SECTION IB RESPIRATORY CARE AND PROFESSIONAL ORGANIZATIONS

SECTION IB RESPIRATORY CARE AND PROFESSIONAL ORGANIZATIONS As was inferred in the previous section, often an individual s personal ethics are directed or defined by standards or rules provided by professional organizations. As a professional, RCP s are expected to be aware of the multitude of organizations that guide their practice, influence their behavior, and contribute to providing safe and appropriate behavior. Let s look at some of the more prominent organizations that have direct or indirect impact on our professional livelihood. Commission on Accreditation for Respiratory Care (CoARC) 9 Laura, an LVN and RCP has worked in nursing and RT for 30 years. She was initially trained as an LVN but early in her career she began working in RT departments, and considers herself a respiratory therapist (since she has not worked as a nurse for 25 years). She gained her RCP license when she was grandfathered into RT in 1986. She now wants to earn an associate degree in respiratory therapy because she has aspirations to earn the RRT credential. In her job, she assists students from two local RT programs as a preceptor providing clinical training. She believes her local community college should grant her credit for the extensive time in the profession, experience both as a nurse and RT, and wants the college to grant academic credit for her experiential qualifications. The college does not allow for experiential credit, and has advised Laura to seek alternative pathways to RRT eligibility. She feels she is more than qualified and states her hospital Medical Director (who is a member of the RT program Advisory Committee) is willing to substantiate her experience. Laura feels all of the factors should qualify her for the college to grant her the academic credits she is seeking. Laura says she will pay for any fees associated with granting her credit. Does the college have professional duty to assist a contributing member of the community for her service? Accreditation is a mechanism for assuring academic quality in higher education. An accredited institution is able to provide eligibility for Federal Financial Aid, ability to transfer credits (e.g., accreditation provides for establishing the acceptability of credits from institution to institution), and ability to obtain a higher degree. Accreditation is assurance that a respiratory care program meets the quality standards established by the profession. Accreditation helps students and their parents choose quality respiratory care programs. Accreditation enables employers to recruit graduates they know are well-prepared. Accreditation is used by registration, licensure, and certification boards to screen applicants. Accreditation gives higher education institutions a structured mechanism to assess, evaluate, and improve the quality of their programs. 9 The Commission on Accreditation for Respiratory Care (CoARC), www.coarc.com CSRC Law and Professional Ethics for RCPs (Online Course) Draft 7/1/2013 11

In the United States, in order for any graduate to sit for a professional credentialing examination given by the National Board for Respiratory Care (NBRC), they must be a graduate of a program accredited by the CoARC. Accreditation is a status that provides assurance to prospective students, their families and the general public that an institution (or a program) meets minimum requirements (i.e., Accreditation Standards) and that there are reasonable grounds to believe the institution (or program) will continue to meet those standards in the future. Respiratory Care Board of California (RCB) Juliette, a California RCP is enjoying her three days off from work at the hospital and chooses to relax by the pool with her three children while enjoying a couple of beers. Her husband arrives home from work and decides to take his kids swimming. Juliette objects, stating the kids have been in the pool all day and wants the kids to go into the house, change, and finish their chores. Juliette and her husband get into an argument that escalates into loud shouting, cursing, pushing, and creating a stir among her neighbors. Juliette is heard to say to her kids she ll kick their butts if they don t listen. One neighbor calls 911 because of the menacing situation and threatening overtones she hears from her residence next door, as the argument has now moved from the back yard to the front sidewalk. When the police arrive, they determine Juliette has consumed a large amount of alcohol, is shouting and acting irrationally. Her husband is behaving rationally, calmly answering questions, which further infuriates Juliette, causing her to lurch out at her husband in a threatening manner, also pushing a police officer aside. The police arrest Juliette for disorderly conduct, public intoxication, child endangerment, and assault on a Peace Officer, for which she is later convicted. Since this situation occurred at home while Juliette was off work, does the Respiratory Care Board have an obligation and duty to review the circumstances surrounding her RCP license? After all, none of this has to do with work or providing services as an RCP. The Respiratory Care Board of California's mission is to protect and serve the consumer by enforcing the Respiratory Care Practice Act and its regulations, expanding the delivery and availability of services, increasing public awareness of respiratory care as a profession, and supporting the development and education of all respiratory care practitioners. The mandate of the Respiratory Care Board is to protect and serve the consumer by administering and enforcing the Respiratory Care Practice Act and its regulations in the interest of the safe practice of respiratory care. Licensed Respiratory Care Practitioners (RCPs) regularly perform critical lifesaving and life support procedures prescribed by physicians that directly affect major organs of the body. RCPs provide care directly to the patient in either a hospital setting or the patient's home. Patients may be suffering from lung cancer, emphysema, asthma, or cystic fibrosis, or may be premature infants CSRC Law and Professional Ethics for RCPs (Online Course) Draft 7/1/2013 12

whose lungs have not yet fully developed. More than 36,000 RCP licenses have been issued in the State of California 10. RESPIRATORY CARE PATIENTS' RIGHTS 1. Patients have the right to professional, conscientious, and competent care. 2. Patients have the right to health care that meets community standards regardless of the setting. 3. Patients have the right to adequate explanations regarding therapy, management, rehabilitation, and diagnostic evaluations or services performed. 4. Patients have the right to refuse any treatment to the extent permitted by law and to be informed of the medical consequences of refusing such treatment. 5. Patients have the legal right to request and review the license of any respiratory care practitioner and be apprised of the current status of the license (i.e. valid, expired, canceled, probationary, revoked). 6. Patients have the right to be informed of the physician(s) responsible for medical direction and the supervision of the respiratory care practitioner. 7. Patients have the right to expect that all records and/or communications pertaining to their care are treated as confidential. 8. Patients have the right to access all health records pertaining to their care as provided by statute. 9. Patients have the right to refuse observation by those not directly involved in their care. 10. Patients have the right to be fully informed and advised of their rights in all health care settings. National Board for Respiratory Care (NBRC) Mike, an RCP who is proud he completed an RT program, took his CRT exam right after school and is now working as an RCP. Like most of his former classmates, he planned to earn his RRT sometime soon. He is a good worker, covers extra shifts when asked, and feels he has gained a lot of valuable experience. After about three and a half years Mike decides now is the time for getting his RRT. He registers for a national review seminar to prepare and also sends an application to the NBRC. Mike is stunned when the NBRC informs him he will need to repeat taking (and passing) the CRT examination because it has been over three years since he earned his CRT. He never heard about such a stipulation, and he is angered because many of his coworkers tell him they sat for the RRT credentialing process but did not encounter this problem. Has the NBRC made a mistake? Is Mike justified in being angry? Is he being treated unfairly? 10 Copyright 2012 State of California; Respiratory Care Board of California 3750 Rosin Court, Suite 100 Sacramento, CA 95834 (www.rcb.ca.gov) CSRC Law and Professional Ethics for RCPs (Online Course) Draft 7/1/2013 13

The National Board for Respiratory Care, Inc. (NBRC) is a voluntary health certifying board, which was created in 1960 to evaluate the professional competence of respiratory therapists 11. The NBRC strives for excellence in providing credentialing examinations and associated services to the respiratory community, and intends to remain at the forefront of the testing field by offering valid, reliable credentialing examinations, consistent with leading measurement standards and techniques. The NBRC remains vibrant by taking a creative, open-minded attitude toward change and new opportunities for growth. The primary purposes of the NBRC and its 31-member Board of Trustees are to provide high quality voluntary credentialing examinations for practitioners of respiratory therapy and pulmonary function technology; establish standards to credential practitioners to work under medical direction; issue certificates to and prepare a directory of credentialed individuals; advance medicine by promoting use of respiratory care in treating human ailments; support ethical and educational standards of respiratory care; and cooperate with accrediting agencies to support respiratory care education. Since its inception, the NBRC has issued over 350,000 professional credentials to more than 209,000 individuals, and currently tests nearly 40,000 candidates annually. One of the respiratory therapy examinations is the standard for licensure in the 49 states that regulate the profession. American Association for Respiratory Care (AARC) Stanley decides to attend the AARC International Respiratory Convention & Exhibition because everyone at work is talking about attending and they are saying fees are reasonable. He is particularly interested in some of the topics he hears will be presented and knows the exhibits and networking can be a lot of fun. The timing is good because the location is in his home state, nearby where he lives. When Stanley goes to register for the Congress, he notices the fees and lodging are quite a bit higher than what he led to believe. When he inquires he learns that his coworkers are members of the AARC, and the fees they shared were for AARC members. Unfortunately, Stanley is not a member of the AARC. Stanley is disappointed and begins to weigh the benefits of attending against the unexpected expenses he will incur if he attends. Should all fees be the same? Is Stanley justified in his disappointment? Should membership in a professional society be required? Since 1947, the American Association for Respiratory Care (AARC) has been committed to enhancing your professionalism as a respiratory care practitioner, improving your performance on the job, and helping you broaden the scope of knowledge essential to your success. With more than 50,000 members nationwide, the AARC is the only professional society for respiratory therapists in hospitals and with home care companies, managers of respiratory and cardiopulmonary services, and educators who provide respiratory care training. 11 The National Board for Respiratory Care, www.nbrc.org CSRC Law and Professional Ethics for RCPs (Online Course) Draft 7/1/2013 14

The AARC mission statement reads: The American Association for Respiratory Care (AARC) will continue to be the leading national and international professional association for respiratory care. The AARC will encourage and promote professional excellence, advance the science and practice of respiratory care, and serve as an advocate for patients, their families, the public, the profession and the respiratory therapist. Among the resources available through the AARC are Advocacy tools, Position Statements, Clinical Practice Guidelines, Cultural Diversity resources, Guides to Professionalism, Patient Safety Checklists, Protocol Resources, Quality Respiratory Care Recognition, and numerous White Papers. In addition, two journals including RESPIRATORY CARE, the foremost scientific journal in the respiratory care profession, publishing original research, case reports, review articles, book reviews, letters to the editor, and teaching cases. The AARC has produced a Statement of Ethics and Professional Conduct, which states the conduct of professional activities the Respiratory Therapist shall be bound by following ethical and professional principles 12. Respiratory Therapist shall: 1. Demonstrate behavior that reflects integrity, supports objectivity, and fosters trust in the profession and its professionals. 2. Seek educational opportunities to improve and maintain their professional competence and document their participation accurately. 3. Perform only those procedures or functions in which they are individually competent and which are within their scope of accepted and responsible practice. 4. Respect and protect the legal and personal rights of patients, including the right to privacy, informed consent and refusal of treatment. 5. Divulge no protected information regarding any patient or family unless disclosure is required for the responsible performance of duty authorized by the patient and/or family, or required by law. 6. Provide care without discrimination on any basis, with respect for the rights and dignity of all individuals. 7. Promote disease prevention and wellness. 8. Refuse to participate in illegal or unethical acts. 9. Refuse to conceal, and will report, the illegal, unethical, fraudulent, or incompetent acts of others. 10. Follow sound scientific procedures and ethical principles in research. 11. Comply with state or federal laws which govern and relate to their practice. 12. Avoid any form of conduct that is fraudulent or creates a conflict of interest, and shall follow the principles of ethical business behavior. 13. Promote health care delivery through improvement of the access, efficacy, and cost of patient care. 14. Encourage and promote appropriate stewardship of resources. California Society for Respiratory Care (CSRC) 12 Revised 07/09; Copyright American Association for Respiratory Care 9425 N. MacArthur Blvd, Suite 100, Irving, TX 75063 CSRC Law and Professional Ethics for RCPs (Online Course) Draft 7/1/2013 15

Seth is a respiratory therapist who recently relocated to California from Tennessee. He wants to work as an RT after he gets settled in. He calls a few hospitals and looks online for job prospects but is unable to identify helpful resources that can help him with his professional pursuits. However, in talking with one hospital manager, he learns the CSRC website provides much valuable information about jobs, professional organizations, educational activities, continuing education credits, California Law and Professional Ethics classes, along with many opportunities to get connected in as a newcomer to the state. Seth immediately logs on to the website and is very impressed with the information he finds. He locates a job lead and is now scheduled for an interview. What benefits exist for membership in the state professional society such as the CSRC? Originally, the CSRC began as the Southern California Chapter and the Golden Gate Chapter of the AARC. The CSRC was officially incorporated as a charter of the AARC on June 27, 1968. CSRC Mission Statement The California Society for Respiratory Care (CSRC), as an affiliate of the American Association of Respiratory Care (AARC), is a non-profit professional organization (501 (c) 6), whose mission is to represent and support our members through public and legislative advocacy, educational opportunities, and to continuously strive for excellence in the cardiopulmonary profession 13. By these means, the CSRC is committed to health, healing and disease prevention in the California community. CSRC Vision Statement The California Society for Respiratory Care strives to be the elite provider of education, consumer information and the benchmark for professionalism. CSRC Core Values Past Board members have discussed the importance of identifying the basic values that define who CSRC is. These core values should guide each of us as we discharge our duties as an elected or appointed official of our State association and should also serve as a focus for the collective efforts and energy of the CSRC, as we move towards the millennium. This focused effort will help guide the CSRC in identifying and meeting its professional goals. The core values consistent with the CSRC mission statement as described above are as follows: COMPETENCY COMMUNICATION COMPASSION COMMITMENT 13 The California Society for Respiratory Care, www.csrc.org CSRC Law and Professional Ethics for RCPs (Online Course) Draft 7/1/2013 16

California is a large state. To represent the membership, the CSRC has divided the 55 counties into five Regions, loosely representing the major population areas. The regions and the counties they represent are: Northern Calif. Region: Del Norte, Humboldt, Lake, Mendocino, Alpine, Butte, Colusa, El Dorado, Glenn, Lassen, Modoc, Nevada, Placer, Plumas, Sacramento, Shasta, Sierra, Yuba, Siskiyou, Sutter, Tehama, Trinity and Yolo counties Greater Bay Area Region: Alameda, Contra Costa, Solano, Sonoma, Marin, Napa, San Francisco, San Mateo, Santa Clara, Santa Cruz, Monterey and San Benito counties Central California Region: Fresno, Kern, Kings, Madera, Tulare, Mono, Inyo, Amador, Calaveras, Mariposa, Merced, San Joaquin, Stanislaus, and Tuolumne counties Southern California Region: Los Angeles, Orange, San Luis Obispo, Santa Barbara and Ventura counties San Diego/Inland Empire Region: San Bernardino, Riverside, Imperial and San Diego counties Each Region has both elected officers and appointed members of the local Board. The state Board of Directors is comprised of elected officers consisting of President, Vice- President, Secretary, Treasurer, two Delegates to the AARC House of Delegates, and one member appointed from one of the five Regional officers, along with appointed Chairpersons for standing committees. All of the organizations we have discussed strive for our understanding professionalism, which is mastering knowledge within a field of study, self-policing for competence and trustworthiness of its members, and incorporating the public s trust. CSRC Law and Professional Ethics for RCPs (Online Course) Draft 7/1/2013 17