Allied Health Week Spotlight: Candice Harmon

Registered Respiratory Therapist / Professional Lead, Respiratory Therapy

Winnipeg Regional Health Authority
Published Monday, May 9, 2022

Briefly describe the role of Respiratory Therapists as part of the health-care system, and how they interact with other Allied Health and health-care professionals.

Respiratory Therapists (RTs) play a vital role in the care of patients from birth to death, as well as from the hospital to the home. We work on the code blue team managing the airway during a cardio-respiratory arrest, and at some sites where no doctor is present, take on the role of medical leader. We are also part of the multidisciplinary team in the intensive care units, as well as on medical and surgical wards, working with physicians, nurses, pharmacists, and dietitians. When helping with difficult discharges from hospital, we may work closely with nursing, occupational therapy, physiotherapy, and Social Work to ensure safe discharge. We also work closely with our Speech-Language Pathologists as part of tracheostomy teams. With RTs having an end-of-life role as well, there are situations where we provide clinical support for Spiritual Health practitioner in those final moments.

What impacts did the pandemic have on Respiratory Therapists and the people they serve?

With COVID being a respiratory illness, the pandemic seemed to highlight our profession a little more than in the past. Our education and expertise through the acute waves of the pandemic was vital for providing safe use of high flow oxygen and ventilation to patients facing the most severe outcomes. Our services from the community were pulled to the bedside during the acute phases, and now we are seeing and supporting those with long COVID symptoms in community RT roles. We saw much more death in our day to day than ever before, which was extremely hard on many of us. I personally found it hard when I would see patients around my age or younger who were so sick. Those kind of impacts are still something many of us are struggling with.

What are the challenges in responding to those impacts?

Staffing remains a big challenge due to the number of RTs needed through the acute phase of COVID. Our workload is still high, and there's a need to fill positions that are currently vacant. Overall, it's been a challenging two years.

Is COVID particularly challenging from an RT perspective? How so?

Yes, absolutely. Even more so for the patients with a moderate to severe disease course. Working to fight a respiratory illness, we were involved with the care of many, but those hit hardest were very challenging to manage on the ventilator. In the second and third waves, we would see patients one daytalking with us, only to be next maxed out of high flow oxygen, intubated and ventilated the next day. They were on ventilators much longer than other disease courses, and it was hard to predict who would be next for the end-of-life conversation during hospital rounds. Once vaccination rates were up in Manitoba, the disease progression wasn't as harsh, and we saw more success and positive outcomes.

What makes the work of RTs so important/rewarding?

For me, it's how varied the scope of practice is for an RT, and the unpredictability. I like that, some people don't. You are seeing and helping a patient through all stages of their illness. In addition, we play a role in preventative testing, provide education to patients, and have a very specialized skillset.  We can go from doing breathing tests on an outpatient to running to a code blue (resuscitation). It can be a high-intensity job, with bursts of high adrenalin, and you always have to be on your toes to provide the best care possible. The RT community is somewhat small compared to other professions, so seeing and working with people who are so passionate about the work they do creates a positive environment that keeps you coming back each day.

What other job satisfactions associated with being an RT?

RTs are an important part of the multi-disciplinary team, and have a knowledge base and skillset that, as a whole, cannot be replaced. Knowing that your expertise is essential in many health-care settings does provide job satisfaction. There are ups and downs when working in such a high-stress role, so it does take a certain type of personality to enjoy the role and situations you face. With the wide variety of work as an RT, no two days are similar.