Respiratory therapists are involved in the care of a wide range of patients, but in most places, COPD patients make up one of the biggest patient populations treated by RTs. As we celebrate National COPD Awareness Month, now is a good time to look at how advocating for these patients adds value to an RT’s career. You might not be able to measure it in terms of promotions or raises, but it is just as important to a therapist’s overall feeling of accomplishment in the profession.
It starts at the bedside
Where’s a good place to start with COPD advocacy? Therapists who work closely with these patients will tell you, the answer is, on the job.
Marlyce Campbell, CRT, is director of respiratory care at Trego County Lemke Memorial Hospital in Wakeeney, KS, but she spends a lot of her time working directly with COPD patients to make sure they know how to take their medications properly and that they have the right home equipment for their care.
She even takes the time to check with the local pharmacy to see if patients are, indeed, getting the meds they were prescribed and if they are refilling them as necessary. “A lot of times, I find those who keep coming in haven’t filled for a long time or are using expired medications,” she said.
Jennifer Blevin, RRT, RRT-ACCS, is the respiratory care supervisor at Integris Southwest Medical Center in South Oklahoma City, where she says the largest part of the patient population is made up of those with COPD. She saw a lack of education surrounding these patients and has worked hard to overcome it.
In 2014, her hospital implemented a COPD and Tobacco Cessation Education Program delivered by RTs, and saw a drop in readmissions. Then in 2019 she launched a Better Breathers Club with the support of the department director and hospital administration. The club has helped them reach at risk patients.
Right before the pandemic hit, Blevin was heavily invested in advocating for a COPD navigator position at the hospital. She had visited a therapist in Tulsa in that position and just brought the information back to her director when COVID-19 began to take precedence over everything else. While it has been on hold since then, she is hopeful the position will be approved in the near future.
“COPD is one of the most common chronic conditions requiring hospitalization,” said Blevin. “As respiratory therapists we have special relationships with these patients and we are the most qualified to educate them. It is so important that respiratory therapists get involved and be more active in advocating for COPD patients.”
Campbell agrees going the extra mile for her COPD patients is the right thing to do, and their appreciation always boosts her spirits. “It makes me feel good when a patient tells their pulmonologist, ‘I’m doing better since Marlyce showed me what to do!’” she said.
COPD coordinators lead the way
Brieanne Condie, RRT, and Jessica Goforth, BS, RRT, AE-C, are both COPD coordinators, Condie at Decatur Memorial Hospital in Decatur, IL, and Goforth at St. Elizabeth’s Healthcare in Kentucky.
Condie says the position has gone much deeper than she never thought it would. In addition to providing spirometry, assessing for symptoms, and addressing social concerns for patients at the bedside, she has gotten involved in interdisciplinary team efforts to improve the care process.
“We would meet once a week to review our metrics and try to fill the gaps in care that would come up,” she said. “Our metrics ranged from readmission rates, appropriate inhaled medications at discharge, CAT scores, increase in 6MDW, etc.” The interventions they put into place not only decreased readmissions, but also improved quality of life for their patients.
Now she would like to see more outpatient services for these patients as well, with interventions beginning at the time of diagnosis, not at the time of hospitalization. “All RTs should have involvement with a COPD program to not only experience the benefits that come from this kind of position, but to give the best care to our COPD patients for best outcomes,” said Condie.
Goforth says her job is centered around providing inpatient education to COPD patients hospitalized with an acute exacerbation and working with care coordination and physicians to come up with the safest discharge plan for these patients.
But she has been out to nursing homes and other care facilities as well, to bring education to COPD patients there too. “I believe many patients aren’t aware of the different resources available,” she said. “They are unsure of how to use and take their inhalers.”
Goforth says reaching out to those beyond the walls of the hospital has enriched her career by helping her see and address the needs that exist in the community. “It’s very eye opening that patients are handed inhalers and not shown how to use them, what they are for, and when to use them,” she said. “It’s also nice to see patients on the outside of the hospital, when they are doing better and moving around.”
Connecting with like-minded groups and organizations
For Mark Mangus, Sr., BSRC, RRT, RPFT, FAARC, Lorin Collins, BS, RRT, PDE, and Rena Laliberte, BS, RRT, advocating for COPD has meant getting out into the wider world to work for causes vital to people with the condition as well.
Mangus, who currently teaches in a respiratory care school program, came by his interest in lung disease advocacy both at work and at home. He spent 21 years of his career running a comprehensive pulmonary rehabilitation and chronic lung disease management program in San Antonio, TX, and he has a daughter with cystic fibrosis who has gone through two double lung transplants.
From the Better Breathers group he started for the patients in his PR program, to his contribution of a regular column to The Pulmonary Paper, to his work with legendary physicians Tom Petty, MD, and Dennis Doherty, MD, to his membership on the Scientific Committee of the Pulmonary Wellness Foundation, to his presidency of the Efforts support group, and more, he has gone above and beyond to ensure these patients have their voices heard.
“With only about 2% of those who have COPD able to access services of disease management and rehabilitation ‘brick and mortar’ programs, there is a glaring need for more of us in this realm of practice and advocacy,” he said.
Collins works in the pulmonary rehabilitation department at Atrium Medical Center in Middletown, OH, so she sees COPD patients every day on the job. But she too wanted to do more and she looked around to see where she could make an impact.
“COPD education has been a passion of mine for years,” she said. “While doing research on this topic, I discovered the COPD Foundation.” She joined the group and became a state captain, and now she uses the resources available from the Foundation to promote awareness and provide additional information and a link to other people in the COPD community to her patients.
“When able, I also set up at area community centers when they have health fairs,” she said. “I always wear an orange ribbon on my badge at work, and I sometimes have people ask about it. You never know where or when you will get an opportunity to touch the life of someone with COPD.”
Laliberte spent many years as director of a pulmonary rehabilitation program, but even though she now works as a clinical education specialist at Henry Ford Hospital in Detroit, MI, she has maintained her involvement with the American Lung Association, Better Breathers Clubs, and numerous health fairs in her community that focus on COPD and other chronic lung conditions.
She was motivated to volunteer through her own experiences in the PR program, where she says she encountered too many patients who knew next to nothing about their condition. “Whether it was the overall pathology of COPD, medications, diet, performing activities of daily living, and even personal relationships with family members, they had
not one piece of information and felt confused and isolated. It was truly heartbreaking,” she said. “I knew I had the knowledge and felt the call to help.”
Like their colleagues featured earlier in this story, all three of these RTs believe their efforts have reaped numerous rewards. Mangus gives them credit for leading to his Fellow of the American Association for Respiratory Care designation and his Specialty Practitioner of the Year Award, along with the opportunities he’s had to speak at the AARC Congress.
Collins says it’s all made her a better and more confident RT, and she’s gone on to acquire her COPD Educator, Pulmonary Disease Educator, and Pulmonary Rehabilitation certifications as well. “These have given me the tools to help my patients stay well and get stronger,” she says.
According to Laliberte, getting involved with outside groups has been one of the most rewarding things she’s done in her career. “It expanded my ability to reach out into many other communities and allowed me to not only assist in identifying those with undiagnosed disease, but immediately begin the process of education, referring, and actively participating in making the lives of these COPD patients much more positive,” she said.
As Mangus looks towards retirement next May, he encourages current therapists to step up and keep the momentum going. “There is much satisfaction in seeing the fruits of our efforts in the better-lived lives of those with COPD and chronic lung disease,” he said. “That, in itself, is a great and satisfying reward.”