Tech new to forum

[Janknitz]

And sometimes we rag on sleep techs, RT's and DME's because there are some true idiots and rotten eggs out there.


That doesn't mean that everyone in your profession and related professions is bad, but we tend to hear more about the bad eggs here because people are more likely to use an internet forum to complain than to praise. So don't take it personally, unless you deserve it

Remember that the newly diagnosed (or almost diagnosed) individual is in crisis and shock, and may not understand what's going on. Sometimes the complaints are very legitimate (e.g. one person's sleep was disturbed during a sleep test by another patient's calling for help. She had to unhook herself and go to the assistance of the other patient--the techs were nowhere to be seen! ), and some are simply venting because of the inherent stress of the situation. Again, don't take it personally.

We understand that sleep labs, sleep physicians, and DMEs are businesses that must make a profit, but we need sleep labs and DME's to understand that we are individuals and our primary concerns are our own health and well-being, not your business goals. So if you hear a lot of complaints about how these businesses are run, again, don't take it personally.

You sound like a good person who is very different from the ones we love to complain about here. We can all benefit from mutual respect. And I'm sure you will have very valuable input from your own perspective on things.

[GumbyCT]

Thanks all for the greetings. Seriously, I'm here to learn. I am not an OSA patient, however I have taken apaps home with a few of my favorite masks. I used the machines for several months at a time, night after night, to see what it felt like to live with cpap. This doesn't make me an expert, but it gave me a different perspective.

I have already been advised to be careful on this forum. I came to listen, not to preach. To avi123: I've never been to the BinarySleep forum. And you don't have to convince me of the benefits of ASV for the patient who needs it.

K.

My first sleep tech said he had 18yrs experience - that would take him back to the late 80's - claimed to be one of the first certified in CT, was a very nice guy. One thing he never told me was how to remove the mask from my head/face.

During the night when he would ask me questions, after trying to answer, I would rip the mask off my head, then he would say "you ripped the mask off". lmao - YES, I did.

When leaving in the morning, I asked him if he had ever tried to talk with "that air pressure" turned ON. He said NO.

Real disappointing that after 18 yrs he had no clue what he was asking me to do.

So good for you for giving it a try and getting the real feel. But be warned the RT's we have come across here have warned of bad things happening when you turn the pressure up past what the doc ordered. You do know that right?

[Appalachian]

I think having a tech on the forum would be a good thing, compare notes, could exchange questions, keep up with the latest/greatest findings & machinary.

I noticed you were from Tenn. mind if I ask wher you do your testing ??

[Uncle_Bob]

I was looking for reviews of national (US) DME providers and ended up spending almost my whole shift reading threads.

So you were on the internet during your whole shift instead doing the job that you are paid to do

Please let me know where you work so i never get a sleep study there.

[SleepTechTN]

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[SleepTechTN]

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[user from Singapore]

SleepTechTN this is for you:

[Slinky]

... During the interview for my current position the manager and I kicked around the idea of having a tech who did nothing but help people troubleshoot their cpap experience. ...

THAT is EXACTLY the idea I've been trying to promote and encourage!!!! Similar to the training and support diabetics get. Except I usually "lay" that responsibility on the sleep doctors to provide such a support person to their patients. And I have absolutley no respect for those sleep doctors who hide behind the walls, never meeting w/or speaking to the patient and just sendkng their dictation to the referring doctor to handle the patient's PAP therapy.

The last two support group meetings I attended (2 different groups, one new, one "older") were the most refreshing I've attended. The new Respironics rep at one meeting was right up front and vocal that patients should KNOW what brand and model CPAP they are using, what mask they are using, what their pressure setting is. Say what?? This is at the "older" meeting where the "hosts" had pretty much discouraged patients from "knowing" too much, always ask your doctor or your DME provider's RRT. And then their last meeting just this week, you could sense the difference in their attitude (after all this while) and they actually allowed and encouraged the patients to take a little more active role in their therapy!!!

The "new" group has only had 2 meetings so far and both were really great, even for an experienced apnean. The Resmed rep was great and the DME provider even better!! Patients have been encouraged from the get-go to take an active part in their PAP therapy.

Both groups are sponsored by hospital sleep labs and "hosted" by sleep techs from the respective labs, the newer one is also co-hosted by the local DME provider. Its a small town and has only the one DME provider altho there are plenty more available in larger towns that are nearby.

[lazer]

Thanks, avi123 for posting the definition of the RPSGT credential. I worked very hard to get it and I'm proud to have it. I also hold the new RST (Registered Sleep Technologist) credential offered by the American Academy of Sleep Medicine.

It didn't take long for me to realize that you folks are the "super users." Reminds me of shade tree hot rodders or computer overclockers. You want to dig in there and really dial it in. It's fascinating.

I wish I could do more for my patients. I wish I could walk them to the DME and help work out the details. I wish I could go into their homes and help them get settled in. Unfortunately I only get them for 8 hours or so. There's only so much information one can impart before and after sleep. I do my best. I know that when I go to the doctor I get 15 minutes of his time. He has to say a lot in a short time. I don't hear half of what he says, but I get the gist. If my patients are anything like me, they are too wrapped up in the experience to process all the information.

The focus of the tech, when you get down to it, is to get a clean recording, observe and report, follow lab protocol regarding application of cpap and oxygen, and keep them safe for the time they are in the lab. I try to go beyond that and provide the best possible experience for my patients. My wife is a nurse practitioner and after 23 years of marriage, I have a pretty good clue as to what quality patient care looks like.

I'd like to see compliance higher. During the interview for my current position the manager and I kicked around the idea of having a tech who did nothing but help people troubleshoot their cpap experience. Try to identify the folks who are falling through the cracks and get them back on the machines. (In other words, do the job the DMEs should be doing.) We get folks who come back for re-titration who are wearing their masks upside down (Swift), or still wearing the same mask they bought eight years ago that the dog got a hold of. You have no idea the stuff people are putting on their faces night after night. (And I wish they'd wash their gear more often.) I've given masks out of lab stock to people whose insurance wouldn't cover a replacement just to make sure they'd continue to use the machine.

I am a true believer in cpap therapy even if I am not a patient. Every night I witness the difference cpap makes in the quality of sleep. During a split-night study it's more evident: there was chaos in the EEG and now there's peace. Even if you didn't know what you were looking at, you'd see it. The results are amazing. And it's air. Air is free. You gotta love it.

I wish you well. Tweak to your heart's content, just be careful. In the hospital my wife slaps bipap on lots of folks at 10/5. I ask, "How do you know? You're flying blind!" But she has a different set of tools and a different focus. You too have a different set of tools--you know your bodies better than anyone else. If raising your pressure 0.2cm makes you feel better, do it. And always consult your doctor.

Peace,
K.

Excellent post. Good to have you on here!

[Madalot]

A big welcome from me too. I appreciate your comments and look forward to seeing more from you!

[Slartybartfast]

I think the applicable expression in Cyberworld is, "Woot! Woot!"

Very refreshing to hear your perspective.

[chunkyfrog]

Slinky: You compared apnea education to diabetes education.
Granted that diabetes education is far ahead of the level provided to apnea patients,
there is still much room for improvement.
Too much of the diabetes educational materials are provided by drug companies,
who have a vested interest in the bottom line, as opposed to improved patient health.
When health is the key focus, everyone wins. Kudos to the OP.

[robysue]

Ken,

Welcome to the forum. Looks like you have the potential to become a valued resource for the forum.

I'd like to see compliance higher. During the interview for my current position the manager and I kicked around the idea of having a tech who did nothing but help people troubleshoot their cpap experience. Try to identify the folks who are falling through the cracks and get them back on the machines. (In other words, do the job the DMEs should be doing.

These are excellent ideas. I sincerely hope that in your current position, you and your manager continue to kick this around and find a way to implement it. One thing to keep in mind about those DMEs that are too often less than helpful: Many (if not most) of them do not specialize in CPAP equipment. Hence many of them really don't provide the necessary quality support for helping folks become compliant.

If your employer was willing to sponsor an AWAKE group or some other patient support group, that might be an appropriate starting place.

We get folks who come back for re-titration who are wearing their masks upside down (Swift), or still wearing the same mask they bought eight years ago that the dog got a hold of. You have no idea the stuff people are putting on their faces night after night. (And I wish they'd wash their gear more often.)

We do hear from folks like this here. Often times they have decided to make a second or third or fourth stab at CPAP because they have finally reached the point where they are no longer in denial. So we're not surprised by your genuine horror stories. It constantly amazes me how many of the newbies have no idea what the make and model of their machine actually is. They have no idea what their prescribed pressure is. They have no idea if the DME set the machine up with the ramp or the exhalation pressure relief turned on or off. They have no idea what the make and model and size of their mask is. And one thing that can partially explain that phenomenon of too infrequent mask washing? Many folks are NOT given any hands on training on how to disassemble and reassemble the mask they are expected to use each night. That goes a long way in explaining how a patient can go for years with wearing a Swift mask upside down or an improperly assembled FFM. It also can explain why a patient falls into the habit of not cleaning the equipment frequently enough.

A lot of the time there's been some serious miscommunication or no communication at the beginning of the process. Folks don't think to contact their insurance company about replacement schedules and the insurance companies certainly don't contact the patients telling them "Here are your benefits: You can get a new mask every 6 months. You can get a new mask cushion/set of nasal pillows every three months. You can get a new filter every month. ." And so there's often a whole lot of confusion on the newbie's part about what (if anything) needs to be replaced and when it should be replaced.

I think one thing you can certainly do with your patients is tell them (at least on the titration studies): Talk to your insurance company about how they cover CPAP equipment and how often they authorize replacement parts.

I've given masks out of lab stock to people whose insurance wouldn't cover a replacement just to make sure they'd continue to use the machine.

CLAP CLAP CLAP! My own DME (one of the gooduns) has done similar things when my nasal pillows have simply worn out several months before my insurance company is willing to pay for a new pair.

[Pugsy]

Welcome to the forum. It is so refreshing to here from someone with some common sense.
Hope you stay around.

[Maxie]

Welcome and I enjoyed you posts and your wit (burger and fries)! Come back often.