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Job Spotlight: Jennifer Crews, clinical coordinator of respiratory care

It was at a tender age that Jennifer Crews just knew that she wanted to someday be in the medical field, in some form, in some way.

"Oh gosh, I can go back to the second grade and a kid getting a nose bleed and the teacher wanting a volunteer to clean up the blood," she said. "Of course, I was the one to raise my hand and get all excited. So I just knew early on that I wanted to take care of people and help people any way I could."

But even when entering Columbus State University in the mid-1990s, Crews didn't know what exactly her destiny in health care would be. Should she become a nurse? She wasn't really sure.

It wasn't until her Hope scholarship assistance was about to run out that she picked up a CSU career catalog, thumbed through its pages, then made the decision that respiratory therapy would be a solid direction to go.

"I had all of the credits and more, and it was in the medical field, and it was interesting, so I got into respiratory therapy that way," she said.

Thus a career was born, putting Crews on the path to jobs at both The Medical Center and St. Francis Hospital. She also finally found roots after being born in Billings, Mont., raised in Klamath Falls, Ore., and bouncing back and forth with her brother from the West Coast to Georgia during their father's Merchant Marine deployments to sea, a very nomadic life indeed.

Today, Crews, 39, a Columbus resident with three children and a fiance, is a registered respiratory therapist and clinical coordinator of respiratory care at St. Francis Hospital off Manchester Expressway.

Like most health-care positions, respiratory care is job security. The U.S. Bureau of Labor Statistics projects 22,700 new therapists will be needed by the year 2022, a "faster than average" growth rate. That's on top of the 119,300 already in the profession, earning a U.S. median annual salary of $55,870.

The profession's specialty is helping people who have a hard time breathing, which includes chronic respiratory diseases such as asthma and emphysema. Patients range from newborns with lungs not fully developed to elderly people with lung disease. Trauma victims -- to include heart attacks, vehicle accidents and drowning -- also are among their patients.

The Ledger-Enquirer visited with Crews recently to talk about her job, why she chose her particular career, and the unique moments she and other respiratory therapists encounter. This interview is edited a bit for length and clarity.

Why did you pick respiratory therapy rather than another area of health care?

My dad and my granddad smoked all of their lives. My grandfather died of emphysema and Alzheimer's, so I was really interested in that process and making him feel better. I remember just watching his disease progress to where he couldn't breathe and then he couldn't lay down to sleep. It was just such an awful process that I wanted to learn a better way to help people with that.

Emphysema and COPD are connected?

Emphysema is a component of COPD. COPD stands for chronic obstructive pulmonary disease and it is kind of an umbrella term for certain diseases like emphysema and asthma, chronic bronchitis, those diseases ... They have different characteristics and causes and treatments.

To become a respiratory therapist, do you become a nurse first and then specialize?

No. We do not do any nursing. I don't have a nursing degree. I have a bachelor's of science in respiratory care, with an emphasis in critical care medicine. We have a school here at Columbus Tech which, of course, does an associate's degree. Way back when I went to school, I went to Columbus State and got my associate's there and then went to Georgia Health Sciences University online to get my bachelor's in 2012.

But you either get an associate's or a bachelor's. In smaller towns like Columbus, it really doesn't matter. And then you take two certification tests. You take your CRT first to be a certified respiratory therapist, and then you go on to take your registry to become RT, to be a registered respiratory therapist, which is what we hire here..

What's the timeframe for doing all of that and is it a difficult process?

Once you get your associate's or your bachelor's, whichever college you go to and graduate from, the actual tests are not that hard. Back in the day when I took it, you actually had to be working for six weeks before you could take your certification, and then you had wait another six months before you could take your registry. Nowadays, since everything is online, the day they graduate they can go sit for their certification. Once they pass that, they can go ahead and turn back around and sit for their registry. It is a lot quicker.

Do you have openings here for respiratory therapists now? Is there turnover?

It is a fast-growing area. Here at St. Francis right now we do not have any open full-time positions. We have filled all of our positions.

How large is the staff?

We have 40 therapists between full-time and PRN, which work as needed.

You are full time?

I do both. I work full-time here at St. Francis and I work PRN (as needed) over at Midtown Medical. So every week or every other week, I work either a Saturday or Sunday over there if they need me. We all have second and third jobs. Respiratory is a really small community, especially here in Columbus and Phenix City. So generally most people work at all of the hospitals, or a couple of hospitals at a time.

So that goes beyond the typical rivalry between St. Francis and Columbus Regional's Midtown Medical Center? The rivalry is set aside?

It is. It's just about taking care of the patient and, especially between Midtown Medical and St. Francis, we serve such a different population. Over here, we don't necessarily see the pediatrics that I get to take care of over at Midtown Medical. We don't get the trauma over here that we get a Midtown Medical.

Respiratory therapists are kind of Adrenalin junkies sometimes. So it's kind of nice to come over here and take care of the cardiac patients, the elderly patients with pneumonia, and see those disease processes, but then get to go to Midtown Medical and work in the trauma (department) and get to see the car accidents and gunshots and take care of those patients. And also go visit the babies and take care of the sick little ones and get my fix there.

Do you enjoy treating one type of patient more than the other?

I started at Midtown Medical way back when I was a student, so of course I have my love for them. It's totally different (with the trauma unit and high-risk baby unit).

But the other side of that is I worked at PRN (as needed) over here when I was full-time over there. I valued coming here because I loved going up to the units and working with the cardiac patients and the open-heart patients and talking to the surgeons and learning how the heart works, and getting to talk to pulmonologists more over here because we take care of lungs and see COPD patients.

Now I love working over here. I get to go all over the hospital. If I want to go down and work in the OB (baby delivery at St. Francis), and not behind the desk doing coordinator stuff, I can go take an assignment and take care of patients.

So all therapists work in multiple locations?

Yes. A lot of our therapists actually work at Midtown Medical or they work across the river at Hughston. We have a couple that work at East Alabama (Medical Center in Opelika). We used to have a couple that worked in Atlanta. It's just a really small community.

What's the most challenging aspect of your job?

As a respiratory therapist, the most challenging ... probably when I was younger and learning to manage my time and multitask. It's gotten easier as I've gotten older and gotten a little more experience in my field.

I think that's the hardest part for a new therapist just coming in, is having a nurse over here with a bad patient, but you're with this (other) bad patient, and knowing how to manage your time and get them all taken care of, and then having to take care of all the patients that need breathing treatments or need education or something like that from us.

At any given time, how many patients can a therapist be assigned?

It depends on what we call a workload. When I come in in the morning, or when the team leader if I'm not here, comes in in the morning, the night shift has counted up all of the respiratory treatments that we have. Whether it's a breathing treatment or a ventilator, anything like that, they've counted them up and have divided between the different units on each floor. Then I come in and look at the people I have, how many there are, and divide it according to workload.

So in the dead of summer we're usually not that busy because people don't necessarily come down with pneumonia and things like that. So we may have a lighter workload, where we have a second and third floor (with patients), or third and fourth floor, but only really have 15 to 20 treatments a day.

That still means we're assigned to every patient on that floor. So if something happens to one of those patients, we're still responsible for them. Though we may have only 15 or 20 treatments, we may have 30 or 40 patients that we're responsible for.

Are some respiratory therapists more talented than others and can take on more, depending on experience? Are some just better than others?

I don't think they're better than others. I think everybody has a talent, a place, kind of a niche maybe that they would prefer to be. It's easier for some people to work with a certain kind of patient because that's what they find most interesting.

But all respiratory therapists, especially at St. Francis, have the ability to go wherever. If I need them in the ER one day, they go to the emergency room and take care of everything there. Or the next day they'll have OB and be down there if they need a respiratory therapist for a delivery. Or they'll go up into the units and take care of our ventilated patients.

We have an aging and growing retiree population in the area. Are you seeing that in your day-to-day work?

Oh, most definitely. We have a huge COPD population in Columbus, and as the years go by it seems our busy season gets longer and longer and longer, just because they're having such a difficult time.

That's from smoking and asthma?

With Fort Benning, yes. People have been smoking since they were 9 or 10 years old. They come in all of a sudden and can't breathe and wonder why.

What's the longest period of time you've seen a patient at the hospital?

It depends on the disease process. For a simple asthma patient they could just be here overnight. We have had patients here for weeks. We have patients here for months.

Do you bond with patients?

Oh, most definitely, especially our repeat customers, because we do have repeat customers just like, I guess, nurses do. You learn their life story. A lot of times you see them when they come in and they can't breathe and you see the fear in their eyes, and then being able to treat them and take care of them and see them move from the emergency room into intensive care.

Or they eventually move to the (recovery) floor where you can actually sit down with them and talk to them and learn about their families and why they're having trouble. Did they start smoking at age 9 or did they have a history of asthma or lung cancer? And then getting to see them go home, and saying goodbye to them.

Is the most difficult thing seeing someone nearing the end of their life?

That's definitely one of the most difficult parts of our job, is taking care of people who are at the end stage of the disease process, at the end of their life, because respiratory therapy is so much about that.

(It's hard) knowing there's nothing you can really do to help their need to breathe, seeing the fear or panic in their face and not being able to alleviate some of that.

Are respiratory therapists as valued by medical colleagues as they should be?

I think we are. We are the first people anybody calls when there's something wrong with a patient. Unlike nursing, a respiratory therapist is trained to go anywhere in the hospital. So we respond to cardiopulmonary emergencies in the emergency room. We are on the co-teams that go to the floors if a patient has a cardiopulmonary emergency. We're part of the rapid-response team.

If a patient just doesn't look right, a lot of times, before they even call rapid response, they'll call the therapist on their phone and say: Hey, will you just come look at so and so? He just isn't looking right. I don't know what to do for him. Should we call the doctor? Should we do this? Should we do that? What do you think?

What's the most rewarding thing about your job?

Getting to take care of people who can't take care of themselves is definitely the best part of this job. I love being able to help people who can't help themselves. And hopefully seeing them get better.

As a coordinator, what are your duties and challenges?

My coordinator position has taken me out of actual patient care most days. As coordinator, I'm involved in policies and procedures and making sure everything is up to date and ready for the various accreditation bodies that are coming through our hospital.

I'm responsible for the education of the therapists in the department. So if there's a new procedure or a new piece of equipment out there or any literature on how to take care of a certain patient population, I'm responsible for educating them. If a new therapist comes in, I start their orientation and then usually send them with preceptors.

And I also, on the back end of that, fill in for staff therapists if we've had a call out. Or if it gets really busy this winter, I'll do more patient care.

It sounds like the coordinator job might not be as fun as a simple therapist, although it's perhaps challenging and rewarding in its own way?

I have learned a lot more about how the hospital works as a coordinator. When you're front line as a staff therapist or a nurse, probably, sometimes you sit back and think, why is it that way? So being back here and working with my director -- she's been a very good mentor, teaching me kind of the ins and outs and how things work administratively -- I understand it more. So now I can go back and tell the staff therapists, well, X, Y and Z isn't happening like this because A, B and C have to be done first.

What talent and qualities does it take to be a good respiratory therapist?

I think first and foremost you have to be a people person. It's really different than maybe a nurse who's assigned to one certain area. Because a respiratory therapist can go anywhere on their shift any given day, you have to be able to talk to anybody and kind of sit down and ferret out what they're not telling you or what they don't know to tell you, or what they can't say.

Number two, you have to be a good critical thinker. A lot of respiratory therapy is taking what you do have and being able to change it to what you need for the situation. That's whether it's a piece of equipment or whatever, being able to fix it, McGyver it, to work the way it needs to work for that certain patient, such as fixing the mouthpiece on their treatment (device) because they can't hold the mouthpiece, or the mask.

And it's also knowing your disease processes. We mainly study the pulmonary system. But your lungs affect your heart, your heart affects your lungs, that all affects your kidneys and your liver. You kind of have to know how it all wraps together. If your kidneys shut down, your lungs are going to do this, which makes your heart do that.

It's being able to understand disease processes and the way they progress, and how to treat them to alleviate those signs and symptoms and take care of the patients.

We've already had a cold spell or two. You could have a busy season coming up, with colds and flu?

Yes. I thought it was going to hit last weekend, but it's kind of slacked off. Right around Thanksgiving, it will probably hit. It just gets busy. People come in with pneumonia, with the flu, because they didn't get their flu shot like they're suppose to. The holidays are hitting, so our diabetic patients also will be coming in because they want to eat all of the yummy goodies that they shouldn't have.

Bio

Name: Jennifer Crews

Age: 39

Hometown: Born in Billings, Mont., and lived most of her life in Klamath Falls, Ore.

Current residence: Columbus

Education: Graduated Columbus High School in 1993; graduated with an associate's of science degree in respiratory therapy from Columbus State University in 1998; graduated with a bachelor's of science in respiratory therapy from Georgia Health Sciences University in 2012; holds certifications in BLS, ACLS, NRP and PALS

Previous jobs: Worked as front desk clerk at The Medical Center while getting her associate's degree (1994 to 1998); her first real job was respiratory therapist at The Medical Center in 1997 (started working there and at St. Francis as a student); after graduating in 1998, she took a full-time job at The Medical Center, working evening, nights and day shifts; during the same period she worked "as needed" at St. Francis; she joined St. Francis in 2011 as a full-time staff therapist, later accepting the clinical coordinator position within her department

Family: Fiancé, Jim Eisenhauer, a civil engineer with American Buildings Corporation, and three daughters, Hannah, 12, Emily, 9, and Autumn, 8; and three dogs -- Lilly, Bella and Smokey

Leisure time: Spends her off days ferrying the girls to various activities; her oldest daughter is active in band and Rainbow Girls, and her middle daughter is in gymnastics twice a week; when not playing taxi for her girls, she's usually helping them with various school projects; also enjoys cooking for people and readings books, and finds cleaning her house cathartic; she lives for October when "The Walking Dead" debuts its new season, and the summer when "Game of Thrones" returns

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