The Power of Unity

1. The Power of Unity Toni L. Rodriguez EdD, RRT President AARC

2. UNITY OF PURPOSE • Purpose: Called to provide patient advocacy in the area of maintaining and restoring normal function of the respiratory system.

3. UNITY OF PURPOSE • So why respiratory therapy? To fulfill a need for: 1. Advanced therapeutic knowledge of the physiology and pathology of respiratory disease 2. Implementation and operation of complex medical equipment 3. Monitoring critically ill patients and the highly complex medical equipment around the clock.

4. UNITY OF PROMISE • The future promise of our trust related to patient advocacy: The profession of respiratory care has an appointment with destiny.

5. Respiratory Care Past • Swartz tube, oxygen tenet, BLB O2 mask, iron lung • O2 technology • Setup and operation of basic equipment • Delivery of aerosol • Provide IPPB • Provide service/perform tasks

6. Respiratory Care Present • ICU vents • Non-invasive ventilation • ECMO • Transport of patients • Home care/Sub acute care • Aerosol delivery • Diagnostic studies • Beginning disease management • Patient education • Consultant on patient care

7. CURRENT TRENDSFUTURE TRENDS Acute Care Focus Chronic Disease Management Cost Unaware Price Competition 3rd Party Payer Consolidated Brokers of Healthcare Inpatient Care Home and Community Care Individual professions Team Approach Traditional practice Evidence Based Information Stockpile Information as a tool Lack of patient decision Consumer engaged and making accountable

8. The dogmas of the quiet past are inadequate to the stormy present. The occasion is piled high with difficulty, and we must rise with the occasion. As our case is new, so we must think anew and act anew. ABRAHAM LINCOLN

9. Respiratory Care Future • ICU: Technical and Clinical Sophistication: expanded monitoring • Expansion 0f Aerosol therapy • Genetic Based Aerosols • Sleep, transport, ECMO • Leadership in Cardiopulmonary Disease Management • Advanced Protocols: ARDS Net, recruitment procedures, determination of correct PEEP, specific protocols for specific patient types

10. Respiratory Care Future • Closed loop ventilation/Adaptive ventilation • Proportional Assist Ventilation • Neurally Adjusted Ventilatory Assist (NAVA) • Evidence based medicine care and treatment plans • Monitoring: Electrical impedance tomography • Extracorporeal Gas Exchange becomes portable • Noninvasive ventilation in the home

11. Unity in Challenge There is no opportunity without Opposition There is no winning without working There is no open door without an obstruction to keep us from entering There is no victory with out vigilance

12. UNITY IN CHALLENGE • The professions ability to claim our future will depend on our ability to mobilize our resources: • AARC • Chartered Affiliates • Individual Members

13. AARC CHARTERED AFFILIATES INDIVIDUAL MEMBERS

14. AARC National Governance/Responsibilities National to include: Professional Vision Provide the mechanisms/resources for actualization of the vision Establish national and international links and partnerships Authorized to represent the profession and patients in all care arenas: Governmental Public Professional Ensure patient awareness and access to the RCP in all care settings

15. State Affiliates State Affiliates/Responsibilities Local Promote intra-professional links to between: specialist, educators, researchers, managers and clinicians Promote extra-professional links to include: State Boards, other professional organizations and volunteer associations and organizations Continuing education Recruitment and mentoring of new leadership Membership Political advocacy Effective judicial governance

16. Individual Member Translate the professional vision into daily practice Be effective in their sphere of influence Support national and state initiatives Join the AARC

17. TRUST AARC CHARTERED AFFILIATES TRUST INDIVIDUAL MEMBERS

18. Blind Trust Trust Fund Brain Trust TRUST Living Trust Trust Buster

19. TRUST • Definitions: • Confidence: Assured reliance on the character, ability, strength or truth of some one or some thing. • Legal: A combination of corporations for the purpose of reducing threat and controlling outcomes through out a business or industry. • Hope: Reliance on something in the future.

20. TRUST Calculus-Based Trust (CBT) vs Identification-Based Trust (IBT) Lewicki and Tomlinson; beyondintractibility.org

21. TRUST Calculus-Based Trust (CBT) • The type of trust that develops early in a relationship • CBT is the trust calculated as a result of the impact of incentives to stay in or leave a relationship Lewicki and Tomlinson; beyondintractibility.org

22. TRUST Identification-Based Trust (IBT) • IBT is the trust developed later in a relationship. • IBT is trust that evolves over time, when individuals have a deeper understanding of each other through repeated interactions. Lewicki and Tomlinson; beyondintractibility.org

23. TRUST Trust is not static: • Trust is destroyed when the positive expectations of conduct which underpin the willingness to open oneself to vulnerability are not forthcoming

24. TRUST Trust Busters: • Deception • Fear • Isolation • Lack of communication • Failure to respect • Insensitivity • Prevailing self interests

25. TRUST = PRODUCTIVITY When two organizations have trusting relationships and interactions their relationship is productive. When trust is violated, relationships are unproductive and organizations and individuals suffer. Lewicki and Tomlinson; beyondintractibility.org

26. TRUST T Tried R Relationship U Understanding S Secure T True

27. “Life is not easy for any of us. But what of that? We must have perseverance and above all confidence in ourselves. We must believe we are gifted for something, and that this thing, at whatever cost, must be attained.” Marie Curie

28. KEY TO SUCCESS TRUST ourselves TRUST each other TRUST our future