Respiratory therapy students must learn several skills during their clinical rotations in order to develop into a successful respiratory therapist.
While it’s good to have theoretical knowledge about respiratory therapy, it’s equally important to be able to apply that knowledge in a real-world setting.
That’s why clinical rotations are so important for students – they provide an opportunity to put what they’ve learned into practice.
So what exactly do respiratory therapy students need to learn during their clinical rotations? Keep reading to find out!
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1. Learn How to Recommend and Deliver Medications
During respiratory therapy school, students are required to learn all about pharmacology and different types of medications. However, during clinical rotations, you’ll be expected to know which drugs are appropriate to administer to certain patients.
Is the patient wheezing? Do they have excessive secretions?
Depending on the patient’s symptoms, you’ll need to know which medication will provide relief.
You must learn which drugs to administer, the precise dose, and the appropriate frequency. Hopefully, our guide on airway pharmacology can help.
2. Learn Infection Control Guidelines and Standards
This is an important skill as well. Is your patient in isolation? If so, what personal protective equipment (PPE) should you wear in order to protect yourself and the patient?
Do you know the difference between contact, airborne, and droplet precautions? Again, this is a skill that you must learn.
You should also know what types of equipment are disposable and which ones are reusable. Finally, you should learn the difference between disinfection and sterilization and how to decontaminate reusable equipment.
3. Learn Medical Charting and Documentation
In the medical field, there’s an old saying that goes like this:
“If it doesn’t get charted, it never happened.”
Therefore, you will be required to learn how to document your findings properly within the patient’s medical record. The details of this process can vary by facility, but the underlying principles are the same.
You must develop an understanding of the universal do’s and don’ts when it comes to charting and documentation.
4. Learn About the Abnormalities of the Sternum
This skill comes easy with experience while working as a respiratory therapist. However, as a student, clinical rotations can be a great opportunity to learn how to perform an assessment of the chest and thoracic region.
What do you notice while looking at the patient’s sternum? Does it stick out externally, or does it cave in? What does this mean?
These are things that you must look for as a respiratory therapist, and this is a skill that you will need to develop.
5. Learn to Recognize Signs and Symptoms
What is orthopnea? How about cyanosis? What is digital clubbing? What does it look like, and when a patient has it, what does it mean?
Digital clubbing, for example, is a common finding in patients with COPD and obstructive lung diseases. It is characterized by rounding and enlargement of the fingertips and nail beds.
This is one of the many signs and symptoms that you will need to look for and recognize in your patients.
6. Learn How Spinal Abnormalities Affect the Respiratory System
What is lordosis? How about kyphosis or scoliosis? Do you know what they mean? What are their differences, and how do they affect the respiratory system?
You may not have realized it, but spinal abnormalities can have major a major effect on the cardiopulmonary system.
As a respiratory therapist (or student), you must learn how to recognize these abnormalities and understand their implications.
7. Learn How to Palpate and Inspect the Chest
Chest inspection is a routine skill that is often performed by respiratory therapists. Simply by palpating a patient’s chest and listening to the sounds that are made, you can learn a lot about their condition.
During clinical rotations, you will have the opportunity to develop the necessary skills and techniques for chest palpitation. This is one of the many skills that you must learn as a student.
8. Learn the Different Tissue Percussion Notes
Percussion is the act of contacting the body tissues of your patient. As a respiratory therapist, this typically occurs over the area of the lungs and thoracic region.
But what do the different sounds mean?
What is hyperresonance? How about resonance, flatness, or dullness? You will be required to learn about each sound that is made and what disease it indicates.
9. Learn How to Properly Use a Stethoscope
I’m sure you already have a basic understanding of how to use a stethoscope, but do you know how to do it the correct way?
Can you perform auscultation properly so that the sounds you hear are accurate and reliable?
As a student during clinical rotations, this is the perfect time to master lung sounds and the art of auscultation. This includes investing in one of the best stethoscopes so that you can perform this skill to the best of your abilities.
This is our top-recommended stethoscope for medical professionals.
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10. Learn About the Different Respiratory Patterns
As a respiratory therapist, you must know and learn about all of the abnormal and irregular breathing patterns.
What is tachypnea? How about Cheyne-stokes and Kussmaul’s breathing? What are the causes?
Again, you must be able to recognize the differences between each abnormal respiratory pattern and understand the pathological implications.
11. Learn the Significance of a Patient’s Blood Pressure
What is the normal blood pressure range? What does it mean if a patient has high blood pressure as opposed to having low blood pressure? What are the different treatment types?
You must be able to describe the various factors that influence blood pressure, such as the pumping mechanism, resistance elasticity, and viscosity of the cardiovascular system.
During clinical rotations, you will have the opportunity to assess a patient’s blood pressure and recommend therapy according to their blood pressure results.
12. Learn How to Assess a Patient’s Work of Breathing
What is work of breathing? How do you know if a patient is having difficulty breathing? What are the signs of dyspnea? Is the patient working harder than normal? Are they using their accessory muscles while breathing?
If so, why and what does this mean? How should you proceed?
This is something you will learn and be required to know as a respiratory therapist. During clinical rotations, you will have the opportunity to assess different patients and identify those with dyspnea and an increased work of breathing.
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13. Learn the Significance of a Patient’s Pulse Rate
You will be required to know and understand the normal pulse ranges for both adult and pediatric patients. You must also know the causes of an abnormal pulse and how rhythm and strength play an important role.
For each patient that you come in contact with, you will be required to check their pulse and heart rate.
Therefore, during clinical rotations, you should focus on understanding the common causes of an abnormal pulse rate.
14. Learn the Significance of a Patient’s Body Temperature
What is the normal range for body temperature? What does it mean if a patient is running a fever? How should their treatment methods be adjusted?
If a patient’s body temperature is increased, it could mean that an infection is present.
As a respiratory therapist, these are things that you must consider and act upon when caring for a patient with an abnormal body temperature.
15. Learn How to Operate a Mechanical Ventilator
Last but most certainly not least, you must develop a basic understanding of how to operate a mechanical ventilator. This is, by far, one of the most important skills that is required of respiratory therapists.
For many students, mechanical ventilation is one of the most challenging subjects to learn and understand. This is due to the complexities of the various ventilator modes and settings.
However, one of the most effective ways to master this topic is by working hands-on with ventilator machines during clinical rotations.
Yes, you can (and should) learn the basics in the classroom. But the best way to truly learn how to operate a ventilator is by using it in the real world.
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Final Thoughts
Clinical rotations definitely aren’t easy. And, as a respiratory therapy student, there is a lot that is expected of you.
You will be required to learn each of the skills that are listed for you here in this article. Not to worry, with time and practice, you will get the hang of it.
Yes, clinical rotations are challenging; however, they can also serve as one of the most beneficial ways to learn the information that you need in order to develop into a successful respiratory therapist.
And that, my friend, is what it’s all about.
So, my advice to you is this:
Watch and learn closely and make the most out of an amazing opportunity that is your clinical rotations. Take notes, ask questions, and always volunteer to help out in any way that you can.
Don’t be afraid to make mistakes — we all do! The key is to learn from them so that you can get better every single day.
Thanks for reading and, as always, breathe easy, my friend.
Written by:
John Landry is a registered respiratory therapist from Memphis, TN, and has a bachelor's degree in kinesiology. He enjoys using evidence-based research to help others breathe easier and live a healthier life.
References
- “Clinical Competencies in Advanced Practice Respiratory Therapy Education: Is It Time to Entrust the Learner?” PubMed Central (PMC), 3 Nov. 2020, www.ncbi.nlm.nih.gov/pmc/articles/PMC6986539.
- Goodwin University. “Respiratory Therapist Skills That Employers Look For | Goodwin College.” Goodwin University, 17 July 2019, www.goodwin.edu/enews/respiratory-therapist-skills.
- “Must-Have Skills for New RTs.” AARC, 7 Aug. 2019, www.aarc.org/careers/career-advice/job-search/cn19-must-have-skills-for-new-rts.
- “How Do We Measure the Quality of a Respiratory Therapy Education Program?” PubMed Central (PMC), 2014, www.ncbi.nlm.nih.gov/pmc/articles/PMC4456848.