RTSO Airwaves Winter 2019

RTSO Airwaves
Winter 2019
Membership Matters! #RTStrOng
IN THIS ISSUE
President’s Messages
Farewell from Kaela Hilderly................................4
Welcome Sue Jones............................................5
Executive Director’s Message........................................7
Introducing Raquel Rubinoff..........................................8
Committee Reports
Community........................................................10
Research............................................................10
Article: The Role of RTs in Research &
Evidence-Based Practice..........12
Research Tips 101: What is Qualitative
Research?..................................13
Leadership........................................................14
Update on the Use of Energy/Ultrasound
by RRTs.....................................15
RRTs, PTSD and Occupational Stress
Injury...........................................17
Student Affairs..................................................20
Introducing Wendy Foote.....................21
Student Literature Reviews....................22
Membership Matters…...............................................29
Award Recipients: RTSO Advanced Practice
Education Award for AAs..................................31
Ministry Updates.........................................................35
RT Week 2018............................................................39
Introducing Harry Kanathasan....................................54
Management’s Corner: Successful Leaders................55
Upcoming Educational Events....................................58
Ask aRTee: Professional Engagement........................60
Volunteer service thanks.............................................61
In Memoriums............................................................62

Sue Jones, RRT FCSRT LSSBB
RTSO President
Kaela Hilderley, RRT CRE BEdAEd RTSO
Past President; Community RT Committee
Co-Chair
Shawna MacDonald, RRT FCSRT
Director; Editor-in-Chief, RTSO Airwaves
Sue Martin RRT MA FCSRT
Treasurer; Co-Chair, Hospital-Based
Leadership Committee
Our Mission
To promote, advance and protect the interests
of respiratory therapists in Ontario through
research, professional advocacy, growth and
development. We do this through strategic
partnerships, professional collaboration
and leadership.
Farzad Refahi, RRT CRE HBSc
Director, Social Media
Gino De Pinto, BEd BSc(Hons) RRT FCSRT
Director; Student Affairs Committee Co-Chair
Wendy Foote, RRT CRE
Student Affairs Committee Co-Chair
Kelly Hassall, RRT FCSRT MEd
Director; Co-Chair, Hospital-Based Leadership
Committee
Raquel Rubinoff, BA(Hons) RRT
Director-at-Large
Tina Yan, RRT HBSc
Research Committee Co-Chair
Shirley Quach, RRT HBSc
Research Committee Co-Chair
Sylvia Mortimer, BSc RRT CRE
Community RT Committee Co-Chair
Dilshad Moosa, RRT CRE CTE MASc
RTSO Executive Director
Nancy Garvey, RRT CRE MASc
RTSO Interim Project Advisor
Our Vision
The RTSO is the voice of respiratory therapists
in Ontario, dedicated to providing the best
in respiratory care and lung health for all
Ontarians, one breath at a time.
RTSO Airwaves may not be reproduced in full or in part without
prior permission from the RTSO.
Opinions expressed in RTSO Airwaves do not necessarily
represent the views of The RTSO. Any publication of
advertisements does not constitute official endorsement of
products and/or services.
EDITOR-IN-CHIEF: Shawna MacDonald RRT FCSRT
CONTRIBUTING EDITORS: Dilshad Moosa RRT CRE MASc
Shirley Quach RRT HBSc
GRAPHIC DESIGN & PRODUCTION SPECIALIST: Elisabeth Biers
Cover photo submitted by Dilshad Moosa BSc RRT CRE MASc

Outgoing President’s Message
Kaela Hilderley
RRT CRE BEdAEd
It’s that time of year again…membership renewal
season!
Coming out of the expense of the holiday season
and spending money just trying to keep warm in
this weather, while trying to decide how to spend
your hard-earned dollars isn’t always an easy task.
I understand that deciding what is worthy of your
disposable income is not always an easy choice,
but I would like to remind you that as a non-profit,
membership-driven organization that represents
our profession, your membership dollars mean
everything to us! The RTSO appreciates every single
membership from you, the Respiratory Therapists
of Ontario. It is your membership dollars that keep
us going, and without them and you, we cannot
continue to be the collective voice of our profession
in this province. Right now, this is a real possibility.
If you are not convinced of the importance of
renewing or initiating your membership, we
hope this message ends that contemplation and
encourages you to support the RTSO. We need
you, and we need you now!
As you will read more about the importance of the
value of the RTSO throughout this edition of RTSO
Airwaves, here are my quick reminders of why your
membership is so valuable:
• The RTSO is your provincial representation
with government and other stakeholders in the
healthcare field. This is extremely important since
the practice of Respiratory Therapy is generally
funded through provincial channels.
• The RTSO is here to provide professional
support, including specific and timely needs that
arise throughout the year in each of our various
practice areas.
• The RTSO provides the option to purchase
professional liability and indemnity (PL&I)
insurance for covering your professional
requirements and protection needs. Your
workplace coverage may not be sufficient, and in
some cases it is even non-existent.
• The RTSO understands, appreciates and values
the role Respiratory Therapists play in the
healthcare system and we want to speak for
you! In order to be more representative of the
collective ‘you’, we need to be able to hear more
of your voices. Each and every one of your voices
is important!
• The RTSO offers all of this and more, for less
than the price of a take-out coffee each day!
• I would also like to use this edition of RTSO
Airwaves to acknowledge a few new hellos
and goodbyes to our valued RTSO volunteers.
This year we say hello to Gino De Pinto, Kelly
Hassall and Raquel Rubinoff as new directors on
our Board, and to Sue Jones coming in to help
lead the organization as RTSO President. The
input and expertise you each bring to the table
are most welcome and appreciated. I would
also like to extend a very grateful, appreciative
goodbye from the Board of Directors and
Executive to Rob Bryan, for the close to 15 years
of volunteerism and passion for the profession
that Rob has demonstrated through countless
levels of service provided on behalf of the
RTSO, and for the RTSO as an organization,
over the years. Rob, your efforts have not gone
unnoticed and we thank you for your tremendous
years of volunteerism for the betterment of our
profession!
RTSO Airwaves Winter 2019 4

President’s Message
Sue Jones
RRT LSSBB
Great to be part of the RTSO again!
Over the years I have added some skills that have
allowed me to provide services voluntarily to the
RTSO in the past year. Planning the Leadership
Summit in 2018 and leading the RTSO Board
through a strategic planning exercise has reignited
my passion to give back to my professional
association as your President for 2019.
You may think to yourself, “glad someone stepped
up because I don’t have time to volunteer”. You
are right…it is time consuming, especially if there
are lofty goals to accomplish, which I and the Board
have for 2019 and beyond. We have so many
committed volunteers present and past; we need
to be proud of what we have accomplished as a
profession. With the renewed strategic plan, the
RTSO is poised to represent you on many levels.
As Kaela reminded you, we are in that time of
membership renewal and we do need your support.
As the new PC government starts to plan for
changes to the healthcare system, we want to be in
position as your voice for the profession. The RTSO
has been working tirelessly over the last few years
despite significant challenges with membership
and if you were ever thinking of supporting your
profession, this is the year to sign up!
As we move through 2019, we are committed to
representing the profession and look forward to your
ongoing support.
Thank you to our Corporate Sponsors
RTSO Airwaves Winter 2019 5

Executive Director’s Message
Dilshad Moosa
BSc RRT CRE MASc
I can hardly believe it’s been a year since joining the
RTSO as the Executive Director. The year in review
has been challenging and exciting, enabling us to
celebrate significant wins as well as make difficult
decisions in the best interest of RT’s in Ontario and
the future of the RTSO.
One of the highlights was the resurgence of
our Student Affairs Committee (SAC) with Co-
Chairs Gino De Pinto (Conestoga College) and
Wendy Foote (St. Clair College). The SAC has
representation by faculty, first and second year
students from seven RT schools across Ontario
and has grown student membership by more than
50%. The RT Week ‘About RTSO’ student poster
competition was a great success and we look
forward to further initiatives from the SAC in 2019.
Another highlight was our Leadership Summit in
June 2018, which had over 70 RT Leaders and
industry partners participate in an eventful day
addressing key issues pertinent to Respiratory
Therapy practice. Congratulations to the Planning
Committee for a job well done. Based on feedback
from RT leaders across the province, we prioritized
key advocacy initiatives such as PTSD support for
RTs, and provided guidance for the implementation
of practice changes required with the amended
legislation related to the use of Ultrasound.
Our efforts towards pay equity for RRT’s working in
the community continue, and the development of
job descriptions for Hospital and Community- Based
RRT’s are in final stages of review. We are excited
to have welcomed new corporate memberships
and look forward to working collaboratively towards
common objectives.
Strategic Planning and RTSO 2019-21 Goals
Our annual strategic planning meeting was held on
November 03, 2018, facilitated by Sue Jones, RRT
FCSRT LSSBB, QI Specialist with Health Quality
Ontario. The Board voted unanimously on accepting
the new funding model presented to achieve fiscal
sustainability. With this new model, the RTSO will
no longer be buying ORCS memberships. This fiscal
decision is aligned with our key priorities. RTSO
members will have the option of buying ORCS
memberships through The Lung Association. The
Lung Association continues to be a strong partner
of the RTSO with our common objective to support
Lung Health for all Ontarians.
Our strategic goals for 2019 – 2021 are prioritized as
follows:
• Financial Sustainability
• Membership Services
• Website Enhancements
• Governance Structures
Aligned with our fiscal priorities came the decision
to postpone our INSPIRE 2019 conference to the
Fall, and to combine the Leadership Summit. An
exciting way to kick off Respiratory Therapy Week,
scheduled October 20-26, 2019!
PLEASE SAVE THE DATES:
RTSO Airwaves Winter 2019 6

Executive Director’s Message
RTSO Leadership Summit – Friday, October 18, 2019 Executive Committee from 2008 to present in
18 Wynford Drive, Toronto
various capacities including RTSO President 2009,
Past President 2010-11; President 2013-14 and Rob
INSPIRE 2019 – Saturday, October 19, 2019 has been on the Executive Committee for the past 4
Westin Prince Hotel, 900 York Mills Rd, years. Rob continues to support the RTSO and is a
Toronto
great resource to myself and the RTSO Board. Thank
you sincerely.
Rob Bryan, RRT AA A-EMCA, RTSO Past President
& Chair, RTSO Executive Committee
Our volunteers work hard for you!
Thank You, Rob Bryan, for your 15-year tenure on Thank You Executive Committee, Board Members,
the RTSO Board! Your commitment to our profession Committees and Working Groups for your
is very much appreciated and continues to amaze me. dedication and efforts towards our profession.
Rob has served on the RTSO Education and
Editorial
Shawna MacDonald
RRT FCSRT
Welcome to the first 2019 issue of RTSO Airwaves!
(https://www.rtso.ca/ultrasound-for-rrts-rrt-aas/).
In addition to our regular features, note the new
Board of Directors and Committee members listed
on the inside cover. You’ll find details regarding our
membership campaign (https://www.rtso.ca/2019-
membership-application/), and as you read through
our publication you will see some of the many
reasons why membership with the RTSO matters!
This edition of RTSO Airwaves also includes
highlights from RT Week 2018, some fantastic
student submissions, Ministry updates, an update on
PTSD advocacy, and we’ve included the details on
point-of-care ultrasound delegation requirements,
with a link to delegation template documents
and educational resources for RRTs and RRT/AAs
As the evolution of our profession continues, I
encourage all of you to support the RTSO, now
more than ever. Members matter! Through
maintaining membership and recruiting new
members, to volunteering, sharing your expertise,
your time, your stories, your concerns and your
vision with us, you make your provincial professional
association stronger. It is through this collective
strength that powerful, unified, professional
representation at many tables is possible.
Membership makes a difference!
Together, let’s make this an exemplary year with
a thriving, engaged community of exceptional
Respiratory Therapists! It’s our time to shine!
RTSO Airwaves Winter 2019 7

Welcome new RTSO Director-at-Large, Raquel Rubinoff
Friends of the RTSO,
I’m Raquel, the most recent
addition to the RTSO.
Pleasure to meet you!
Since graduating from
Michener in 2017, I have
worked about a year with
a home Oxygen vendor,
serving the GTA anywhere
from Oakville to Oshawa,
and everywhere in between. I enjoyed working in
the community, being able to spend time with
my patients and helping empower them to be in
control of their O2 needs, while doing my best to
preserve their lifestyle within the confines of their
disease process.
Towards the latter portion of 2018, I decided to
take a leap and move on to acute care. I feel I have
entered a truly dynamic space that challenges me
each and every day - I have to admit, I really love it!
From endless discussions I’ve had with the most
recent graduating class, it was clear to me that our
struggles were alike: unsure of how to enter their
career, what it means to network, and how to create
a short and long term plan. It has been my mission
to help improve the transition from clinical year
to professional. This gap is definitely something I
would like to fill in my years to come, with the RTSO.
Developing mentorship opportunities, providing
easier access to continuing education/professional
development and enhancing resume writing and
interview skills, to better conducting themselves in
the workplace, are opportunities for support that
come to mind. It is definitely an ambitious pursuit!
Feel free to reach out - the RTSO is always looking
for additional support and areas to grow!
Next time you see me at a conference, RT event,
or local yoga studio - don’t be a stranger! I look
forward to developing with the RTSO and helping
further advocate for our profession in the province.
Take care and see you soon,
Raquel Rubinoff, BA(Hons) RRT
RTSO Airwaves Winter 2019 8

GE Healthcare
To learn more visit:
www.gehealthcare.com/carescape_R860
HOW THE JEWISH HOSPITAL – MERCY HEALTH
AND GE HEALTHCARE HOPE TO TAKE A BITE OUT
OF ICU COSTS
Admission rates to hospital Intensive Care Units
(ICU) are rising dramatically – along with the cost
of critical care. 1 Here’s how nutrition can impact
the cost of care for ventilated ICU patients.
GROWING ICU ADMISSIONS
FIVE
MILLION
ICU Patients 1
INCREASE
ICU Patients
2006-2015 2
UP TO
50%
ICU Patients
Malnourished 2
Extending this solution across all
U.S. hospitals could potentially
impact hospital’s clinical and
financial outcomes.
Nutrition is critical
in ICU recovery.
GE’s critical care
ventilators feature an automated
nutrition assessment application
to assist caregivers with their
ventilated patients.
ICU Patients
on ventilator 3
THE JEWISH HOSPITAL
RESULTS: 90-DAY STUDY 4
MULTI-DISCIPLINARY CLINICAL NUTRITION PROGRAM
28%
REDUCTION
Average ventilated ICU
patient LOS
~ 9k
LESS
Avg. cost reduction
per ICU ventilated
patient
$6
MILLION
Projected
annual savings
1. Department of Health Policy, George
Washington University School of Public
Health and Health Sciences, Washington,
DC, USA. http://www.ncbi.nlm.nih.gov/
pubmed/23672362
2. Reid, CL. Nutritional requirements of surgical
and critically-ill patients: do we really know
what they need? Proc Nutr Soc. 2004
Aug;63(3):467-72.
3. The American Association for the Surgery
of Trauma: Trauma Source - Mechanical
Ventilation in the ICU. Note: % ventilated
ICU patients referenced is a single source –
actual % may vary)
4. The Jewish Hospital Demonstrates Over
2-Day Reduction in ICU Length of Stay with
GE Ventilation. 2015.
Note: GE does not guaranty any cost savings.
These results are specific to The Jewish
Hospital only.
© 2015 General Electric Company. JB36390US
GE and the GE Monogram are trademarks of
General Electric Company.

Community RT
Sylvia Mortimer
BSc RRT CRE and
Kaela Hilderley
RRT CRE BEdAEd
Committee Reports
The Community RT Committee continues to
advocate for better, consistent access to Respiratory
Therapists for patients in Primary Care, Home Care,
and in Public Health sectors.
The Community RT Committee has the following
work underway:
• Primary Care Workforce survey (a joint task
force with the RTSO Research Committee)
• Needs Assessment for RRTs working in home
and community care
• Generic job description development for
home care RRTs
The results of each of these initiatives will be shared
when this work is complete.
Thoughtful and meaningful RT community
engagement is essential to creating strong, visible
and proactive leadership that advocates and
promotes the delivery of quality, patient-centered
care in the community. We are currently recruiting
volunteers. If you are an RTSO member with an
interest in community RT work and would like to
help, send us a message at office@rtso.ca and a
committee member will be in touch!
Research
Louise Chartrand
RRT PhD and
Shirley Quach
RRT HBSc
Happy New Year! New year, new changes. In this
edition of RTSO Airwaves, we have some very
important announcements.
As you may recall, in our previous update, Louise
Chartrand, one of our Co-Chairs, will be stepping
down to start a new and exciting position at
the University of Manitoba. At this time, we are
welcoming our interim and transitioning Co-Chair,
Tina Yan HBSc RRT CHT.
Tina has been an active committee member since
2017 and currently works at several downtown
academic hospitals. She was previously involved in
research, examining sleep quality among caregivers
of children who are dependent on medical
technology. She hopes to bring her enthusiasm,
dedication, and passion for research to help
RTSO Airwaves Winter 2019 10

Committee Reports
facilitate collaborative research opportunities among
RTSO members.
The RTSO Research Committee also extends a warm
welcome to our two new regular members: Tiffany
Tram and Praveen Nakesvaran. Tiffany has been
working in Critical Care and Hyperbaric Medicine at
University Health Network (UHN) since 2013. During
this time, she has completed multiple projects and
has held the position of a Research Coordinator.
Currently, Tiffany is involved in Quality Improvement
in healthcare through the Collaborative Academic
Fellowship at UHN. Our second member, Praveen,
works at Toronto Western Hospital, Humber River
Hospital and Sunnybrook’s Neonatal Intensive Care
Unit. Research is something Praveen always wanted
to advocate for in Respiratory Therapy practice. We
are happy to have such dedicated members join our
Research Committee; they both are looking forward
to contributing and improving the knowledge
translation of research into clinical practice.
We would also like to welcome our student
member, Mithin Koshy, onto our Committee. Mithin
is currently a student at St. Clair College, and
comes with previous research experience from the
Population Health Research Institute (Hamilton,
ON), in the Cardiovascular department. Mithin
views research as a key facet in the progression of
healthcare, as new treatments and technology can
further enhance patient care. He looks forward to
furthering the discussion about medical research
in terms of respiratory therapists as well as in
interprofessional development.
Furthermore, the Research Committee would
also like to report new student volunteers, whom
will work closely with Mithin to provide the latest
updates and research in respiratory care, which will
be available on the RTSO main Facebook page.
Please join us to welcome Sherry Said, Desmond
Chan, Harry Kanathasan, and Tanvi Patel. We are
so pleased to have students interested in the
importance of research in respiratory care! The team
of Student Respiratory Therapists have so far been
working hard to come up with creative new ideas to
share current innovative respiratory research with our
peers in Ontario.
Lastly, the Research Committee is pleased to
announce that we have started a new section in
RTSO Airwaves: Research Tips 101 for the RT.
This new section will feature articles focusing on
different essential components in research for our
RT colleagues, to enhance their understanding when
reviewing research articles.
This concludes our update for the beginning
of 2019. With the addition of new regular and
student members, the Research Committee plans
to review and revise our current strategic plan in
order to enhance our activities and opportunities for
Respiratory Therapists across Ontario. Do not hesitate
to reach out to our committee by emailing us via the
main RTSO email: office@rtso.ca.
“Alone we can do so little; together we can do so much.”
~Helen Keller
Membership Matters! #RTStrOng
RTSO Airwaves Witer 2019 11

More Than A Button Pusher:
The Role of RTs in Research and
Evidence-Based Practice
By Tina Yan RRT HBSc
Over the years, the role of respiratory therapists
has expanded from simple technicians and machine
operators to highly skilled professionals who are
indispensable team members in managing even the
most critically ill patients.
As a Michener Institute graduate and practicing
Registered Respiratory Therapist (RRT) with just
over one year of acute care experience, I have been
immersed in evidence-based practice (EBP). EBP
is a principle that incorporates research evidence
to guide everyday practice. Over the past decade,
EBP has been integral in healthcare to provide the
best recommendations for diagnostic tests, risk
stratification, disease screening, and treatment. In
the field of respiratory medicine, for instance, EBP
has been used to: i) identify optimal ventilation
settings in acute lung injury and acute respiratory
distress syndrome, ii) support the use of non-invasive
positive-pressure ventilation in COPD exacerbation,
and iii) identify optimal PEEP pressures using
esophageal balloons – to name a few examples.
RTs are uniquely qualified to think critically and
identify gaps in our own practice. As clinicians on
the frontlines of healthcare, we are often tasked with
providing our expertise in assessing patients and
making important treatment recommendations. For
example, RTs can be, at times, more knowledgeable
than any other healthcare professional when it
comes to monitoring and managing mechanical
ventilation.
Despite our clinical skillset and the ubiquity of EBP, a
relatively small proportion of RTs actively participate
in research, and fewer still contribute in a leadership
capacity. In reality, leadership roles such as principal
investigator roles have been primarily entrusted
to physicians. This begs the question: what do RTs
believe about the importance of EBP and what
are the barriers preventing RTs from engaging in
research-related leadership roles?
A study by Martins and Kenaszchuk (2013) surveyed
112 practicing RTs and education researchers
across six University of Toronto-affiliated teaching
hospitals to explore RTs’ attitude, perspective,
and perceived barriers towards research. They
found that the majority of RTs believed respiratory
therapy research was important and that research
would help advance the professional practice of
respiratory care. Most respondents also agreed RTs
were not only interested in research, but also best
suited to perform respiratory therapy research. The
study found that the major barriers to participating
in research included lack of time, incentive, and
skill. Interestingly, the level of attained education
was also positively correlated to the willingness to
perform research.
As clinicians with valuable expertise to offer, we
should aim to increase our presence in more
significant research roles. Clearly, from Martins
and Kenaszchuk’s (2013) study, RTs have conveyed
an interest in participating in research. One
solution is to modify respiratory therapy curricula
to convey the importance of research and equip
trainees with the tools to contribute in meaningful
roles. Leaders at academic hospitals should also
recognize the value of RTs in research and allocate
resources to encourage participation, for instance
by incorporating a formalized research role or by
offering opportunities for continuing education and
development.
Despite the variety of barriers, I am proud to report
that many of my colleagues have been actively
involved in research and some have authored articles
and earned higher academic degrees in pursuit
of this passion. I applaud them for their efforts in
helping to advance our practice and profession, and
I encourage others to follow in their footsteps.
RTSO Airwaves Winter 2019 12

More Than A Button Pusher:
The Role of RTs in Research and Evidence-Based Practice
References
Acute Respiratory Distress Syndrome Network.
(2000). Ventilation with lower tidal volumes as
compared with traditional tidal volumes for acute
lung injury and the acute respiratory distress
syndrome. New England Journal of Medicine,
342(18), 1301-1308.
Ambrosino, N., & Vagheggini, G. (2007). Noninvasive
ventilation in exacerbations of COPD.
International Journal of Chronic Obstructive
Pulmonary Disease, 2(4), 471.
Hess, D. R. (2004). What is evidence-based medicine
and why should I care? Respiratory Care, 49(7), 730-
741.
Martins, C., & Kenaszchuk, C. (2013). Research
capacity of respiratory therapists: A survey of
views, opinions and barriers. Canadian Journal of
Respiratory Therapy, 49(4), 15.
Piraino, T., & Cook, D. J. (2011). Optimal PEEP
guided by esophageal balloon manometry.
Respiratory Care, 56(4), 510-513.
RESEARCH TIPS 101
What is Qualitative Research?
By Tara Fowler, RRT CHT MHSc
Qualitative research is an inquiry that centers on the
way people make sense of their experiences and
the environment in which they practice. The aim of
qualitative research is to understand and describe
social phenomenon as perceived by individuals or
groups. Qualitative approaches are often used when
the researcher wants to explore behaviors, feelings
and experiences of people within the context of
a defined system. It is also used to understand
disparities in quantitative data. It is a very useful
approach to research when exploring changes or
within a system and to describe lived experience.
Qualitative research requires a unique set of skills
from the researcher. For example, building rapport
with participants is crucial therefore, active listening
skills are essential. The richest data can be obtained
when the relationship between the participant and
the researcher is one of trust and rapport.
Qualitative researchers need to have an awareness
of a broad range of research methods and the
knowledge to choose the most appropriate method
(Economic and Social Research Council, 2018).
Furthermore, the researcher should be flexible and
capable to modify his method to better cater to the
uncertainties of the research. They must then apply
those methods in a way which is consistent with
underlying philosophical assumptions. Qualitative
research analysis requires the researcher to make
sense of large amounts of data, which can be both
textual and visual and most times, a combination of
both (Economic and Social Research Council, 2018).
One of the main challenges with qualitative analysis
is to make the link between raw data, words and
or visual image, and theory. This involves reducing
the volume of raw information to what is significant,
identifying themes and constructing a conceptual
framework (Patton, 2002).
Qualitative research is able to capture the patient
perspective of healthcare, and to enable health
professionals to understand how patients and
families perceive the care provided to them
(Bryman, 2001). There is a growing body of
published research in this area which is used to
influence health policy and practice. Qualitative
RTSO Airwaves Winter 2019 13

What is Qualitative Research?
research in healthcare is important for answering
why and how questions. For example: “Why are
patients not compliant with treatment” or “What
are the enablers or barriers for Ventilator Associated
Care Bundles?” or “How does patient and
healthcare provider interact with each other?”
Some of the criticisms aimed at qualitative research
are concerned with the approach that involves
adapting research methods as the data-gathering
generates new information during the process of
the study (Bryman, 2002). Researchers have been
accused of ‘moving their goalposts’ (Greenhalgh
and Taylor, 1997). According to Britten et al (1995),
they have warned that this could result in a lack of
focus as researchers become unclear about what
they are investigating. The counterargument is that
researchers want to base their inquiries on realities
and viewpoints of those being studied, and these
might not be apparent at the outset of the study.
Furthermore, social context is highly unpredictable
and does require some flexibility in order to be able
to get to the answers that are really wanted.
Leadership
Sue Martin
RRT MA FCSRT
Kelly Hassall
RRT FCSRT MEd
The Leadership Committee has been working on list of available resources is anticipated to grow.
an RRT Outcome-Based Role Description. This Anyone who has additional resources to share or
comprehensive document aims to outline the who is in need of assistance in moving forward
various in-hospital roles the RRT can fulfill and with a medical delegation for point of care
will be inclusive of all patient populations, acute ultrasound is welcome to contact the RTSO at
and sub-acute areas of the hospital as well as office@rtso.ca.
outpatient services such as pulmonary function
and rehabilitation. A huge thank you to all of SAVE THE DATES!! The dates for the RTSO
those who have contributed to the document thus Leadership Summit and the INSPIRE conference
far. The aim is to have it Board approved by the have now been set. The RTSO Leadership
spring and forwarded to hospital CEOs across the Summit will be held on Friday, October 18th at
province, as well making the document available the RTSO/Lung Association Office. The RTSO
to RTs via the RTSO website.
INSPIRE Conference will be held on Saturday,
October 19th at the Westin Prince Hotel on York
The medical delegation resources for the use Mills Rd. in Toronto. What better way to kick off
of point of care ultrasound are now available RT Week than by networking with your fellow RTs
on the RTSO website https://www.rtso.ca/
and RT students and learning about the advances
ultrasound-for-rrts-rrt-aas/. As sites begin creating in the field of respiratory care!!
learning packages and training programs, the
RTSO Airwaves Winter 2019 14

Update on the Use of Energy/Ultrasound by RRTs:
RTSO Resources for Training, Delegation and Medical Directives
Related to the Use of Ultrasound in RRT and RRT/AA Practice
RRTs and RRT/AAs can use ultrasound for various
procedures in our practice. As of January 1st,
2019, an amendment to section 7.1 of the Ontario
Controlled Acts Regulation 107/96 will be in effect
permitting only Members of the College of Medical
Radiation Technologists of Ontario (CMRTO) and
the College of Nurses (CNO) to perform diagnostic
ultrasound under this provision.
As of January 1st, 2019, the following amendment
will be made to section 7.1 of the Ontario
Controlled Acts Regulation 107/96.
7.1 (1) A person is exempt from subsection 27 (1)
of the Act for the purpose of applying soundwaves
for diagnostic ultrasound if the application is
ordered by a member with ordering authority,
and the soundwaves for diagnostic ultrasound are
applied.
Note: On January 1, 2019, subsection 7.1 (1) of the
Regulation is amended by striking our “A person”
at the beginning and sustituting “A member of the
Colllege of Medical Radiation Technologists or a
member of the College of Nurses of Ontario other
than a member who is a registered nurse in the
extended class.” (See: O. Reg. 56617, s. 4(1)
O. Reg 107/96 Retrieved from:
https://www.ontario.ca/laws/regulation/960107
The changes to RHPA amendment 107/96 excludes
Respiratory Therapists and Respiratory Therapist
Anaesthesia Assistants from being able to
apply point of care soundwaves for diagnostic
ultrasound without delegation.
In an effort to support the RRTs and RRT/AA’s of
Ontario who are currently performing point of care
ultrasound at the bedside, the RTSO has worked
closely with Mackenzie Health to create a universal
delegation template document and sample
learning package.
The delegation document has been reviewed by
the CRTO and deemed to meet the requirements
to appropriately delegate the use of diagnostic
ultrasound at the bedside from the physician group
to the RRT or RRT/AA.
As with any procedure, the clinician would still
require a medical order to complete the procedure.
This order can come in the form of a written or
verbal order directly from the physician, or in the
form of a medical directive. It is possible to merge
the medical directive and medical delegation into
one document should your facility support doing this.
These can be found at: https://www.rtso.ca/
ultrasound-for-rrts-rrt-aas/
Diagnostic Ultrasound
Delegation Template Documents
• Point of Care Delegation Template
• Authorizer Approval Form Template
• Delegator Approval Form Template
• Delegatee Performance Readiness Form Template
RTSO Airwaves Winter 2019 15

Update on the Use of Energy/Ultrasound by RRTs
For additional templates (i.e. Medical Directive
combined with Delegation), please consult the
Rederation of Health Regulatory Colleges of Ontario
http://www.regulatedhealthprofessions.on.ca/
templates.html.
Additional Educational
Resources
In an effort to support the dissemination of
information and educational resources, the RTSO
has complied the following learning tools in regards
to the use of Point-of-Care Ultrasound.
• Point-of-Care Ultrasound Introduction Package
• New England Journal of Medicine
• Literature Search Results
Should you wish to contribute to this learning
repository, please contact the RTSO at office@rtso.ca.
Your input is very much appreciated and valued.
The documents are intended to serve as samples
for delegation and medical directives. The RTSO
and Mackenzie Health are not responsible for the
adaptation any of the content.
Ongoing Advocacy
The RTSO is advocating to the Ministry of Health
and Long-Term Care for RRTs including RRT/AAs to
be included in the next iteration of the amendment
to the legislation.
Links
CRTO Member Communique re: Diagnostic
Ultrasound
http://www.crto.on.ca/pdf/Communiques/
Ultrasound_Communique.pdf
Regulation 107/96, RHPA
https://www.ontario.ca/laws/regulation/960107
RTSO Resources for Training, Delegation and
Medical Directives
https://www.rtso.ca/ultrasound-for-rrts-rrt-aas/
#RTStrOng
Membership Matters
“Membership in the RTSO has been an investment in
not only my career but also health care in Ontario!
The RTSO advocates on behalf of our profession for the
best in patient care…across all practice settings.
I am proud and honoured to be a Respiratory
Therapist and RTSO member. The RTSO is ‘our voice’!”
Nancy Garvey, RRT MAppSc
RTSO Interim Project Advisor
RTSO Airwaves Winter 2019 16

RRTs and PTSD…and OSI
(Occupational Stress Injury):
Ontario RRTs are invited to participate in a survey
It is imperative to have services and supports in place to keep RRTs 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.
Submitted by Nancy Garvey, RRT, MAppSc, Fatima Foster, RRT, CRE, Co-Chairs and PTSD Working
Group Members
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). RRTs 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
invites Ontario RRTs to take part in a validated
survey that will provide anonymized insight to RRT
emotional and mental health experiences.
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.
RRTs are resuscitations 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), RRTs 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
RTSO Airwaves Winter 2019 17

RRTs and PTSD…and OSI (Occupational Stress Injury):
Ontario RRTs are invited to participate in a survey
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 RRTs protected, mentally
fit and healthy. To ensure we carry on our important
and heavily relied on expert services in very intense
and stressful situations, RRTs 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 RRTs 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/legislativebusiness/bills/parliament-41/session-1/bill-163
to
the Ministry of Labour.
In the meantime, the PTSD (post-traumatic stress
disorder) Working Group is assembling reliable
resources that are currently available to support us
all should we need them, planning to post them to
the RTSO website.
Stay tuned!
Your PTSD Working Group
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
Tania Del Rizzo RRT, William Osler Health Centre
Rob Bryan, RRT AA, A-EMCA, Mackenzie Health
Centre
Fatima Foster RRT, CRE, St. Joseph’s Healthcare,
Hamilton, Co-Chair
Nancy Garvey RRT, MAppSc, RTSO Interim Project
Advisor, Co-Chair
The RTSO Research Committee - Research Projects Summaries
RT Week 2018
For RT Week 2018, the RTSO Research Committee
called for submissions summarizing research
projects that Respiratory Therapists have been
or are currently involved in. The RTSO wishes to
thank tall who participated and submitted their
summaries, as we continue to recognize and
celebrate the great work that Respiratory Therapists
do to help keep our profession growing! These
summaries have been posted for your review at
https://www.rtso.ca/rt-week-2018-research/
RTSO Airwaves Winter 2019 18

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surgery: impact on the incidence of ventilator-associated pneumonia. J Hosp Infect. 2013;85(4):312-315.
3. Sargin M, Uluer MS. Comparison of McGrath® Series 5 video laryngoscope with Macintosh laryngoscope: A prospective,
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Committee Reports
Student Affairs
Gino De Pinto
BEd BSc (Hons) RRT FCSRT
Wendy Foote
RRT CRE
The Student Affairs Committee (SAC) has had a
great start to the school year. Student membership
to the RTSO is at an all time high. I would like to
thank all the student representatives who gave
talks to their classmates and encouraged them to
register. You all did an amazing job.
We had a successful social media campaign during
RT week (“Did you know the RTSO….”). The
campaign resulted in spreading the word of the
importance of our professional association which
is the collective voice of our profession at the
provincial level. Our hope is that students continue
with their support of the RTSO as they transition
to Graduate Respiratory Therapists and eventual
Registered Respiratory Therapists. Congratulations
to Sanjana Hye and the submission from Fanshawe
College as their interactive video garnered the most
social media engagements over a 24 hour period.
We would also like to take this time to thank Miriam
Turnbull and ProResp for sponsoring the event.
There has been a few changes to the SAC over the
past few months. Robyn Klages has stepped down
from the role as Chair as well as from the Board of
Directors. At this time we would like to thank Robyn
for all her contributions to the SAC and for her work
with the RTSO. Robyn will remain on the committee
and provide input as we move forward. I was asked
to put an application forward to take over the Board
of Directors role and I am happy to say that the
Board accepted my application. I am very honoured
to be a member of the RTSO Board of Directors
and Co-chair of SAC and with this new role be able
to give back to the profession that has given me so
much over the years.
We would also like to take this time to welcome
Wendy Foote from St. Clair College as she has
recently taken on the role of Co-chair. The table on
the following page has been updated with the new
roles and responsibilities.
Our two meetings this past fall have been very
positive. We have been able to provide some
great feedback to Nancy Garvey as she is working
to develop the PTSD policy. I would like to thank
Kathleen Olden Powell from The Michener Institute
for providing input and resources to help Nancy with
the project. We have 2 more meetings scheduled
for the winter semester.
Next on the agenda will be the recruitment of first
year student representatives to the SAC committee.
We hope to fill these vacancies in the next couple of
months.
We continue to encourage our students to provide
submissions to Airwaves so that respiratory
therapists can stay informed with evidence informed
practice. So please take the time to read the winter
submissions.
As always the committee looks forward to sharing
our future initiatives.
RTSO Airwaves Wiinter 2019 20

Committee Reports - Student Affairs
Faculty/Board Member
Gino De Pinto: Conestoga College, Co-Chair, BOD
Wendy Foote: St. Clair College, Co-Chair
Dave Wall: Fanshawe College
Sabrina Boucher: La Cité
Kathleen Olden Powell: The Michener Institute of
Education at UHN
Darren Brownrigg: Canadore College
Candace Murray-Norton: Algonquin College
Robyn Klages: William Osler Health System
Student Representative
Sarah Mohr: Conestoga College
Jessica Hodgkin: St Clair College
Sanjana Hye: Fanshawe College
Jessie-Lee Berniquez- La Cité
Shannon Smith: Michener Institute
Michelle Dadswell: Canadore College
To be Determined
Introducing Wendy Foote, RRT CRE
Co-Chair of the Student Affairs Committee
About Wendy:
Living in a border city, I graduated in 1990 with an
associate degree in Science – Respiratory Therapy
from Henry Ford Community College, Dearborn,
Michigan. Directly after graduation, I entered acute
care and continued there until 2000. I also gained
experience in OR instrumentation/maintenance,
PFT’s, and assisted in the development of a
pediatric asthma clinic for the Windsor region.
My career continued into community care with an
Ontario-based Home Oxygen vendor. I became
a CRE, and thoroughly embraced chronic disease
management! During this time, St. Clair College
invited me to sit on the advisory committee for the
new Respiratory Program starting up, and I was
hooked! I was asked to join the Program on a parttime
basis for the first cohort of students in 2011
and continued until moving into a full-time position
in 2014. I began a post-diploma BHSc program
through Dalhousie University on a part time basis
during this time.
I feel the variety of experiences I have gained over
the years, as well as being a student myself, are
of benefit to my students. I am very happy to be
supporting our students and their involvement in
the future of their profession, through the RTSO
Student Affairs Committee!
Wendy Foote, RRT CRE
Professor, Respiratory Therapy Program
School of Health Sciences, St. Clair College
2000 Talbot Road West
Windsor, ON N9A 6S4
Office: 519-972-2727, ext. 5291
wfoote@stclaircollege.ca
RTSO Airwaves Winter 2019 21

Student Perspectives: A Literature Review
Student Perspectives: A Literature Review
Respiratory Therapy programs throughout Canada
have been mapping their curriculums to the new
National Competency Framework (NCF). One of
the competencies that needs to be attained by
all Student Respiratory Therapists is B0.4 Apply
Evidence to Practice. The first step in applying
evidence to practice is finding and reading the
research that is currently available. Students can
accomplish this by completing a literature review and
give a student perspective on how this can impact
and ultimately improve patient care.
The mission of a Student Affairs Committee (SAC)
is to provide guidance and services that empower
students to realize their educational goals and
personal potential while they strive for lifelong
learning. Students will be sharing their findings with
the Respiratory Therapy community. This aligns nicely
with the performance category B0.4.1 of the NCF.
The SAC hopes you enjoy reading and learning
from the student submissions.
Gino
Interprofessional Education and
Training for Healthcare Students
Submitted by Manjot Mangat, SRT
Students coming from various healthcare
backgrounds such as nursing, medicine, and
respiratory therapy are educated and trained
separately, but are expected to work together
as a team in critical patient situations. In order
to give the best possible and most error-free
care to patients, it is dire that these healthcare
professionals are aware of the expertise
and roles within their team. The Canadian
Interprofessional Health Collaborative (CIHC)
has created national competency domains
to encourage and evolve interprofessional
collaboration (Gordon et al., 2017). Consistent
standards are used to measure the competence
of healthcare professionals which include
communication, collaboration, conflict
resolution, patient/family-centered care, roles/
responsibilities, and team functioning (King et
al., 2016).
Technology has advanced over the years and
one of the most effective ways to train healthcare
professionals on communication, collaboration, and
setting team goals within patient care practice is
to use simulation training (King et al., 2013). Many
studies have been conducted using simulation
based training where realistic scenarios of
respiratory distress were staged (King et al., 2013).
The teams consisted of students from nursing,
medicine, and respiratory therapy who had to
resuscitate a patient (King et al., 2013). Quality of
performance is measured in these sessions based
on team dynamics and how they interacted with
one another to appropriately manage and care for
RTSO Airwaves Winter 2019 22

Student Perspectives: A Literature Review
patients (Sigalet et al., 2015). After taking part in
an interprofessional simulation the training results
show there was significantly higher performance in
areas of leadership, patient-centered care, resource
utilization, and in task delegation (Sigalet et al.,
2015). These students then commented on their
experiences and understood the importance of
collaboration, communication, and knowledge of
other professions (Sigalet et al., 2015). Simulation
training should be placed in every program’s
curriculum to better prepare students for their
entry into practice. Simulation training can change
the attitudes, perceptions, and behaviour of
these healthcare professionals that leads to better
patient care and safety (King et al., 2013). Often,
healthcare professionals are afraid to question
another professional’s diagnosis, order, or treatment
plan. However, through this simulation training it
could be observed that professionals such as nurses
and respiratory therapists felt more confident in
questioning and communicating with doctors (King
et al., 2013).
If we consider the profession of respiratory therapy,
it has evolved significantly over the past sixty years.
It is important that interprofessional education exists
to raise awareness of the roles and responsibilities
of RTs (Sergakis et al., 2016). Mechanical ventilation
is a key concern in a healthcare setting. Respiratory
therapists can educate the health care team on
respiratory procedures (Sergakis et al., 2016). As
the needs of patients become complex, more
and more health care professionals are involved
in the treatment and care of these patients. It is
important for others to learn the roles and skill sets
of respiratory therapists and vice versa. Nurses
and other healthcare students need to learn of
the various respiratory therapy instruments and
techniques as well as consult with respiratory
therapists for various situations which would ensure
patient safety (Zamjahn et al., 2018).
Debriefing is very important for these simulation
trainings because these teams need to know
where they went wrong and where they performed
efficiently (Zamjahn et al., 2018). There is a lot of
work and research that is needed before educators
can optimize such training within their curriculum
but it will ensure patient safety.
References
Gordon, R., Flecknell, M., Fournier, T., Dupont, D.,
Gowlett, K., & Furlong, K. E. (2017). Partnering
for Patti: Shaping future healthcare teams
through simulation- enhanced interprofessional
education. Canadian Journal of Respiratory
Therapy, 53(4), 81-87. Retrieved September 26,
2018, from http://content.ebscohost.com/Conte
ntServerasp?T=P&P=AN&K=130789417&S=R&D
=ccm&EbscoContent=dGJyMNHX8kSeqLc40dv
uOLCmr1CeprVSsKm4TLG WxWXS&ContentCus
tomer=dGJyMOHl7H3x6rmF39/sU Pa8QAA
King, A. E., Conrad, M., & Ahmed, R. A. (2013).
Improving collaboration among medical,
nursing and respiratory therapy students
through interprofessional simulation. Journal of
Interprofessional Care, 27(3), 269-271. doi:10.31
09/13561820.2012.730076
King, J., Beanlands, S., Fiset, V., Chartrand, L.,
Clarke, S., Findlay, T., & Summers, I. (2016).
Using interprofessional simulation to improve
collaborative competences for nursing,
physiotherapy, and respiratory therapy students.
Journal of Interprofessional Care, 30(5), 599-605.
doi:10.1080/13561820.2016.1189887
RTSO Airwaves Winter 2019 23

Student Perspectives: A Literature Review
Sergakis, G., Clutter, J., Holthaus, V., Nelms, M. N.,
Rohrig, L., Legg, J., & Wilcox, J. (2016). The
Impact of Interprofessional Clinical Simulation on
Attitudes, Confidence and Professional Identity:
The Added Value of Integrating Respiratory
Therapy. Respiratory Care Education Annual,
25, 11-16. Retrieved September 26, 2018, from
http://content.ebscohost.com/ContentServer.asp
?T=P&P=AN&K=118287772&S=R&D=ccm&Ebsc
oContent=dGJyMNHX8kSeqLc40dvuOLCmr1Ce
p7BSsqm4TK6WxWXS&ContentCustomer=dGJy
MOHl7H3x6rmF39/sU Pa8QAA
Sigalet, E. L., Donnon, T. L., & Grant, V. (2015).
Insight into team competence in medical,
nursing and respiratory therapy students. Journal
of Interprofessional Care, 29(1), 62-67. doi:10.31
09/13561820.2014.940416
Zamjahn, J. B., Beyer, E. O., Alig, K. L., Mercante, D.
E., Carter, K. L., & Gunaldo, T. P. (2018).
Increasing Awareness of the Roles, Knowledge,
and Skills of Respiratory Therapists Through
an Interprofessional Education Experience.
Respiratory Care, 63(5), 510-518. doi:10.4187/
respcare.05869
The Impact of Chronic Obstructive Pulmonary
Disorder Morning Symptoms on
Patient Care and Quality of Life
Submitted by Kirsten Matthews, SRT
Chronic obstructive pulmonary disease (COPD)
is a common, progressive respiratory disease
characterized by constant airflow limitation
(Stephenson et al., 2015, p.577). The primary
symptoms of COPD include, but are not limited
to, sputum production, cough, and difficulty in
breathing (Tsiligianni et al., 2016, p.16040). The
main cause of the disease is tobacco smoking (which
includes second-hand and passive smoking), and
is more frequently occurring among individuals
with other chronic diseases as compared to those
without. COPD mostly affects individuals aged 35
and older (Public Health Agency of Canada [PHAC],
2018, pp. 1-2). Known to be a major cause of
death and disability, the World Health Organization
estimated COPD to be the third leading cause of
death in 2012 worldwide (PHAC, 2018, p. 24).
Many studies have determined there to be variations
among reported COPD symptoms throughout the
day, with the greatest severity of symptoms seen in
the morning. Research has also found an association
between severity of morning symptoms and
frequency of exacerbation of COPD (Roche et al.,
2013, p. 112).
A study by Stephenson et al. completed a 30-minute
cross-sectional survey on a patient sample of 1,239
individuals aged 40 and older (2015, p. 578).
Individuals with other lung diseases and/or HIV
diagnoses were excluded from the study. Eligible
patients who gave verbal consent were asked survey
questions which included information about specific
COPD symptoms, when patients experienced
them, the number of mornings/nights patients had
experienced these symptoms, symptom severity,
RTSO Airwaves Winter 2019 24

Student Perspectives: A Literature Review
and how symptoms impacted the patients’ sleep Therefore, further research needs to be done on
and/or early morning activities (Stephenson et al., other treatment options to allow for personalized
2015, p. 578). Severity of symptoms was measured combination therapy.
using the modified Medical Research Council
(mMRC) dyspnea scale, and the impact of COPD Based on this research, by improving approaches
on health status was measured using the COPD to evaluation of COPD and COPD disease
Assessment Test (Stephenson et al., 2015, p. 579). management, there is potential for better control
of symptoms and better patient care (Roche et al.,
The study found that a large proportion of
2013, p. 112).
individuals reported having early morning symptoms
only, or in combination with nighttime symptoms. References
As well, over half of all patients reported symptoms Public Health Agency of Canada. (2018). Asthma
as being moderate to severe. Finally, patients
and Chronic Obstructive Pulmonary Disease
reported that these early morning symptoms caused (COPD) in Canada, 2018 [CCDSS Report 2018].
limitations to their daily activity, or caused feelings Retrieved September 27, 2018, from https://
of anxiety, thus interfering with their quality of life www.canada.ca/en/public-health/services/
(Stephenson et al., 2015, p. 280). Stephenson et publications/diseases-conditions/asthma-chronicobstructive-pulmonary-disease-canada-2018.
al. concluded that experiencing early morning
symptoms was “significantly associated with
html
poorer health status”, and “the presence of both
nighttime and early morning symptoms [was Roche, N., Chavannes, N. H., & Miravitlles, M.
also associated] with the occurrence of previous (2013). COPD symptoms in the morning:
exacerbations, dyspnea, and poor medical
Impact, evaluation and management.
adherence” (2015, p. 585).
Respiratory Research, 14(1), 112. http://doi.
org/10.1186/1465-9921-14-112
An important conclusion following this research is
that care providers should be including morning Stephenson, J. J., Cai, Q., Mocarski, M., Tan, H.,
symptom evaluation as part of their clinical
Doshi, J. A., & Sullivan, S. D. (2015). Impact
assessment, with control of morning symptoms as and factors associated with nighttime and early
a treatment goal. As well, validated assessment morning symptoms among patients with Chronic
tools should be created to help with evaluation
Obstructive Pulmonary Disease. International
of symptoms and disease process (van Buul
Journal of COPD, 10, 577-586. http://doi.
et al., 2017a, p. 160033). Pharmacotherapy is
org/10.2147/COPD.S76157
another suggested tool for improvement of
Tsiligianni, I., Metting, E., van der Molen, T.,
disease management (van Buul et al., 2017b,
Chavannes, N., & Kocks, J. (2016). Morning and
p. 320). Though van Buul et al. showed that
night symptoms in primary care COPD patients:
pharmacotherapy can help to alleviate morning A cross-sectional and longitudinal study. An
symptoms and enhance performance of everyday UNLOCK Study from the IPCRG. Primary Care
morning activities, it was concluded in their
Respiratory Medicine, 26, 16040. http://doi.
study that “pharmacotherapy alone will not solve org/10.1038/npjpcrm.2016.40
morning symptoms in all patients” (2017b, p. 320).
RTSO Airwaves Winter 2019 25

Student Perspectives: A Literature Review
van Buul, A. R., Kasteleyn, M. J., Chavannes,
N. H., & Taube, C. (2017). Association between
morning symptoms and physical activity
in COPD: A systematic review. European
Respiratory Review 2017, 26, 160033. DOI:
10.1183/16000617.0033-2016
van Buul, A. R., Kasteleyn, M. J., Chavannes, N. H.,
& Taube, C. (2017). Morning symptoms of COPD: A
treatable yet often overlooked factor. Expert Review
of Respiratory Medicine, 11(4), 311-322. https://doi.
org/10.1080/17476348.2017.1305894
Nasal High-Flow Therapy for Primary Respiratory
Support in Preterm Infants
Submitted by Lindsey Morin, SRT
Preterm births are those that occur at less than 37
gestational weeks (Mayo Clinic, 2017, Premature
Birth, para. 1). Premature infants often have an
increased risk of respiratory-related issues, with
the reason ultimately being that their bodies
have not had the full-term gestational period to
completely develop. Some of the most common
causes of fatality in premature infants admitted to
neonatal intensive care units include pulmonary
disorders and respiratory failure (Mauro et al., 2017,
pg. 117). To reduce complications and long-term
respiratory challenges in these preterm infants,
noninvasive respiratory support approaches have
been developed and are used regularly in hospitals.
One of the most recent respiratory support systems
developed is nasal high-flow therapy (nHFT).
Calum et al (2016) discuss a study performed on
the topic of nHFT for preterm infants in the article
“Nasal High-Flow Therapy for Primary Respiratory
Support in Preterm Infants” (pp. 1142-1151).
The study aimed to test the efficacy of nHFT as
a primary respiratory support in preterm infants
with respiratory distress and compares it to that of
an alternative treatment method known as nasal
continuous positive airway pressure (CPAP). For the
study, 564 preterm infants (gestational age of more
than 28 weeks) that had early respiratory distress
were randomly assigned to two groups: either
treatment with nHFT or treatment with CPAP. All
infant participants had not received endotracheal
ventilation or surfactant treatment prior to their
nHFT or CPAP treatment. The infants in which
nHFT did not work on received rescue CPAP, and
those in which CPAP did not work were intubated.
Treatment failure was the primary outcome of this
study, along with multiple secondary outcomes
including nasal trauma, use of mechanical ventilation
within 72 hours, and complications of prematurity.
The outcomes were analyzed based on intention-totreat.
The study found that treatment failure within
72 hours occurred in 25.5% of infants treated with
high-flow, compared to 13.3% of the infants in the
CPAP group, showing a significantly larger failure
rate for the nHFT (Calum et al., 2016, pg. 1145).
There was not, however, a significant difference in
intubation rates between the two groups. The CPAP
group also showed significantly more nasal trauma
(18.5%) compared to the nHFT group (8.3%) (Calum
et al., 2016, pg. 1148). Conclusively, Calum et al
RTSO Airwaves Winter 2019 26

Student Perspectives: A Literature Review
(2016) found that when used as a primary support Mauro, A.D., Capozza, M., Cotugno, S., Tafuri, S.,
for preterm infants that have respiratory distress, Bianchi, F.P., Schettini, F., Panza, R., & Laforgia,
nHFT produced significantly higher treatment failure N. (2017). Nasal high flow therapy in very low
rates than did the CPAP therapy.
birth weight infants with mild respiratory distress
syndrome: a single center experience. Italian
Although this study found nHFT to have a higher Journal of Pediatrics, 43, (116-123). doi: 10.1186/
failure rate than that of CPAP, nHFT is considered s13052-017-0438-9
a preferable and alternate treatment because
of its non-invasive nature and ability to improve Mayo Clinic (2017). Premature birth. Retrieved
interaction between the parent(s) and infant
September 27, 2018, from https://www.
(Prentice, 2018, pg. 102). Owen et al. (2017)
mayoclinic.org/diseases-conditions/prematurebirth/symptoms-causes/syc-20376730.
describe additional benefits of nHFT as “[having] a
simple interface, easy application, improved infant
comfort, and preference by parents and nurses” Owen, L.S., Manley, B.J., Davis, P.G., & Doyle, L.W.
(pg. 1653). Some concerns regarding this form of (2017). Neonatal intensive care 2: the evolution
respiratory therapy have risen, mainly surrounding of modern respiratory care for preterm
the fact that there are no measurements or control infants. The Lancet, 339(10079),1649-1659.
over the airway pressure in this method (Owen et al., Retrieved on September 26, 2018, from https://
2017, pg. 1653). Overall, most would say nHFT has journals-scholarsportal-info.libproxy.wlu.ca/
been a positive addition to the respiratory therapy pdf/01406736/v389i10079/1649_teomrcfpi.xml
world, as it has provided a more non-invasive
treatment for premature infants (as well as a larger Prentice, CM. (2018). Heated humidified high flow
population). Due to the novelty of nHFT, more
nasal cannula compared to nasal continuous
studies need to be done to fully understand the positive airway pressure for neonates: a systematic
processes involved during nHFT, and the short- and review and meta-analysis. Journal of Paediatrics
long-term outcomes of that arise from this form of and Child Health, 3(128), 102. Retrieved on
respiratory therapy.
September 26, 2018, from https://journalsscholarsportal-info.libproxy.wlu.ca/pdf/10344810/
References
v54inone_s/102_hhhfncnasram.xml
Bailey, C.A. (2011). What is CPAP? Journal of
Asthma & Allergy Educators, 2(3), (147-148). doi:
10.1177/2150129711410565
“Save the Dates!”
October 18 RTSO Leadership Summit
October 19 INSPIRE 2019
RTSO Airwaves Winter 2019 27

RT’s & PTSD – Let’s Talk About It
How often do you
disconnect?
Flusso is a by pass adapter that can be used
with passive or active humidity systems
to prevent the disconnection of the patient
from the mechanical ventilator during a circuit
change or disconnection of patient for transport.
www.flussobypass.com
Made in Canada
McArthur Medical Sales Inc
1846 5th Concession Rd W
Rockton, ON L0R 1X0
1-800-996-6674
mmsi@mcarthurmedical.com
www.mcarthurmedical.com
Flusso and Swing Valve Technology are trademarks used
under licence by McArthur Medical Sales Inc.
US and International Patents Pending

The RTSO serves as the voice of the profession,
and its purpose is to:
• Represent the professional interests of
Respiratory Therapists in Ontario, voicing
concerns in a consistent, unified manner.
• We provide a voice at many provincial
tables, and pursue initiatives in
collaboration with many partners. Have
a look at what we have accomplished:
https://www.rtso.ca/advocacy/
• Promote leadership and direction in the
expansion of the role of the Respiratory
Therapist in response to the changing health
needs of the community.
• Did you know we host an annual
Leadership Summit, that brings together
RT leaders from across the province to
network and share information related to
healthcare transformation, Patients First
implementation, professional growth,
advocacy work, and more!
• Encourage the professional growth of our
members by supporting the development,
promotion and provision of research and
educational opportunities, supporting
programs in research, patient care,
education, leadership and management.
• We strive to provide and share
educational opportunities throughout the
year
• RTSO Airwaves is a quarterly publication
ROLE OF THE RTSO
that highlights our profession and the
great work happening across the province
• Our Research Committee provides
leadership, support and resources relating
to respiratory research, evaluation and
quality improvement initiatives that will
improve health outcomes
• Participate in the planning and delivery of
high quality health care.
• We care about what matters to you!
• Support and provide public education and
advocacy on respiratory health and disease
prevention.
• Have you read the joint CSRT-RTSO
Cannabis position statement?
• Promote the profession of Respiratory
Therapy.
• Here is some of the work we do for you:
• Point of Care Ultrasound Delegation
and Medical Directive resources for
RRTs and RRT/AAs https://www.rtso.
ca/ultrasound-for-rrts-rrt-aas/
• Post-Traumatic Stress Disorder (PTSD)
advocacy for RRTs
• Primary Care RRT role description
development and salary compensation
advocacy work
• Bill 71, Lung Health Act - RTSO
Deputation
• Develop and maintain standards for practice
for Respiratory Therapy.
RTSO Airwaves Winter 2019 29

Membership Matters
#RTStrOng
#RTStrOng
Membership Matters
“I am proud to be a Respiratory Therapist working
in Ontario. As a member of the RTSO, I have an
opportunity to share ideas, voice concerns, and
work with others to advocate for our patients and
my chosen profession.”
Kelly Hassall, RRT MEd
Clinical Resource Leader, Respiratory Therapy,
St. Joseph’s Healthcare, Hamilton
RTSO Board of Directors & Co-Chair of the RTSO
Leadership Committee
Membership Matters
“I proudly support my professional association
through membership and volunteerism.
The RTSO is the voice of Respiratory Therapists
in Ontario. If you are not a member, who is
speaking for you?”
Shawna MacDonald RRT FCSRT
RTSO Board of Directors &
Editor-in-Chief, RTSO Airwaves
Membership Matters
“I am a proud student member of the RTSO. I
value that our profession has a collective
voice in Ontario to advocate for and promote
Respiratory Therapy. I’m looking forward to
being a part of that voice for Respiratory
Therapy students.”
Hannah Erhardt SRT
RTSO Student Affairs Committee
First Year Conestoga College Representative
#RTStrOng
Membership Matters
“As a Student Respiratory Therapist, I am
proud to be a part of an organization that
encourages students across the province
to become active participants in
developing our profession!”
Laura Tangelder, SRT, BHSc
RTSO Student Advisory Committee
Fanshawe College
Membership Matters
“I am a proud member of the RTSO and the
Student Affairs Committee! Being a member has
allowed me to have a greater understanding in
the importance of a committee that advocates
for the Respiratory Therapy profession.”
Carissa Coghill, SRT
Member, Student Affairs Committee (SAC)
St. Clair College, 1 st year SAC Representative
#RTStrOng
#RTStrOng
Membership Matters
Membership Matters
“I’m grateful for the strong voice of the RTSO in
advocating for, and promoting of our
profession. I’m proud to be a member, and
appreciate opportunities to work with others
who are focused on strengthening our ability to
provide quality care to our patients.”
Kari White, RRT FCSRT
Clinical Leader Manager – Respiratory Therapy,
St. Michael’s Hospital, Toronto
Member, RTSO Leadership Committee
“ RTSO Membership means ‘collective advocacy’.
The RTSO ensures a consistent voice for Respiratory
Therapists at the local and provincial level, striving to
market the profession and make our voices heard.
This impacts professional practice and ensures
decision-makers recognize the contribution of RTs,
with the ultimate goal of benefiting the healthcare
system and patients/clients.
We can do it!!! ”
Mike Kampen, RRT BSc MHS(c)
Chief of Interprofessional Practice, Hamilton Health Sciences
RTSO Airwaves Winter 2019 30

Membership Matters
#RTStrOng
Membership Matters
“As a member of the RSTO and the SAC representative
for the Michener Institute, I have learned the
importance of a collective voice for RTs within Ontario.
The profession deserves all the recognition and
enthusiasm the RSTO works for. I am proud to be a
student RT and an RTSO member.”
Shannon Smith, SRT
RTSO Member
Michener rep for the Student Affairs Committee
Membership Matters
“The RTSO is a progressive and collaborative
organization that advocates for all Registered
Respiratory Therapist working in Ontario. I am
proud to be a member of an organization that
promotes initiatives important to the profession
and the health of our patients.”
David Wall RRT, B.Sc., M.Ed., CCAA
RTSO Student Advisory Committee
#RTStrOng
#RTStrOng
Membership Matters
“It’s important in any profession to have a formal
body that advocates on behalf of the professionals
who devote their time, energy, and passion. The
RTSO is that body for Respiratory Therapists in
Ontario and I am proud to be a participating
member.”
Sarah Mohr, SRT BA MA
RTSO Student Advisory Committee
Conestoga College
Membership Matters
“Being a member of the RTSO has given me the
opportunity to get involved in the Respiratory
Therapy community and a platform to grow and
also be the voice of our growing profession. Let’s
get involved and be an advocate for the RT
profession together!”
Sanjana Hye, SRT RPSGT BSc
RTSO Student Advisory Committee
Fanshawe College
RTSO Advanced Practice Education Award
for Anesthesia Assistants
The RTSO sponsors this award to recognize Anesthesia Assistant Students
from an accredited Anesthesiology Assistant program in Ontario
for exemplary clinical and leadership skills at the provincial level.
Congratulations to recent recipients of this award:
Jennifer Hedley
Karen Stockwell
Please join the RTSO in congratulating these exemplary individuals on
their dedication to patient care, practice excellence, and leadership!
The call for nominations for the RTSO Advanced Practice Education Award
for Anesthesia Assistants is NOW OPEN!
See https://www.rtso.ca/wp-content/uploads/2018/10/Anesthesia-Award-2019.pdf for details
RTSO Airwaves Winter 2019 31

MeMbership ApplicAtion
SPECIAL 15 MONTH RENEWAL
For Membership Term - January 1, 2019 to March 31, 2020
18 Wynford Drive, Suite 401
Toronto, ON M3C 0K8
Tel: 647-729-2717/Fax: 647-729-2715
Toll Free: 1-855-297-3089
E-Mail: office@rtso.ca
www.rtso.ca
First Name:____________________________ Last Name: ____________________________CRTO Number: _________________
Mailing Address: __________________________________________City ______________________Postal Code______________
Personal Telephone: _______________________________ Email: ____________________________________________________
Employer: ________________________________________
Position:______________________________________________
Bus Telephone: ______________________________ Ext.: _______________
Fax: ___________________________________
Please indicate areas of interest:
Advocacy Research RTSO Airwaves Student Affairs Leadership Community RT
MeMbership OptiOn DescriptiOns
Practicing MeMber
Option 1
PL&I included
Professional Liability & Indemnity Insurance benefits** included.
RTSO Membership January 1, 2019 through March 31, 2020;
PL&I for April 1, 2019 to March 31, 2020.
$230.56
(HST $18.20 & PST
$5.36 included)
Option 2
NO PL&I
RTSO Membership January 1, 2019 through March 31, 2020. $158.20
(HST $18.20 included)
HST Registration # 107889339
*In choosing to apply for the Professional Liability & Indemnity Insurance**, the undersigned respiratory therapist declares that he or she has never been the recipient
of a claim which could be covered under the present policy; or is not aware of any circumstances which could lead to a claim under the present policy.
**Professional Liability & Indemnity Insurance coverage: $2M/incident / $4M aggregate; Nil Deductible
Disciplinary Defense: $175,000/claim / $175,000 Annual Aggregate
Criminal Defense Reimbursement: $200,000/incident / $200,000 Annual Aggregate;
Sexual Abuse Counselling & Rehabilitation: $10,000/insured / $250,000 Annual Aggregate
Legal Representation Expenses: Subpoenaed as witness $1,500 each claim
Complaint $5,000 / Max annual aggregate for both $50,000
Please be advised that RTSO membership no longer includes complimentary ORCS membership.
The RTSO is a strong supporter and strategic partner of the Ontario Lung Association and encourages all RTSO members to register or renew their ORCS
membership through the following link: https://lungontario.ca/orcs-membership
To Register.....Click Here
RTSO Airwaves Winter 2019 32

RTSO CORPORATE MEMBERSHIP PROGRAM
The RTSO provides the opportunity to showcase your company and products through various options that
offer you the best exposure to Respiratory Therapists across Ontario.
With over 3000 Registered Respiratory Therapists in the Province of Ontario, the RTSO reaches out to our
membership and beyond.
MEMBERSHIP BENEFITS:
The Corporate Membership program for 2018 is $2,500 plus HST (total $2,825) per 12month period includes:
• One full page interior advertisement in our quarterly Airwaves editorial
• Corporate sponsor participation in the annual Leadership Summit
• Leadership Network contacts updated on a regular basis (courtesy part of program)
• One 30 Day Job Posting (Web-site, LinkedIn, e-blast)
• Logo posting and RTSO web link on the RTSO website for one year
• A Product launch or service information e-blast to members
• Corporate sponsor acknowledgement as relevant, i.e. during RT week emails/postings, presentations
to hospital groups, etc. (courtesy part of program)
• Preferred CME opportunities via Ontario Telemedicine Network, Live Events (CME not included in the
cost)
• Reduced rates for booth participation at our annual conference
• Real World research opportunities through our RRT research network
To Register…. Click Here
For more information contact:
Dilshad Moosa BSc RRT CRE MASc
RTSO Executive Director
18 Wynford Drive, Suite 405
Toronto, ON M3C 0K8
Tel: 647-729-2727
Toll Free: 1-855-297-3089
office@rtso.ca
dmoosa@rtso.ca
www.rtso.ca
RTSO Airwaves Winter 2019 33

MORE THAN
75 YEARS
OF IMPROVING
THE HEALTH
& WELL-BEING
OF PEOPLE
WORLDWIDE
At Grifols, we are proud of our
pioneering spirit and history of
innovation. In 1940, we founded
a company that has helped
transform hematology.
Today, we are a global leader
providing life-saving protein
therapies, diagnostic solutions,
and other tools that hospitals,
pharmacies, and healthcare
professionals need to deliver
expert medical care.
Learn more about Grifols at
www.grifols.com
US/CO/0116/0049

The Allied Health Professional Development
Fund (AHPDF) provides financial support
to nine allied health professions to provide
continuing education opportunities that
contribute to increased quality of patient
care in Ontario, and to encourage allied
health professionals to stay and work in the
province.
Respiratory therapists can apply for up
to $1,500 for professional development
courses and programs.
The AHPDF has invested in a multi-year
subscription to an electronic health library
for practising members of the nine eligible
health professions. The library provides
access to the most recent health care
literature to help allied health professionals
determine the best approach to patient care.
Visit: https://ahpdf.ca/index.php?q=en/
howtoapply for details and https://www.
ahpdfonline.ca to apply online for funding.
NEWS
Ministry of Health and Long-Term Care
OHIP+ Changes
OHIP+ is being redesigned, with changes
coming in to effect on April 01, 2019. The
MOHLTC is hosting weekly webinars to
provide an overview and to answer questions
regarding changes to program coverage,
and the RTSO will share the webinar
information with you as it becomes available.
See https://www.ontario.ca/page/learnabout-ohip-plus
to learn more.
Ontario Health agency
Learn how Ontario is building a health
system that works for everyone by
integrating provincial health agencies and
programs to improve the patient experience.
Visit https://www.ontario.ca/page/ontariohealth-agency
for details.
RTSO Airwaves Winter 2019 35

Ministry of Health and Long-Term Care
Non-invasive Ventilation (NIV) and CoughAssist (CA) Therapies
in Long Term Care (LTC) Homes Program Engagement
Program goal:
To support care and service needs of residents with
complex medical conditions requiring NIV and CA
therapies in LTC homes.
Target population:
We identified 4 possible resident populations:
• Individuals who are living in hospitals and
cannot be discharged because of their higher
care needs, including NIV therapy, which
currently cannot be met in LTC
• Individuals living in the community with NIV
therapy supports who meet the criteria for
admission to a long stay LTC bed (O. Reg
79/10 s. 155)
• Individuals living in the community with NIV
therapy supports who meet the criteria for
admission to a short stay LTC bed (O. Reg
79/10 s. 156)
• Individuals who live in a LTC home and require
NIV therapy due to the progression of their
co-morbid clinical condition(s)
Mid/long term outcome objectives:
• Residents of LTC homes requiring NIV and/or
CA therapies are deemed eligible for ADP
• Residents of LTC homes have access to NIV
equipment through the Ontario Ventilator
Equipment Pool
• Residents of LTC homes requiring NIV
therapies have access to support programs in
LTC long and short stay beds that meet their
complex medical conditions requiring NIV
therapy
Short term outcome objectives:
• Target population estimate, demographics
and geographic locations
• Defined program parameters and budgets
(direct and indirect costs) to meet the
needs of each of the four identified resident
populations in LTC
• Operational design (LTC caregiving/
environmental process map) and best practice
guidelines, outcome and performance
indicators
• Implementation plan based on prior research
done by SWLHIN
• Communications plan and materials for
residents, families, other health service
providers and stakeholders
• Tool kit to support residents of LTC homes
currently on NIV (best practices)
The RTSO representative on this panel is
Mika L. Nonoyama PhD, RRT, FCSRT.
RTSO Airwaves Winter 2019 36

NEWS
Ministry of Health and Long-Term Care
Ontario’s Government for the People Supporting Compassionate End-Of-Life Care
Helping more people get end-of-life care in a home-like setting
December 10, 2018 11:42 A.M.
Ontario’s Government for the People is providing
more people across the province with the
compassionate care they deserve when nearing the
end of their lives.
Today, Christine Elliott, Deputy Premier and
Minister of Health and Long-Term Care, was joined
by Effie Triantafilopoulos, Parliamentary Assistant
to the Minister, and Jane McKenna, MPP for
Burlington, at Carpenter Hospice to announce that
the government is moving forward with plans to
build 193 new hospice beds across Ontario.
“Building new hospice beds across Ontario will
provide people with end-of-life care and support
in a more comfortable setting,” said Elliott. “With
early investments like these, our government is
ensuring that these patients are provided with the
proper comfort, dignity and respect they deserve.
This will also help to make more beds available for
those who need hospital care. Our government
is moving forward quickly to address challenges
facing the health care system as we develop our
long-term transformational health care strategy.”
Hospices provide patients with palliative care in
a comfortable space, where they can be close to
loved ones. In this environment, family and friends
can have peace of mind knowing that patients
will have access to appropriate end-of-life care.
Hospice care focuses on relieving suffering and
providing services like psychological, spiritual and
bereavement support.
“Our government is increasing access to hospice
beds across the province, by providing appropriate
end-of-life care for those who need it,” said
Triantafilopoulos. “This investment is also helping
to address hallway health care, by ensuring more
hospital beds remain available for those in need of
acute care. We’re creating more beds and spaces to
alleviate the pressures on our health care system.”
“Everyone should have access to dignified endof-life
care that respects the wishes of the patient
and their loved ones,” said McKenna. “That’s
why I am proud our government is committed to
improving access to comfortable, end-of-life care in
communities across the province like Burlington.”
QUICK FACTS
• Ontario is investing nearly $33.6 million to build
193 new hospice beds across the province.
• When these beds open, the government will
provide $20.3 million each year in operational
funding for nursing, personal support, and other
services.
• The government is supporting an additional
6,000 new long-term care beds – the first wave
of more than 15,000 new long-term care beds
being added in the next five years.
• Ontario is investing an additional $90 million
in 2018-19 to build 1,100 beds and spaces in
hospitals and the community, including 640 new
beds and spaces.
Media Line Toll-free: 1-888-414-4774
media.moh@ontario.ca
GTA: 416-314-6197
David Jensen Communications Branch
media.moh@ontario.ca
416-314-6197
For public inquiries call ServiceOntario (Toll-free
in Ontario only)
1-866-532-3161
Hayley Chazan Deputy Premier & Minister of
Health and Long-Term Care’s Office
hayley.chazan@ontario.ca
416-726-9941
Available Online
Disponible en Français
RTSO Airwaves Winter 2019 37

What Science Can Do
At AstraZeneca, we believe in the power of what science can do to transform
serious diseases like cancer, heart disease, diabetes, COPD and asthma.
Each and everyone of us is bold in the belief that science should be at the
centre of everything we do. It compels us to push the boundaries of what is
possible. To trust in the potential of ideas and pursue them, alone and with
others, until we have transformed the treatment of disease.
The AstraZeneca logo is a registered trade-mark of AstraZeneca AB, used under licence by AstraZeneca Canada Inc.

RT Week at Hamilton Health Sciences
RT Week at Hamilton Health Sciences (HHS) has
been recognized and celebrated for many years.
Public displays at our community kiosks, hospital
news announcements, daily “Lunch & Learns”,
social activities and two Respiratory Therapy awards
are some of the many highlights to this special
week. New this year was the week long lighting
of the McMaster Children’s Hospital towers, in
RTSO colours of purple and orange, as part of our
celebration!
The 2018 recipient of this prestigious award was
Kevin Fisher, who works both as a therapist and an
HBO clinician at Hamilton General Hospital (HGH).
Kevin was nominated for this award by 3 of his
peers. Congratulations, Kevin, for this wonderful
accomplishment and recognition of greatness!
Another way we celebrate our profession is to plan
and host an annual RT Educational Retreat each Fall.
This year our event was held in September. This
highly engaging event was organized by a group of
volunteer staff Respiratory Therapists led by Kendra
Mantha, RT Clinical Leader at McMaster Children’s
Hospital, and Allison Nykolaychuk, an HHS RT
Education Clinician. Designed with Respiratory
Therapists in mind, the event showcases speakers,
workshops and professional networking supported
by healthcare partners and many great RT product
and service vendors that contribute to and celebrate
our profession. We also held a CRTO PORTfolio
Workshop directly following this year’s event…
special thanks to Carole Hamp for supporting us!
Respiratory Therapy Excellence Award
The Hamilton Health Sciences (HHS) Respiratory
Therapy Excellence Award is an award that
celebrates an outstanding Respiratory Therapist
who consistently demonstrates excellence in their
role and it’s relation to patient care delivery and
teamwork. Nominators provided their reflections
and information about the nominees in the
following domains: Clinical Excellence, Teaching /
Education Skills, Leadership Skills and Professional
Accomplishments.
Alison Chadwick (left), Co-Chair, HHS RT Practice
Council, presents the 2018 RT Excellence Award to
Kevin Fisher (right) on Monday, October 15, 2018 in the
RT Department at the Hamilton General site of HHS.
Respiratory Therapy Bedside Teaching Award
The HHS Respiratory Therapy Bedside Teaching
Award is an award that celebrates an outstanding
Respiratory Therapist who consistently demonstrates
educational excellence with Student Respiratory
Therapists (SRT’s) at HHS. The nominators for this
award are all SRT’s who have had clinical rotations
through HHS. The 2018 recipient of this prestigious
award was Veena Deekonda, a staff therapist in NICU
at McMaster Children’s Hospital. Congratulations,
Veena, on this wonderful accomplishment and
recognition of greatness!
RTSO Airwaves Winter 2019 39

RT Week at Hamilton Health Sciences
Allison Nykolaychuk RRT and Clinical Practice &
Education Clinician at HHS (right), presents the 2018
RT Bedside Teaching Award on October 17, 2018 to
Veena Deekonda RRT (left), a staff therapist in NICU
at McMaster Children’s Hospital.
RT MONTH AT CONESTOGA!
We celebrated RTs for a whole month at
Conestoga College with engaging and
educational events. From a welcome BBQ
for the first year RT students, a Thanksgiving
Food Drive to benefit the local food bank, to
an Oxygen Therapy Peer Mentoring Night and
an RT Night at Oktoberfest, to hosting Airway
Olympics and Poster Board Presentations,
this series of events built awareness of the
profession and celebrated its important role
within the healthcare community.
RTSO Airwaves Winter 2019 40

RTSO Airwaves Winter 2019 41

RT WEEK 2018 AT
THE MICHENER INSTITUTE OF EDUCATION
AT UHN.
Contributing authors: Isabelle Grisé, Kathleen Olden-Powell, Jaspreet Singh,
Shannon Smith and Jacqueline Wilcox
The faculty and students of The Michener Institute
of Education at UHN found out on November 21st
that we have the honour of being selected as the
winners of the
CSRT Respiratory
Therapy Week
contest for 2018.
This was the
“icing on the
cake” for a week
that began back
in July with the
initial planning
meeting. Two
faculty members,
Felita Kwan
and Kathleen
Olden-Powell
established a timeline for tasks, booked September
meetings, and developed a plan to approach
organizations for donations. Also at this time, a
notice was sent to the incoming Year 2 class to
recruit students interested in working to procure
the Mayor’s Proclamation, following the successful
application last year. Isabelle Grisé and Jacqueline
Wilcox, two of our CSRT student representatives
answered the call and began working on their
submission to the office of Mayor John Tory, the
mayor of Toronto. Their efforts were rewarded with
an official proclamation of RT week in the city of
Toronto. The letter of application described the
important work of RTs in the city of Toronto and the
contributions made to the health of those in the
Greater Toronto Area.
On September 25th 2018, Felita and Kathleen met
with Year 1 and 2 students interested in helping to
plan, organize and/or run RT week activities. Each
year during this meeting a charity is selected to
receive the profits of any fund-raising activities. This
year, “Journey Home Hospice” was selected as the
charity. The hospice has partner organizations to
assist in the running of the four-bed hospice and
community outreach programs for the homeless.
The member partners have a “joint passion to
improve equitable access to hospice palliative care
for Toronto’s homeless community in a socially
innovative way.” On the Friday of RT week, Dr.
Sandy Buchman, the current president of the CMA
and one of the physicians at the Hospice spoke
to the third year students during their seminar
day about the hospice, palliative care and how
housing and a living wage figure in to the social
determinants of health. When any of the hospice
patients die, Dr. Buchman and his colleagues would
like state “poverty” as the cause of death on the
patient’s death certificate but this is not recognized
as an “official” cause of death by those who
administer death certificates. We were delighted
that we raised in excess of $1,400.00 to donate to
this very-deserving charity.
At the September planning meeting, decisions were
made about activities for RT week, and many were
RTSO Airwaves Winter 2019 42

RT Week
considered as possibilities. Flip chart sheets were
posted for students to sign up and once activities
were finalized, faculty signed up to support one or
more activity.
The week itself kicked off with two key events. First
was our guest speaker
Andrea White Markham
whose topic was “Blowing
smoke: how should we
respond to cannabis?”.
This was a reprise of the
presentation Andrea gave at
this year’s CSRT education
forum in Vancouver, with
some updates, including specific reference to the
CSRT and RTSO Position Statement on Respiratory
Health and Cannabis. The
presentation not only kicked
off RT week: it was also the
RT portion of Michener’s 60th
anniversary lecture series. The
lecture was well-received and
the recording of the lecture has
been viewed by some of our
clinical partner organizations.
The second event to kick off the week was the
launch of the Michener RT Program Facebook page.
Each class has had their own page for many years
and we were inspired by the very professional RT
program pages offered
by our colleagues at
Fanshawe and Conestoga
and decided to launch our
own page: RT week was the
perfect time to do this!
The “word of the day”
event ran through the week.
This event
has been a
tradition for
a number of
years and
is always a
success. There
is a word of
the day and also a word of the week: anyone caught
saying the word makes a donation to the collection
jar. A student in Year 1 and another in Year 2 take a
jar to class and lab and collect while there whenever
a student or faculty
member says one
of the words. Words
likely to be used
during labs and
lectures that week are
specifically selected.
The RTSO recognizes
RT week in a number
of ways and we joined
in on two of the events.
New this year was a
student contest kindly
sponsored by ProResp.
Each RT student program
in Ontario was given the
opportunity to submit
a poster. Those who
participated were given a function of the RTSO to
describe in their
poster and the
posters were then
exhibited on the
RTSO Facebook
page. A contest
was launched
to select the
RTSO Airwaves Winter 2019 43

RT Week
best poster. Shannon Shannon Smith is one of our CSRT student
Smith, our year 2
representatives as well as our Year 2 RTSO
RTSO representative representative. She designed a sticker for RT week,
submitted a poster reading “Respiratory Therapists Inspire Me”. The
which earned a $50.00 stickers were handed out to any individual who
donation (courtesy of participated in an event, bought an item at the back
ProResp) to our RT week sale, or donated at an event.
fund-raising activities.
Thank you Shannon The idea behind the stickers was to advertise RT
and Congratulations week around the Michener campus and beyond
to Fanshawe College for
as well as to give an opportunity to RT students to
winning the contest. The
show some pride in their profession by wearing the
second RTSO activity
sticker all week.
we participated in was
recognizing the lighting of
The RT week bake
the CN tower in the RTSO
sale is always a
colours on October 25th.
well-received
We’re very fortunate that we
event, anticipated
have excellent views of the
by many students
CN tower from our Michener
and staff on
campus. Students captured
the campus.
“selfies” with the tower in
Some staff
the background and also
have “preferred
captured the skyline with the CN tower showing the buyer” status and
RTSO colours. A proud moment for RTs in Toronto! purchase items
before the sale
Our colleagues at Mt. Sinai Hospital held their starts at noon
annual RT week t-shirt design contest and t-shirt as they have been faithful buyers for many years.
sale. Our own Carol Zhang (Year 2 Students set up the sale in the lobby for two days
student) used her creative talents during lunchtime and groups of students went
to submit a design and it was door-to-door with “treats trolleys” on both days,
selected. Congratulations Carol! selling to those who have hunkered down to study
Students and faculty proudly wore in the library or to work in their office. This year,
their t-shirts
our neighbourhood café “Jimmy’s Coffee” kindly
during the week.
donated carafes of coffee to sell during the bake
Thanks to our Mt. Sinai colleagues,
sale. More than $900.00 was raised at the bake
a portion of the funds raised with
sale. During the bake sale, an information booth
the t-shirt sales was donated to our
was also set up in the lobby providing information
selected charity.
about our profession and respiratory illnesses.
Creative projects completed by students were
RTSO Airwaves Winter 2019 44

RT Week
displayed, including a rap presentation about ARDS
is responsible for coaching
and another presentation based on the text of “The
the student in the opposite
Lorax” by Dr. Seuss. This became “The Thorax” and
year in a skill that they’ve
described Interstitial Lung Disease. These, along
not yet learned or in a
with visual presentations showcased the talent of
skill they learned in Year 1
our RT students and their abilities to use multiple
and may now be “rusty”
methods to “spread the word” and provide learning
with. All coaching is done
opportunities.
without the coach pointing
to or touching any of the
The bake
equipment.
sale and
information Each team has a creative team
booth events name and time-trials are run with
also launched each team. The winning team is
the pop-up the team with the quickest time
Instagram for completion of all tasks. Many
photo booth students and faculty are involved
used by faculty, staff and students throughout the in setting up, timing and
week. The photo booth was designed and crafted refereeing the event. Prizes are
by an industrious and creative group of Year 2 awarded to all team members.
students. They also created a second photo booth Thanks to Praxair and Jimmy’s
used later in the week during the stethoscope Coffee for donating prizes.
ceremony.
The
Olympics
More than ten years
was also
ago, Jhoanna (née
the event
Laguerder) Morlock
to launch
and Lindsay (née
the first
Thompson) Zinken
Michener
created the RT
RT week
week Olympics. Snapchat geofilter. One Year 3 and two Year
2 students worked collaboratively with our
Communications department to create the filters:
the second filter was launched at the Stethoscope
The tradition has lived on with
ceremony.
variations on the Olympics
happening each year since then.
For the second year, Michener’s RT students and
Each participating team has two
faculty joined with Michener’s Charity Committee
Year 1 students and two Year 2
to provide food for the annual food drive. Again
students. Each team member
this year, food collected was for Covenant House,
RTSO Airwaves Winter 2019 45

RT Week
an organization that
provides shelter and
services to homeless and
at-risk youth and young
adults. All faculty and
students were invited
to bring a nonperishable
food item
to the Olympics and
to Movie Night as
“admission” to the
events.
Movie Night was held the evening of October 25th.
A screening of the film “Breathe” starring Clare Foy
was held in Michener’s Auditorium. The students
who planned this
event selected the
film as they felt it was
loaded with examples
of an RT’s scope of
practice. Students
were encouraged
to make note of
the “Hollywood”
adaptations of various
RT competencies such
as suction procedures,
BVM equipment, and both Negative Pressure and
Positive Pressure Ventilation. They also felt that
the film highlights how some patients dealing with
a “grievous and irremediable medical condition”
may consider Medical Assistance in Dying, an area
student RTs need to be exposed to when learning
about our practice.
On the same day
as “Movie Night”,
a parfait breakfast
serving station was
set up in Michener’s
lobby in time for
8am to serve up
a yummy and
healthy breakfast
to those in need
of some morning
sustenance.
Yogurt was
served with fruit
and granola and
for those in need
of a sugar fix, chocolate chips were also available.
The students cheerfully greeted those who came
through the lobby and they spoke passionately
about the role of RTs and why they have chosen
the profession. This contributed to an inspiring
morning and the further development of the interprofessional
community at Michener.
One of the final events of RT
week is one of the highlights: our
annual stethoscope ceremony. At
the ceremony, our Year 2 students
have their stethoscopes draped
around their necks by a member
of the RT faculty or one of the RT
guest speakers. This, along with the recitation of
the oath is a right of passage. The event is attended
by guests of the Year 2 students as well as students
from Year 1 and 3, all faculty, our Chair and guest
speakers. The speakers each provide a different
perspective on the profession as well as professional
responsibilities. Following the ceremony, a pizza
lunch (sponsored by AstraZeneca) was shared by all
RTSO Airwaves Winter 2019 46

RT Week
who gathered. It is always
an inspiring gathering.
RT week officially ended
on the evening of Friday,
October 26th when all three
years of students as well as
some of the Stethoscope
ceremony guests gathered for a pub night. Fun was
had, stories were shared and the end of Michener’s
RT week was celebrated.
RT WEEK Niagara Falls Lighting
RT WEEK McMaster Children’s Hospital Lighting
RTSO Airwaves Winter 2019 47

RT Week
Farzad ‘Raffi’ Refahi HBSc RRT CRE participated in the 5K Run at Toronto’s
Scotiabank Waterfront Marathon event, where he raised $200 for Respiratory
Therapists Without Borders (RTWB). He even donned a customized headband to
show his RT pride! Way to go, Farzad!!
Various RT WEEK Activites
Photos submitted by Rachel Nesbitt
Victoria/
University/
St. Thomas
hospitals
celebrate at
Bull and Barrel
in London
RTSO Airwaves Winter 2019 48

RT Week
Various RT WEEK Activites - Photos submitted by Rachel Nesbitt
Windsor Regional Hospital/leamington District
Memorial/VitalAire Windsor/Chatham spend the
evening celebrating at the Grove in Kingsville
And to end RT week, we had a very special RT
week wedding. Jose Contreras married his special
lady (a RN in our ICU) and brought nursing and
Respiratory Therapist together to celebrate!
This photo is RTs from Victoria Hospital
RT Week 2018: Student RT Week Poster Contest
Second year SRT SAC representatives from each College asked their classmates to create a fun and
interactive poster that was shared each day of RT week. The poster theme was, “Did you know the
RTSO….?”
Posters were shared each day of RT week through the various social media accounts associated with
the RTSO (Facebook, Instagram, Linkedin and Twitter). Miriam Turnbull from ProResp kindly offered
to sponsor this RT Week SAC activity. For every submission received from an Ontario Respiratory
Therapy program, ProResp donated $50.00 to the RT program. Additionally, the school with the most
social media engagement (likes, shares, etc.) over a 24 hour period earned an additional $100.00!
Engagement was generously and carefully monitored by the RTSO Social Media Director, Farzad ‘Raffi’
Refahi.
Creativity was encouraged, and students could use Snapchat filters, video or anything interactive and
suitable for Facebook, Instagram, Twitter or LinkedIn. Submissions included some branding from each
institution to ensure each school was properly recognized for each social media post.
RTSO Airwaves Winter 2019 49

RT Week 2018: Student RT Week Poster Contest
Monday October 22-Canadore College
Tuesday October 23-Conestoga College
RTSO Airwaves Winter 2019 50

RT Week 2018: Student RT Week Poster Contest
Wednesday October 24-Fanshawe College Poster and Video
Thursday October 25-The Michener Institute of Education at UHN
RTSO Airwaves Winter 2019 51

RT Week 2018: Student RT Week Poster Contest
Friday October 26-St. Clair College (poster)
All the posters were very well done and there was a flurry of social media engagement. By October 29 at
10:00 a.m., posters from all the colleges that submitted had a social media reach of 20 785 people, 446
likes, 217 shares and 4 000 videos watched. Great job promoting the profession and the RTSO! After
reviewing the results, Farzad declared that Sanjana Hye and the SRTs from Fanshawe College were the
winners of the additional $100.00. Way to go!
The RTSO and the SAC would like to graciously thank Miriam Turnbull and ProResp for sponsoring this
fun, interactive activity for RT Week! Congratulations to Gino and the SAC for coordinating this contest,
and to all of the students who participated and engaged in this activity to promote the profession for
#rtweek2018. Great job!
RTSO Airwaves Winter 2019 52

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Retirement Announcement: Mario Aquilina
Please be advised that effective March 1, 2019 I will be retiring and as such
I will not be renewing my membership with the RTSO. It has been a real
pleasure to be member of the RTSO for many years and I wish to express
my appreciation and thanks for all of the hard work and advocacy done
on behalf of respiratory therapists in Ontario. I have truly loved being a
respiratory therapist and it’s been great to see how the profession has
changed and grown since my graduation in 1982. This is in no small part
due to the hard work the RTSO and it’s executive perform on a daily basis.
I’m also very grateful for the life it has afforded me both professionally and
personally. I will always think back on my career with good thoughts, no regrets and much joy and
appreciation. Thank-you! Keep up the great work!
Sincerely,
Mario Aquilina
Membership Matters! #RTStrOng
RTSO Airwaves welcomes a new student contributor
to Student Corner: Harry Kanathasan!
Harry will begin contributing teaching, as well as health administration and
to RTSO Airwaves in the logistics, until I finally realized I wanted to enter the
Spring 2019 issue. Below, field of Respiratory Therapy.
Harry provides us with a brief I believe helping someone regain the ability to
introduction. Join the RTSO breathe is an honour, and something I can find joy
in welcoming Harry!
in for the rest of my life. Through my exploration of
our health network, I learned one important lesson:
Hello to all, my name is Harry Kanathasan and I am that is that health is holistic. Through Student
currently a 1st year Respiratory Therapy student at Corner I wish to embrace this holistic approach.
The Michener Institute of Education at UHN. Prior Too often do we only look at health issues clinically;
to entering the profession of Respiratory Therapy, I I want to change that. I hope to deliver a fresh
completed my Bachelors Degree in Kinesiology at new perspective on Respiratory Therapy, looking
York University. Like most new grads, I was slightly into social, economic, or even geographic factors
overwhelmed by the thought of my future. I didn’t contributing to an issue. I wish to shatter the purely
really know where to go. Although I always had a pathological discourse we tend to have when
passion for healthcare, I was perplexed on how I thinking about our respiratory health. Hopefully, with
could meaningfully contribute to its vast meshwork. and through Student Corner, we can learn a lot and
I decided to take some time to explore the various look at the world a little differently.
avenues in front of me. I dabbled in research,
RTSO Airwaves Winter 2019 54

Management’s Corner
Lucy Bonanno
RRT MA MBA CAE CHE
Chief Executive Officer
Geraldton District Hospital
I was going through a Harvard Business Review
magazine in my doctor’s office (yes, waiting for hours
to be seen in an office environment, not just the
emergency department!) and came across an article
I found quite interesting.
I thought you all might find it revealing too, about
what skills you possess and which ones you need to
work on as you move on in your career.
This is a summary, in my own words, in which I am
trying to pass on the most relevant information.
The Skills Commonly Found
in Successful Leaders
It is assumed that because someone is promoted
to a management position, that somehow that
automatically makes them a good leader. Not at
all; that couldn’t be further from the truth. Making
it to management can make you a boss but not
necessarily an effective leader. This question is
often asked by many…what are the most important
leadership skills and how does the team benefit?
It is my belief that one does not have to have a
title to be an effective leader. We see many leaders
throughout our lives, in various contexts. They
can be found in our families, our friends, teachers,
work colleagues, etc. In other words, leaders can
be found without having the title of ‘manager’ or
‘coordinator’. Leadership is about the skills you
possess and how those skills affect the people
around you.
Now you are probably thinking, “is someone born
with these skills or can one learn them or acquire
them over time?” This question sparks much
debate; however, the latest academic research is
showing that one can learn these skills. One who is
not necessarily ‘a born leader’ can slowly develop
into a leader. Again, this is debated, as back about
a decade ago it was felt that one was born with
a certain personality type and leadership came
naturally to a certain type; however, this has been
proven to be a false overarching belief and not
necessarily true.
Thus, the good news is that regardless of the
position you are in presently, you can develop these
leadership skills if these are found lacking.
Effective Communication – is important
everywhere, but its importance in good leaders
is uncontested. Most and predominant problems
RTSO Airwaves Winter 2019 55

Management’s Corner
at work have their origins in miscommunication. Empathy – this particular skill was considered a
Communicating well doesn’t just include speaking weakness as little as a decade ago (10 years ago);
well, but also listening, inspiring and persuading. however, it has emerged as a trait that shows
understanding, support and compassion for your
Problem Solving – the actual chief task of any lead team members. This particular trait shows your
is to solve problems. This takes a cool head, the people-acumen, meaning, you can connect with
ability to reason, not lose your temper or be seen your team on an emotional level when they are
as ‘a hot head’. Gather information and become going through particularly difficult times. When one
knowledgeable. One must be able to set goals and shows empathy to their team members, it builds a
achieve them.
strong sense of team and improves staff satisfaction
and productivity, and translates into a happier work
Relationship Building – building a foundation of environment. This does not mean that an employee
trust with your team and individuals is imperative. will take advantage of the employer; that is not the
This is done by investing time, effort and emotion, meaning of empathy.
into your relationships at work. The ability to make
your team members feel valued and appreciated In summary, the importance of these skills cannot be
is vital. It helps to motivate people and cultivates a emphasized enough:
successful team atmosphere.
Effective Communication
Feedback – no matter how good someone is or how Relationship Building
good you might think you are, we can all do better. Problem Solving
There is always room for improvement. Giving
Feedback
encouraging feedback to team members and being Trustworthiness
able to take constructive feedback from your team Empathy
will emerge as the defining line between your success
or failure. By being able to take constructive feedback These will help to build a strong foundation for your
from your team and likewise, being able to give career. Adopting and nurturing these qualities and
feedback in an encouraging but honest way, is one of skills will not only help you survive as a leader but
the most exceptional leadership skills to build. will also help your team thrive and be a productive
department within your organization.
Trustworthiness – with business shifting in the
world around us, showing your team that you can
be trusted by being of high integrity, maintaining References
privacy and confidentiality, and being honest in
your everyday operations, will show those around Henry, Matthew. “Managing Yourself.” Harvard
you that they can foster respect for you. The core of Business Review, September-October 2018: pp 86-
trustworthiness is integrity and truthfulness. When 97. Print.
one has integrity, one will do the right thing, in all
aspects of business.
RTSO Airwaves Winter 2019 56

“Outstanding leaders go out of their way to
boos the self-esteem of their personnel. If
people beleive in themselves, it’s amazing
what they can accomplish.”
Management’s Corner
The following quotes were found on
“Leadership Freak”
“Successful leadership is best seen
in the growth of others.”
~ Sam Walton
“Successful leaders are both
curious and decisive”
“Be the kind of leader that would follow.”
Mindful Moment: Practicing the Art of Presence
Take time to pause and breathe it all in. Notice your breath. Notice and reflect, which may bring
clarity and focus to any given moment.
Take time to notice bodily sensations and feelings in different situations.
• When you feel big, ugly or messy thoughts…acknowledge them. They have their purpose.
• When you feel joy or happiness, savour those moments and how you feel experiencing
them.
Take time to say thanks…develop an attitude of gratitude. Don’t forget to thank yourself, too.
Practice self-compassion. Appreciate your innate abilities along with those you worked hard to
build.
Enjoy mindful moments throughout your day:
• set an intention for your day
• try a minute of mindful breathing before a stressful task
• take a walk, or stretch, every now and again
• pause to appreciate things in your day that normally go unappreciated
• offer kindness with no expectation or need for acknowledgement
“Let us accept the invitation, ever-open, from the stillness, taste its exquisite sweetness and
heed its silent instruction.” ~ Paul Brunton
RTSO Airwaves Winter 2019 57

Upcoming Educational Events
Exciting topics & breakaway sessions!
Hot Breakfast & Buffet Lunch!
Many door prizes!
Registration $60
Students $35
Postponement of the RTSO INSPIRE Conference
After much deliberation, the Respiratory Therapy Society of Ontario
(RTSO) Board of Directors voted to postpone the INSPIRE 2019 conference
originally scheduled in January, due to some unforeseen circumstances. We
feel that combining the INSPIRE Conference with our Leadership Summit
may make the most sense from a business perspective, and would also
afford RT schools and students an opportunity to participate. MARK YOUR
CALENDAR! The RTSO Leadership Summit will be held at head office on
Friday, October 18th, with INSPIRE 2019 planning underway for Saturday,
October 19th, at the Westin Prince Hotel, Toronto.
RTSO Airwaves Winter 2019 58

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Ask aRTee
Dear aRTee,
“How can I be professionally engaged when I
already have many obligations from my work and
personal life to fulfill?”
Obligated
Dear Obligated,
are required to continuously improve and engage
with our profession as science and technology
grow and change. The GROW wheel is a good
guide and reminder to us to be professionally
involved and improve our practices as we go. For
more information, please visit the CRTO website:
http://www.crto.on.ca/members/professionaldevelopment/grow-2/.
There are many ways to be professionally engaged.
As working Registered Respiratory Therapists
(RRT), it is actually our responsibility to maintain a
basic level of competency and knowledge through
the means of academic activities and professional
engagement. And remember, you don’t have to
be in a classroom taking notes, in order to learn
something! More often than not, you may already
be professionally engaged either at your workplace
or contributing to the bigger Respiratory Therapy
community.
The College of Respiratory Therapists (CRTO)
presents a Professional Development Framework
that highlights several important traits to guide the
development of diverse abilities in working RRT. We
Then the question becomes, how can I be
professionally involved? If you contribute your
time to activities or work groups at work or with
professional associations, then you have already
taken the first step to being professionally engaged.
For those of you who are extremely busy with
current responsibilities at work and at home, and
feel you do not contribute to the profession, I
encourage you to take the initiative. Take the
initiative to participate in something new that
requires minimal time commitment to get started.
By doing so, you can explore where your interests
are, which will aid in motivating you to dive deeper
into that topic. We all start somewhere!
Authored by Shirley Quach, RRT HBSc
RTSO Airwaves Winter 2019 60

The RTSO would like to thank and acknowledge the support of
these fantastic volunteers that have greatly contributed to the
profession and to the RTSO’s vision and mission.
Rob Bryan, RRT AA EMCA-A
Mike Iwanow, RRT MBA
Robyn Klages, BSc RRT
Mike Keim, RRT MA
Marianne Ng, RRT BSc MHSM
Sara Han, BSc RRT CRE
Louise Chartrand, RRT PhD
RTSO Airwaves Winter 2019 61

Remembering: Dr. Winston ISAAC
In 1973, Winston
graduated from
the Respiratory
Technology program
at the Toronto
Institute of Medical
Technology, which
is now the Michener
Institute of Education
at UHN. He became
Clinical Coordinator,
and later, the Director
of Michener’s
Respiratory Therapy program. He didn’t stop there.
Winston went on to earn his Masters in Education
from Central Michigan University, and Masters of
Public Administration from Queen’s University,
followed by a PhD in Adult and Continuing
Education from Michigan State University. Among
many other accomplishments, Dr. Isaac also became
a Certified Health Executive of the Canadian
frances-1166565
College of Health Service Executives, served on
the Central West LHIN, and co-founded the Walnut
Foundation (https://thewalnutfoundation.com).
Winston received the Alumnus of Distinction
award from the Michener in 2013 and an Honorary
Diploma in Health Sciences in 2017. A Dr. Winston
Isaac Scholarship is available to students in the
Respiratory Therapy Program at The Michener
Institute of Education at UHN.
Winston’s extensive experiences have left a
remarkable legacy, and he will be truly missed. The
RTSO offers our deepest condolences to those that
knew or were touched by this remarkable man.
Obituary: https://www.legacy.com/obituaries/
theglobeandmail/obituary.aspx?n=winstonisaac&pid=191600731&fhid=17724
In Memorium: Mary Frances GERMAN
Proud mother of Sam and Jack. Loving sister of
John (Pat), Peter (Julia) and Paul (Kate). Mary will be
missed by many nieces, nephews and friends. She
was a wonderful human being and a dedicated RRT.
Donations in Mary’s memory may continue to
be made to Sick Kids Hospital and are greatly
appreciated by the family.
Mary passed peacefully at her home in Shanty Bay,
surrounded by her family, on Tuesday, December 18,
2018, at the age of 52.
Obituary posted Dec 19, 2018 11:50 AM to https://
www.barrietoday.com/obituaries/german-mary-
Loving daughter of Frances Balint (nee Stauder) and
the late John Balint. Beloved wife of Rob German.
The RTSO sends heartfelt condolences to Mary’s
family, friends and colleagues.
RTSO Airwaves Winter 2019 62

In Memorium: WILLIAM (BILL) C. BOYLE
Bill passed away peacefully on November 27, 2018,
survived by his wife, Joe-Anne (Armeni), and two
children, Colin and Caitlin.
Bill was a certified hyperbaric technologist/RRT,
serving as a Board member for both the Respiratory
Therapy Society of Ontario (RTSO) and the
Canadian Society of Respiratory Therapists (CSRT).
Bill was well known for championing hyperbaric
medicine. He became a Certified Health Executive
and more recently became Director of Operations at
Medical Oxygen Research.
We wish to express sincere condolences to Bill’s
family, friends and colleagues on behalf of all of us
at the RTSO.
“Our fingerprints don’t fade from
the lives we touch.” ~Judy Blume
Clinical use:
Should not be used in patients under 18 years of age.
Contraindications:
• Patients with known hypersensitivity to peanut or soya
• Pregnancy
Most serious warnings and precautions:
Gastrointestinal perforations: Cases reported in clinical studies and postmarketing
period; many post-marketing events were serious and some
have resulted in fatal outcomes. Use OFEV in patients with a known risk of
gastrointestinal perforation only if the anticipated benefit outweighs the potential
risk. Permanently discontinue OFEV in patients who develop gastrointestinal
perforation.
Hemorrhage: Serious and fatal bleeding events reported in clinical trials and postmarketing
surveillance systems. Use OFEV in patients with known risk of bleeding
only if the anticipated benefit outweighs the potential risk.
Other relevant warnings and precautions:
• Risk of diarrhea, nausea and vomiting
• Risk of weight loss; monitor weight
• Should be taken with food
• Use caution when treating patients with higher cardiovascular risk including
known coronary artery disease
• Not recommended in patients with moderate or severe hepatic impairment
• Drug-induced liver injury
• Liver enzyme elevations
• Measure systemic blood pressure, hepatic transaminase and bilirubin levels
before initiating treatment and periodically after as clinically indicated
• Based on mechanism of action: potential for increased risk of thromboembolic
events and impaired wound healing
• Women: use adequate contraception during OFEV treatment and for at least
3 months after the last dose of OFEV
• Not recommended for use in nursing women or in children and adolescents
• Safety data for black patients are limited
For more information:
Please consult the Product Monograph at www.boehringer-ingelheim. ca/sites/
ca/files/documents/ofevpmen.pdf for important information relating to adverse
reactions, drug interactions and dosing information which have not been
discussed in this piece.
The Product Monograph is also available by calling 1-800-263-5103 x 84633.
References: 1. Raghu G, et al. An Official ATS/ERS/JRS/ALAT Clinical Practice Guideline:
Treatment of Idiopathic Pulmonary Fibrosis: An Update of the 2011 Clinical Practice Guideline. Am
J Respir Crit Care Med 2015;192:e3-e19. 2. OFEV® (nintedanib) Product Monograph. Boehringer
Ingelheim (Canada) Ltd., October 24, 2017.
© 2018 Boehringer Ingelheim (Canada) Ltd. All rights reserved.
OFEV® is a registered trademark of Boehringer
Ingelheim International GmbH, used under license.
POWER IN IPF TREATMENT
RTSO Airwaves Winter 2019 63

Don’t take a Gamble on
Insurance Coverage!
Protect yourself and your family
The PL&I Package offered by the RTSO
provides you with the following:
• Professional Liability & Indemnity Insurance coverage: $2M/incident /
$4M Aggregate; Nil Deductible
• Disciplinary Defence: $175,000/Claim / $175,000 Annual Aggregate
• Criminal Defence Reimbursement: $200,000/incident / $200,000
Annual Aggregate
• Sexual Abuse Counselling & Rehabilitation: $10,000/insured / $250,000
Annual Aggregate
• Legal Representation Expenses: Subpoenaed as witness $1,500 each
claim
• Complaint $5,000 / Max Annual Aggregate for both $50,000
Any Questions?
Contact the RTSO office at office@rtso.ca