From Day One

Respiratory therapists work to wean patients from ventilator care

As one might expect, a health profession that is central to the care provided at Rockcastle Regional's Respiratory Care Center is the respiratory therapists, or RT.

Fifty-five respiratory therapists currently staff the center, which at 143 beds, is the largest freestanding ventilator care center in the nation. Its patients, due to illness or injury, depend on mechanical ventilators to breathe. 

At a long-term care center such as Rockcastle's, one of a respiratory therapist's main duties is to manage those ventilators, a task for which they are clinically and didactically trained. They determine the appropriate settings on the ventilator to keep the patient breathing, and they play a critical role in the weaning process.

"Weaning is the goal," said Jeff Smithern, director of respiratory therapy at Rockcastle. "That's what we are always striving for, and it starts as soon as they come in the door."

When admitted, RTs evaluate patients' ability to generate sufficient pressure for deep breathing and airway clearance, and they do studies to measure oxygen, pH, and carbon dioxide levels in the bloodstream.

If a patient is determined to be a candidate for weaning, RTs are there every step of the way, gradually allowing the patient to breathe independently for increasing periods of time each day.

They also assist with intubations, extubations, and are a critical part of the care team that responds to emergencies such as cardiac or respiratory arrest.

Increased demand for therapists during the pandemic has highlighted a shortage that has persisted for years.

"Recruiting enough RTs to staff the facility is one of our biggest challenges right now," Smithern said. "We could use as many as 25 more RTs right now."

Respiratory therapists must have a minimum of an associate degree from an accredited respiratory therapy education program, and many go on to earn a bachelor's degree.

RTs must pass the Certified Respiratory Therapist (CRT) exam, and most go on to earn their Registered Respiratory Therapist (RRT) credential.

The nearest RT programs are at KCTCS located in London, KY and Bluegrass Community & Technical College in Lexington. 

The laboratory's vital role in patient care

Rockcastle Regional's laboratory provides a vital service to the Respiratory Care Center. Phlebotomists draw patients' blood for testing, while lab technicians are responsible for testing and analyzing specimens. A pathologist diagnoses and characterizes health conditions by examinging those specimens. Rockcastle Regional's laboratory staff of 24 provides daily services to the Respiratory Care Center. The lab recently underwent renovation and equipment upgrades.