Respiratory therapists are essential in caring for asthma patients who come to the hospital or clinic with an acute exacerbation of their disease. But they can also play a big role in ensuring those exacerbations never occur.
Elaine Homa, MRC, RRT, AE-C, and Mary Jo Eyler, MSAH, BSRC, RRT, RRT-NPS, RPFT, AE-C, are both great examples. As asthma educators, they equip patients and families with the knowledge they need to keep asthma under good control.
She wanted to do more
Homa is a 17-year veteran of respiratory care who initially got into the profession because of her own asthma diagnosis.
“I was in the hospital a lot as a child,” she said.
Her personal experience drove her to want to do more than just care for patients when they were feeling their worst. So when the opportunity arose to join the Chronic Care Education and Support Center at Akron Children’s Hospital in Akron, OH, in 2012, she took it.
“I strive to educate children and their families on ways to help them breathe better, manage their asthma, and minimize the impact of asthma on their lives,” she said.
Homa spends her entire day educating patients and families about asthma and also provides anaphylaxis education.
“As an asthma educator, I act as a liaison for children with asthma and anaphylaxis and their families, caregivers, and other health care providers,” she said.
That includes schools and community agencies that deal with children with asthma. In addition, she employs a family-centered approach in her education and delivers that education both in-person and virtually.
Another important part of her job is collaborating with physicians, staff, patients, and families to assess learning needs and plan and implement appropriate educational activities in all settings that depend on her for education. In addition, she follows up with families a month after the educational sessions have been completed to assess their Asthma Control Test scores and provide any additional education that may be required.
Homa brings her expertise to bear on internal and external groups dealing with asthma too.
“I sit on the Inpatient Asthma Pathway Committee and the Parent Advisory Council to improve care and patient/family education,” she said. ”I also participate in community health fairs to educate the public about asthma and anaphylaxis.”
She and the other asthma educators on staff are involved in community task forces and committees to advocate for asthma and anaphylaxis. Homa also assists with collecting and analyzing data to determine the effectiveness of the educational activities provided by the Center.
Making a difference
Eyler has been an RT for 40 years now and first became interested in asthma education when she was treating a pediatric asthma patient who was frequently in the hospital for his asthma.
“I spent many a night talking with this patient as he would take his breathing treatments,” she said.
When she was working on her bachelor’s degree, she had to acquire three credentials related to the profession, and she decided to go after the AE-C. She began serving as an asthma educator in 2015 after talking with a pediatrician at Samaritan Albany General Hospital in Albany, OR.
“One early morning, toward the end of my night shift, one of the pediatricians and I were talking about the need for asthma education for these kids,” she said. “That conversation led to starting an asthma clinic at the children’s clinic associated with the hospital.”
Then in 2017, she also built an adult asthma/COPD inpatient education program, and last year, she started providing asthma education for new pediatric nurses in the hospital system as well.
Eyler says the job entails reviewing patient charts to identify patients with asthma, assembling teaching materials, and meeting with patients.
“My outpatient clinic is every other week in the evenings for a total of eight hours,” she said. “New patients have an hour-long block of time, and returning patients are seen in 30-minute slots.”
On the inpatient side, each patient is seen for 30-60 minutes or more, depending on their needs. Eyler also works in the PFT lab and sometimes takes on a staff shift, but she typically spends about 30 hours of her workweek specifically on asthma education.
She knows she’s making a difference because, for her capstone project for her master’s degree, she decided to see if there were any significant improvements in asthma control for the kids in her clinic.
“The indicators I chose were asthma control scores, PEFR for those old enough, and urgent care/ED visits/same-day clinic usage,” she said. “All of the numbers improved, but most impressive was the 53% decrease in same-day clinic visits.”
Challenges and rewards
Both Homa and Eyler say the job of an asthma educator comes with both challenges and rewards.
“Adult patients or parents who refuse to accept they or their child may have asthma is a huge challenge,” said Eyler. “The number of no-shows can be discouraging as well.”
Homa says language, customs, beliefs, and values can throw up barriers to getting her points across, although her hospital system has resources she can use to overcome these challenges.
“Another challenge is non-compliance of asthma medication,” she said. ”Many emergency department visits and hospitalizations can be prevented if the patient/family is compliant with prescribed medications.”
The rewards come when patients and families demonstrate understanding of their–or their child’s–asthma and through the bonds that the asthma educators develop with the people they help.
“I feel one of the most rewarding things about being an asthma educator is developing relationships with the patient and their families, so they feel comfortable to reach out with any questions, concerns, or needs,” said Homa. ”Also, it is very rewarding when you see that a family gets it.”
She enjoys knowing that she helped a family build self-management skills and the ability to handle flare-ups. But then, when they show their appreciation for all she has done, that’s icing on the cake.
“It makes me feel good when a family thanks me at the end of an education session and tells me that the information and resources I provided them were invaluable and helped them better understand and treat their child’s asthma,” said Homa.
Eyler says the reward for her comes when she sees the relief on the faces of the parents who see their kids getting better. “Getting credentialed and being willing to take a chance on starting a clinic has been an incredible experience,” she said. “It has made me a better RT and built my confidence. I have skills I can take anywhere, should I choose to do that.”
Yes, you need the AE-C
What advice do these asthma educators have for their fellow RTs who might be interested in following a career path similar to the one they have followed? Mary Jo Eyler suggests people work to become the “resident expert” in asthma in their facilities, find a mentor if they can, reach out to other asthma educators in their community, and make sure their asthma education materials are age and language appropriate.
Attending conferences where the latest information on asthma is presented is invaluable as well.
But both of these educators emphasize that, first and foremost, anyone interested in pursuing a career as an asthma educator should sit for the Asthma Educator-Certified exam.
“Getting credentialed allows others to see that you are dedicated to patient welfare,” said Mary Jo Eyler. “Just studying for and taking the test, I learned so much.”
Elaine Homa could not agree more. In fact, in her case, she had to agree to take and pass the AE-C exam before she could even get the job.
“In the evolving field of asthma, obtaining the asthma educator certificate will make you a better advocate for your patients,” she said. ”Becoming a certified asthma educator gave me the confidence to provide my patients with the most up-to-date and accurate education to live with and manage their asthma.”
Help is available
As more and more hospitals and clinics realize the value of educating asthma patients about their conditions, job opportunities for RTs in this area of care are likely to grow, especially if they go the extra mile to earn their AE-C. If you are interested in working as an asthma educator, the AARC’s Asthma Educator Certification Preparation Course can help ensure you are ready to pass the test.
