So You're are a Graduate-Now what?

If you’re used to coming to this blog and finding useful information as you traveled through your respiratory education, well you’re right to continue visiting because we here at Respiratory World can help you get started preparing for the National Board of Respiratory Care (NBRC) exam.

As a graduate, readying to take the NBRC exam, you must mentally prepare yourself because no doubt you have probably been hearing all kinds of horror stories from friends, instructors or even working respiratory therapists that would love to scare you just for laughs. 

First let’s start off by saying that the AARC provides some useful information for “Preparing For Those NBRCCredentialing Exams;” tips that attempt to keep you from “cramming” for the exam and sensibly pace yourself for the long haul.

One of your first stops should also be the NBRC; it has a lot offer in the realm of preparation. 

• Read over the NBRC examination requirements, this will help you make sure you have all your ducks in order prior to applying for the examination.
• Some of your concerns can be easily answered for the NBRC’s FAQ section; this section covers anything from “general FAQs” to “sleep disorders specialty credential FAQs”.
• PSI/AMP is a company, sanctioned by the NBRC, to help you find the resources you need to take any of the exams that are offered.  Here, you could also take “free” practice exams that would help you assess your strengths and areas that you may need help in.

Let the Pros Help

Like any profession that expects one to pass a national exam there is a whole network of providers that, for a fee, will prepare you for the NBRC exam.  The great thing about this is most of them will offer a 100% money back guarantee if you don’t pass!  Below are just a few:

1. Kettering NationalSeminars offers extensive courses, live or self-study, that could prepare you and give you specific tactics into approaching each test question.
2. Lindsey Jones, much like Kettering, can deliver a different approach to the same exams, but as with teachers and learners, sometimes it’s best to look at the same thing with a different set of eyes.
3. AARC Exam PrepProgram, is the newest on the block but note worthy.  The program, being that this is the organization that establishes all the rules, can give the test taker multiple paths to take in order to direct your energies in the appropriate categories. 

As a last note, Craig Scanian offers some advice for persons getting ready for their board exams in “Test-Taking Tips and Techniques.”  He puts forth a plan that educates the tester into the understanding that “knowledge of subject matter” and “good test-taking skills” equal passing the NBRC exam. 

Now remember, there are many ways for you to prepare for this exam, but whatever path you take, make sure it is one that you are comfortable with.  Also, share what works, share what doesn’t, you never know how your experience might impact someone feeling the same way you are at this time.  No matter the case, GOOD LUCK!!

RT in RealTime: Your Internship

As a student, after your first 15 weeks in the respiratory therapy program, you’ll be taking the knowledge you acquired in the classroom and begin to put it to work within the hospital setting. 

The easiest I can make this is to have you think about what your mothers would tell you about “being a visitor in another person’s house,” you would want to make the best impression possible.

Going into a healthcare facility can be a intimidating and a trying experience, yet you are expected to go into this environment and perform at the top of your game.  But don’t fret, everyone you meet in the hospital, at one time, was in the same position as you are now; the beginning of your healthcare career.

Your clinical rotation is a way to become involved with your patients in a direct manner.  This gives the learner a chance to get some hands on experience that will develop into skills that can last a lifetime. 

The RespiratoryTherapy Cave gives advice to budding respiratory therapists from the perspective of the “preceptor” (the person you be paired with), give this article a read to gain an idea of what staff respiratory therapists may be thinking about students’ approach and behavior.

The AmericanAssociation for Respiratory Care (AARC) asked specialists in different areas of respiratory care what rubbed them the right and wrong way in regard to students in the clinical environment in PuttingYour Best Foot Forward in Clinical Rotations.

In the U.S. News andWorld Report, Alison Green wrote an article, Don’t Make These 10Internship Mistakes about how students can shine or bust in front during an internship.

This and instructions from your educators should help you towards a more relaxed clinical experience, pay attention to what others are able to offer in terms of skills but be sure to do what you can to shine.  Remember, this is your first job interview.

Where is Your Spot?

In the time that you will spend in your clinical rotations you will see many different aspects of the medical life, which also means you will see many different specialties.  Some people I know work on the night-shift and I look at them as if they were mad, yet they look at us, that work on day-shift, the same way.

As it stands right now, where would you like to work in the healthcare profession, where is your spot on that map?  Listed below are several specialty areas, look at them and see where you might fit, and then let's take this same survey at the end of the respiratory therapy program and see if you still feel the same way.

After you pick (only one choice please), if you want, please leave a comment telling why you chose what you did,  maybe your classmates might be able to shine a light in an area you never thought of before.  Good luck!!

Getting to Know Your Patients

After thirty years of working within a hospital setting,  I still catch myself forgetting why I’m there, and who these people are that I am seeing on a regular basis.  These people that, sometimes don’t speak, sometimes don’t look at me, or even look as if they care, when in fact, they are looking to me so see if I even do.  These people are my patients.  It’s a hard life knowing that your happiness at work is sometimes limited to the extent of the mood of that person laying in that bed, and again, we sometimes forget why we are there.

You are about to embark on a journey that will test your sense of humanity, your ability to recognize the pain of others and whether you are able to reach out to a soul that is sometimes silently calling for help.  Our classroom is so different from the real world, we sit at our desks, I lecture and attempt, every now and then, to make a joke, but during this time we must remain focused of what we will be called to do, and that is to be a person of not only physical assistance but also to be empathically connected to our patients.

Please watch these two videos produced by the Cleveland Clinic to help you see things from someone else's perspective, that perspective being YOUR patient.

Podcast: Respiratory Therapy Introduction

For you students that are just coming into the Respiratory Therapy Program I am experimenting by making a podcast introduction of what you will be experiencing over the next 15 weeks.  This recording is created to help you get a better insight as to what we will be doing together and hopefully help to take the nervous edge off when you get started.  If all goes well, future recordings will be made available that correspond to the day's lecture, this way whatever you feel you might have missed during class, the podcasts will aid in your understanding of the day's topic.

Remember if you have any question please feel free to leave a comment or email me.

Can a Kazoo Change a Young Girls Outlook on Life?

I’m a grandfather, particularly a grandfather to a four year old little girl I named “Duckie” while she was still cooking in my daughter in-law’s tummy.  Now that she is really starting to express herself in a manner that is comprehensive and engaging, she is starting to display some mannerisms that I didn’t think would start to surface for a few more years yet.  She is becoming a “girl,” I’m saying this in the sense of, “Papa, I can’t do that, I’m a girl,” or “Papa, I can’t wear that, that’s for boys! I’m a girl!” and my favorite, “Papa, I told you, pink is for girls, blue is for boys.”  All of this has me thinking of our daughters, one through four; did they start acting this way so early on in life?  Despite the similarities and differences between our daughters in how they grew up, I did my best to educate them on being their own person and taking pride in that, to not have any limitations, if they wanted to do something then do it!  But I digress, Duckie is on a fast pace of becoming a “girl” becoming in awe of “prince-charming” coming to the rescue and I have spoken to the boss (my dear wife) and Dil (daughter-in-law) about this and they claim they have no clue how she’s picking up these concepts and mannerisms.

Erin Bried, the editor of Conde’ Nast had an awaking one day while in a bookstore with her daughter, when discovering that all the magazines geared for girls had content that prepped them to becoming young “women.”  In other words carrying for their appearance more than anything else.  She embarked on creating “Kazoo” a magazine that aimed at girls from 5-10 a life that could be inspiring, to teach girls to be fearless and make themselves true. 

I don’t have every say about “Duckie’s” life but this is one aspect that I’m going to do my best to see if I can’t redirect her and make her feel strong at the same time.

Digital Natives or Immigrants: Do We Have to Fit in Either Category?

As I read through Marc Prensky’s Digital Natives, Digital Immigrants I felt as if I was completely in the dark as to the mindset of learners who could be defined as “digital natives.”  Being relatively new to education, his ideas of approach to “digital natives” versus “digital immigrants” immediately made me ponder my relationship with my students and how I have always understood how to convey concepts and theories instead of thinking how I could relate this knowledge to a generation that is primarily digitally focused.  Nothing was truer than his notion of the “digital immigrant accent” where we the individuals, having assimilated the digital life, need traditional safety nets in order to ensure the process is completed.  My example would be that I always announce to my class that I sent them a text and/or email, when in fact isn’t that what the “text” or “email” was designed to do?

Again, considering myself a novice in education, Prensky’s paper initially impressed me from a “Wow, I never heard it said that way before,” position.  I did quickly remember how much I love taking my students in the simulation lab and have them play out clinical scenarios on a life size manikin.  This is a great resource to learn from, but I started to re-evaluate my thinking, could I teach respiratory physics via a computer game and apply it to respiratory conditions and how those theories work together?  I think not.  Jamie McKenzie furthered that same line of thinking in her piece Digital Delusions and Digital Deprivation, where the argument is made that Prensky has over-simplified the understanding between those who have been brought up in this digital age and how a complete different methodology is necessary to educate this demographic. 

Professor Thomas Reeves stated, “media comparison studies have failed to find evidence for the differential effectiveness for one educational technology over another.” Laying out the foundation, one would express to someone that held “digital natives” to be a demographic that has to be educated through completely “new” methods.  The old adage of having many ways to skin a rabbit applies to the myriad of ways that could be applied to education or the many ways of how students learn, and that’s where WE come in.  From my perspective, it is my duty to find a way for that student to learn.  I always start off by telling my learner(s) as they are having a problem in answering a problem, “No it’s not you, maybe I haven’t asked you the right question yet.”  As I continue to learn to be a better educator, the differences between digital native and immigrant has to be a factor worth investigating but it must be strongly emphasized, it doesn’t have to be the only factor.  

A Leap of Faith?

Guest Blogger: Stephen Shitara

For many of us the pursuit of higher education has become a leap of faith. The discussion on the pros and cons of higher education is not a new one, but with costs skyrocketing, the discussion is not just one of semantics, but one that truly must be wrestled with, hand to hand combat style. My perspective may not be unique, but recent events have made this a personal struggle. A little background here, I am a respiratory therapist. For those of you that don’t know what that is, we are lung specialists. We work side by side with physicians, to treat lung disease, perform CPR, and we manage ventilators (you know, the funny looking machines keeping people alive on your favorite TV show). I am also a college instructor, and lastly, a parent of a newly graduated high school senior, so as you can see I have a vested interest on many levels. The entry level degree for a respiratory therapist (RT) is currently an associate’s degree, but over the last few years, our profession has made an effort to push towards a bachelor’s degree minimum. The American Association for Respiratory Care, or AARC, is our professional organization that represents over 120,000 (US Dept. of Labor 2015) RT’s nationwide. The AARC created a task force and held a number of conferences over the years to address the changing roles of RT in the rapidly change world of healthcare. The results of the task force were published in The Respiratory Care Journal in 2011. The main outcome of these conferences was the recommendation to “the need for a baccalaureate degree as the minimum entry education level and the RRT as the credential for beginning respiratory care practice” (Barnes, Kacmarek, Kaegler, Morris, Durbin Jr, 2011). Being an RT is for me is no doubt a great job choice. Providing patient care, saving lives, and serving the community is truly a rewarding experience. That along with a medium salary of $57,790, and a better that average projected job growth of 12% (US Dept. of Labor 2015) makes respiratory therapy a good choice for many seeking a degree in healthcare.

Now the scary part. Costs. Cost vary greatly depending on institution, but the cost of an associate degree in RT can be as high as $50K and then potentially tack on thousands more for a bachelor’s degree, and choice does not now seem so clear cut. Nationwide students are struggling to pay back what seems to be never ending student loan payments. As costs grow, so do the loan amounts, and likewise the time to pay them back. A recent article in US News (Oct 2014) suggests the average pay off time at 21 years, yes that right, 21 years. As a college instructor who teaches bachelor level courses in respiratory therapy, I know doubt see the benefit of pursuing higher education. Many of my students are long time RT’s who are returning to college as either an employer requirement or for potential career advancement. They regularly offer testimonials on how their advanced degree helped them grow personally, professionally, an ultimately helped them to provide better patient care, so indeed the benefits are tangible. I personally have no regrets, having bought and paid for 2 degrees in respiratory therapy (sort of, as I too am still paying off a student loan).

Ultimately it will be a personal choice for the aspiring student, or the returning RT seeking an advanced degree. We as a family, have taken the leap as well, signing on to support our son attending a fine private university. No doubt rising costs have muddied what at one time was a clear choice and part of the American dream instilled in us, of attending of college and having more opportunity that our parents. I do have my concerns, but I still hope that dream stills hold true for my children and yours. I’d be interested to hear your comments on this topic.

About the author

Stephen Shitara BS RRT is an experienced respiratory therapist who specializes in acute critical care. Stephen has also taught respiratory therapy for a number of years as a clinical instructor and to associate and bachelor level students in a large nationally accredited respiratory therapy program. He resides with his wife and three children in Idaho.

Laptops No, Me Yes!

The Absents of Digital Devices within Entry-Level Classrooms

A few days ago I walked into the faculty break room where a discussion was taking place between three of my colleagues about digital device usage within the classroom.  I thought this to be ironic since I had recently read about the same concern in a blog on my Feedly.com page.  This is something that is affecting instructors on a grand scale, it is almost impossible to not hear of some sort of digital device being utilized in some fashion within a school's curricula.  Once a “tool” that began as an aid within the office or home setting is now commonplace in any venue.  Personal use of such devices: cell phones, tablets, laptops, etc. can be helpful, time saving and educational, but can we find these same benefits in every classroom without relinquishing control and guidance? It depends.

The push to use such devices applauds the ability to learn the building of communication skills and by the utilization of collaborative tools that give students the chance to collectively learn.  Annie Murphy Paul states, the “integration of electronic devices should be built into curriculum that instructs the students on how to engage safely and effectively with the Internet.”  Then again, Carl Straumsheim remarks that a study published in May of 2016 from the U.S. Military Academy at West Point that suggests the effectiveness of not allowing students' computers and tablets in introductory classes.  The results indicating that student in the “beginnings of their college careers are most susceptible to their grades suffering from device-induced distractions.”

Which brings me to my point.  Not so strange is the fact that based on the arguments I can see pluses and minuses on both sides.  The fact still remains, is the outlawing of digital devices appropriate for my class?  The answer has to be an emphatic yes.  My learners are walking into a respiratory therapy class for the first time where it is fair to say that most of the learners, if not all, have little to no experience in this area.  Learning about the human respiratory system requires true commitment to understanding how individuals breathe normally and subsequently how disease conditions progress thus allowing a clinical practitioner a way of knowing what the best course of treatment would be.  One could argue that since the learners are being exposed to this material for the first wouldn’t it be nice to allow them to look up concepts, words, therapies, etc. during class?  The problem with that still allows for the student to potentially be left behind as the lecture moves on, hence the better solution would be for one to make “old school” notes and build a list on which they can be researched later on.  Is my method sound?  Probably not, but it does allow me to have the learners all on the same page, each getting the same chance to learn together as a class.  Although this may put me in the light of being paternal, I have seen this work; students develop a way of coming out of their shells improving their participation and level of engagement which leads to them becoming more involved in the learning process by sharing…. together.

Taken from Larry Cuban on School Reform and Classroom Practice@https://larrycuban.wordpress.com/2012/11/24/digital-natives-2-cartoons/