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Thread: Anyone else have trouble with RT's while in hospital

  1. #1
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    Anyone else have trouble with RT's while in hospital

    The last time I was in for a bowel obstruction I had trouble with the respiratory therapist treating me like I was a child. I was nauseated the whole time I was in. It is really hard to do treatments on their schedule when you're puking. She got really hateful with me if I hadn't been so sick at the time she would had heard an earful. With having cepacia and MRSA these treatments are what have kept me alive. I dont skip them.

  2. #2
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    It's been awhile since ds was admitted, but last bowel obstruction and subsequent surgery, he was supposed to do cot every 4 hours. Waiting for the rts, was unacceptable, nurses would page and they'd eventually wander in. Fortunately, DH and I would either strap on his vest and or do manual cpt. I'd speak with your doctor and see if he can take care of this issue
    Parent to a child wcf double delta f508.

    Started Orkambi July 2015
    Began Symdeko August 2018

  3. #3
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    I'm so sorry Regina! Hope you feel better soon. Feeling nauseated and doing chest PT is such a horrible combination especially with all the coughing involved! I would talk to your doctor as ratatosk suggested and let him/her know what's going on. I know the RTs have a specific schedule they tend to follow daily so they can make the rounds to all their patients, accommodate everyone's schedule, etc. but they need to understand that sometimes your sickness doesn't follow a schedule! Ask if you can be worked into someone else's schedule for the day or if they can get a vest for you (or bring your own) so that you can do that if you're not ready for them when they need to come.

  4. #4
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    Very sorry to hear. Hope you're feeling better soon. Occasionally we get a "new" RT, but then I go in mama bear mode and straighten then out. I would definitely let your doctor/team know. Only problems we've had is that some of our RT's are wearing strong perfume/cologne, which triggers coughing in my daughter and myself (having asthma). I let our nurse know, and they will get a new RT. Good luck and take care.

  5. #5
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    I also recall as per suggestions from here to stick a folded up towel under the vest on ds' stomach/incision site to help with vest treatments, he was prescribed an anti-nausea med prior to his surgery and they also had a belt he tried rather than his full vest which was lower pressure and placed at his chest. Last thing we wanted on top of dealing with obstruction was to end up with respiratory issues.
    Parent to a child wcf double delta f508.

    Started Orkambi July 2015
    Began Symdeko August 2018

  6. #6
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    I havent been in the hospital in decades (I refuse to stay "in-house") but when I was, I remember the RT's often being literally hours late for our scheduled time. Meaning, of course, that the nebbbie had completely worn off. Often after a few complaints to the head nurse and my doc, they either got someone else or a nurse did it. Granted they werent trained, but ON TIME and HARD meant a whole lot more. I also got RT's that acted as though I was a crystal, and simply did not have the strength to do anything useful other than give me a massage. I usually didnt see them again. And sometimes, I would get a GEM- an RT that was on time, knew their job, and could whack the hell outta me. Those folks were worth their weight in gold. But sadly, that was rare. My parents also did about 50% of my PT's when I was hospitalized, since I was getting them every 4 hours (nighttime too!).

  7. #7
    The Dot
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    RT's while in hospital

    Quote Originally Posted by regina65 View Post
    The last time I was in for a bowel obstruction I had trouble with the respiratory therapist treating me like I was a child. I was nauseated the whole time I was in. It is really hard to do treatments on their schedule when you're puking. She got really hateful with me if I hadn't been so sick at the time she would had heard an earful. With having cepacia and MRSA these treatments are what have kept me alive. I dont skip them.
    I am an RT and it has been my job to work with the physicians and the staff to begin providing the necessary in-hospital care for the adult CF patients from the adult CF center across the street from us, who have for years used our neighboring hospital. That is why I joined this Blog - to get feed-back from people just like you. First of all, I am sorry that the therapist made you feel worse than you already felt. That is not what we are charged to accomplish. What we are trying to do here is to identify the CF patients who cannot adhere to our schedule for whatever reason and ask the physician if they are OK with us allowing the patient to self administer in their own time. If the physician says yes, we deliver at the regularly scheduled time and do an assessment of vital signs and breath sounds. Then, we check back to assure the patient was able to self-administer the medications. This is not what we have always done, so you may have stayed at our hospital and not been offered this option. Be sure and ask if this option is available if needed in the future.

    Also, we try to leave the VEST in the room with the patient at all times, so they can do their CPT at any time. We always use the wrap around type VESTs unless the patient brings in their own, which we attach to our unit. I have struggled with chronic migraines which often manifest as nausea without headache, and I cannot imagine how difficult it must be to take a VEST treatment when nauseated. The doctors here offer the patients a choice of airway clearance, including flutter device and IPV. Perhaps, you should ask your doctor if you could use some other form of airway clearance when you are neauseated?

    Under no circumstances do we perform hand CPT. (I'm responding to some of the other writers in the Blog.) The way RT Departments are staffed these days, it is really difficult to allocate an RT to perform hand CPT, and I doubt that RT schools are teaching it the way the used to. The VEST is far superior (according to the studies), and flutter or IPV (device you take your medication with that constantly puff-puff-puffs at you), compare favorably to hand percussion.

    Again, my sole purpose for being on this site is to learn from you all, so I thank you. I also want to apologize for any bad experiences you may have had (even at the hospital where I work). Every institution is only as strong as it's weakest member. Please, respond with any recommendations you have that would help us to do better.

  8. #8
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    Dot, I am so happy you are here! Having a "voice" really helps! A few thoughts:
    The "ideal" as I see it is to let the CF patient know the options (obviously making sure they follow through). I'm coming from the parent perspective where when our son was hospitalized with DIOS/obstruction, I handled all his treatments because he I had to time everything perfectly given the "input" and "output" issues. And we do this day-in-day out anyway so we know what to do and what works (need for breaks, etc.) So with adults, I could see similar desires...to do it on their time and their way. They do it every day already. Now, if the person isn't compliant that's another issue, but my ideal would be when the person checks in to say, these are our options:
    1) We do everything and will be here at X,Y,Z, ZZ times.
    2) You can do everything and we will bring in the meds. Let us know the times and times for check-ups that works best.
    3) Or what option do you prefer.

    I can imagine that some can't do anything but having the option for the "tune ups" that are "normal" would be so liberating, I'd think. Also sleep interruption is a huge issue, so that would help with recovery too.

    Thank you for your dedication. There are good and bad employees/providers everywhere. And personally, I can't tell you how much it means when we have someone so dedicated...thank you,

  9. #9
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    PS I wonder if it even possible that the clinic provides patients with their options so that they know before going to the hospital and can think through things and be ready when they get there. "Knowing" what to expect really helps me handle the stress of hospitalzations.
    PSS I love the idea of being able to use the own equipment and we brought ours in. We're use to it and don't have to worry someone made a mistake in infection control protocals!

  10. #10
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    During our last stay, the doctor scheduled vest & neb treatments every 4 hours. We coordinated with the nurse & rt regarding times. First time in the NICU, treatments were coordinated a certain time after meals -- he ate every 3 hours, was supposed to have cpt every 4.

    With his obstruction it wasn't an issue as he wasn't allowed to eat. However, We weren't allowed to use our own vest. The hospital policy didn't allow outside equipment, so a vest was provided to us during our stay. There were disposable tubes, a full disposable vest and band. It stayed in the room and wasn't used by other patients (cross contamination issues). The RTs handled inhaled meds, so while we could strap on his vest, we didn't have access to albuterol, atrovent or pulmozyme. Middle of the night treatments, we always did CPT at home as his vest would wake him up. Between his first stay in the NICU and his bowel obstruction (6 years) RTs no longer knew how to do cpt. Which was fine, we could do his CPT. But again, no inhaled meds available if the RTs were running late or a no show.

    One thing that had changed in the 6 years since our first stay. There was no longer the community bottle of albuterol. When DS was in the NICU, RTs would go from bassinet to bassinet -- they'd wash hands, but they'd pull tubes of saline and a brown bottle of albuterol out of the pocket of their scrubs. They also would hold the babies up against their chests to do CPT treatments. My MIL, who had been a nurse in a TB ward YEARS before brought up concerns with that, wondered why they didn't gown and glove up...
    Parent to a child wcf double delta f508.

    Started Orkambi July 2015
    Began Symdeko August 2018

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