Respiratory Therapist - Adult Critical Care - (36 hours day/night rotating) - Sign On Bonus Eligible

Job Profile Summary 

This role focuses on assessing the needs of patients who have physical, mental, or emotional disabilities and delivering therapy services to improve their developmental, physical or cognitive impairment. In addition, this role focuses on performing the following Respiratory Therapy duties: Evaluates patients and helps them improve physical and mental conditions through treating cardiopulmonary related dysfunction.  A professional individual contributor role that may direct the work of other lower level professionals or manage processes and programs.  The majority of time is spent overseeing the design, implementation or delivery of processes, programs and policies using specialized knowledge and skills typically acquired through advanced education.  A specialist level role that is a recognized subject matter expert in job area typically obtained through advanced education and work experience.  Typically manages large projects or processes with limited oversight from manager, coaches, reviews and delegates work to lower level professionals, resolving difficult and often complex problems.

Job Overview 

This position is responsible for assisting department leadership with supportive, educational and day-to-day clinical support.  In addition, this position also performs respiratory care for patients of all age groups, who are diagnosed with cardio-pulmonary dysfunction.  Sets up various types of equipment to administer prescribed doses of medicinal gases and aerosolized drugs.  Administers all types of respiratory therapy treatments including, oxygen delivery, mechanical ventilator management, diagnostic procedures (e.g., blood gas sampling and analysis, bedside pulmonary function testing, pulse oximetry, EKG's, BCLS, function and troubleshooting of respiratory therapy equipment). Works cooperatively within department and other services to create a system of quality health care. 

Job Description 

Minimum Qualifications: 

1. Associate’s degree from an accredited Respiratory Care program.
2. Licensed by the state of Massachusetts to provide respiratory care.
3. Registered Respiratory Therapist (RRT) or Certified Respiratory Therapist (CRT). If employed at TMC, must be RRT.
4. Basic Life Support (BLS) certification.
5. Eight (8) years of experience as a Registered Respiratory Therapist. 

Preferred Qualifications: 

1. Bachelor’s degree from an accredited Respiratory Care program.

Duties and Responsibilities: The duties and responsibilities listed below are intended to describe the general nature of work and are not intended to be an all-inclusive list.  Other duties and responsibilities may be assigned. 

1. Provides clinical expertise and assistance Respiratory Care department team members on a daily basis including managing day-to-day clinical issues that arise which may include: participating in patient rounds; Assisting therapists when clinical expertise and assistance is needed; monitor daily caseload assignments; reallocate work flow for pediatric transport, ECMO, or increasing acuity in clinical areas; reviewing patient census; facilitate break coverage; and assisting with reporting/analysis.   

2. Assists quality improvement measures (such as SBT initiation for applicable patients, RT presence and participation in rounds, lung protective ventilator strategies). Also assists with process improvement efforts. 

3. Collaborates with nursing colleague clinical leaders with patient quality initiatives  

4. Initiates patients on invasive and non-invasive mechanical ventilation; routinely checks and maintains proper function of ventilator in conjunction with the physician order.  

5. Abides with infection control guideline for invasive and non-invasive equipment per departmental policy.  Changes and adjusts ventilator parameters based on clinical assessment and blood gas analysis in accordance with physician orders.  

6. Weans patients from mechanical ventilation and other therapies through patient assessment and adjusting parameters within prescribed protocols. 

7. Administers inhaled medications in accordance with institutional guidelines derived from the department of respiratory care and pharmacy. 

8. Administers oxygen using low flow, high flow, open and closed circuits. 

9. Embodies patient and family centered care. Explains procedures to patients and family.  

10. Provides services to analyze blood specimens for blood gases, glucose and electrolytes in neonatal and pediatric intensive care units. 

11. Administers Positive Pressure Breathing, (e.g. CPAP or BiPAP), which consists of the application of positive pressure to the upper airway to promote better lung inflation and aerosol distribution.  

12. Routinely assists in the transport of patients requiring life-support to and from referral hospitals.   

13. Provides in-house transport of mechanically ventilated and other high-risk patients.  

14. Provides non-traditional therapies, e.g. Nitric Oxide gas administration, as ordered. 

15. Provides resuscitation and support services at all high-risk deliveries. 

16. Monitors effectiveness of therapy using non-invasive techniques such as pulse oximetry, end tidal CO2 and transcutaneous PO2/PCO2, in addition to invasive techniques such as arterial blood gas sampling. 

17. Analyzes inspired oxygen concentration using various oxygen analyzers.  

18. Calibrates monitors and maintains Transcutaneous Oxygen Monitors, End Tidal CO2 and pulse Oximetry monitors.   

19. Assists in Cardio-Pulmonary Resuscitation as part of Code Team primarily providing airway management and manual resuscitation.   Commonly administers drugs via the endotracheal tube during cardiopulmonary rescue e.g. Lidocaine, Atropine Sulfate and Epinephrine. 

20. Documents therapy, patient assessment, and interventions performed and test results in the progress notes of the medical record in a concise, accurate, and thorough manner.  

21. Transcribes a detailed shift note for all patient’s cared for during the shift.  

22. Responsible for acknowledging the proper assembly of all respiratory therapy equipment prior to and during patient use. 

23. Performs daily rounds and fairly bills patients for services rendered. Attend rounds daily with the intensive care unit critical care team and is an active participant in the patient’s care. 

24. Assists with development of in-service programs for departmental personnel. 

25. Assists the Associate Director with the orientation of new employees; acts as a preceptor for new employees and is utilized as a clinical instructor for students enrolled in local universities. 

26. Performs duties of an ECMO specialist including: Directly monitoring patient; Working in conjunction with bedside nurse on ECMO patient care; troubleshooting ECMO circuit and clearly and effectively communicate their findings to the ECMO service; intervening during critical ECMO emergencies; including being able to separate the patient from ECMO, troubleshoot and correct the problem, and return the patient to ECMO support as soon as possible. 

27. Maintains collaborative, team relationships with peers and colleagues in order to effectively contribute to the working groups achievement of goals, and to help foster a positive work environment.

28. Supports one (1) of the following: Operational initiative such as schedule template, biomedical engineering liasion , EPIC quality audting, cross trained in PFT lab. 

Physical Requirements:  

1. Able to walk and stand for approximately 90% of the time. 

2. Able to transport respiratory therapy equipment (up to 100 lbs) using carts or wheels on the equipment to and from patient areas.  

3. Able to communicate with and assess the patient needs of different age populations. 

4. Requires manual dexterity using fine hand manipulation to operate computer keyboard and or respiratory equipment. 

5. Requires ability to see computer screen and reports. 

Skills & Abilities: 

1. Knowledge of medical terminology, physiology of the cardiopulmonary system, and Respiratory Science. 

2. Ability to communicate effectively with all professional staff as well as all patients. 

3. Ability to assess patient status and develop treatment plans. 

4. Ability to perform all required duties under emergency and stressful situations. 

5. Knowledge of Respiratory Care clinical practice such as mechanical ventilation strategies, non-invasive therapy, high flow oxygen therapy, artificial airways, and aerosolized medication administration.