have been as studied as asthma, few have as many effective treatments, and fewer still have been the topic of such extensive national guidelines. But asthma remains a major health concern, with increasing prevalence and severity despite overwhelming evidence the disease can be well controlled with proper medications and care. Earlier this year, Respiratory Care convened a Journal Conference to investigate the reasons why so many asthma patients continue to be ineffectively managed, and the highlights from that conference will be presented by Carolyn Kercsmar, MD.
- The 23rd Phil Kittredge Memorial Lecture, “Managing Respiratory Care—Where Is the Science?”, will take a closer look at how respiratory therapy managers can best respond to the needs of employees, patients, and financial limitations; gain a greater understanding of the issues involved in providing quality care; learn which types of leaders will be needed in the future, and find out whether they have the right stuff to lead a department. The session will be presented by Karen J. Stewart, MS, RRT, FAARC.
ARCF Trustee Steve Nelson and Kerry Ross from Cardinal Health (VIASYS) announced the winning team in the Ventilator 5-K competition yesterday during the AARC Annual Business Meeting. Janelle Gardiner and Kaytie Scott accepted the grand prize, a VIASYS Vela ventilator, on behalf of Weber State University.
The American Respiratory Care Foundation has announced the winners of this year's Ventilator 5-K, a new program sponsored by the Foundation to raise funds for local lung health concerns. Best in Show went to Weber State University in Ogden, UT; Most Enthusiastic to Kokomo Pulmonary in Kokomo, IN; Best Dressed to Alvin Community College in Alvin, TX; and Miss Congeniality to Retreat Hospital in Richmond, VA.
Weber State won a brand new VIASYS Vela ventilator (thanks to a donation from Cardinal Health). Prizes for the other categories included convention registrations for next year (Most Enthusiastic), Old Navy gift certificates (Best Dressed), and a pizza party (Miss Congeniality).
Want to learn more about the Ventilator 5-K? The January issue of AARC Times will include a feature story on the event, with lots of great pictures sure to get everyone fired up about organizing a Vent 5-K of their own next year!
Karen Y. Allen, CRT, RPSGT
Daniel L. Herald, RPSGT, shared his expertise on the impact of shift work on sleep patterns in a presentation yesterday afternoon. Optimal sleep and wakefulness, he says, requires proper alignment between the desired sleep-wake schedule and circadian rhythm-related propensity for sleep and wakefulness.
About 20% of the U.S. workforce is involved in some form of non-standard work schedule, which could be working the nightshift on a permanent or intermittent basis, rotating schedules, early morning shifts, or random work assignments. There is significant inter-individual variability in tolerance to non-conventional work schedules.
Working these variable shifts can result in a shift work sleep disorder (SWSD). Some of the classic symptoms are a recurrent or persistent mismatch between the habitual sleep-wake schedules and endogenous circadian rhythms. Complaints of insomnia or excessive sleepiness (or both), distress, and functional impairment are common. Poor sleep quality and duration when sleep is attempted during the day can be caused by circadian rhythm-related alerting influences. Fragmented sleep, short sleep, reduced slow wave sleep, and limited REM contribute to excessive sleepiness.
It is difficult to remain alert and productive when work occurs during the time the homeostatic sleep drive rises. Prolonged latency when sleep is begun on the morning following nightshift work may involve sleep onset insomnia and difficulty waking up. SWSD is prevalent in about 10% of the night and rotating shift work population. It affects workers of all ages, with no significant gender differences.
Consequences of SWSD include higher rates of ulcers, more sleepiness-related accidents, greater absenteeism, higher rates of depression, and more missed family and social activities. Other complaints include chronic fatigue, malaise, problems with digestion, ischemic heart disease, glucose intolerance, weight gain, and alcohol and substance dependency.
Countermeasures for SWSD generally include: exposure to bright lights in the workplace, administration of wake-promoting medications during night work to decrease sleepiness and improve alertness and performance, use of melatonin or hypnotic agents to improve daytime sleep, and prescribed sleep schedules, including napping.
Although there is limited efficacy, shift workers should maintain a regular and comparable sleep-wake schedule during both work and non-work days, allow sufficient time in bed for sleep during the daytime, minimize light or noise in the bedroom, limit light exposure by using dark sunglasses during the morning trip home from work, and address other causes of excessive sleepiness.
The AARC will publish Volume 17 of the Respiratory Care Education Annual in the spring of 2008, and the Education Section invites educators to submit papers for consideration. Deadline for submission is Feb. 15, 2008. Full information is available in “RC Currents” in the December issue of AARC Times.
The AARC’s Asthma Educator Certification Preparation Course offers respiratory therapists valuable training to become asthma disease managers. Five courses are being planned for 2008 in Houston, TX; Phoenix, AZ; Harrisburg, PA; Livingston, NJ; and Tallahassee, FL. Stay tuned to the AARC meetings page for specific dates.
This popular course has prepared hundreds of respiratory therapists to take the National Asthma Education Certification Board (NAECB) exam. The instructors are noted experts in asthma management and education.
“I am planning to attend David Pierson’s ‘The Evolution of Respiratory Care: Parts I–III’ to enhance my knowledge of the profession’s history and incorporate it into my ‘Introduction to Respiratory Care’ course, which includes a module on the history of the profession.“