(soft guitar music)
- Hello everyone.
And welcome to The Wrap,
brought to you by Michigan Medicine Headlines.
I'm Dan Ellman with the department of communication.
Today, I'm gonna be joined by two respiratory therapists
who are carrying out vital work
on the front lines of patient care.
Before they join us, be sure to get caught up
on any episode of The Wrap you may have missed.
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Episodes they debut each week,
and could also be found as part of the headlines
we can review.
With that let's bring in two important team members.
First, can both of you introduce yourselves
and tell us your roles at Michigan Medicine?
- My name is Scott Cox.
I am a clinical specialist on the education team,
at Mich Children's Hospital.
- How are you doing everybody,
my name is Tom Nemeth,
I'm a respiratory therapist,
a newly appointed supervisor
at Michigan Medicine for respiratory therapy once again.
- Great, well thank you so much for being here.
Now many people may have heard of respiratory therapists,
but they may not be sure exactly
what it is your teams do on a daily basis.
On a very broad level,
what type of work do respiratory therapists carry out?
- Do you want me to start, Tom?
- Go right ahead my friend, take it away.
- I think on a broad level,
most people associate respiratory therapists
with breathing treatments.
Every time I've mentioned respiratory therapy,
people are like,
oh, you delivered the breathing treatments,
we do, it makes a very small percentage
of the work we actually do
within Michigan Medicine.
So some of the other things we're involved with,
obviously running life support,
so ventilators CPAPs, BiPAPs,
delivering specialized medical gases,
transports, tracheostomies,
bronchoscopes, a whole multitude of other things.
I'll let Tom, it's more in there.
- We're there for cardiac and renal support as well.
I will do a lot of cardiac output tests
and a lot of other tests
that just show how well people are,
how organ systems are working, whether it's brain renal,
heart failure, we're always, there's so much things
that affect your breathing.
So we have to be aware of what affects
your breathing for just about everyone there.
- Yeah, absolutely.
Now more specifically with regard to COVID- 19 patients,
what sorts of things are you doing to help on the floors?
- So on the floors,
obviously we were just doing mainly treatments,
high flow oxygen delivery.
Tom and I mostly,
I believe work in the ICU and that,
so some of our main support would be,
life support system ventilators.
Turning patients over to longterm,
so that would involve a tracheostomy as longterm care plans,
things like that, that's all.
- I would say our role really change.
Unfortunately, there's a lot of sick patients
that are in the hospital
and they still need a ton of types of ventilatory care.
So you have either COVID
or non-COVID positive patients.
We still have to deliver aerosol therapies,
not invasive ventilatory support,
invasive ventilatory support, it doesn't change.
It's just the hazard of possibly catching
or passing along COVID is now in that mix.
- So when you're taking that all into account
and sort of the hazards,
and I know you're wearing PPE and all that type of stuff,
what does a typical day look like for you right now?
- Again, it really doesn't change.
It's a very fast paced, changing environment.
It just goes day to day what could happen.
I mean, I know when me and Scott started
in the Recue originally,
it just changed dramatically every single day,
as far as what we found out,
whether we found out turning patients on their stomachs,
helped with their oxygenation status
or patients didn't have secretions,
or we found out patients
had a lot of problems with clotting.
So we had to add heparin into their treatment therapy.
It's just something we learn every single day
with these patient populations.
So it's an ever changing environment.
- I believe we all had some ideas
of what this patient population
would look like when they would come here.
And then when they got here,
it was kind of like, okay, we need to do
some on the fly adjustment here,
things aren't spelled out exactly the way
that we, they thought we would be.
So, it's kind of on the job manipulation
of your normal therapies,
trying some different things
that you kind of think might work in,
just through trial and tribulation,
just figuring out the path
that's gonna be best for each specific patient so.
- What would you say
is the most challenging aspect of your work?
- Personally for me,
it's just keeping everyone safe
and not, making sure we don't pass it to the next person.
'cause there's still a lot of patients in there
that do not have COVID-19.
So we, if we go to a one patient
that does have it,
and then we might have a rapid response
or a code somewhere else that we have to respond to
and they definitely won't have it
maybe beyond the floors, general care
that's not ICU status.
You don't wanna pass it along to somebody
that's already having other issues.
So just containing the virus within even the facilities,
is very easy to pass along.
- I think another thing is just the overall numbers
that we see.
So obviously, this is a much higher patient census
than we would normally see in our ICUs and that,
so that is a major point.
And then just to piggyback off time,
I feel like the highest anxiety with everyone working
within the ICU is with these type patients
is just contaminating yourself
or contaminating someone else.
So just going through those PPE processes
and staying away from distractions and things like that
I think is the most important part of working there.
- You can't take any shortcuts, right?
- Yeah, you can't be distracted
that's for sure.
- Now when you talked about
sort of the patient census and what would you say
is sort of a typical number of patients you're working
with in a shift?
- The unit I work on right now,
which is the Recue, we probably have,
I think right now, we're probably running
about 30-some ventilators in this section we're at,
but we have, probably a good 50, 60 patients probably
up in the units there.
- It's definitely a lot just like Scott said,
it's not our typical ventilator amount
that we're used to.
I know some therapists they went through the H1N1 phase,
where we did have a lot more of ventilators.
And I obviously wasn't part of that phase.
I was still in high school when that was going around.
I was partially part of the mass space when I arrived
but we didn't have a spike like this.
So I know we're running currently
over a hundred ventilators through both sides.
And that's definitely a lot more,
we're usually in the 50, 60, 70 numbers in that season.
So it's a big deal,
but everyone's been handling it very well.
University is very, very focused on keeping everyone safe
and trying help as many people as possible.
We've definitely taken a lot
of patients from outside facilities.
- I think that streamlines perfectly into my next question.
'cause we've talked a lot
about some of the challenges you guys face,
but there's also been an incredible amount of teamwork
and compassion put on display, over the past few weeks.
Can you talk about sort of some
of the more uplifting aspects of the work
that you're performing right now?
- I think, from my standpoint,
mainly I work with pediatric neonatal patients.
So there was a major shift for us,
going back to adult type respiratory care.
So going up into the unit, which these are all floors
that were used too,
now this has turned into a COVID Recue unit,
integrating with adult RTs,
adult nursing, totally different
anesthesiology medicine teams.
It just took a lot of transition phase for us.
But one thing I will say is, we have felt totally supported,
we have felt totally a part of everything.
And, I really feel good about what we've done up
in the Recue there
and I feel like we are giving the patients the best care
that we could possibly give.
- I totally agree.
I mean, we see miracles every day.
We're watching these patients be extubated
that probably not to say the other hospitals
aren't working hard, but we see a lot of sick people.
We even had an ECMO patient
that recently was able to come off the ventilator,
which is fantastic.
So just the idea of all these teams coming together,
we're even doing team nursing.
I mean, these nurses have never worked
with ICU level patients before,
but are working with a team just
to kind of manage all these patients
that are coming around.
It's an incredible amount of work and stress
and everyone's doing their best.
And it's amazing just to see anesthesia,
pulmonary, medicine, surgery, all coming together
to make sure that we can take care
of this huge patient population.
- That's so great.
- Now to close out the conversation
for each of you can answer this.
What is sort of the one thing
you would want people to know about the work you
and others are doing on the front line of patient care?
- I think one of the biggest things
is just to know that respiratory therapist,
we're working together as a group,
we're doing a lot more
than just providing breathing treatment.
We're providing life support,
but we're having to kinda learn on the fly,
these new illnesses and that,
and how to properly take care of patients on it.
- Just overall, everyone to be patient
because this isn't something
that's gonna go away just like every virus,
it goes back overseas, Australia, China, it gets mutated.
And especially if this virus, it's not your typical virus,
it mutates and jump species to species barrier.
We've seen a do it now four times now,
and we're not gonna wanna make a vaccine for it right away.
So for everyone just be patient,
to understand that the health system
is completely overwhelmed.
We've seen it now with Beaumont, Henry Ford,
everyone's taken the hit financially and just personally.
And I know it's a super stressful time,
but just for everyone to be patient,
'cause we are gonna get through this, we're all strong.
We can all come together like we are doing,
and it is working.
We've seen the curve, we've seen the plateau now,
this is what we want, this is what we need.
'cause we don't want everyone getting sick.
We've lost, I personally lost family members now to this.
So we all just need to be very careful with this disease.
- Well, thank you so much to both of you,
for your perspective on this
and your perspective from the front lines.
If you wanna learn more about the work going on,
surrounding COVID-19,
Headlines had a plethora of features this week,
for instance, readers learned
about the organization's first patient,
a double lung transplant recipient, who is now home
and doing well, security also shared
how they are keeping the health system safe.
Employees describe some of the most heartwarming moments
they've seen at the hospital.
And those working from home gave colleagues tips
and how to best meet new challenges,
while working to flatten the curve.
For those stories and more, go to mmheadlines.org,
that's mmheadlines.org.
All right, it's time for the weekly trivia contest.
Last week, we asked listeners to name one
of the four high reliability universal skills
that are currently helping employees
at the Academic Medical Center.
Congratulations to Dr. Gregory Dallek
who sent in STAR,
an acronym that will help you remember
to stop think act and review.
Dr. Dallek, a member of the department
of communication will be in touch
to help you claim your prize.
Now for this week's question,
physician assistant Cecile Hollinshed,
recently created photo mosaics of employees
who work in which department,
once again, physician assistant Cecile Hollinshed,
recently created photo mosaics of employees,
who work in which department?
You can find the answer in this week's headlines story,
about moments that matter.
And once you know it, send it to headlines@med.umesh.edu,
for the chance to win a prize.
And everyone who sends in the correct answer,
will automatically be entered into a raffle
to win an Amazon Echo.
Thank you, Scott and Tom for being here,
it's all the time we have for this week.
And thank you to all of our viewers
and listeners for everything you do for patients,
families, and each other.
We'll see you next week.