Respiratory Care Practitioner II

Under supervision of a physician experienced in respiratory care, in accordance with policies and procedures approved by the Medical Director, is expected to assume clinical responsibility for specific respiratory care modalities and to adjust or modify therapeutic techniques within well-defined procedures based on a limited range of patient responses.   Works under the general supervision of an administrative supervisor or at the direction of a technical lead to deliver respiratory care services to patients in all areas of the hospital.  Must be able to adapt to the particular area of duty assignment and to perform special duties required by the assignment.  Standards of performance for the area to which the individual is assigned must be maintained.

Special duties may include provision of basic and advanced respiratory care to neonatal and pediatric patients in the intensive care unit and during transport, which frequently requires making rapid decisions and assisting physicians to respond to status changes in neonatal and pediatric patients.

Special duties may include performance of a variety of diagnostic tests of the cardiopulmonary system and to determine the effect of disease and treatment on that system.

• Selects, Reviews, Obtains and Interprets data


• Reads and evaluates physicians orders, clarifying as needed. Accurately transcribes phsyician orders to electronic charting system or departmental patient master. Reviews patient information including history, lab data, radiologic studies, progress ntoes, respiratory and cardiovascular monitoring data and performs assessment/data collection in systematic manner. Ssyutematically assesses patients overall cardiopulmonary status by inspection, palpation, percussion, auscultation, and patient interview. Interprets data to formulate goal-directed plan of care and determines requirements for treatment such as type and duration of therapy, precautions to be observed, equipment required, and medication and dosages. Determines modifications to physician orders, which optimize patient, care and makes recommendations to physician. Recommends procedures to obtain additional data including radiographs, bronschocopy, Gram stain and C&S, spirometry, blood gas analysis, lung mechanics, work of breathing, EKG, non-invasive monitoring.


• Performs Diagnostic Modalities


• Performs procedures and interprets results


• ABG sampling and analysis, co-oximetry, spirometry, pressure-volume and flow-volume loops, cuff pressure, sputum duction. May perform EKGs May place Holter monitor. May perform pumonary function, and sleep diagnostic tests. May perform Exercise Tests. May perform indirect calorimetry.


• Selects, assembles and checks equipment for cleanliness, proper function and safe operation. Ensures proper function and ready availability of respiratory related life suport equipment. Troubleshoots and performs minor repairs of equipment. May perform Quality control procedrues for blood analysis devices. May perform Quality control, calibrate, maintain and troubleshoot pulmonary function diagnostic equipment. Participates in routine departmental programs of cleaning,disinfecting and sterlizing of respiratory care and other related equipment. Orders/stocks departmental supplies.


• Initiates, conducts and modifies presribed therapeutic or diagnostic procedures.


• Operates all medical equipment within manufacturer and department guidelines to safely treat patients. Checks and ajdusts alarms. Observes established safety and security procedures and protects patients from nosocomial infection. Explains planned therapy or procedure and goals to patient in understandable terms to achieve optimal therapeutic outcome. Conducts therapeutic procedures to maintain a patent airway, remove bronchopulmonary secretions, and/or achieve adequate ventilation and oxygenation.Monitors patients physiological responses to therapy, recognizes patient adverse reaction and stops or modifies or recommends modificaiton to procedure based on patient response. Documents all required information in the medical record according to departmental policy and procedure. Initiates pressure-cycled/volume-cycled/high frequency ventilation. Weans/modifies mechanical ventilation according to assessment and physician orders. Assists with or performs extubation. Conducts patient education and disease management. Performs cardiopulmonary resuscitation according to resuscitation guidelines. May assist with or perform intubation. May assist the physician when performing bronchoscopy, thoracentesis, tracheostomy, cardioversion, and intubation. May particiapte in and/air critical care transport. May assist with high risk deliveries. May assist with surfactant replacement in neonates. May participate in pulmonary rehabilitation, home care. May assist with discharge planning. May aissist with community outreach. May initiate and implement therapist driven protocols.


• May assign, organize and coordinate the work of assigned Respiratory Care Practitioners. May demonstrate respiratory care procedures to trainees and other health care personnel. May train assigned practitioners and complete assigned practioner competency reviews. Contributes to departmental quality improvement activities. May schedule staff and perform staffing functions. Assesses priorities for delivery of patient care and redistributes resources as necessary thorughout shift. Protects data from intentional or unintentional destruction, destruction, modification, or disclosure. Maintains a current knowledge base of departmental information management systems, including collection, maintenance, and dissemination of information, as well as appropriate  audit trails. May develop policies and procedures, both clinical and administrative. May serve as Timekeeper for TIME system.


• Complies with attendance and punctuality expectations andn with meal and break schedules. Accurately documents time in/out in TIME keeping system or time card. Maintains a professional apperance, displays professional conduct and ethical behavior. Participates in continuing education for professional development in Respiratory Care and related fields. May serve on hospital committees. May participate in professional organizations.


• This job has no supervisory responsibilities.


• To perform the job successfully, an individual should demonstrate the following competencies:


• Reading/Writing/Math:


• Reads patient charts and lab results, hospital and departmental policy and procedure manuals, technical manuals. Charts legibly in computerized charting system as well as manaully on ventilator flow sheets and treatment records. Performs basic computations for example: calculate drug dosages, ventilator parameters, and staffing requirements.


• Demonstrates knowledge of curent respiratory care modalities. Demonstrates knowledge and basic skill in the care of infants, pediatric and adult patients. Has basic knowledge of cardiopulmonary physiology and other sciences related to respiratory care. Has a thorough understanding of drugs used in respiratory care procedures. Has knowledge of equipment used in respiratory care procedures. Demonstrates advanced knowledge of fetal cardiopulmonary development, disease states specific to neonatal and pediatric patients, and special considerations in dealing with these patients prior to working in neonatal/pediatric intensive care units.


• Works efficiently with minimal supervision. Organizes assigned work to complete all tasks and duties. Remains flexible to respond to unplanned demands on time and emergency situations. Re-organizes and prioritizes, disciminating between essential and non-essential, recognizing the importance of providing for all essential patient care.


• Identifies problems in a timely manner; collects and analyzes information, using intuition and experience to complement data; guided by well defined procedures, makes decisions and takes action.


• Subject to stressful professional relationships. Understands the management of and displays an ability to control his or her own behavior and to influence the behavior of others. Contributes to building an effective multidisciplinary team; balances team and individual responsibilities.


• Speaks and understands English. Able to effectively communicate technical ideas to both medical and lay, verbally and in writing. Listens and gets clarification to ensure that instructions and requests are fully understood. Able to take direction in emergencysituation, such as during a code. Gives complete verbal report, listens when receiving report from peers.

Grade 755