How are the hospital shifts for Respiratory Therapists? Workflow and Rounding

Alright, so people who are interested in becoming a Respiratory Therapist may ask “What is it like to work in the hospital as a Respiratory Therapist?” Well, there are many things that entail hospital life, but let’s narrow it down to what it is like working in the Intensive Care Unit as a Respiratory Therapist.

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Why Q is the most relevant letter in Healthcare

Q is the frequency in which a routine task, therapy, medication is delivered to a patient. This goes for all healthcare professionals. We can replace the word Q for “every.”

Q2 - Every 2 hours.

Q4 - Every 4 hours

Q6 - Every 6 hours

Q8 - Every 8 hours

Q12 - Every 12 hours

Etc, etc, etc.

Note: We also have BID (bi-daily), TID (Three times a day), QID (Four times a day), PRN (as needed).

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The Framework

So there is a framework for our shifts that entail respiratory therapists doing their routine care for specifically ICU patients. So most hospitals will have three main rounds during the shift. Consider this as a rough framework for RT’s in the ICU. Most ICU patients will be seen at least three times a day.

Depending on the hospital protocols, these are going to be the frequency of checks for the following devices. (Disclaimer: Always abide by your hospital's policies and procedures for frequency of checking machines, delivering medications, and delivering therapies. Also, communicate and carry out frequency of checks as ordered by the Physician.)

Checks that are usually Q4

Ventilator, BiPAP, CPAP, Bubble CPAP (Neonates), High Flow Nasal Cannula, vital signs, breath sounds, patient assessments, suctioning, endotracheal tube movement, oral care, just to mention the basics.

Here is an example of the Routine Workflow for rounds in the ICU

Now here are all the things that happen in-between routine care. EXPECT THE UNEXPECTED!

Time Management

That brings me to the next point on Time Management! It is extremely important to manage your time and make sure you are not falling behind. Because we can see just how easy it is to fall behind when something unexpected happens. Sometimes you may have time to get your coffee in the morning and sometimes you might not. (advice: take a k-kup just in case you don’t have time to go get a coffee or make an early stop at Starbucks on the way in). At my first job I barely had time to use the restroom because we were so busy! But, keep in mind the busy hospitals are the ones where you see the most, build your experience, and learn to MANAGE YOUR TIME!

“A smooth sea never made a skilled sailor.”

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Team Rounds

Team Rounds are when the physician team (resident, fellow, attending, are rounding with nursing, dietitians, physician specialists, and respiratory therapists.) This usually takes place after 1st rounds around 930-10 AM. The team discusses the plan, the course of action, how each patient did overnight, any changes that they feel are necessary to escalate or de-escalate care including respiratory support in order to get the patient through their hospital course in an efficient and timely manner.

What are they going to ask the Respiratory Therapist?

Now remember, you would have already seen all of your patients and have suctioned, listened to, assessed, and read up on; so you should know something and have some kind of suggestion or addition you would like to add when they get to the respiratory system. I will go more in depth on this topic in another blog post!

That's all for this post, I hope you learned something more about the workflow in the hospital for Respiratory Therapists! Don’t forget to subscribe to my Newsletter so you can stay up to date with all my blog posts, eBooks, and educational videos.