By Corina B. Clark, Co-Chair CAHL Coastal California LPC
March 18th, 2020, was my first day as a leader in my new role. After years of being in management at UCLA Health, I decided to transition to a smaller community hospital closer to my family in Northern California. Little did I know, I was walking into a role that an entire health system, community, and families would depend on. I had been a respiratory therapist for over a decade and led plenty of RTs and other specialists in various settings, but this was different. I had taken the leadership role of the Respiratory Care Department as a historic respiratory pandemic was unraveling.
Leaders have different procedures when transitioning into a new role, setting up one-on-one meetings, engaging with other leaders, and other imperative action items. Unfortunately, my guidebook for the first 90 days did not include an addendum for managing during a global pandemic. I had to jump in and work with a team who had no idea who I was. If there was a time I needed a “how-to book,” it was now. How to get a team to trust their leader while navigating an international crisis alongside a national supply and PPE shortage.
Building Trust and Showing Up
I kept my one on one meetings with the frontline staff, but the conversations were different. These meetings were walking meetings and occurred anywhere away from patient care areas. “How are you managing throughout this time? How is your family? What is the most important thing I can do for you during this time to make your days better when you go home to your family?”
As the late Stephen Covey might say, these were my “quadrant one” items to address. These were my urgent and important tasks, so I adjusted my days to ensure this was my top priority.
There were a lot of different things shared in my sessions from staff, but the top three were very simple:
- Keep us safe.
- Advocate for us.
- Make sure we have enough equipment/resources to take care of patients.
I was constantly rounding on the team and connecting with the night shift that worked from 7 p.m. to 7 a.m. I traded my heels and blazer for scrubs and sneakers, so the team knew there was always an additional RT on standby.
Keeping your Word
Of all the things the team could ask for, they kept it very simple. Keep us safe, advocate, and ensure there is equipment. Easy right? Not so much. Along with the pandemic came shortages of equipment, N-95 masks, parts, and more. I had to look at our resource supply differently. I contacted all of the local respiratory schools to obtain any respiratory equipment they had stocked. The schools were closed due to the pandemic, so they had no use for the equipment. We established contracts with the schools and retrieved their ventilators, N-95 masks, high-flow cannulas, PPE, and BIPAP devices. We added these items to our stock, and the team was elated to learn we had nearly doubled our inventory of equipment and supplies. They felt safe and equipped.
My next step was involving the RTs from the beginning when implementing anything related to respiratory care. One of the first obstacles we had to navigate was figuring out the safest way to safely transport patients who required a lot of oxygen from the ER to the Covid unit. The RTs teamed with an ER doctor to work on a tented system that was fully covered to move patients from one unit to the next without harming other staff, patients, or providers. The RT team created a procedure, partnered with infection control, and helped establish a cleaning and disinfecting process.
This was the first of many collaborative “wins” for our team. The RTs were recognized for their contributions and took the lead in providing education throughout the hospital. That was only the beginning! The RTs partnered with pulmonologists to establish ventilator settings for Covid patients, created procedures that decreased the amount of oxygen the patients required, provided education to children in the community with underlying health conditions, and more. I also contacted other CAHL members in similar healthcare sectors to brainstorm ideas and approaches to managing this pandemic. The feedback and willingness to help were overwhelming in the best way possible.
What is a Respiratory Therapist?
The question most people ask when an RT shares their title is, “What is that? What do you do?” Well, during the Covid-19 pandemic, we had the opportunity to show everyone what we do. We manage the ventilators, establish treatments alongside physicians, and treat Respiratory illnesses. As we ventured through the first, second, and third surges of Covid-19, the American Association of Respiratory Care and the California Society of Respiratory Care recognized the team for their work with the patients as well as the community to keep them safe. They received the “Respiratory Care Department of Excellence” award for the greater Bay Area. Another major part of this journey is that this team did not utilize travelers throughout the pandemic. When asked about securing travelers, the team said they would be willing to help and provide additional shifts as needed and would communicate if they felt any sense of burnout. This was a considerable risk, but I believed them, and they delivered. I don’t know of many Respiratory Departments or any departments that did not rely on travelers throughout this pandemic, but my team did it. They showed up when times were tough and advocated for every patient and one another.
Moving Forward
As we navigate through 2023, unsure of what it will bring, I confidently move forward. Our team has been able to navigate one of the most significant pandemics in history and did so with grace. They were clear and direct in their requests, selfless, and never jeopardized patient safety.
Respiratory Therapy is a vital field sometimes forgotten when you mention critical care teams. To all of the Respiratory Therapists around the world, Thank You!! Thank you for stepping up to the challenge and leading the charge through this pandemic. An enormous Thank you to all my Respiratory Therapists at Salinas Valley Health. You are the definition of true Healthcare Heroes, and I am grateful to learn from and lead this incredible group.