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Respiratory Therapists are always ready to serve, but they have come front and center during COVID

By Maridith Yahl
NKyTribune health reporter

Respiratory Therapists at St. Elizabeth hospitals are front and center in the fight against COVID-19. Working with patients with breathing difficulties, the rapid spread of COVID has changed how these professionals do their jobs.

The job of a Respiratory Therapist (RT) is ambiguous to a lot of people.

“That’s why anytime I get to talk about what we do it’s really exciting because we kind of fly under the radar. But, we’re still a really important piece of patient care, especially with breathing,” says Niki Kallmeyer, System Respiratory Therapy Manager for St. Elizabeth, RRT- NPS.

She and her team are licensed, specialized professionals. Anytime a person is having breathing difficulties, they are there. But Respiratory Therapists are probably most well known for their work with ventilators or breathing machines. RT’s manage those and collaborate with the physicians.

RTs Brittany Kendall, Niki Kallmeyer and Heather Citrone.

“That’s where we’ve been really crucial with the COVID-19 pandemic and that’s where we’re getting a lot of recognition. We’re such a specialized profession,” Kallmeyer says.

RT’s are at the bedside, managing the ventilators and collaborating with the team. The number of patients who required ventilators because of COVID was challenging she says.

In mid-March so much was coming out about COVID, yet so much was unknown. Every patient entering the emergency room was treated as if they had it. Kallmeyer worked and collaborated with physicians across all departments on their processes. They had to rework their standard of practice to prevent the virus from spreading.

It was challenging reprocessing some procedures. Information was coming in quickly and patients became sick, quickly.

“Those processes to keep us safe, keep other patients safe, was our priority. We did a really good job addressing that very early on and we were extremely proactive,” Kallmeyer says. She is proud to say that no RT on her staff has tested positive for COVID.

Creating new procedures happened quickly and Kallmeyer worked around the clock some days. “Whatever I needed to do to make sure my team had the resources, that was very important,” she says.

Using a system called process mapping, Kallmeyer got out the sticky notes and mapped procedures. “I went to the floors with the doctors and [said], ‘This is our current process, this is what we need to do to keep everybody safe, so I need your suggestions on how this is going to impact our patient care and what we need to do to make sure every patient and provider is safe,’” Kallmeyer says.

She told them where they would re-adjust. “Having them agree in that moment,” was extremely important to Kallmeyer. “Everything was about safety for everybody. That was our number one priority,” she says.

As fast as the information was coming out, she got it to her staff.

“They needed to hear it that quickly because we were getting these patients, one after the other, just at a very rapid pace. Having everybody at the table, on board, and providing that information right on the spot, that was actually a beneficial thing,” she says.

To get information out, she had team meetings every day at shift changes, 7 a.m. and 6 p.m. They had live video conferences with all 110 RT’s, training her staff on new procedures or demonstrating new equipment. With information changing, ensuring they were standardized across the system, 5 hospitals — Covington, Edgewood, Florence, Fort Thomas, and Grant County — was crucial. RT’s are in every department and float across hospitals.

The safety processes changed for COVID will continue. Respiratory Therapists all over and from their national board are saying, “We know this is going to change our profession forever, it is having long standing impacts on safety,” Kallmeyer says.

The pandemic required more staff than normal at Fort Thomas, where all COVID patents were treated. To accommodate this, they moved some staff around. ICU trained RT’s were designated to work there and staff was added. Through all this, Senior leadership were very supportive and accommodating.

The toll this has taken on staff at Fort Thomas was significant. The mental and physical effects of being on everyday was wearing on them.

“Once things reached [a] sustainable [level], giving breaks was necessary,” Kallmeyer says.

It was imperative in supporting them with how exhausted they were. Check-ins and time off will continue because Kallmeyer says this is not over yet.

RT Mike Milliron in a wet suit.

“We are the best team. There was no question. It’s kind of like, it’s just like your Call of Duty, ‘this is why I’m here to help people breathe and whatever I need to do to be there for the patients is what we’re going to do and that requires a little bit more work,’” says Kallmeyer.

The RT’s, nursing staff, and physicians already had a team mentality of helping each other.

“It really speaks to our culture here, but I can’t think of anything more in a time like that where you would need that culture,” Kallmeyer says.

Having that made doing their job that much easier, she says.

One of the physical tolls working in the ICU was wearing what is called a wet suit. Early on, the severity of the virus and contamination of it was unclear. It is a 20-minute process to get dressed and a nurse must be there to help. The RT is fully covered, and PPE is doubled. They cannot use the bathroom, eat, or drink. Because of this, they can only wear it up to four hours at a time. The RT’s needed to come into work physically prepared and hydrated. Imagine trying to do CPR in a suit like that, put in an airway, and turn a patient over. It was physically demanding.

They had RT’s who were familiar and comfortable with wearing the suits designated as workers in the unit. Once the standard recommendations for PPE were put in place, they were able to transition back.

“We’re still working through it,” she says. “We’ve become very adaptable to quick changes, even though health care is pretty fast already,” For her team, adapting quickly was crucial.

Kallmeyer and her team work to help patients breathe easier. When the pandemic hit, it changed their profession’s processes, but did not stop their determination to care for their patients.

Maridith Yahl is the NKyTribune’s health reporter

Thanks to Report for America, with support from the Ground Truth Project, St. ELizabeth Healthcare, Foundation for a Healthy Kentucky and the Douglas G. Martin Foundation. You, too, can support this reporting and other NKyTribune reporting with a tax-deductible donation today. Help us continue to provide accurate, up-to-date local news and information you can depend on.

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