Shortage of respiratory therapists

A Saskatoon respiratory therapist says patients are being left in critical condition because of the shortage of workers in his field.

Warren Chykowski, a respiratory therapist (RT) at Royal University Hospital, said he sometimes has to choose between two patients whose conditions both demand top priority, leaving one either to wait, or to be treated by a less-qualified caregiver.

Tempers can flare when delays occur in critical care and Chykowski said he has been yelled at by the physician for not responding immediately.

A respiratory therapist is responsible for keeping a patient breathing by doing CPR, inserting -breathing tubes, performing ventilation and administering oxygen.

They are also specially trained, as doctors are, to take blood samples from arteries in the leg, a more complicated and potentially dangerous procedure than taking blood from the veins, which nurses are trained to do.

RTs work. in emergency wards, intensive care units, operating rooms and pediatric transport.

The work is intense and high stress. A delay or mistake can make the difference between a complete recovery or permanent damage to the patient, .and can even be a matter of life or death.

"Without the tube, they don't breathe," Chykowski said.

"For the major tertiary centre in the Saskatchewan, the RUH, there's only two respiratory therapists on," he said.

"If you don't have the staff you should have, sometimes things are delayed."

He recalls an incident where he was not available to administer oxygen and someone else did it. When asked later why the patient seemed to be ailing, he discovered they were hooked to plain air.

When positions are vacant, remaining workers are called on to work long shifts and on days off.

"The absolute worst times are in summer and around Christmas. People would love to have time off. At some point even management feels sorry for you and gives you a bit of time off but when that happens, we're working short staffed.

"If we get busy, that's when those situations arise."

Professional detachment helps Chykowski cope with patient crises but it doesn't offer much protection from feeling he has failed his fellow caregivers.

"You know sometimes they're disappointed in the service they've given. ...You know it could be performed better. You know if there were staff it would be okay."

It is difficult for health professionals to accept that their team cannot offer the best possible care, he said.

"That's a hard pill to swallow."

Respiratory therapy is one of 11 occupations evaluated by a market supplement review committee of employers.

The committee found a 27 per cent vacancy rate among RTs and agrees that a temporary market supplement is needed to make wages competitive.

The committee found that the shortage caused reduced critical care in smaller centres and resulted in more patients being foisted upon Saskatoon and Regina's "already strained respiratory therapy services."

One of the health districts reported that the shortage jeopardized the pediatric transport program. It was unable to provide RTs to transport critically ill children and newborns. Assigning RTs to the transport team reduced in-hospital services in emergency, intensive care units and surgery.

There is no training program for RTs in Saskatchewan, forcing employers here to recruit trained workers from Alberta, British Columbia, Manitoba and Ontario, where wages are higher.

Employers said workers often left soon after collective agreements providing insufficient salaries were signed in Saskatchewan, or after agreements providing considerably higher wages were signed in other provinces.