Occupational Stress Injury (OSI) Post-Traumatic Stress Disorder (PTSD) and Respiratory Therapists (RTs)

It is imperative to have services and supports in place to keep RTs protected, mentally fit and healthy to ensure we can carry on our important and heavily replied upon expert services in this very intense and stressful role…for the good of each one of us and the patients we serve.

Respiratory therapists (RTs) work as essential members of rapid response, various code, disaster, radiation and other emergency response teams. In that “first responder” role, we may encounter traumatic incidents and experiences while providing patient care that may result in occupational stress injury (OSI) which may lead to post-traumatic stress disorder (PTSD). RTs help in the community with services ranging from chronic care to palliative support that may, relative to the individual situation, cause emotional and/or mental health stress.  Respiratory Therapy students practicing during their clinical rotations may also encounter the same traumatic incidents and experiences.

In that context, the RTSO’s PTSD Working Group is collating data and preparing a report based on a survey that was conducted during March and April 2019. Results will be published in Airwaves and available on this part of the website once Board reviewed and approved.

See “Resources” below.

In an emergency, we are often some of the first clinicians to help patients. We manage the airway, insert arterial lines, sample urgent blood work, perform cardiopulmonary resuscitation and other front-line care for adults, children, and infants who may be victims of fires, accidents, deadly illnesses like SARS and Ebola, and other traumatic events.

RTs are resuscitation specialists assigned to every resuscitation team and responding to all life-threatening emergencies affecting any patient populations, age group and clinical situations in all hospital programs. The staffing model for Respiratory Therapy Services in most hospitals commonly assigns an individual RRT to cover multiple departments who will respond to an array of high stress emergency situations throughout their shift. One RRT could literally attend a Code Pink resuscitating of a newborn in the Labour and Delivery Unit then run to the emergency department to assist with a life-threatening trauma and be paged to a Code Blue in the Intensive Care Unit or a Medical- Surgical floor all in one shift with little or no down time or opportunity to debrief or regroup. Further, during “surge” periods with higher acuity (e.g. Flu season), RTs do not get additional funding to bring in extra staff, adding little to no break time while on shift to an already heavy workload, and being called for many different things at the same time. This results in further increased mental stress and burden.

We are experts in mechanical ventilation, follow our critically ill patients into the operating room and intensive care units – and it doesn’t stop there. In the community we help with services ranging from chronic care to palliative support that may, relative to the individual situation, cause emotional and/or mental health stress. This front-line role for RT’s places us into a direct emotional connection with our patients and whether from a single traumatic episode or a series of events, we are equally vulnerable to OSI and PTSD as other “first responders”. Most other disciplines are trained and assigned to support a specific patient population or program and do not usually participate on multiple response teams or follow the patient from ER to ICU, to the wards, and potentially into the community on discharge. This is inherently unique to the practice of Respiratory Therapy.

Dealing with these types of events, often in life and death situations, can place an unusual emotional and/or mental health burden on any one of us. This front-line role for RT’s places us into a direct emotional connection with our patients and whether from a single traumatic episode or a series of events, we are equally vulnerable to OSI and PTSD as other “first responders” or health care providers working in the community with challenging chronic care or palliative care situations.

This is why it is imperative to have services and supports in place to keep RTs protected, mentally fit and healthy.  To ensure we carry on our important and heavily relied on expert services in very intense and stressful situations, RTs and the patients we serve, deserve to have supports in place.  Specifically, this includes prevention, intervention and recovery and return to work policies and practices.

The RTSO is advocating for RTs to be included in the next amendment to Bill 163, Supporting Ontario’s First Responders Act (Posttraumatic Stress Disorder), 2016  https://www.ola.org/en/legislative-business/bills/parliament-41/session-1/bill-163 to the Ministry of Labour.

In the meantime, the PTSD (post-traumatic stress disorder) Working Group has begun to assemble the following reliable resources that are currently available to support us all should we need them.

Resources:

  1. Centre for Addiction and Mental Health Tutorial Series: Posttraumatic Stress Disorder:  https://na01.safelinks.protection.outlook.com/?url=http%3A%2F%2Fwww.camhx.ca%2Feducation%2Fonline_courses_webinars%2Fmha101%2Fposttraumaticstressdisorder%2FPosttraumatic_Stress_Disorder_.htm&data=02%7C01%7CGdepinto%40conestogac.on.ca%7C0bdbed57464149d556d008d6516c2f99%7C4ddd393ae98a4404841fc4becdd925a5%7C0%7C0%7C636785922473167683&sdata=3IHRjPUL0uYi1xGWmYmxbrTDRLryECZ3NiYQZlGKY90%3D&reserved=0
  2. BOOTS ON THE GROUND: PEER SUPPORT FOR FIRST RESPONDERS (Serving first responders across Ontario) (includes help for those in crisis) https://www.bootsontheground.ca/
  3. #FIRSTRESPONSERSFIRST: PTSD Resource Toolkit: http://www.firstrespondersfirst.ca/
    1. The Working Mind:   https://www.theworkingmind.ca/
    2. 13 Factors: Addressing Mental Health in the Workplace:  https://secure-web.cisco.com/1KyjwY-iVaMBzFEf3J9DHU7MoRsh8cJn9FsuhK9fSCPcOlJbU4u3IK0BRv90NIlqeN45g7I8Uc864g5HX3MFMwONjOo5-JDReC6NW4jzqPgdFQDxTyNeMFUBBap4RsCjjMlp4TkWE1yqcYDGQsOIVe1MhnwsWCwb5OG57-Z3oOFSjwfEbZcGvtjUO1er8in2H_6XSY76yX-zX_J3GsaENDywgTm6nxnImiV3bt48n-lH0qZ6ZOw64kXif9vXnpoJ31FcbG54MgUVqrgJTPFURyw/https%3A%2F%2Fwww.mentalhealthcommission.ca%2FEnglish%2F13-factors-addressing-mental-health-workplace
    3. 13 Factors videos: https://www.youtube.com/playlist?list=PL2NuAPXp8ohZmoVaECl6sRiV9lQ25XkId
       

       

  4. Sunnybrook Magazine Fall 2018, Miranda Lamb RRT Code Orange Experience: http://health.sunnybrook.ca/magazine/fall-2018/health-care-providers-recall-code-orange/

PTSD Working Group Members:

Louise Bates RRT, Niagara Health System
Samantha Zettler, RRT, CRE Southlake Regional Health Centre
Brandie Elliott RRT, CRE, Bluewater Health Hospital, Asthma Research Group Inc.
Mirika Fraser RRT, Sinai Health System
Bert Reket RRT, FCSRT, VitalAire
Rob Bryan, RRT AA, A-EMCA, Mackenzie Health Centre
Tania Del Rizzo RRT, William Osler Health Centre
Fatima Foster RRT, CRE, St. Joseph’s Healthcare, Hamilton, Co-Chair
Nancy Garvey RRT, MAppSc, RTSO Interim Project Advisor, Co-Chair