Do You Have What It Takes to Be a Transport Therapist?
Every medical profession has its more and less exciting aspects, but for respiratory care, nothing compares to the transport arena when it comes to getting the adrenalin pumping. Respiratory therapists who work in this challenging environment are charged with providing critical care services to patients who are often hanging on to life by a thread. And they have to get the job done in a cramped — and speeding — environment with limited tools and no backup other than their fellow transport team members.
But if you find yourself wishing you were in the back of every ambulance that passes you on the street, or looking wistfully up at the sky when you see a medical helicopter, then this might be the arena for you. In the following interview AARC member Alex Brendel, MBA, RRT-NPS, pediatric outreach education coordinator for the transport team at Carillion Clinic Children’s Hospital in Roanoke, VA, explains what it takes to enter the specialty.
How did you end up becoming a transport therapist there at the Carilion Clinic? What led to your interest in the area?
Alex Brendel: The thing that attracted me most to the transport team was the increased scope of practice and autonomy. The nurses and therapists on the Neonatal & Pediatric Transport Team at Carilion are expected to function as advanced practice clinicians who extend our hospital and physicians out into the community. I can say that I joined the transport team for the excitement and adventure, but I stay because of the great people I work with.
Transport is certainly a high octane area of the profession. What are some of the personal characteristics you believe it is essential for therapists to possess before seeking out a place on a transport team?
Alex Brendel: There are two things that I always focus on with potential applicants. The first is having strong critical thinking skills. As a transport therapist you will have to quickly assimilate a lot of information to accurately assess and respond to any situation you may encounter.
The second is the ability to give and receive direct communication. The typical personality on transport teams tends to be more assertive and direct. Being able to express your concerns and opinions is essential to patient care and your survival. Some people aren’t comfortable with direct communication, as it can come off as abrasive. I have found it to be critically important to the ultimate success of a clinician on our team.
What kind of educational background, credentialing, and/or experience is necessary to make the move from say, ICU care, to membership on a transport team like yours?
Alex Brendel: We are a CAMTS (Commission on Accreditation of Medical Transport Systems) accredited organization, so they set many of the standards for us. CAMTS 9th edition requirements say that an RT must have three years of clinical experience to apply for a transport position. Other standards may be set by your operational medical director, health care system, or the state you operate in. For example you may be required to get your EMT Basic or Paramedic to perform specific tasks.
There are numerous subspecialty certifications that an RT can get that are applicable to transport as well. The Neonatal Pediatric Specialist (NPS) and Adult Critical Care Specialist (ACCS) are probably the most applicable NBRC exams. For neonatal or pediatric focused teams there is also the Certificate of Added Qualification in Neonatal Pediatric Transport, or “C-NPT.” This exam is open to RTs, RNs, paramedics, physicians, etc.
What are some of the biggest differences between delivering care in the ICU and delivering care on transport?
Alex Brendel: There are a lot of differences between the hospital ICU and a mobile ICU. The most obvious difference is the environment in which you are working. If you take all of the challenges of taking care of a critically ill patient in the hospital and try to condense that down into what will fit into the back of a truck you will have some idea of what it takes. You also face the same space restrictions with an aircraft. Our EC135 helicopters have about as much space to work in as a compact car. There are environmental stresses that you have to deal with as well; for example, travel vibration and motion forces.
The last environmental challenge that comes to mind is the danger level that you face while driving on the road or flying through the air. There is a reason why medical transportation is one of the most dangerous professions in the country.
How hard is it to find a spot on one of these teams? How can someone make themselves stand out from the crowd?
Alex Brendel: The job market for transport therapists really depends on where you are looking to work. Some systems embrace RTs as essential to function while others are looking at replacing us with paramedics. I would say the competition would likely be higher than for a regular hospital position.
The best advice for making yourself stand out would be to talk directly to the crew members on the team and express your interest in joining the team. The current staff will have the best insight on what that system is looking for when hiring new employees. They can also give you a recommendation when a spot opens up.
What’s the most exciting transport you’ve ever been on and why?
Alex Brendel: I have some great stories about the tremendous difference our team has made in the lives of patients and their families, although talking about them would probably reveal too much patient information. The best transport experience I have had that doesn’t involve direct patient information occurred on July 4th several years ago. I was working a nightshift and we were preparing to fly down by helicopter to pick up a patient. My nursing partner and I left the hospital by ambulance to go to the helipad down the street because our rooftop pad was closed.
There are several large open fields for sports activities across from the hospital and adjacent to the helipad. Each July 4th thousands of people gather to watch the fireworks and listen to music. I remember our ambulance had to get a police escort to part the massive crowd of people that was flooding in for the festival. As we were lifting off, the national anthem started playing. We could see the crowd waving to us and cheering while a fantastic fireworks display started to our right. It was an incredibly surreal sight and has to be the best sendoff I have ever had.
Here are four things Alex Brendel believes therapists should keep in mind before seeking a position on a transport team —
- It goes without saying that your first priority will be to learn and grow as a clinician so you can have the appropriate knowledge base to function more autonomously.
- After that I would say make your desire to be a part of the team known and follow the advice of the current members as to how best to join the team.
- I would also strongly suggest that you get involved in the AARC Transport Section, as that has been a tremendous resource for me. There are so many great and talented people across the country whose work and experience you will want to tap into.
- Lastly, be prepared for the work to be physically and mentally exhausting and your team to be misunderstood, and know that you will either love or hate the challenges that come with this job. For me there is nothing like the rush I get when we arrive on scene for a call and begin to stabilize a critically ill patient with just the resources I have in my bag and the knowledge that myself and my partner bring to the table.
