Clinical rotations are a crucial component of the education and training of respiratory therapy students.
These hands-on experiences allow aspiring respiratory therapists to apply their theoretical knowledge in real-world healthcare settings.
In the context of respiratory care, clinical skills play a pivotal role in shaping competent and proficient professionals.
This article breaks down the essential clinical skills that respiratory therapy students must master during their clinical rotations, emphasizing the practical aspects that are fundamental to their future roles in patient care.
What are Clinical Rotations?
Clinical rotations for respiratory therapy students are hands-on training sessions in healthcare settings where students apply their classroom knowledge to real-world situations. Under supervision, they interact with patients, learn to use medical equipment, and develop diagnostic and therapeutic skills crucial for a successful career in respiratory care.
Required Clinical Skills for Respiratory Therapy Students
- Master Medication Recommendation and Delivery
- Understand Infection Control Guidelines and Standards
- Master Medical Charting and Documentation
- Learn About the Sternum Abnormalities
- Identify Key Signs and Symptoms
- Understand the Impact of Spinal Abnormalities on the Respiratory System
- Perfect the Art of Chest Palpation and Inspection
- Interpret the Different Percussion Notes
- Master the Art of Using a Stethoscope
- Understand Diverse Respiratory Patterns
- Recognize the Implications of a Patient’s Blood Pressure
- Evaluate a Patient’s Work of Breathing
- Understand the Importance of a Patient’s Pulse Rate
- Grasp the Importance of a Patient’s Body Temperature
- Become Proficient in Operating a Mechanical Ventilator
1. Master Medication Recommendation and Delivery
Respiratory therapy often involves the precise administration of various medications, either to maintain lung function or treat underlying conditions.
It is imperative for respiratory therapy students to understand the pharmacodynamics and pharmacokinetics of these drugs.
This means not only knowing how to deliver medications using devices like nebulizers or inhalers but also recognizing appropriate dosages, potential side effects, and contraindications.
Mastery in this area ensures that patients receive the correct medication in the most effective manner, maximizing therapeutic benefits while minimizing potential risks.
2. Understand Infection Control Guidelines and Standards
Infection control is paramount in respiratory therapy, given the direct interface with patients’ respiratory systems.
Students must familiarize themselves with both hospital-specific and general infection control standards, including the proper use of personal protective equipment (PPE), sterilization of equipment, and hand hygiene techniques.
An understanding of these guidelines ensures patient safety, reduces the risk of hospital-acquired infections, and protects the health of the respiratory therapist and other healthcare professionals.
3. Master Medical Charting and Documentation
Accurate and timely charting is a cornerstone of healthcare, ensuring continuity of care and providing a clear record of patient interactions and treatment progress.
Respiratory therapy students must learn to meticulously document their assessments, interventions, and observations in the patient’s medical record.
This includes noting vital signs, medication delivery, patient responses, and any changes in the patient’s condition.
Mastery of medical documentation ensures that all members of the healthcare team are informed and aligned in their approach to patient care and that a clear historical record is maintained for future reference.
4. Learn About the Sternum Abnormalities
The sternum, or breastbone, plays a critical role in the respiratory system as it anchors the ribs and provides structural integrity to the thoracic cavity.
Respiratory therapy students need to be acquainted with various sternum abnormalities, such as pectus excavatum (sunken sternum) and pectus carinatum (protruding sternum).
Recognizing and understanding these abnormalities is essential because they can affect lung function, respiratory mechanics, and overall cardiopulmonary health.
By understanding these conditions, respiratory therapists can tailor interventions and therapies to address individual patient needs.
5. Identify Key Signs and Symptoms
In respiratory therapy, the ability to identify and interpret key signs and symptoms is crucial.
This includes recognizing symptoms such as dyspnea (shortness of breath), cyanosis (bluish discoloration of the skin due to lack of oxygen), wheezing, and other manifestations of respiratory distress or failure.
By quickly and accurately identifying these signs, respiratory therapists can initiate timely interventions, potentially preventing complications and ensuring optimal patient outcomes.
Students must be trained to differentiate between various clinical presentations and understand their underlying causes to provide the most effective care.
6. Understand the Impact of Spinal Abnormalities on the Respiratory System
The spine’s alignment and structure can significantly impact the respiratory system.
Conditions such as scoliosis (a lateral curvature of the spine) or kyphosis (a forward rounding of the back) can reduce lung capacity, impede airflow, and compromise respiratory function.
Respiratory therapy students must understand how these and other spinal abnormalities influence breathing mechanics.
By recognizing the interplay between the spine and respiratory system, respiratory therapists can develop appropriate therapeutic strategies, adjust ventilatory support settings, and educate patients on how to optimize their respiratory function in the context of these conditions.
7. Perfect the Art of Chest Palpation and Inspection
Chest palpation and inspection are fundamental physical examination techniques in respiratory therapy.
Through palpation, respiratory therapists can detect abnormalities like crepitus (a crackling feel under the skin due to the presence of air), or assess chest wall movement and expansion during breathing.
Inspection involves visually examining the chest for deformities, symmetry, skin color, and respiratory patterns.
Mastery of these skills enables the respiratory therapist to gather vital information about the patient’s respiratory status, identify potential issues, and formulate appropriate therapeutic interventions.
8. Interpret the Different Percussion Notes
Percussion is a diagnostic technique used to determine the underlying character of thoracic structures by tapping on the chest wall.
Different areas of the chest will produce distinct sounds based on what lies beneath—whether it’s air-filled lung tissue, solid organs, or fluid.
Recognizing and interpreting these various percussion notes, such as resonance (normal lung sound), dullness (indicative of solid mass or fluid), or tympany (hollow, drum-like sound), is crucial.
This skill helps respiratory therapists differentiate between healthy and abnormal areas, aiding in the diagnosis of conditions like pneumonia, pleural effusion, or pneumothorax.
9. Master the Art of Using a Stethoscope
The stethoscope is an indispensable tool in respiratory care, allowing RTs to listen to breath sounds and heart rhythms.
By mastering auscultation, respiratory therapists can identify normal breath sounds and detect abnormal sounds (like crackles, wheezes, or rhonchi).
Understanding the nuances of these sounds and their implications for respiratory health is essential.
Therefore, the mastery of stethoscope use not only aids in diagnosing various respiratory conditions but also helps in monitoring the effectiveness of therapeutic interventions and detecting potential complications early on.
Balancing acoustic performance, durability, and affordability, this stethoscope is our top recommendation for a wide range of healthcare professionals.
10. Understand Diverse Respiratory Patterns
The rhythm, depth, and rate of a patient’s breathing can provide invaluable insights into their respiratory health and overall physiological status.
Respiratory therapy students must become proficient in distinguishing between various respiratory patterns.
For instance, tachypnea (rapid breathing), bradypnea (slow breathing), hyperpnea (increased depth of breathing), and Cheyne-Stokes (a cyclic pattern of breaths followed by a period of apnea) can all indicate different underlying conditions or disturbances.
Recognizing these patterns early and accurately can guide clinical decisions, prompt further diagnostic tests, and determine the course of therapeutic interventions.
11. Recognize the Implications of a Patient’s Blood Pressure
While blood pressure primarily provides information about cardiovascular health, its relationship to respiratory function cannot be ignored.
Respiratory therapy students should be trained to understand the implications of blood pressure values on respiratory status.
For instance, elevated blood pressure might be seen in patients with hypoxemia, while low blood pressure could indicate shock or sepsis, both of which can compromise respiratory function.
By correlating blood pressure readings with other assessments, respiratory therapists can better gauge the severity of a patient’s condition and anticipate potential complications.
12. Evaluate a Patient’s Work of Breathing
Work of breathing refers to the effort required to inhale and exhale.
Respiratory therapy students must learn to evaluate this finding, as increased work of breathing can be a significant indicator of respiratory distress or impending failure.
Key signs to observe include the use of accessory muscles (like the neck muscles), nasal flaring, retractions (inward movement of the chest wall during inhalation), and paradoxical breathing patterns.
By assessing a patient’s work of breathing, respiratory therapists can determine the need for interventions such as supplemental oxygen or mechanical ventilation and monitor the effectiveness of ongoing treatments.
13. Understand the Importance of a Patient’s Pulse Rate
The pulse rate (i.e., heart rate) offers critical information about a patient’s cardiovascular and respiratory health.
An elevated pulse rate can indicate reduced oxygen levels in the blood, potentially stemming from respiratory issues.
Conversely, a notably low pulse rate might suggest issues like hypoxia or certain drug effects.
Respiratory therapy students must comprehend the intricate link between pulse rate and respiratory function, recognizing that changes in one often reflect disturbances in the other.
Monitoring and interpreting the pulse rate aids therapists in making informed decisions about respiratory interventions and gauging a patient’s overall stability.
14. Grasp the Importance of a Patient’s Body Temperature
Body temperature can directly and indirectly impact respiratory function.
Fever, resulting from infections, inflammation, or other conditions, can increase metabolic demand and consequently respiratory rate.
Conversely, hypothermia can depress respiratory drive.
Furthermore, certain respiratory conditions, like aspiration pneumonia or atelectasis, might present with fever as a primary symptom.
For respiratory therapy students, understanding the implications of body temperature variations is essential.
This knowledge enables them to anticipate respiratory changes based on temperature, identify potential respiratory complications, and guide therapeutic approaches.
15. Become Proficient in Operating a Mechanical Ventilator
Mechanical ventilators are lifesaving devices used to assist or replace spontaneous breathing in patients who cannot breathe adequately on their own.
Respiratory therapy students must acquire expertise in operating these machines while understanding their various modes, settings, and alarms.
This includes grasping concepts like tidal volume, positive end-expiratory pressure (PEEP), and inspiratory-to-expiratory ratios.
Additionally, they must be adept at assessing a patient’s need for ventilation, making timely adjustments based on the patient’s condition, and recognizing potential complications like barotrauma or ventilator-associated pneumonia.
Proficiency in mechanical ventilation ensures that critically ill patients receive optimal respiratory support, minimizing risks and maximizing recovery potential.
Final Thoughts
Clinical rotations play a pivotal role in shaping the competence and readiness of respiratory therapy students.
The skills acquired during these rotations are not only essential for providing high-quality patient care but also for ensuring the safety and well-being of individuals with respiratory conditions.
As respiratory therapy continues to evolve in response to the ever-changing healthcare landscape, the importance of the skills learned during clinical rotations remains undeniable.
The required 600 hours of clinical experience help prepare students to become skilled and compassionate respiratory therapists who make a meaningful impact on the lives of their patients.
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), 2020.
- “Must-Have Skills for New RTs.” AARC, 7 Aug. 2019.