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Respiratory Therapy Under Attack by Polysomnography Legislation

From RT Magazine:

"AARC: Respiratory Therapy Under Attack by Polysomnography Legislation
In a letter to AARC state society presidents, state board of directors, and members of the AARC House of Delegates, the association stated, “We are at the precipice of a situation where state by state the profession of respiratory therapy stands to legally have part of its scope of practice rescinded and taken away from you.”

The letter goes on to say, “In some cases respiratory therapists will be forced by law to take (and pay associated costs) [of] an additional credentialing exam in order to continue to provide sleep disorder services …. In other cases, the potential is very real that some of these new laws will require respiratory therapist[s] to obtain an additional license to continue to provide sleep services you have always been legally able to provide before.”

The American Academy of Sleep Medicine (AASM) is aware of the correspondence and stated in an announcement, “These messages from the AARC are not new, and they generally have not been received positively by legislators or many respiratory therapists who understand and appreciate the care provided by polysomnographic technologists in their communities and throughout the country.”

In their letter, the AARC asks all respiratory state societies to stand up and ensure that:
• “The diagnosis and treatment of sleep disorders, sleep diagnostics, sleep testing, sleep therapeutics or other terms now being defined as polysomnography are and have been an integral part of the respiratory therapist Scope of Practice”
• “Any additional testing, credentialing or licensing of the respiratory therapist in polysomnography is unnecessary and unwarranted.”

The letter concludes by stating: “It is our firm conviction that any requirement for further testing, credentialing or licensing of the respiratory therapist in the services deemed polysomnography is not warranted. We support state regulation of appropriately educated, competency-tested and credentialed polysomnographic personnel so long as it does not in any way adversely impact the scope of practice and/or licensure status of the respiratory therapist.”

The AASM and the American Association of Sleep Technologists (AAST) stated that they would issue a responsible, fact-based response to the AARC letter.

“This response will clearly state that the AASM and AAST do not have an agenda that in any way will restrict the practice of respiratory care,” said the AASM.

Do you support the AARC’s position? Join the discussion at RT’s Facebook page."

Personally, I do NOT support their position. Not given my experience w/local DME supplier RTs and not given how many members of the various sleep apnea support forums resorted to the apnea support forums in self-defense due to not just poor, but actually LOUSY, local DME supplier RTs. RTs who don't know how to do a proper mask fitting, RTs who don't know anything about the devices they provide and set up except what the Quick SetUp Guides says. RTs who never bother to look at much less thoroughly read the Clinicians Manual that comes w/each device. RTs who are less than truthful or totally ignorant of the patients insurance benefits and advise them incorrectly. RTs who are less than empathetic, pleasant or even polite or civil to their patients. This type of RT may well be in the minority, but if so, judging by the apnea support forums they are a pretty big minority.

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Sleepguide is in favor of whatever rules and regulations bring about the best outcome for the patient . . . even if that means very few rules and regulations.
the last thing i want to do is get in the middle of a pissing match between RTs and sleep techs but . . .

. . .ah, what the heck, i'll get in the middle of a pissing match between RTs and sleep techs: RTs have a role to play if they're good, and sleep techs have a role to play if they're good. I'd like the playing field to be level as between the two fields so that whomever is the cream of the crop, whether they are an RT or a sleep tech, rises to the top. Whatever rules and regulations, or lack of rules and regulations, that accomplishes that end is what I'll be rooting for.

now the question is, what would that be?
I believe the pissing match is between the BRPT and the AARC not the techs. The best outcome for the patient would be that labs employ a wide variety of EDUCATED employees. This would include RPSGT, RT, REEGT, and an RN if possible. The problem lies in that last paragraph. This concerns the online classes that teach a tech the basics of running a study. The AARC does not think that RTs, RRTs, or CRTs need to take these classes. The other problem right now is the educational programs for sleep. The BRPT would add strength to the cause by requiring a 4 year degree in addition to passing the boards. Right now All that is required is a high school diploma or GED. Please don't get me wrong there are some very smart sleep techs with all sorts of degrees under them. I have had the pleasure of working with some of the smartest minds I have ever known since starting in this field. It is a sink or swim field. I think that it is very arrogant of the AARC to assume that a respiratory tech can do a sleep techs job without any formal training. To let you know if the BRPT were to pass a mandated 4 year degree I would be out, as I chose to drink and chase woman instead of going to class. Regardless it would strengthen the field of sleep.
True story. As told by a RRT.

A oxygen delivery technician, aka respiratory therapist, went to take the SDS exam recently. The RRT stated the exam was very easy. Upon completion of the exam, when asking about the results, the RRT was informed that typically the results would be given to them at the completion of the test. Unfortunately they could not do that at this time becuase...you ready for this...the passing grade has not been determined.

Whhhaaaaa.....? The NBRC/AARC has not determined what is considered a passing grade for the SDS exam?

OK folks, here's the deal. The SDS "credential" is basically going to be the same as that CPR/First Aid card you're required to get. You know, the class everone passes. And that's the way the NBRC/AARC want's it to be.

Alot of RRT's are embarrassed by the decisions and performance of their "elected" officers. The RRT's who have the RPSGT credential understand how difficult it is to earn and will not hesitate to tell the other RRT's how pitiful the SDS exam/credential is.

Anyway, the Bell Curve...

In true use of bell curve grading, students' scores are scaled according to the frequency distribution represented by the normal curve. The INSTRUCTOR CAN DECIDE what grade occupies the center of the distribution. This is the grade an average score will earn, and will be the most common. Traditionally, in the ABCDF system this is the 'C' grade. The instructor can also decide what portion of the frequency distribution each grade occupies and whether or not high and low grades are symmetrically assigned an area under the curve; for example, if the top 15% of students earn an 'A,' do the bottom 15% fail or might only the bottom 5% fail? In a system of pure curve grading, the number of students who will receive each grade is ALREADY DETERMINED at the beginning of a course.

Grading in this way is essentially normative; scores are referenced to the performance of group members. There must always be at least one student who has a lower score than all others, even if that score is quite high when evaluated against specific performance criteria or standards. Conversely, if all students perform poorly relative to a larger population, even the highest graded students may be failing to meet standards. Thus, curved grading makes it difficult to compare groups of students to one another. ( Meaning the SDS “certificate” can’t be compared to the RPSGT credential ).

And coming soon...the Kettering SDS study guide. Guaranteed to help you pass! Kettering, providing questions and answers for 30 years!

A Kettering statement, from their webpage.

"Kettering National Seminars has been providing professional examination reviews and continuing education to health care practitioners for 30 years! Each year, we conduct hundreds of seminars nationwide, helping thousands of individuals earn their CRT, RRT, NPS, RT(R) CPFT, RPFT, CCT and AE-C credentials. Thousands more use our self-study courses to prepare for these challenging exams without ever leaving home
Jeff I don't believe this to be a fight between techs. I work with some great RTs. All of which think that the SDS is a crock. Most Rts who want to be in sleep take the RPSGT boards. From what I have seen the fight is between the controling bodies. I thought this was a funny post relating to this post.

j n k said:
My overly-simplified position is that anything designed to keep good RTs out of sleep medicine is bad, but that anything designed to raise the bar and improve the education of health professionals working with sleep is good. How the education and job distribution is orchestrated is an ongoing question, but as long as the organizers on both sides are clearly and publicly stating everyone's concerns so that all concerns can be addressed, the individuals in the fields should mostly just ignore the politicial positioning and concentrate on keeping up good working relationships with their fellow health professionals in order to provide the best care possible for each patient now.
I am a RT and i have sleep apnea, i also do sleep study.I went to school to learn to do sleep study.and i know more about polysomnography going in the class than all of the EEG people[28]of them was EEG and one RT.thay were from all over the USA.I had to teach some of the things ,like SPo2 how it works.some of the apnea,how and why and ekg's .I have 39yr as RRT + RN.Have not done EEG at all till I went to the 8 day school. How you tell me that a EEG tach is the better person or tach to do than a RT.The NBRC and AARC.would do better AASMand BRPT, THIS IS ONLY MY THOUGHS ON ALL OF THIS FROM MY POINT ON VIEW THANK YOU
That 8 day class must have been truly overwhelming for you. Give me a break. The AARC does a great job for respiratory. Sleep needs to be an independent practice.

Wayne McGavic said:
I am a RT and i have sleep apnea, i also do sleep study.I went to school to learn to do sleep study.and i know more about polysomnography going in the class than all of the EEG people[28]of them was EEG and one RT.thay were from all over the USA.I had to teach some of the things ,like SPo2 how it works.some of the apnea,how and why and ekg's .I have 39yr as RRT + RN.Have not done EEG at all till I went to the 8 day school. How you tell me that a EEG tach is the better person or tach to do than a RT.The NBRC and AARC.would do better AASMand BRPT, THIS IS ONLY MY THOUGHS ON ALL OF THIS FROM MY POINT ON VIEW THANK YOU
I don't much give a rat's rear about the RRTs in sleep AS LONG AS THEY EARN the PSGT training and credentialing as well. No way do I want an RRT w/o the comprehensive PSGT training conducting and scoring my in-lab PSG.
This was not at all overwhelming. I ace it.Iam a RPSGT,RRT,RCP

Rock Hinkle said:
That 8 day class must have been truly overwhelming for you. Give me a break. The AARC does a great job for respiratory. Sleep needs to be an independent practice.

Wayne McGavic said:
I am a RT and i have sleep apnea, i also do sleep study.I went to school to learn to do sleep study.and i know more about polysomnography going in the class than all of the EEG people[28]of them was EEG and one RT.thay were from all over the USA.I had to teach some of the things ,like SPo2 how it works.some of the apnea,how and why and ekg's .I have 39yr as RRT + RN.Have not done EEG at all till I went to the 8 day school. How you tell me that a EEG tach is the better person or tach to do than a RT.The NBRC and AARC.would do better AASMand BRPT, THIS IS ONLY MY THOUGHS ON ALL OF THIS FROM MY POINT ON VIEW THANK YOU
Okay. Sleep is SLEEP. I do NOT want an EEG or an RN or whoever doing my in-lab PSGs UNLESS they have had good thorough prolonged PSG training such as RPSGTs go thru. No less. Sleep is NOT just brain waves. Sleep is NOT just apneas and hypopneas.
LMAO!

Wayne McGavic said:
This was not at all overwhelming. I ace it.Iam a RPSGT,RRT,RCP

Rock Hinkle said:
That 8 day class must have been truly overwhelming for you. Give me a break. The AARC does a great job for respiratory. Sleep needs to be an independent practice.

Wayne McGavic said:
I am a RT and i have sleep apnea, i also do sleep study.I went to school to learn to do sleep study.and i know more about polysomnography going in the class than all of the EEG people[28]of them was EEG and one RT.thay were from all over the USA.I had to teach some of the things ,like SPo2 how it works.some of the apnea,how and why and ekg's .I have 39yr as RRT + RN.Have not done EEG at all till I went to the 8 day school. How you tell me that a EEG tach is the better person or tach to do than a RT.The NBRC and AARC.would do better AASMand BRPT, THIS IS ONLY MY THOUGHS ON ALL OF THIS FROM MY POINT ON VIEW THANK YOU
You are wright.It is the two in one all new.Part EEG and part Respiratory.it is Sleep Disorter

Judy said:
Okay. Sleep is SLEEP. I do NOT want an EEG or an RN or whoever doing my in-lab PSGs UNLESS they have had good thorough prolonged PSG training such as RPSGTs go thru. No less. Sleep is NOT just brain waves. Sleep is NOT just apneas and hypopneas.

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