Breathlessness
Imagine a scenario. You are in your classroom after lunch break with a guest speaker who is sharing an exciting story with your students. Suddenly, the speaker’s voice becomes muffled, their eyes open wide, they begin to breath faster and heavier and they tell you it is hard to breath. Are they having a heart attack? An allergic reaction? Asthma? Did they have too much to eat? Did they talk too much? Is it COVID-19? What could it be and what should you do?
Breathlessness. Shortness of breath. Air hunger. All these terms mean the same thing. Breathlessness is simply defined as breathing discomfort. Ultimately, you feel like a fish out of water (I don’t expect you to know what that feels like). 27% of the world’s population experiences breathlessness on a regular basis (Banzett & O’Donnell, 2014). That is a staggering 2106000000 people!
When you are short of breath, you may:
- Tighten up your chest muscles to breathe.
- Breathe faster.
- Have feelings of fear, anxiety, panic or general unrest. (Juraviski Cancer Center, 2015)
As a Respiratory Therapist, I specialize in everything lungs and encounter breathlessness on a daily basis. I deal with life threatening events and manage them well; however, when it comes to a simple request from the patient asking for help when it is hard for them to breath, I need to put my detective hat on and question the patient in a way that is respectful and that will give me the answers to determine the source of shortness of breath.
By simply searching shortness of breath on the internet I found many resources that describe every possible source of shortness of breath. For example, the Mayo Clinical states that “very strenuous exercise, extreme temperatures, obesity and higher altitude all can cause shortness of breath in a healthy person. Outside of these examples, shortness of breath is likely a sign of a medical problem.” (2020). As a Respiratory Therapist (RT), after determining the cause of shortness of breath, the most important question that I ask myself is “why”. Knowing the why allows an RT to effectively explain to the patient what is going on in their body that causes them to feel short of breath.
In my role, I find that student RT’s lack the skill of using questioning to advance their critical thinking, the ability to determine the cause of shortness of breath and suggest treatment outside of the acute care setting. So after all, how do we determine the cause of shortness of breath? Why does it matter? What diagnostic tests will confirm the most likely problem? How will this information be related to the patient? How is the “system” affected by shortness of breath? These questions are alive and well in today’s society. Someone struggling with shortness of breath will limit their daily activity; as a result of this muscles will begin to deteriorate. With deterioration patients lose their ability to work and will need to go on disability. This lack of control over their body can lead to depression. All these factors affect the patient, the patient’s family and friends, and the healthcare system as costs of caring for such individuals are drastic. As a respiratory therapist I am passionate and determined to solve the puzzle of what causes shortness of breath and use a preventative approach to ensure that patients are able to enjoy life and control their breathing.
Educational goals have shifted from curricula content to curricula outcomes. Beyond the mastery of content, the development of specific skills (critical thinking) and innovative responses to problems are now required of advanced practice RT’s. I think that inquiry-based learning offers an opportunity for graduate students to develop the necessary skills for effective practice.
My experience with inquiry is superficial as I learned about the terminology “inquiry approach to education” when I registered for the course and felt that it was very applicable to healthcare. With Respiratory Therapy students I use an inquiry based approach when working on improving critical thinking skills. I typically provide case studies that they are likely to encounter in the hospital and ask them to gather information they think it relevant and identify how to troubleshoot a problem, suggest treatment and always back up their decisions with theory. From this course I hope to become more comfortable with leading my students through an inquiry based approach and I want to prepare myself for what to expect by using this approach. I am personally a fan of structure and in the readings a few authors comment on the “messiness” and “unstructured” classroom that comes with this approach. I am worried that this may bother me but I realize that learning can be very powerful if inquiry is used more often. After further discussions about “messiness” I believe that an inquiry-approach to education does not have to be messy. I need to structure and facilitate the discussion in a way that will allow my students to think outside of the box and encourage them to ask more questions with the aim of making a positive impact on patients and the community.
UPDATE: Why is inquiry the most appropriate way of approach this project? Friesen et al. (2015) emphasize the importance of knowing fewer topics but in depth rather than superficially learning about many concepts. (ch.1) and that “we learn best by acting on, thinking and actually participating in the world.” (ch.1). Friesen & Scott (2013) also write that through inquiry, students learn to “think critically and creatively, and how to make discoveries—through inquiry, reflection, exploration, experimentation, and trial and error (p.3) The article states that “students “construct meaning in the context of their lived experience through active inquiry and engagement with their school and community” (p.5). I think that this is very applicable in the last year of the Respiratory Therapy program because my students come equipped with didactic knowledge and are responsible for incorporating it into practice. If they are able to ask questions, then it is more likely that they are taking ownership of their learning and as a result of questions, will develop their critical thinking and reasoning skills. If I, as the teacher, am able to facilitate and encourage questions, information seeking and empowering my students to find answers, then they will become competent respiratory therapists at the end of their training and be able to provide quality patient care.
This is the perfect topic where questions are encouraged, necessary and have a lot of importance. Not only for me as a teacher but also for my students, the patients and the community. The ultimate goal is to help my students be amazing practitioners and help create a healthier community. One breath at a time.