Respiratory Therapist

POSITION SUMMARY:
Performs safe respiratory therapy modalities as ordered by physician, developing a plan of care based on assessment data and standards of care, identifying needs for alternative action in the plan of treatment and involves the multi-disciplinary team in revisions to plan of care. Sets up, maintains and monitors mechanical ventilation according to policy and procedure. Administers medications demonstrating thorough knowledge of policy and procedure. Assembles, selects, and operates equipment for proper operation and cleanliness. This includes but is not limited to mechanical ventilators, BIPAP/CPAP systems, oxygen delivery devices and oxygen analyzers, manual resuscitators and suctioning equipment. Performs tracheal, endotracheal and nasopharyngeal suctioning including the instillation of pharmacologic agents according to policy and procedure. Draws and analyzes blood gases by arterial stick according to policy and procedure. Interprets arterial blood gas and oximetry results. Differentiates between patient and equipment problems and intervenes appropriately. Documents and communicates all patient therapies including concerns during shift.

EDUCATION/CERTIFICATION:

• Graduate of an approved Respiratory Care program. Must provide copy of diploma or transcript upon hire.
• The candidate must hold the credential of Registered Respiratory Therapist (RRT) or Certified Respiratory Therapist (CRT) from the National Board of Respiratory Care and a current license from the State of Connecticut to practice as a Respiratory Care Practioner.
• A candidate with a CRT credential must be registry eligible and obtain the RRT credential from the NBRC within 18 months of employment. 
• The candidate will hold a current Basic Life Support (BLS) certification.
• Current Neonatal Resuscitation Program Provider (NRP) or Neonatal Advanced Life Support (NALS) and Pediatric Advanced Life Support (PALS), Advance Cardiovascular Life Support (ACLS) certifications are desirable but not required.
• Pulmonary Function Testing (PFT) certification desirable.

EXPERIENCE:

• A minimum of one year of skilled respiratory experience within the last two years.
• Must be able to work well with others in a multi-task, fast paced patient care environment. 

COMPETENCIES:

• Must possess a strong focus on customer service and the ability exhibit patience and empathy while providing care to a culturally diverse group of patients.
• Must be able to speak, read, and write using the English language.
• Effective verbal communication is essential with patients, co-workers, and physicians.
• Effective written communication is required for accurate medical charting of respiratory services provided and concurrently clear and precise medical billing.
• Must have access to reliable transportation to travel between multiple work sites; and travel is required in order to perform essential duties.

ESSENTIAL DUTIES and RESPONSIBILITIES:
Disclaimer: Job descriptions are not intended, nor should they be construed to be, exhaustive lists of all responsibilities, skills, efforts or working conditions associated with the job. They are intended to be accurate reflections of the principal duties and responsibilities of this position. These responsibilities and competencies listed below may change from time to time.

Job-Specific Competency

• Understands the theory and operation of the blood gas analyzer as evidenced by the ability to assess the accuracy/precision of the instrument utilizing daily maintenance record, routine troubleshooting and QC material.
• Exemplary: Performs basic troubleshooting, change a cartridge and run CVP.

• Performs and monitors daily QC. Recognizing problems and taking appropriate corrective action as evidenced by documentation in the QC daily log sheet. Complete documentation of pre-analytic indicators in the blood gas result form.
• Exemplary: > 90% compliant in documentation of pre-analytic indicators.

• Demonstrates safe and proper sampling, collection and transport of arterial, capillary and A-line blood gases as evidenced by successful completion of competencies including understanding age specific requirements for sampling and testing and direct observation.
• Exemplary: Consistently labels syringes and transports specimen in biohazard bag with compliance > 90%.

• Ability to perform pulmonary function testing (PFT) as evidenced by test data review, direct observation and feedback from medical director. Completes PFT in < 45 minutes, with ABG or Desat within 1 hour.
• Exemplary: Performs routine maintenance on PFT machine.

• Ability to perform Broncho Provocation and Pulmonary Exercise testing as evidenced by test data review, direct observation and feedback from medical director. 
• Exemplary: Quality tests > 90%

• Demonstrates knowledge of operation and set up of bronchoscopy and monitoring equipment. Shows proper skill level setting up cart including labeling of medications/solutions when appropriate and performing Time Out during out-patient and in-patient procedures as evidenced by competencies and/or direct observation.
• Exemplary: Consistently labels medications/solutions removed from original packaging with compliance >90%.

• Performs all respiratory care services according to physician’s order demonstrating a good knowledge of departmental policy and procedure and the ability to make appropriate decisions based on these policies and procedures as evidenced by direct observation.
• Exemplary: Less than 3 notifications to supervisor/site-manager for policy and procedure decisions.

• Demonstrates knowledge of principles, theory and operation of respiratory equipment and monitoring systems in the critical care environment (vents, BIPAP) to all age groups as evidenced by competencies and/or direct observation.
• Exemplary: Trouble shoots equipment, labels and removes equipment from service and notifies Biomed.

• Performs patient assessment prior to initiation of all respiratory therapy and as part of the reorder evaluation according to departmental policy and procedure.
• Exemplary: Consistently identifies and moves Problem/Goal and documents Education needs for respiratory interventions in Meditech. Compliance > 90%.

• Demonstrates proper operation, set-up and monitoring or equipment used for the delivery of therapeutic gases (Heli-Ox, Bubble CPAP, Hi-Flow O2, heated humidifiers, nebulized and humidified O2) as evidenced by competencies and/or direct observation.
• Exemplary: Minimum Qshift documentation in Meditech Process Interventions (PI) Compliance > 90%.

• Performs aerosol therapy (small volume nebs, large volume nebs, RespirGuard nebs, Vix1 nebs) in accordance to departmental policy and procedure as evidenced by competencies and/or direct observation.
• Exemplary: Consistently performs therapy as ordered and documents administration andnon administration in Meditech e-MAR and Process Interventions (PI). Compliance > 90%.

• Performs Chest Physio Therapy (postural drainage, percussions and vibrations) in accordance to departmental policy and procedure as evidenced by competencies and/or direct observation.
• Exemplary: Consistently documents therapy given and therapy not given as ordered in Meditech Process Interventions (PI). Compliance > 90%.

• Performs proper technique in suctioning (open and closed systems) in age specific populations in accordance with department policy and procedure as evidenced by competencies and/or direct observation.
• Exemplary: Minimal Qshift documentation of suctioning in routine vent check. Compliance > 90%.

• Delivers medications safely in accordance with 2-identifier policy and procedure as evidenced by competencies and/or direct observation. Responds to adverse effects of medications by proper notification to physician an on-line IRIS report.
• Exemplary: Consistently performs 2-identifier policy and procedure. Compliance > 90%.

• Performs 12-lead EKGs to all age groups when necessary (RGH only). 

---