Under general oversight of the clinical supervisor and manager administers complex respiratory therapy procedures in the evaluation and treatment of individuals with cardiopulmonary functions threatened or impaired by developmental defects, the aging process, physical injury, or disease. The senior respiratory therapist should define through their practice, clinical and professional leadership, advance evidence based practice and mentor others to grow professionally. Employees will adhere to all departmental and UMMC behavioral standards.
Principal Responsibilities and Tasks
The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all job duties performed by personnel so classified.
Working within the defined scope of practice, performs a variety of respiratory care treatments to a specific patient population (adult, pediatric, or neonatal).
Explains treatments to patient and/or family before performing.
Observes and monitors physical signs and symptoms, general behavior, general physical response to respiratory care procedures. Collaborates with physician regarding therapeutic treatment plans to determine whether initiation, modification, or discontinuation of the treatment regimen is warranted.
Terminates patient treatment upon notice of patient discomfort, troubled medical status, or inability to accept treatment.
Participates in Cardiopulmonary Resuscitation (CPR) procedures, including, airway management, manual ventilation, and compression as needed.
Administers therapeutic and diagnostic gases (exclusive of general anesthesia), analgesic agents by subcutaneous injection, bronchodilator treatments, chest physiotherapy, aerosolized medication treatments in accordance with departmental procedures, as directed by a physician. Delivers oxygen and humidified air through a variety of devices to reverse and prevent tissue hypoxia, treat arterial hypoxemia, decrease the work of breathing and decrease myocardial work.
Assists with the non-surgical insertion, maintenance and removal of artificial airways.
Suctions artificial and nasal/oral airways by using a sterile disposable catheter which is inserted into the airway.
Performs age specific respiratory techniques when working the adult/pediatric/neonatal population.
In Critical Care areas, administers mechanical ventilation and Continuous Positive Airway Pressure (CPAP) to critical care patients, adjusts ventilation and CPAP. Collaborates with senior respiratory therapists within the assigned service area.
Evaluates the effectiveness of mechanical ventilation and other therapeutic interventions in the critically ill patient by interpreting chest x-rays, and blood gas results. Monitors patient appearance, respiration rate and oxygen saturation, and notifying doctor as required.
Ensures the effective operation, calibration and maintenance of ventilators (life support systems), pulse oximeters, nebulizers, Metered Dose Inhaler (MDI), oxygen and humidity equipment as directed by the physician in accordance with departmental procedures and standard operating procedures.
Ensures correct ventilator alarms and settings.
Makes an adjustment to ventilator parameters and settings, as necessary, in accordance with patient's response and overall condition of the patient. Guides others in performing the same.
Applies cleaning/sterile techniques or ensures decontamination of equipment essential for optimal operation of the respiratory therapy equipment. Follows protocols and guidelines regarding the disinfecting of equipment.
Initiates and performs maintenance rounds on all types of oxygen and humidity equipment used through the hospital.
Insures that all equipment in need of service is labeled appropriately and sent to biomedical engineering for repair, in accordance with departmental procedures.
Leads in the evaluation of new equipment.
Transports patients both internal and external to the organization.
Documents and reports information on activities related to patient care in accordance with departmental procedures.
Completes all required documentation either on paper forms or within the electronic medical record. Reviews documentation and clinical charges are captured.
Receives and provides a complete hand off communication during shift change for all assigned areas. Works to coordinate a plan for the shift with others assigned within the service area.
Collects data, such as, Arterial Blood Gas (ABG) readings, Electrocardiogram (ECG), Hemodynamics, laboratory values and patient history to fully understand reason for adjusting patient's life support equipment.
Evaluates and interprets arterial blood gas results, basic x-rays, and lab results, and relates them to attending physician.
Documents quality improvement information such as, inappropriate ventilator changes, incident sheets, and equipment failures. Reports to the appropriate manager or Risk Management.
Notifies physician of any problems requiring immediate attention, such as, abnormal blood results, declining ventilation parameters and general clinical condition.
Collaborates with supervisory staff when further direction or clarification is required to maintain all expected clinical practice standards.
Provides clinical guidance and training at the role model level for all respiratory therapists working within the assigned service area. Proactively corrects any variance from expected performance or policy and procedure.
Leads department and interdepartmental meetings and committees
Able to manage shift needs in the absence of a clinical supervisor.
Maintains ability to work outside the normally assigned service area.
Helps to facilitate discussions when called upon to do so.
When we say "our community" we mean it.
UMMC Midtown Campus, one of two campuses of the University of Maryland Medical Center, has had a long history of working to keep our community healthy and has grown to become a trusted teaching hospital for medical and surgical care in Baltimore City.
Located in Baltimore's cultural center near the historic Mount Vernon neighborhood, UMMC Midtown Campus is a 180-bed, community teaching hospital with a focus on helping people manage chronic diseases, including diabetes, hypertension, pulmonary conditions, and infectious diseases.
Education and Experience
An Associates Degree is required. A Bachelors Degree is preferred.
Registration by the National Board of Respiratory Care as a Respiratory Therapist (RRT) is required. Registered in pulmonary function testing (RPFT) required when staffed fulltime in the pulmonary diagnostics division.
Licensure as a Respiratory Care practitioner by the Maryland Board of Physician Quality Assurance is required.
CPR certification is required. ACLS or PALS certification is required (defined by area of clinical focus).
Adult Critical Care Specialist (ACCS) or Neonatal Pediatric Specialist (NPS) credentials required.
Two years' experience as a Registered Respiratory Therapist in a critical care environment is required.
Knowledge, Skills and Abilities
Advanced knowledge of anatomy and physiology of the respiratory system, biology, microbiology, technical mathematics, and pharmacology are required. Proficient knowledge of medical terminology and operation and use of standard respiratory equipment and supplies, such as, various types of ventilators, nebulizers, aerosol masks, nasal cannulas, mist tents, oxyhoods and other oxygen delivery devices.
Frequently leads educational programs and proactively works to enhance the professional growth of the respiratory therapy staff. Helps lead departmental competency initiatives.
Knowledge of respiratory diseases and standard treatments in order to assist in training employees. Knowledge of respiratory procedures (auscultation, administration of bronchodilators), respiratory surgical procedures, x-ray and arterial blood gas interpretations, and lab result analysis.
Leadership quality verbal and written communication skills are necessary in communicating with patients, doctors, respiratory staff and nursing staff throughout the medical system, and in maintaining accurate and complete documentation of testing procedures.
Ability to draw arterial blood from the artery and evaluate blood-gas results.
Ability to determine quality of patient performance, judge degree of patient discomfort or failing medical status, and the inability of patient to perform during treatment process. Assures respiratory therapist not as familiar with a give service area, are comfortable and have the necessary support and guidance to function proficiently.
Ability to demonstrate knowledge and skills necessary to provide care appropriate to the patient population(s) served. Ability to demonstrate knowledge of the principles of growth and development over the life span and ability to assess data reflective of the patient's requirements relative to his or her population-specific and age specific needs.
Participates in and frequently leads departmental committee structure and special projects.
Maintains the required continuing education credits and attends professional conferences as defined by department policy. Constructs and leads educational programs and materials.
Looks for opportunities to publish abstracts or professional papers in accordance with IRB requirements. Assists the respiratory therapists in the same.
Actively seeks opportunities to be involved in professional activities both internal and external to UMMC. Works with state and national respiratory care professional associations.
The Senior Respiratory Therapist (RRT) works within the RCP 3 and RCP 4 level of the department's professional advancement model.
The Respiratory Therapist ensures patient safety in the performance of job functions and through participation in hospital, department or unit patient safety initiatives.
Takes action to correct observed risks to patient safety.
Reports adverse events and near misses to appropriate management authority.
Identifies possible risks in processes, procedures, devices and communicates the same to those in charge.
Assists the clinical supervisors in the continued preparation of all standards required to assure successful TJC certification.
The University of Maryland Medical System (UMMS) was created in 1984 when the state-owned University Hospital became a private, nonprofit organization. It has evolved into a multi-hospital system with academic, community and specialty service missions reaching every part of the state and beyond. UMMS is a national and regional referral center for trauma, cancer care, neurocare, cardiac care, women's and children's health and physical rehabilitation. It also has one of the world's largest kidney transplant programs, as well as scores of other programs that improve the physical and mental health of thousands of people daily. The hospitals and health systems that comprise UMMS are: University of Maryland Medical Center, University of Maryland Medical Center Midtown Campus, UM Rehabilitation and Orthopaedic Institute, UM Baltimore Washington Medical Center, UM Capital Region Health, UM Charles Regional Medical Center, UM St. Joseph Medical Center, UM Upper Chesapeake Health, UM Shore Regional Health, Mt. Washington Pediatric Hospital and UM Community Medical Group.