In March, we shared the good news with our readers that the VA Maryland Health Care System (VAMHCS) had created an official role for the Advanced Practice Respiratory Therapist (APRT) in its organization.
Now the first-ever APRT has been hired. Mindy Conklin, MRT, RRT, has been selected to fill the position and will begin working in her new job soon.
As chief of respiratory therapy at VAMHS and a key driver of the move to approve an APRT at his medical center, Daniel Whitt, BHS, RRT, RRT-ACCS, RRT-NPS, could not be happier.
“It feels great to be a part of something historic,” he said. “The APRT will enhance the delivery of pulmonary and special care services while diagnosing, managing, and treating patients with cardiopulmonary conditions. This innovative approach to health care delivery . . . is greatly welcome in the post-COVID landscape and an ever-changing world impacted by climate change and toxic exposure.”
Dream come true
For Conklin, it’s the culmination of a dream that has been in the works ever since she had a brief conversation with Georgianna Sergakis, PhD, RRT, FAARC, director of the APRT program at Ohio State University, before she had even graduated from her RT program.
“About 15 years ago, when I was a respiratory student, I met Georgianna Sergakis at The Ohio State University’s Current Concepts in Respiratory Care conference,” explained Conklin. “As we were talking, she stated, ‘One day you will be in my first APRT class.’”
It was just brief remark, but those words stuck with Conklin, and she knew that she wanted to be a part of the program when it finally came about. “I worked very hard and patiently waited until the day applications for the MRT program were open,” she said. ”It was honestly an easy decision to apply. I knew deep down this was the path I was supposed to take.”
The MRT program — which stands for Master’s in Respiratory Care — was launched in 2020 to prepare RRTs to take on a clinical role similar to that enjoyed by physician’s assistants and nurse practitioners. The first class — which included Conklin — graduated in 2021.
But it wasn’t until Dan Whitt decided to float the idea for creating an APRT role at his facility in Baltimore with the Veteran’s Integrated Services Network for his region that she (or anyone else) had an actual APRT job to apply for.
“From the moment I heard about the APRT opportunity at the Baltimore VA medical center, I knew the job was meant for me,” said Conklin. She had always envisioned a role that would be a good mix between the acute care and outpatient settings and knew this job would provide it.
“I started asking lots of questions. I sent Daniel multiple emails a day. I think I even asked him a ‘what if’ question at some point,” she said. “In all honesty, I knew that if I did not apply, I would regret it. This was a once-in-a-lifetime opportunity.”
Hard work pays off
It’s a big moment for Georgianna Sergakis and her colleagues in the Ohio State program too and they have been cheering Conklin along every step of the way.
“As a trailblazer in 2020, Mindy’s leadership skills stood out early on in assessment lab,” said Jessica Schweller, MS, RRT, RRT-SDS, APRN-CNP, a member of the APRT faculty. “She took the reins and was motivated to learn and excel during the program. She continued to shine in both academics and clinical settings, and was able to take those experiences and run with it. Her motivation both then and now to bring this profession to fruition is why it is no surprise she is the first employed APRT.”
Sarah Varekojis, PhD, RRT, FAARC, APRT director of clinical education, notes that Conklin has a long history of employment as an RRT working in adult acute care at The Ohio State University Wexner Medical Center as well, and will bring that knowledge to the VA.
“During her APRT educational program, she was able to complete clinical rotations in pulmonary, sleep, and critical care with some of the same physicians she has worked with for years,” said Dr. Varekojis. This created an opportunity for significant professional growth into the APRT role in a supportive environment.”
Overall, she continues, Conklin logged more than 1,200 clinical hours during the program, making her more than prepared to take on the APRT role at the VA. “Mindy recognizes the importance of establishing the unique value that the APRT brings to the physician-led care team, and she is prepared for both the personal and professional growth this new role will demand,” said Dr. Varekojis. “In fact, she has been preparing ever since the announcement about the opportunity was disseminated, utilizing all of the resources she has from faculty and physician mentors to meet this new challenge.”
She’ll bring some cutting edge technology expertise with her too. Dr. Sergakis notes that Conklin explored the use of point-of-care ultrasound for her MRT capstone project, conducting a systematic review of the literature and developing an evidence-based implementation plan to demonstrate the value of the APRT to the health care team. She has since leveraged the expertise she gained in point-of-care ultrasound in other research opportunities and has even spoken on the topic at conferences around the country.
“Mindy has the tools and the talent to contribute to evidence-based APRT practice in the acute care environment,” said Dr. Sergakis. “Her ability to lead, innovate, and explore/transform expanded areas to practice evidence-based advanced respiratory care is what makes Mindy the perfect first APRT to practice.”
These Ohio State faculty members don’t believe she’ll be the last. According to all three, this is just the beginning of the APRT movement and will lead to additional practice opportunities, additional educational programs, and state licensure.
Licensure effort moves ahead in North Carolina
That optimistic view is playing out in North Carolina as we speak.
William L. Croft, EdD, PhD, RRT, FAARC, who serves as co-chair of the AARC’s APRT Committee along with David Vines, PhD, RRT, FAARC, FCCP, and is also chair of the Respiratory Care Board of North Carolina, believes the VAMHCS position bodes well for efforts in his state to create a license specifically for an Advanced Respiratory Care Practitioner (ARCP), a role mirroring the APRT.
The Board began working towards that goal a couple of years ago after conducting a study of currently employed PAs in the state specializing in pulmonary disorders, along with physicians specializing in pulmonology.
Overall, they found only 63 PAs in North Carolina who specialized in pulmonary care and 407 physicians specializing in pulmonology — all for a population of more than ten million people.
“Our patients require knowledgeable, experienced, hands-on care for their multiple morbidities, and the ARCP physician extenders offer an excellent solution,” wrote NCRCB Board Member Lisa Mansur, MD. “ARCP graduates will often have considerably more experience and expertise than other physician extenders. They are beyond qualified to care for our patients in the Advanced Practice Setting.”
Dr. Vines agrees the time has come and says the AARC will continue to work with educational programs to establish more APRT programs across the country and the state societies as they promote licensure for APRTs in their states.
“The APRT is the next step in the clinical advancement of the respiratory therapist and improving outcomes of patients with cardiopulmonary diseases and beyond,” he said.
You can view a copy of the latest version of the North Carolina bill, which just passed the Health Committee last week and thus has a better chance of allowing other committees to act quickly, here.
Ready to work for our veterans of service
In the meantime, Mindy Conklin plans to make the most of the awesome opportunity she has been given to go to work as the nation’s first Advanced Practice Respiratory Therapist.
“I am excited about everything!” she said. “I am excited to finally be able to practice as an APRT and to set the precedent for future APRTs.”
She’s also immensely grateful to be accomplishing this goal in a setting dedicated to the brave men and women of the U.S. Armed Forces. “It is truly going to be an honor to provide the best cardiopulmonary care to our nation’s military veterans,” said Conklin.