June 9, 2021

Respiratory Therapy: Bucking A Trend

Central, Rural Health

Respiratory care services are vitally important for people living with chronic respiratory diseases, such as COPD. And people living in rural communities have a higher COPD prevalence rate (12%) compared to people living in other communities in the U.S. (7%), according to a report from the University of Minnesota Rural Health Research Center. Despite this, it’s less likely that critical access hospitals in America offer respiratory therapy services compared to rural and urban hospitals. At CentraCare, three of its critical access hospitals – Carris-Redwood, Monticello and Paynesville – are bucking this trend by offering respiratory care services on site.

Partnering and perspectives

Lynn Sieben, Respiratory Therapist (RT), joined the CentraCare-Paynesville team about three years ago to provide these important services. “We have patients we are keeping here now that we would have previously had to send to other facilities, which feels great,” said Sieben. “I’m the only RT on staff in Paynesville, so it was a learning curve for all of us.” Collaboration has been a big reason for the early success. “A large part of my work is partnering with nurses to train them and expose them to treatments and equipment that are vital,” said Sieben.

We have patients we are keeping here now that we would have previously had to send to other facilities, which feels great.

Lynn Sieben, respiratory Therapist

Heather Holzer, Nursing Manager of Med/Surgery in Paynesville, says the partnership is working. “In a critical access hospital, nurses have to be knowledgeable in a lot of different areas because we don’t focus on one specific area,” Holzer stated. “Having respiratory therapy here has helped us really advance our care. We’re identifying patients who are more critical than they initially appear before they need intubation, and we’re doing interventions sooner. I think we’ve come a long way from that perspective.”

COVID’s impact

Having respiratory therapy capabilities has been crucial during the pandemic, especially since COVID is such a respiratory-driven disease. “It’s hard to put the whole experience into words,” said Sieben. “The feeling of seeing those first patients struggle, and then our coworkers struggling, and then our family members being affected was really difficult.”

“When the pandemic started, it felt like we were going into the unknown,” said Holzer. “We quickly learned a lot about the best ways to treat patients and to use different equipment, so looking back, there was a ton of knowledge gained.”

One of the treatments that proved to be highly effective is the use of Airvo, a form of high-flow nasal oxygen therapy. This method augments the breathing process so that patients don’t have to fully pull in their breath. The patient isn’t intubated, so they can still talk, yet 100% oxygen can be flushed to support their breathing needs. “We were fortunate to have four Airvo units in Paynesville, and there were times we had all four in use,” said Sieben.

Stepping up

Sieben says the entire team is embracing collaboration with respiratory therapy. “I was working with one patient, using the Airvo unit, and Dr. Christopher Anderson came over and wanted to understand everything I was doing. He was on call that night and wanted to make sure he was prepared for the overnight. He opted to sleep in the lounge so he could check on the patient every hour and make adjustments, if needed. By morning, the patient was off the machine and doing better.”

The last year has been tough on everyone, but Sieben says that nursing and respiratory therapy have each other’s back and appreciate one another. That appreciation was on display in October when Sieben was called down to the ER and told she was needed immediately. “I ran into the room and all the nurses were standing there with flowers and a gift certificate and a cake for me because it was Respiratory Care Week,” said Sieben. “It was the sweetest thing ever and it made me really feel part of the team.”