Unsung health care heroes

Respiratory therapists play a crucial role working with patients who have acute respiratory illnesses like COVID-19. Darlene Baldaro, Professional Practice Leader for Respiratory Therapy and Clinical Respiratory Educator at North York General Hospital, explains more about what respiratory therapists do and why they are especially important right now.

On a daily basis, respiratory therapists care for patients ranging from newborns to the elderly. They work in all clinical environments, including labour and delivery, the neonatal intensive care unit (NICU), the paediatrics unit, the emergency department (ED), the operating room and the intensive care unit (ICU). We help patients with breathing difficulties who require oxygen therapy, intubation (insertion of an artificial tube into the trachea) and life support called ventilators. We are also essential members of the Critical Care Response Team here at North York General.

COVID-19 is a respiratory illness that affects the breathing system, so on top of treating our usual patients who come in for different reasons, we are now regularly caring for patients with suspected or confirmed COVID-19. Although patient volumes have certainly gone up, with more patients requiring intubation and ventilation, we have increased our staffing to help manage these numbers.

While most patients with suspected or confirmed COVID-19 may experience only mild symptoms, some experience low levels of oxygen and may progress to pneumonia. For these patients, we work with the emergency team, Critical Care Response Team and intensivists to decide whether to intubate and put them on life support. If the patient is put on life support, we ensure the patient’s breathing is well managed on the ventilator. When signs of illness show improvement, we start to gently wean them off of the ventilator.

The procedures that respiratory therapists are involved in are called aerosol-generating medical procedures, which are classified as high-risk in terms of infection prevention and control. This means we often wear enhanced personal protective equipment (PPE) like N95 masks to ensure we stay safe and don’t transmit or contract any infections. If we remove the sense of anxiety and newness surrounding COVID-19, we realize we’re essentially doing what we’ve always done.

Thanks in part to community PPE donations, we currently have an adequate PPE supply. However, these donations continue to be essential so the supply remains this way.

Besides my heartfelt gratitude for community PPE donations, there is so much that I am thankful for right now. I’m grateful to work in a hospital that is well prepared to manage this crisis, has an incredibly supportive leadership team and has a knowledgeable team of experts who consistently provide timely and accurate information. I’m also thankful for my amazing team and for the outpouring of appreciation from the community, such as the messages outside of the hospital that inspire confidence in us as we gear up for the day ahead. As well, I appreciate coming home everyday after a long day at work to such a supportive family who has been pitching in by doing things like grocery shopping and preparing meals that I don’t have time to do.

Finally, I appreciate the media’s use of inclusive language like “health care providers”, “health care professionals” and “frontline workers”. I think this is so important because when one profession is recognized over another, it can make people forget that a whole team of professionals is caring for patients. Respiratory therapists are an integral part of that team, and we simply couldn’t get through this pandemic without the expertise and support of each other as a health care team.