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Back in 1992, after I received my bachelor of science degree in respiratory therapy from SUNY Stony Brook in New York, I came back to my country to work as a respiratory therapist. Back then, respiratory therapy in Panamá was provided only by nurses and doctors.

At the Social Security Hospital there was a section for respiratory therapy under supervision of the neumology service in the department of medicine. Working in this section were three respiratory technicians (who had graduated in Mexico) and some other personnel trained within the health institution to perform basic duties such as oxygen therapy, aerosol therapy, hyperinflation therapy, and some lung testing. The duties in the intensive care units and other complex tasks were not within our scope of practice. I started to work in this area, but my duties were limited due to the other personnel who had seniority. I was always striving to help open up opportunities in the field, offering a variety of services, but that was not enough.

In 1995 I became a member of the Panamanian Association for Respiratory Care (formed in 1991) to promote recognition of respiratory personnel’s duties and to improve the respiratory field in Panamá. My colleagues and I started to explore an opportunity at the different universities to create a respiratory therapy program in Panamá to educate and prepare new respiratory professionals and increase the field’s human resources. At the same time, I set out to enhance my knowledge in education so I could improve my teaching skills at an institution of higher education. I wanted to specialize in research-based teaching and learning techniques and obtain an education in a broader context of academic preparation and student education.

Being a member of the AARC gave me the idea to apply to the International Fellowship Program offered by the American Respiratory Care FoundationSM. I applied in 1998 and was fortunate to be selected. During my fellowship, I was able to exchange valuable respiratory therapy information and experiences with RTs at six hospitals and two colleges in Boston, MA, and Tupelo, MS.

In Boston, I toured four big hospitals. Although I had graduated at SUNY Stony Brook, I found it very interesting because I was able to observe the kind of patient care RTs in Massachusetts provide during a full working day. I saw RTs perform procedures that were not very common for me, such as hyperbaric oxygen therapy and extracorporeal oxygenation. I was included in the rounds at General Massachusetts Hospital, and the respiratory therapists were eager to take me with them to the ICUs and the wards. I visited a cancer hospital, where I saw RTs respond to a code blue, and I saw a children’s hospital and pulmonary rehabilitation hospital. During my trip to the college, I received educational materials that I used later for my respiratory therapy program in Panamá.

In the college I saw how RTs teach respiratory therapy and realized that students actively participate during the lessons and receive intense practice training in fully equipped laboratories. The respiratory equipment was remarkable, and I was especially impressed with a human simulator that could mimic various pathological scenarios.

My experience in Tupelo, MS, was also intense and full of variety. The organization of the health system and its various inter-related services amazed me. I visited all the services, as well as another institution in their health system. On my last day, I visited the Itawamba College, where I spoke of my experiences as a respiratory therapist in Panamá and shared with respiratory therapy students some of the great places to see in Panamá. I also had a nice surprise: A local television crew interviewed me about my visit to Mississippi and then aired it on the evening news.

The Mississippi Society for Respiratory Care gave me a great reception dinner at the end of visit, and we shared several experiences about respiratory therapy in the health systems of Mississippi and Panamá.

What was rewarding for me was the camaraderie of both my host-city representatives and their willingness to show me how respiratory care can be practiced. My trip to the United States ended with the AARC International Respiratory CongressSM in Atlanta, GA, where I met with many respiratory therapists who helped make my fellowship a really unforgettable experience. It was great to meet the other International Fellows and the AARC International Committee, as well as once again see some of my professors from Stony Brook. The standard of respiratory care in the United States is admirable, and this profession’s team spirit of giving and sharing is amazing. The enthusiasm to promote the profession and help mankind is so visible.

The AARC International Respiratory Congress, with its ceremonies, receptions, and programs, made my international fellowship complete, giving it the perfect ending I will never forget. It also gave me the strength to set out on a new beginning—the establishment of a respiratory education program in Panamá.

With all the background in respiratory therapy from America, my colleagues and I were able to begin forming our own educational program. We presented a proposal to several universities, and in 2002, the Universidad Especializada de las Américas opened the door to our respiratory program, which offers students a bachelor’s degree. At that time, our difficulties were obtaining respiratory books in Spanish, and I was the only respiratory therapist who knew English. The respiratory program attracted professionals in neumology, critical care medicine, and pediatrics. Since I did not have any formal experience in education, I went back to school and obtained my master’s degree in education in 2003.

So far, we have graduated four bachelor-degree students who now work at private and public hospitals. In our department at Social Security Hospital, the respiratory staff has grown to include 10 respiratory therapists, two technicians, and two respiratory assistants.

With all the change that has come to the way we practice respiratory therapy in our country, we can now offer a better quality service to our patients. For example, we now offer 24-hour coverage in the ICUs. We still have a long way to go and more therapists are needed, but at least we can offer more time to their treatments and other health programs. We now implement holistic health care and offer prevention and health promotion to our ambulatory patients.

The best thing is that special legislation went into effect on Aug. 5, 2008, that legitimizes the role of the respiratory therapist and the profession in Panamá, allowing us to have all the rights to practice respiratory therapy, among other responsibilities and benefits. Now our professional association is growing, the field is advancing, and we are helping our community raise the standard of good respiratory health, evidenced by our special research projects in cardiopulmonary rehabilitation. We will keep working for the profession we love.

Briseida Delgado Rodriguez, MS, CRT, is coordinator of the respiratory program in Bella Vista, Panamá, and president of the Panamanian Association for Respiratory Care (APTR in Spanish).

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