Just Breathe

Award-winning anesthesiologist Dr. Paul Goldiner has a degree in history, attended dental school, worked for the U.S. Army, went back to school for anaesthesiology, oversaw intensive care units at some of Manhattan’s largest hospitals, sits on state medical boards and wrote numerous articles and a book about critical care.

He has also taught respiratory therapy courses at BMCC since 1974.

Dr. Goldiner is currently the Medical Director of the Respiratory Therapy Program at BMCC and received the Golden Tree of Life Award at the annual meeting of the New York Downtown Association for Respiratory Therapists, Inc. held in the fall. This award is given to a person who has made outstanding contributions to the field of respiratory therapy.

“When I was appointed director of Respiratory Therapy at Memorial Sloane Kettering, BMCC needed someone to teach a course in cardiopulmonary physiology. It was 1974,” he recalls. “So, I started teaching in the classroom, eventually becoming the medical director of the program. And I’ve been here ever since.”

What exactly is respiratory therapy?
Dr. Goldiner calls respiratory therapy, “the most versatile healthcare professional in the hospital setting.”  Respiratory therapists render essential care to sick patients in the hospital, outpatient and homecare setting.

“It’s managing the patient’s respiratory (breathing) system. In the hospital, acute care setting, the respiratory therapist (RT) manages the patient’s ventilator, the airway…on the floors, they provide care to the patient using various pieces of equipment. In homecare, RTs manage the patient’s equipment and their response to treatment that been prescribed.”

Respiratory therapists oftentimes work closely with the physician that manages the patient. “If the respiratory therapist doesn’t feel the care is adequate, they’ll let the physician know,” says Dr. Goldiner.

Human Patient Simulator Lab
Established to give nursing and respiratory therapy students an opportunity to perform various procedures on patients without the fear of harming them, at BMCC’s on-site simulator lab, medical models simulate an actual patient.

“These models are hooked up to monitors and breathe and respond to drugs in the same way that an actual patient would,” says Dr. Goldiner, who is very proud of the lab and says it’s extremely advanced, and utilizes top-notch technology. “In the lab, we can create scenarios that require a response from the student. We also videotape students during the scenario to show them what they did wrong and right.”

Monitors record the model’s vital signs—respiration, heart rate, oxygenation—and vary the oxygen they are getting and their response. “The model’s responses are very similar to a human being deprived of oxygen,” says Goldiner. “We can set up scenarios where the students have to react in a therapeutic way to correct the situation we’ve created.”

The attraction to BMCC
Dr. Goldiner has worked at various hospitals in Manhattan, including Sloane-Kettering, Mt. Sinai and Albert Einstein. Although he retired from working in a hospital setting in 2004, and is enjoying his retirement by spending time with family on the West Coast, he is still affiliated with BMCC after first stepping foot on the campus in the 70’s.

“I really like it here. BMCC is just so unique,” he says of his attraction to the college. “I’ll do site visits at schools all over the country and always compare them in my mind to BMCC.”

Because Dr. Goldiner spent many years on the credentialing board for respiratory therapists, he knows what the licensure pass rate is for the first-time test takers. “The pass rate for those taking their first level of certification, the CRT, is 68-72 percent.”

However, BMCC’s pass rate for first time test-takers “is always in the 90s,” says Dr. Goldiner. “That’s because we have very enthusiastic students. Those that always stick to the program really have to work—they want to do well. They want to be successful and in that drive for success they really soak up the information we give them.”

Dr. Goldiner shares a story about a time he met some BMCC respiratory therapy alums. “I was at a meeting about respiratory care in Anaheim, California and talked with BMCC alums who graduated 25 years ago. They were all very successful. In fact, the technical directors of most hospitals in this area are graduates of BMCC.”

We need ‘more healthcare professionals’
The attraction to a career in respiratory therapy, says Dr. Goldiner, is that it’s one of the most versatile healthcare professions in terms if work schedule and settings.

“We need more healthcare professionals. Over the years, the testing requirements have gone up—there is more to learn, but the respiratory therapy credentialing process provides a career pathway for people to improve their lives,” he says.

Nowadays, respiratory therapists can climb the career ladder to become specialists in critical care, pediatric care or even work in a growing area, sleep medicine (polysomnography).

According to Dr. Goldiner, in New York State, there are two levels of RT certification. The first credential level is Certified Repiratory Therapist. “In New York State, that gets you a license as a technician (CRT). The second level, Registered Respiratory Therapist (RRT) raises you to the level of a Respiratory Therapist,” says Goldiner.

According to Dr. Goldiner, “today, we are turning out a much more sophisticated graduate—one who knows both the physics of the body and the physics of the machines.”

Also, today’s respiratory therapists have a “tremendous amount of knowledge and the ability to support patients in ways we wouldn’t have dreamed of 20 or 30 years ago.”