|Author: Anne Baublitz|
|Staying Motivated For a Variety of Reasons
|Knowing that no two days on the job are ever the same is what keeps Dean Boike, RRT, CRT, MN RCP, energized and eager to approach his work each morning. As the Assistant Director of Respiratory Care at Rice Memorial Hospital in Willmar, Minnesota, Boike knows that there is only one thing he can be sure about: whether he is scheduled to visit with an ICN premie or to oversee sleep tests on an elderly patient, his job is constantly changing, and it is packed with the variety he craved when he chose a career in healthcare.
Based on this constant change, Boike describes his position as the Assistant Director, explaining how it is flexible, and frequently morphs to encompass new responsibilities and surrender to other ones. "That's what I like about the work—the variety," he says. "We have the opportunity to work with premies and the elderly, and everyone in between."
Since he works in one of the fastest-growing cities in Minnesota, Boike sees patients from all over the surrounding areas that come to the hospital for a variety of reasons. He describes Rice Memorial Hospital as a 110-bed city-owned hospital 90 miles west of the Minneapolis/St. Paul area. Located in a town of approximately 20,000, the hospital is a regional referral hospital for the West Central and Southwest areas of Minnesota.
Depending on which patients are on Boike's schedule each day determines his activities and his locations within the hospital for that particular day. He describes how respiratory therapists at Rice Memorial Hospital are responsible for all areas of inpatient care, including the ER, ICU, PEDS, OB, the nursery, PACU, ambulatory care, adult health, women and children's health and mental health. "Because we meet with patients in all these areas, my day to day responsibilities tend to vary, but most commonly, I meet with adult and pediatric patients," says Boike. We also have an outpatient pulmonary rehab program to cater to those particular patients. He adds that this diversity is what keeps the job exciting and motivates him to come to work each morning. "That's what has always made Rice Hospital interesting—the variety of patients we care for and all the different areas we serve."
Besides dealing with a vast assortment of patients, Boike also enjoys working in Rice Memorial Hospital's recently renovated facilities. He describes the hospital, which is still involved in a $52 million expansion, as "beautiful" and "state-of-the-art." "Our hospital's expansion project will probably be finished by the end of 2006," he says. "We have all new patient care areas and all new ancillary departments too." Boike describes how the new facilities are not only attractive, but they are also functional and allow the staff members to do their jobs more efficiently. "We are much closer to our patients in our new department. We still are responsible for therapy in all locations throughout the hospital, but getting there doesn't take as long," he says.
Boike believes that the recent expansions have not just made the layouts of the departments in the hospital closer together. He also believes the staff members feel professionally closer to one another as well, saying, "I think our therapists do a good job of communicating with nurses and physicians and amongst ourselves. We do daily patient rounds to discuss, with other departments, all patients. Interdepartmental communication is key to good outcomes. It, of course, takes time and commitment, but we are all here to benefit the patients, and our physicians are very receptive to suggestions we might have for them."
Because he deals with many patients who experience a broad range of symptoms, Boike is trained in several different areas including EEG, PFT, Holter monitoring, EKG and TCO2. He explains that he is also proficient in plethysmography, and uses these and other procedures in his daily routine at the hospital. During one of these projects, he recently worked on developing a Rapid Evaluation Team (RET) to bring a unique approach to patient care. "We developed a RET team, where an ICU nurse, a staff nurse and a respiratory therapist respond to the bedside to evaluate and treat a patient who is displaying a change for the worse in his or her condition," he explains.
Although the RET program is a new addition to Rice Memorial Hospital, Boike explains that the idea is widespread among patient care facilities. "The RET—or, as some hospitals call it, RRT (Rapid Response Team)—is actually in place in many hospitals throughout the country. It is aimed at recognizing signs and symptoms early in a patient's condition and calling the RET to come and evaluate the patient, call the physician and make interventions."
Boike explains that the ways team members respond to these patients varies depending on the symptoms each patient exhibits. "In many cases, response may mean suctioning the patient, providing proper dosage and administration of oxygen, fluid administration or the use of diuretics," he says.
Because these programs are in existence throughout the United States, Boike explains that Rice Memorial Hospital is now involved in a national movement to provide better, more responsive care for patients. "There is a national goal to decrease by 50% the number of Code situations that occur outside the ICU and ED," he says. "This RET—or RRT—team is a way to help recognize early decline in a patient's status and get key people in to evaluate and treat the patient."
Since the RET program at Rice Hospital has only been in effect since October 1, 2005, Boike explains that there have not been very many opportunities to test the system. But that's fine with him, and he still believes it is important to have a system like RET in place. "We've never had many Code situations outside the ICU or ED, but this is still a great way to help evaluate patients who we are concerned about," he notes.
Because of new approaches like RET, Boike believes that the role respiratory therapists play has developed significantly in the past decade or so, and he also feels confident that it will continue to expand and change in the future. "The respiratory therapist's role has definitely evolved over the last 10 or 15 years," he says. "We provide so much more than therapy. We are the smoking cessation providers here at our hospital. We are also going to provide COPD education, in a more formal way, to our inpatients."
Not only does Boike believe the professional responsibilities of respiratory therapists have changed over time, he also believes people's attitudes towards RTs have changed as well. "We are viewed much more as professionals and less as technicians," he says. "Respiratory therapists have done a great job of stepping up to the plate to all new and varied services in our ever-changing work world."
Although Boike says respiratory therapists have done a good job of accepting increasing responsibilities and have, therefore, earned the respect of other medical professionals, he is a bit worried about how everyday people view him and his colleagues. "I am concerned about the general public's awareness of our job and our role in the healthcare team. We need to continue to present our profession in as many avenues as possible to increase awareness of what we do," he says.
Boike believes one way this can be accomplished is through educational outreach. "We can help promote RT as a profession by inviting groups, such as the Boy Scouts and the Girl Scouts, to a department tour at the hospital and explaining the work we do," he says. He also believes health career fairs at local high schools are effective educational tools for older children and teens. By highlighting the work respiratory therapists do, Boike says these fairs also allow RTs to meet young people who may be considering career paths similar to their own. "Also, something as simple as a career spotlight in a local newspaper during RT week can increase awareness," he says.
Boike also describes how, in the past, he visited his children's fifth and sixth grade classrooms to discuss the respiratory system with the students. Through hands-on experience, like showing them how an oximeter and other tools work, Boike believes a greater understanding of the work RTs do is formed.
And, to those students who do grow up and decide to pursue a career in respiratory therapy, Boike recommends becoming involved in as many areas of the field as possible. "Pursue your special interests, as many opportunities await," he says. "From working with newborns to the very old, and with everyone in between, variety is the thing I have always enjoyed."
Dean Boike, RRT, CRT, MN RCP, holds both an AA and an AS degree from North Hennepin College in Brooklyn Park, Minnesota. He also had respiratory clinical training at North Memorial Hospital in Robbinsdale, Minnesota. Today, he is the Assistant Director of Respiratory Care at Rice Memorial Hospital in Willmar, Minnesota.
Anne Baublitz is a freelance writer from Glen Rock, Pennsylvania. She is on the editorial board of NEWS-Line for Respiratory Care Professionals.