One of the biggest hurdles for COVID-19 patients is breathing. Respiratory therapists help make it happen, but the field is dwindling.

They are the people who help patients awaken from sedation and take their first breath.

Often unsung in the COVID-19 crisis, respiratory therapists focus on helping people breathe — job duties include managing ventilation and artificial airways and assessing breathing challenges — and that means they play a large role in the treatment of coronavirus patients.

During normal times, their work ranges from setting up ventilators in a neonatal intensive care unit to helping someone who recently had lung surgery. These days, many are paged to help patients struggling with COVID-19, which impacts the lungs and causes issues ranging from shortness of breath to a need for a ventilator.

“This is a very respiratory virus, and causing the (respiratory therapists) right now to be the tip of the spear here,” said Rush University Medical Center respiratory therapist and associate professor Brady Scott. “We are constantly in these patients’ rooms.”

Even as they are needed to help COVID-19 patients, many respiratory therapists say people don’t understand their role. Meanwhile, the workforce is dwindling. According to the National Board for Respiratory Care, more than 125 million patient visits each year are for respiratory-related illnesses, with an aging population increasing the need. Respiratory therapist jobs are projected to grow, but the number of people entering the field is shrinking, said board CEO Lori Tinkler. COVID-19 has even brought people out of retirement, she said.

“I think it’s primarily an awareness issue,” she said. “Kids in junior high and high school, when they talk about health professions, they’re hearing about nursing, or being a doctor. They’re not hearing about being a respiratory therapist.”

In a situation like treating COVID-19, Tinkler said, “Who’s really taking care of you, who’s right there by your side, is your respiratory therapist.”

Scott said the field has changed in the decades he has been in it, growing from a more mechanical mastering of sophisticated machines to a holistic understanding and assessment of a patient.

“The profession has changed away from a technical-type profession more to a thinking-type profession,” he said. “Now respiratory therapists are required to be critical thinkers.”

Knowing the mechanical piece is still vital. At the height of the spring COVID-19 surge, Rush was using ventilators from the Centers for Disease Control and Prevention’s Strategic National Stockpile, Scott said, which involved operating machines the respiratory therapists weren’t normally using.

“You can pretty much put any device in front of a good (respiratory therapist), and they will make it work,” Scott said.

The coronavirus forced the field to shift and adapt many practices, such as putting a surgical mask on a patient in case they expelled droplets during an airway procedure, or finding ways to keep some equipment outside rooms to limit exposure.

Scott said COVID-19 has been one of the more difficult things he’s experienced because of how sick patients were and how many patients they had. “We were learning each day about how the patients were different,” he said. “One patient in one room was a little bit different than the other.

“Frankly, the novelness of the virus made this a little scary, because you weren’t sure if you were going to get sick or not,” he said. “There’s always in the back of your mind, ‘Did I touch something I wasn’t supposed to?’”

For weeks during the spring, respiratory therapist Damon Myers, 27, would leave a shift at Northwestern Memorial Hospital and head to LondonHouse, where he slept in one of the hotel rooms the city allocated for health care workers who wanted to limit exposure to their families. He wanted to protect his wife, who was pregnant — they have since welcomed twins — and their 7-year-old daughter and 2-year-old son.

About once a week, he would return to their Manteno home, sleeping on an air mattress in a different room. He wore a mask and kept his distance from his children and wife.

“I didn’t know if I was infected,” he said. “I didn’t want to worry.”

Still, despite the risks of staying in patient rooms for lengths often longer than doctors or nurses, the respiratory therapists said they love what they do. They are trained to make breathing easier. “They need help, you help them,” said David Vines, Rush’s chair of the Department of Cardiopulmonary Sciences.

Scott recalled one recent COVID-19 patient experience that has stayed with him. He had assessed a man’s ability to breathe on his own, then suctioned his airways to ensure there were no obstructions. Finally, Scott removed the breathing tube. The man’s first words when he could speak for himself were to thank him.

“I didn’t think I was going to wake up,” the patient said.


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