Respiratory Therapist Trying to Help

One of my under graduate degrees is in respiratory therapy.  I am registered by the National Board for Respiratory Care. I was licensed as a respiratory care practitioner in the State of Georgia as well as Maryland, Pennsylvania and Ohio.  Prior to retiring I notified the Georgia Composite Medical Board I would not be renewing my license.

Weeks before I retired I was still meeting with patients and their physicians to discuss clinical research, trials, or therapies.  Since I retired I have been published several times in medical periodicals, published a book about health and received three patents specific to medical devices used to monitor cardiopulmonary physiology.  But, I did let my Georgia Respiratory Care Practitioner’s license become inactive.

Before I let my status as a Respiratory Care Practitioner become ‘inactive’ in Georgia I spoke with a representative at the State regarding the decision.  She assured me that should I want to reactivate my license it would be ‘simple.’

When the coronavirus hit I recognized this was going to be a strain on respiratory therapists.  I am not alone among my retired friends who want to help.  This group of Georgian friends willing to help is all over the age 60.  People over 60 have a greater chance of developing more severe symptoms should they get the virus than people under 60 (now that age has dropped to age 50).

We, those of us retired and over 60, can still help without putting ourselves at an unreasonable risk.  The patients typically being admitted to hospitals requiring respiratory support doesn’t go away because there is a new virus to handle.  The workload does increase.  Those therapists willing to come out of retirement during this period when they can supplement today’s work staff can handle the seasonal usual load of people needing respiratory support.  This way, currently employed therapists can focus on the covid-19 patient needs. In fact, there are all sorts of activities where ex-retirees could support the current body of respiratory therapists.

I’ve contacted staff members of the Georgia Composite Medical Board for help.  I’ve asked they approach Governor Kemp and request a waiver of CEUs for six months and allow inactive licenses reinstated for those therapists, previously in good standing, to help.

I was told I needed to complete and submit a stack of forms, supply letters of recommendation from my “medical director” and proof of 30 hours of continuing education.  My suggestions to Governor Kemp seem to been lost, unread or considered then rejected.

I’ve got the reinstatement forms. The forms have been set aside – worthless without 30 hours of continuing education units (CEUs).  I’m working on CEUs.  The medical director form and signature is the Catch-22.  The medical director attests to my skills as a respiratory therapist – someone familiar with my work.  You have to be working in order for a medical director to assess your skills.  You can’t work unless you have the form signed and submitted prior to working.

I considered asking a friend, that was a medical director I’d worked with, to help me out on the medical director form.  However, all my friends who were medical directors have retired.  I’m even a retired Chief Clinical Officer, albeit useless in this endeavor.

By the time I pay for, complete and submit the 30 hours of CEUs this covid-19 problem may have a remedy. Still, I’ll work through the process and reactive my license.  When it comes to a medical director’s support I’ll need to look around to discover one that I’ve worked with here in Georgia. (Fortunately, two are still working.  One weeks away from retirement, the other in private practice and may not be a respiratory care medical director – I’ll need to check.)

When all that is complete there is still the $400.00 required to reinstate my license and a $5.00 fee to verify my National Board for Respiratory Care credential. As it turns out reinstating my Respiratory Care Practitioner license in Georgia is not ‘simple.’

4 thoughts on “Respiratory Therapist Trying to Help”

    1. George,

      I’ve completed 3/4 of your credits. I’ll grab the last one later. I took a break from Vapotherm and tried two other sites. Both offered free CEUs. One put me into the loop of infinity as I approached the final exam, the other revealed 2 of the 15 quiz questions and no matter how you work the math 2 out of 15 will never achieve the 70% success required for the credit. I hope GIII is well. David

  1. David, I considered the renewal of my license but do not have the necessary education, the Univ. Chicago program was a certificate program.
    We have not had the serious problem in Savannah and surrounding area but the issue of a lack of ventilators has deeply disturbed me.
    Apparently no one has considered the feasibility of using older model equipment. There must be hundreds of Bennett MA-1 and Bird Mk 7 machines around.
    When I posted on the Savannah page there was a story about 4 patients on 1 vent. Of course they had to receive the exact treatment regardless of need.
    I supported more patients than I care to count with both of the above and even developed the first control to allow the MA-1 to reduce rate down to 1 . I am not looking for credit or praise.
    There are few variants in all parameters currently used that cannot be manually performed with little effort. What is your opinion?
    Possible negative arguments 1. Too old and may fail. Neither is too complicated to easily return to full capability. MA-1 may take a day if stored and has not been run. The Bird can be overhauled in less than an hour and has only 4 moving parts, a couple of o-rings that may need replacement, Engineering probably has them in stock. Bird has no alarms. A Bennett bellows type attachment could collect TV and alarm. Close observation does take time but the sound produced by the Mk-7 when, when disconnected, is a great warning.
    The point, to me, Is almost instant response is available in house for good vent. support. Most hospitals heave this onsite from the equipment storage. If there are several hospitals in an area equipment can be shared.
    The greatest barrier, this should embarrass the staff, if no one can operate the Bird as a vent.
    I used to go to Guyana with a medical mission,there they had the opposite.
    In storage, they had 30-40 state of the art Dental chairs and all the supporting equipment and a smaller number of vents. No one had any knowledge or skills to operate either. They had MK-7’s for treatments and did not use them properly. Training up was impossible i spent hours trying to provide some basics one hour on Resp rate.was easy, and tidal volume was very difficult.
    I was reluctant to approve any for setup,other than a Bird and I did .
    Could there be a reverse situation here no one knows how to use a MK-7?
    If so, this should be easy to correct with any RRT. Please give me your opinion. Should this be perused?
    Thanks for your patience this is not an easy read.
    Will stop here before I confuse myself.
    It is truly good to have a friend and one time colleague who has done so much with your life.
    Kindest Regards, Richard

    1. Hi Richard,

      Sorry for the delay, I’ve not been on this site as often as usual. My extra time has been spent collecting CEU’s.

      Right now we have 395,011 cases of Covid-19 in the US. Most of them, 82% have mild symptoms. If the 18% that need to be hospitalized, 71,101, 5.4% need to be in ICU or 3768. Current numbers per calculation. Does not include the total over time that is higher. Many have been discharged and 12,545 died. These numbers are spread out over the curve.

      Those numbers suggest to me we don’t need all the ventilators at once we’re hearing we need. Our current base of vents, if shifted the way Cuomo did in NY seems to work. Much like we did in Savannah when we needed to borrow vents from one another.

      The last data I read suggests that a much smaller number of patients my need to be intubated. The impact of Covid-19 is on the heme molecule, which is treated with hydroxychloroquine. In fact, a number of physicians are arguing to start hydroxychloroquine early to reduce the impact of the heme disruption – which is reducing the O2 carrying capacity. They are further pointing out that the ventilators are leading to greater occurrence of iatrogenic lung lesions in the Covid population. If hydroxychloroquine is started early physicians are having success keeping patients off vents and supplemental O2 is working. The important part of this therapeutic seems to be early intervention. Vents, they are adding, should only be a last resort. Then, using low VT and no PEEP as the hypoxia is more like CO poisoning and not like ARDS. The ARDS in Covid patients is iatrogenic.

      I don’t think we’ll need more vents. Years ago when I was working on US reserves I recall a much higher number than the 2000 the Federal Government put into service a coupled of weeks ago. In 2010 we had 82,755 vents, full feature, in the US (https://www.ncbi.nlm.nih.gov/pubmed/21149215). In addition there are 98,000 less advanced ventilators (http://www.centerforhealthsecurity.org/our-work/events/2018_clade_x_exercise/pdfs/Clade-X-ventilator-availability-fact-sheet.pdf) That’s 180,775 vents. I think the folks posting MA-1s and Birds are trying to create alarm. I am disappointed that I haven’t seen a PB – PR2.

      As far as you and I being able to help I starting to believe we won’t be needed. Still, I am collecting CEUs – which is mind numbing. 1/3 of the online CEU programs won’t work for me (for instance, one program only ever presented 2 of the 15 questions for the final). The CEUs offered by manufacturers are free but there is still a price –75% of the time they are so bias to be ridiculous. One was downright wrong in places! I know I have the patent on what he was trying to explain.

      Another presenter said “New research has shown, etc..” He was describing a product application that did not exist until 2000. He was showing a slide of his “new research” on muco-ciliary function. That research was completed in 1998 (not by the speaker) – two years before the product was invented! Kolobow and I (NIH) worked on the problem and he published it in Chest in 1995. I built the system at the NIH to help Kolobow with the problem in 1993.

      Believe me I think I feel your frustration. But, I don’t think we’ll need the number of vents the media has been suggesting. At least this is what I am now hoping.

      Here a bottom line: Guys like us probably need to somehow become involved in respiratory care again. Between us we have over a century’s worth of knowledge. We should figure out a way to not let it go to waste. Best regard, David

Leave a Reply

Your email address will not be published. Required fields are marked *