In the last 3 years, the respiratory care department at Shands Hospital has expanded, adding 49 new positions.

Nestled within the small college town of Gainesville, Fla, sits Shands Hospital, a world-class medical facility whose respiratory care practitioners play a key role in patient care. The positive influence of its respiratory team is apparent throughout every department in this teaching/research institution.

According to Tracy R. Holden, MBA, RRT, RCP, director of cardiopulmonary and neurodiagnostic services, business as usual involves access to top-of-the-line equipment and fully computerized charting. “We have computers on wheels for staff so they can do procedures at the bedside, like blood gas testing and measuring electrolytes,” she says. The department comprises 160 full-time respiratory care practitioners.

Several ongoing educational and training opportunities help keep staff up-to-date on the most current research, techniques, and equipment in the field. “Two educational coordinators provide training at three different in-house conferences every year,” says Holden, adding that Harvard University also conducts a 6-month project management course on-site. The administration encourages staff to attend state and national conventions as well.

Moreover, both the hospital and the department have joined the national movement toward 4-year degrees for respiratory care therapists. Holden notes that the hospital’s affiliations with the University of Florida, as well as its own teaching facilities, facilitate obtaining a degree.


Respiratory therapists at Shands have a unique opportunity to become involved in several research initiatives. For instance, Holden reports that the medical director, Michael A. Jantz, MD, who is ranked #2 nationally in his field, has done significant research on bronchial thermoplasty. Severe asthmatics who are not maintained on medications, but whose lives are controlled by their illness, have shown positive outcomes, Holden explains. “After 6 years of study, they have little to no asthma issues. Fewer than 10 centers do this,” she adds.

Additionally, therapists have worked with David W. Kays, MD, who specializes in diaphragmatic hernias, and has used extracorporeal membrane oxygenation (ECMO) extensively to help many patients survive what used to be a terminal diagnosis. An accredited Center of Excellence in ECMO, Shands received an Award for Excellence in Life Support for its ECMO program.


While equipment, education, and research opportunities enhance their jobs, staff unanimously agree that the people make the biggest difference at Shands. The scope of experience—time on the job ranges from 2 to 20 years—offers a balance of fresh, new ideas and proficiency. Holden looks for academically qualified individuals who have integrity and a good outlook on patient care, and will advocate for them, and who demonstrate teamwork. “To fit in, they have to be dedicated, have energy and a positive attitude,” she says.

In the last 3 years, the respiratory care department has created 49 new positions. One of the ways in which the department fills those slots is through its residency program, which instills confidence and enhances self-esteem. “We offer a 2- to 5-week preceptorship where students learn the job,” says respiratory practitioner Tom Selig. “The students come in and see how we function. They get to know the doctors and evaluate the hospital, and the department gets a 5-week job interview.”

Not only does the respiratory care staff collaborate during work hours, but they also extend their camaraderie outside the hospital. All staff is invited to—and a majority participate in—several activities from holiday parties and golf outings to camping trips and tubing at one of the 40 natural springs in the area. Selig says, “These activities bolster teamwork.”

Practitioner Leonile Kicnurse attributes the cohesiveness and progress in the department to Holden. “We are going in the right direction due to our director’s vision and leadership. She supports us and allows us to grow,” she says.

Holden, in turn, credits her staff for its dedication. “We want the best of the best, people who are committed to the excellence of the team. Our goal is not to be one of the best, but to be the best in the nation.”

Phyllis Hanlon is a contributing writer for RT. For further information, contact .

1600 SW Archer Rd
Gainesville, FL 32608