Respiratory Therapy Clinicals: Making it Count

Picture of a respiratory therapist and patient

Respiratory therapy school is hard.  The schedule is tight.  The material is demanding.  The skills lab makes you want to vomit…and if that isn’t enough, you also have to survive clinical rotations.  You are tired and emotionally drained when you realize you are going to have to rise up at 5am and be prepared to masquerade as a professional in a hospital you’ve likely never been to, under the watchful eye of an instructor who is evaluating your every move.  

I am that instructor and I have some advice for all of you.

First and foremost, you are going to need to be positive.  Your instructors know how hard the program is, we all graduated from one.  We know the herculean task of trying to focus on your studies while still holding down a job and, for some of you, juggling the kids and a personal life.  (Let’s face it, what personal life?), BUT, you absolutely cannot stroll up into your clinical rotations and spend the entire day complaining about it.  I know, I know, the terms “happy” and “respiratory therapy student” may seem like an oxymoron, but, they don’t have to be.  You can refuse to get sucked in to the vortex of negativity and remember that ultimately you want to be a person who changes the lives of others.  Put a smile on your sleepy head and approach your clinicals expecting it to be educational AND enjoyable.  

Once you’ve set your mind to a place of downright gratitude we can chat about first impressions.  When I go to the lobby of my clinical location to greet my new students it takes me about 3 seconds to make an initial assessment about who you are.  With one quick glance I am noting  your body language, your demeanor, the tidiness of your general appearance and whether or not you have arrived on time.  I cannot stress enough the importance of this first impression so here are some tips:

  • Early is “on time”.  Actually, it is much better for you overall if you are very early than it is for you to be late.  In most institutions, the clinical instructor is responsible for treating patients on a chosen unit. When you are late, you run the risk of delaying patient care and irritating your instructor.  My advice to you is to plan for delays in traffic or wrong turns, and remember that once you’ve  joined the ranks as a respiratory therapist you’ll need to arrive early for your shift, so you might as well start now!
  • Next up, appearance.  Students are expected to be clean and well groomed, wearing the appropriate clothing and when required, a clean white coat.  You should be wearing your identification badge, ideally located at the breast pocket of your lab coat.  Hair and nails should be kept clean and neat and a reasonable length. You’re trying to treat patients, not give them “cat scratch fever”.  Lastly, easy on the fragrances.  You may think you smell lovely, but respiratory patients have a funny way of being repelled by perfume and cologne.  Remember, a picture is worth a thousand words, so make sure the image you initially present is representative of the professional you are working towards becoming.
  • Come prepared! RT students headed in to clinical sites should ensure that they have everything they need to set up a successful day.  If it is your first year, there are going to be a lot of words, skills, and pieces of equipment that you have never heard of.  Keep a notebook and pen in your pocket and everytime you come across something unknown, write it down.  Make sure you have a watch with a second hand for recording vital signs, and your handy stethoscope for auscultating your patient’s lungs.  If your particular school requires that you bring any classroom materials, make sure you have them with you.  Someone once said, “Failing to prepare, is preparing to fail”.

So now that first impressions are out of the way let’s talk about surviving the weekly rotations.  Obviously every school, every clinical site, and every instructor will be different but, I think it’s safe to say the following advice will be universal.

  • Be your authentic self!  Don’t pretend to be anything you are not.  That said, if you tend to be the loud, boisterous type – keep in mind you are in an environment of care and thus should remember that your inside voice is much appreciated. Use that inside voice to ask ALL the questions even if they make you sound slightly foolish.  Questions lead to learning. Step up and ask, that’s what we instructors are for!
  • Be aware that you are not the only flock of students roaming the halls with an instructor.  There are nursing students, and radiology students, and medical students too.  Accept now that you are going to feel “in the way”.  It is unfortunate that there are so many people in the medical field who have forgotten the awkwardness of clinical rotations when the staff is rolling their eyes because there are so many people near the nurses’ station and the dietary staff are huffing and puffing while they slalom through bodies in the hallway passing out food trays. Some staffers will greet you  kindly and others will make it clear that they wish you weren’t there.  Just accept it, and try to keep it in your back pocket for a few years from now, when you will be a staff RT and students will need YOUR kindness.  
  • It is perfectly okay to say, “I don’t know.”  Your instructors will be spewing information at breakneck speed – and that can be intimidating.  Anyone who tells you being questioned in front of a patient and colleague is not scary, needs to see a GI doctor, STAT, because they are full of it!  The important thing to remember is that we don’t expect you to know the answers.  However, we do expect you to say that you will look for the information and return with it the very next week.  Saying “I don’t know” shows honesty, and an ability to put your ego aside, two characteristics we all like in a  medical professional.
  • Be afraid, and do it anyway.  Clinical rotations are where you learn the hands-on skills that you will eventually use daily.  Handling your first patient experience might scare the bejesus out of you, but volunteer to go first!  I know that you think you are going to have a nervous breakdown while you are assessing your patient but, every time you do it, you’ll learn something new.  I remember in my first assessment my patient was nearly deaf.  I felt like I was screaming at him… I wasn’t prepared for something like that, but I am glad it happened.  I learned that in my career I am going to deal with more than just respiratory problems. 

Overall, your clinical experience does not have to make you hit the panic button. Like everything else in life it is going to be what you make of it.  Show up, be professional, have careful confidence and a positive attitude and try to gain exposure to every aspect of respiratory care.  Don’t just survive your rotations, make them count! Get in there and get your hands dirty. Your clinical instructors will be your best allies if you give us your best efforts and consistently show us a willingness to learn.  I wish you all the best and expect to see you on the front lines!

About Anne Wandycz BS, RRT-NPS-ACCS 7 Articles
Anne is a staff Respiratory Therapist at Children's Specialized Hospital, Toms River, NJ as well as an adjunct instructor in the Respiratory Care program at Brookdale Community College, Lincroft, NJ.