Respiratory therapists at RIH discuss their work and how it has been impacted by the pandemic

From a baby’s first breath to a palliative care patient’s last, respiratory therapists are involved in caring for patients at any stage of life.

They can be found working throughout hospitals, in operating rooms, diagnostic clinics, working in hospice care and, pre-COVID, working with patients in their homes to alleviate symptoms and educate.

As the COVID-19 pandemic began, these healthcare professionals found themselves on the front lines, tackling severe symptoms caused by the virus in some patients while adapting models of care for those with other breathing difficulties.

Lindsay Wetterstrand, an RT at Royal Inland Hospital and the clinical site coordinator for TRU’s Respiratory Therapy program, said at the beginning of the pandemic, they were constantly adapting to new information.

“Every single day, new policies were coming out, new information, and putting that into our daily practice right away was a really important thing,” Wetterstrand said, adding that increased cleaning procedures and more protective gear for workers had been a staple, since day one.

Wetterstrand said they see COVID-19 patients in hospital who may not need a breathing tube right away, but they feel too ill to stay at home.

“They’ll come in, and we’ll support them, which is wonderful, because then we can give them the care they need,” she said.

“If they haven’t made it to the intensive care unit yet...they’ll get oxygen or medications to optimize their pulmonary functions, puffers and things like that.”

Wetterstrand said many disciplines at the hospital work together to help patients affected by COVID.

“Making sure that their body positioning optimizes how their lungs are working…chest physiotherapy, hydration, dietary, all of these things tie in together to optimize a patient’s health status so they can fight COVID.”

Alexa McMillan is also an RT working at Royal Inland Hospital, a clinical resource educator, and volunteers on the BC Society of Respiratory Therapists’ board of directors.

McMillan said when a patient requires a higher level of care, respiratory therapists intubate a patient in order to put them on a ventilator. For COVID-19, this means donning more protective equipment to ensure the virus doesn’t spread.

“We are right at the patient's head, we're going into the mouth, there's a higher chance of us potentially getting COVID if we're doing an invasive procedure like that,” she said.

“We have to be very careful to make sure that we're protecting ourselves and the people that we're around quite a bit more extensively than we would in the past.”

Looking ahead to the future, McMillan said some at RIH are looking into how they can support and educate former COVID-19 patients who may be dealing with long-haul symptoms.

She said in other communities, some COVID patients have come back with cardiac conditions or other issues related to the virus.

“It’s just something we have to be aware of, and try to make sure that we’re there to support them as best we can,” she said.

McMillan said another challenge brought on by the pandemic was that respiratory therapists could no longer perform home care visits or group care programs with people who live with other lung conditions.

She said they had to pivot to using online platforms, like the BC Lung Association’s Better Breathers Facebook group, which have been successful.

In the group, McMillan and a physiotherapist will help to answer questions from those who have chronic lung conditions or their loved ones who help with care.

“It’s been pretty amazing to be able to help reach these people that maybe have fallen through the cracks in the past. A lot of people don't live close to be able to have access to an RT or be able to go to the hospital all the time,” she said.

“I think that it's so rewarding to be able to provide education to people on the internet, I think we've seen a lot of going virtual has created some benefit.”

Ultimately, McMillan and Wetterstrand said they are proud to be part of healthcare teams across Canada that are helping patients through a challenging year.

“This has been such a great year to spotlight what RT’s do. And I think that because of COVID, it's really put a spotlight on us and how needed we are within the hospital and the community,” McMillan said.

The two RT’s thanked people in the community who are taking efforts to wear masks and follow health guidelines to keep themselves, and others, safe.

“It really does reflect on the amount of workload that we have to manage,” Wetterstrand said.

“There's only so many of us right now. Let’s make sure that everybody gets health care as they need it.”