Respiratory Technician

Job Description Summary

Under the auspices of the South Shore Hospital Director of Respiratory Care and the direct supervision of a Massachusetts licensed respiratory therapist preceptor, the student/respiratory technician will perform duties permitted by the Commonwealth of Massachusetts’s M.G.L. c. 112, §§ 23R through 23BB as defined in 261 CMR 2.06 – 2.08. The student must apply for and be granted a limited permit to practice respiratory therapy to be accepted as an employee of this program. At any time the limited license expires, is revoked or the student is no longer enrolled in his/her respiratory program prior to graduation, the employment will be revoked. The student will only be permitted to perform those services which have been successfully completed as part of the curriculum of his/her respiratory therapy program. South Shore Hospital may however further limit the scope of practice that may be performed by the student. The student, in conjunction with the educational respiratory therapy program director, will be responsible for filing a Verification of Education form to the Board of Registration in Respiratory Care and updating this form as the student further completes his education. The student must keep a logbook of all services performed at South Shore Hospital and pass them in to the Respiratory Care Operations Manager each week. These logs will be retained in the student’s departmental personnel file. The student’s preceptor must verify all entries in the logbook. Duties That May Be Performed If Included In The Limited License: Equipment storage, assembly, disassembly and maintenance. Gas cylinder transport. Administration of oxygen. Administration of hand held nebulizer treatments. Instruction of incentive spirometers. Instruction of metered dose inhalers. Sputum inductions. Subsequent applications of CPAP and BiPAP. Blood Gas Analysis (verified by preceptor) Pulmonary Function Testing Ventilator application and maintenance. (only with direct observation by preceptor) Manual ventilation during CPR and transport. (only with direct observation by preceptor) Duties That May Not Be Performed Regardless of Licensure Inclusion: Ventilator application and maintenance. (without direct observation) Arterial punctures. Hemodynamic line draws. Nasotracheal suctioning

Job Description

ESSENTIAL FUNCTIONS

1 - Responsible for the safe and effective administration of medically prescribed medications, knowing their indications and contraindications.

   a - Assures proper physician order before administration of medication as evidenced by Process Improvement

   b - Demonstrates proper procedures for the procurement of respiratory medications and reconciliation of medication count variances.

   c - Completes Respiratory Care Patient Assessments before treating patients as evidenced by process improvement reviews

2 - Knows and follows the indications and contraindications, the policy and procedures in administering therapeutic modalities including but not limited to: IPPB, IS, HHN, CPAP & BiPAP.

   a - Assures proper physician order before treatment administered as evidenced by Process Improvement review.

   b - Discontinues treatment if any adverse or contraindication noted and documented in patient chart at time of occurrence as well as notifying the appropriate staff member, i.e., nurse, physician.

   c - Assesses the patient status before, during, and after therapy has been provided.

3 - Safe utilization of gas cylinders and piped in gas outlets.

   a - Sets up gas cylinders and assures proper usage and safety measures are in place.

   b - Lifts and moves gas cylinders utilizing proper body mechanics.

   c - Demonstrates knowledge of the set up, use and problems associated with oxygen, air and vacuum outlets, regulators, flowmeters and devices.

4 - Performs PFT’s to the standards of the American Thoracic Society.

   a - Patients are consistently coached to produce reliable data as evidenced by the number of needed retests.

   b - PFT data is confirmed on a daily basis to have been transferred into the MEDITECH system

   c - Maintains and backs up patient data on a regular basis

5 - Familiar with oxygen delivery systems as determined by their proper application and set up (i.e., nasal, venturi mask)

6 - Familiar with measuring devices to include, but not limited to, pulse oximeter, Wrights respirometer, oxygen blenders

   a - Demonstrates ability to properly utilize the various oximeters and probes and is able to verbalize the limitations of the systems.

   b - Demonstrates ability to perform weaning mechanics utilizing a respirometer, manometer and cuff pressure manometer and documents the data in the medical record.

   c - Measures and records the static compliance and dynamic resistance of the airways for all mechanically ventilated patients.

   d - Familiar with and promotes the use of mechanical ventilation protocols for both ventilator management and weaning evaluation.

7 - Responsible for the set-up and safety check of mechanical ventilators

   a - Returns dirty non-disposable equipment to the department for reprocessing

   b - Keeps non-disposable supply stocked.

   c - Demonstrates the ability to set properly set up and check the functionality of all ventilators at South Shore Hospital.

8 - Under direct supervision of a preceptor, responsible for the set-up, safety check, monitoring and troubleshooting of mechanical ventilators.

   a - Performs ventilator checks at the prescribed frequency during assigned shift as determined by the ventilator flow sheet.

   b - Expedites weaning by advocating the weaning protocol.  This is demonstrated by the therapist obtaining permission for the protocol and documenting the weaning attempts in the medical record.

   c - Upon the order of a physician and the direct supervision of a senior level therapist, the technician demonstrates the ability to safely perform an endotracheal extubation.

9 - Familiar with the set-up and administration of CPAP and BiPAP

   a - Demonstrate ability to select proper equipment and fit the mask to the individual patient.

   b - Demonstrate the ability to set all parameters and alarms when setting up a patient for NPPV.

   c - Fully capable of explaining the different modalities and their applications with respect to the patient's disease process.

10 - Attends all required Safety Training programs and can describe his/her responsibilities related to general safety, department/service safety, specific job-related hazards.

   a - All required safety programs have been attended

   b - Provides complete and accurate responses to safety questions

   c - Operates assigned equipment and performs all procedures in a safe manner as instructed

   d - Maintains work area and equipment in condition required by department standards

   e - Demonstrates proper body mechanics in all functions.

   f - If Manager/Leader, provides for the safety of department employee.

11 - Responsibly follows the Hospital Exposure Control Plans/Bloodborne and Airborne Pathogens.

   a - Demonstrates knowledge of techniques, procedures and correct use of protective barrier equipment.

   b - Assures a safe environment by instituting appropriate control measures

   c - Attends annual education programs.

12 - Demonstrates respect and regard for the dignity of all patients, families, visitors and fellow employees to ensure a professional, responsible and courteous environment.

   a - Interacts with all of the above in a considerate, helpful and courteous manner as observed by Manager and peers.

   b - Fosters mature professional relationships with fellow employees in a courteous, friendly manner as measured by management observation and peer input.

   c - Maintains professional composure and confidence during stressful situations.

   d - Maintains open communication using appropriate chain of command regarding issues.

   e - Conducts all work activities with respect for rights and wishes of patients, visitors, families and fellow employees.

   f - Maintains confidentiality of all Hospital and patient information at all times as observed by peers and management.

   g - Presents neat appearance in proper attire and identification as required by the position, department, and South Shore Health & Educational Corporation policy.

   h - Continuously displays a "can do" attitude within the department and across departmental lines to contribute to the overall customer service program in place at South Shore Health & Educational Corporation.

13 - Promotes effective working relations and works effectively as part of a department/unit team inter and intra departmentally to facilitate the department's/unit's ability to meet its goals and objectives.

   a - Participates in staff meetings as determined by Manager.

   b - Supports the Hospital's mission, policies and procedures through attendance and participation at committee meetings, if applicable.

   c - Utilizes automated system to communicate inter and intra departmentally, as appropriate.

   d - Completes work assignments on time/readily accepts assignments as observed by Manager.

   e - Reports to work on time and is at work as scheduled, as observed by Manager.

14 - Maintains accurate and legible records, documenting clinical notes in patients charts.

   a - Accurate and legible notes are to be kept in the Integrated Progress Notes section of the patient record as evidenced in process improvement reviews.

   b - All medications administered and missed are documented in the MAR as evidenced in process improvement reviews.

   c - The treatment renewal process is applied according to policy and followed up as evidenced in process improvement reviews.

   d - Assures Kardex system is current and complete by end of shift as evidenced by shift report; i.e., full name, room number, diagnosis, full treatment order, date ordered, time of treatment given noted.

   e - PRP documentation is completed in a timely manner.  RN who triggered PRP notified of any interventions.

15 - Participation in reporting patient progress, patient condition, and documenting needed level of care to the next shift as determined by observation at shift change.

16 - Safety Awareness – Fosters a “Culture of Safety” through personal ownership and commitment to a safe environment.

   a - Adheres to patient identification policies/procedures as evidenced through the PI system.

   b - Makes appropriate use of personal protective equipment at all times.

   c - Adheres to respiratory etiquette guidelines and universal precautions.

   d - Appropriately disposes of hazardous materials.

   e - Adheres to electrical safety guidelines.

17 - Adheres to policies and procedures required for the implementation of the National Patient Safety Goals as determined by process improvement reviews

UNIT / DEPARTMENT SPECIFIC JOB FUNCTIONS

1 - The student-technician will report to their preceptor and pass along to the oncoming therapist

2 - All activities performed will be kept in a log and routinely reviewed by the department operations manager

3 - Participates in rounds, when applicable, and documents recommendations

4 - Can perform sputum inductions using the departmental hypertonic saline protocol.  All material will be screened for acceptable quality and labeled at the patient's bedside.

JOB REQUIREMENTS

Minimum Education - Preferred

Must be currently enrolled in an approved school of Respiratory Care as a second year (or greater) student or have successfully graduated from the program.
Must have a current, full or limited, Massachusetts Respiratory Care license.  Must hold a current BLS certification.

Minimum Work Experience

Previous clinical respiratory hospital rotations.

Required Licenses / Registrations

RLP - Respiratory Limited Permit

Required Classes/Skills -

BLS - Basic Life Support

ACLS - Advanced Cardiac Life Support if treating adult patients

PALS - Pediatric Advanced Life Support if treating pediatric patients

Required additional Knowledge, and Abilities

Knowledge of oxygen therapy and limitations of the various devices.  Good interpersonal skills.  Understanding and basic ability to interpret blood gases.  Understanding of aerosol therapy and the medications used.  Successful completion of the first year instruction in Respiratory Care from an accredited institution.