Caribbean Paradise Island Offers Respiratory Care

Caribbean Paradise Island Offers Respiratory Care

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Caribbean Paradise Island Offers Respiratory Care

By Hector L. Bermudez, MD, CRTT

early every day of the year, at least one cruise ship embarks for vacation sites in the Caribbean paradise islands. The destinations are legendary for their ability to offer plenty of good times: Jamaica, Barbados, Grenada, Trinidad and Tobago, Aruba and Cazumel. All offer balmy weather, wonderful beaches, and warm, blue water 12 months a year.

While wall-to-wall fun is available nearly 24 hours a day, these are first and foremost tourist spots. Medical facilities are secondary to hotels, restaurants, golf courses, well-groomed beaches and recreational facilities. Medical care is not lacking, by any means, but it is not the same as is provided stateside.

In the United States, for example, respiratory therapists can be found almost everywhere there is a medical facility. Beyond this nation’s shores, it is a far different picture. In the Caribbean, you can find respiratory therapists in only a few locations: Puerto Rico, Jamaica, and the U.S. Virgin Islands. Of these, I would like to offer my viewpoint of care in the first.

Puerto Rico has numerous therapists. Like everywhere else, there are good ones and some bad ones. I have personally trained some of the best.

Because places like Jamaica, the Cayman Islands and the Bahamas elicit feelings of good cheer, many try to visualize everything Caribbean in a romantic way. I would like to try to explain how things really work, especially in Puerto Rico.

We have excellent and dedicated RCPs on this wonderful island. About 97 percent of them are overworked and underpaid. And I mean underpaid. Let’s not even talk about benefits. There are hardly any. I have worked in various hospitals, and everywhere the situation is the same.


Let’s start by talking about the supervisors. Most are your worst enemy. Their sole concern in life appears to be keeping their jobs. To accomplish that, they get rid of anybody who represents a threat to them. You do not need a degree to be a supervisor, so many do not have one and are suspicious of anyone who does. Supervisors are not necessarily into problem solving either. In fact, sometimes if you do take a problem to them, you find out they have no idea at all of what you are even talking about.

In some respects, it almost seems supervisors were hired on their abilities to laugh at jokes and make some good points about a particular topic once in a while.

A good number of doctors treat therapists like illiterates. Some would not use RCPs at all if it were up to them. That’s a philosophy to really cheer you up! And the nurses never remember your name. For many of them, you are simply Mr. or Ms. Therapy. They may remember your name if you work the graveyard shift with them, sit with them in a gossip session or are the clown of the department. But if you are doing your job the way it really should be done, nobody remembers your name.

Only the nurses in the ICU take you seriously and respect you, but even then you have to show them first you are worthy of their respect. On a positive note, nursing supervisors will back you up, if you have demonstrated first you are a good RCP.

To hospital administrators, RCPs are not professional caregivers. They really do not care if you have gone to college and taken boards to gain certification. The cleaning crew occupies a higher position in their eyes. They do not care whether your credentials are RCP, CRTT, RRT or CPFT. Everyone gets the same low pay, regardless of credentials. Degrees mean little either. A person with a BS degree or a PhD will get paid the same as the person holding an AS degree.

It gets a little disconcerting sometimes if you are reporting to a supervisor with one year of college under his belt and no credentials to his name (he took the boards three times and never passed them).


Still I think Puerto Rico is way ahead of most other nations in providing health care in the Caribbean, considering all the negative things. There are excellent therapists who work hard to give their patients the care they deserve. They make sure their patients get the care the way it is meant to be too. Despite some of the internal problems, they have a genuine flame of humanity burning inside them.

What it all comes down to is if you ever do go this vacation paradise in the Caribbean and do need respiratory care, you can bet your boots you will get the best. *

Hector Bermudez has been affiliated with respiratory care departments in various hospitals in Puerto Rico and is a former clinical instructor there.

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