40 years of critical care: One respiratory therapist’s experience in the MICU

From an early age, Lynn Mellecker knew she wanted to be a respiratory therapist and knew where she wanted to work: University of Iowa Hospitals & Clinics. This stems, in part, from the care her older brother received here for spina bifida.

“After I graduated high school, I said to myself, ‘Oh, I need to go work there,’” Mellecker, senior respiratory therapist in the Medical Intensive Care Unit (MICU), says.

Since 1980, Mellecker has watched the evolution of the organization. She’s seen a lot of changes in terms of facilities, people, and the methods in which we deliver care to patients.

“It’s amazing in 40 years how much medicine has changed. You have to keep up on the literature,” Mellecker says.

Ahead of the curve

Mellecker says even before the COVID-19 pandemic, the respiratory care team focused on new treatments and techniques that would improve patient recovery.

“Other institutions would publish articles about new innovations and we’d see it and go, ‘Yeah, we’ve been doing that for six months,'” Mellecker says.

For example, Mellecker recalls that the MICU team began using the proning technique—where patients are placed on their stomach to help with oxygenation—before national guidance suggested the treatment was useful for patients with COVID-19.

For her, it’s about keeping up with the latest methods of care, but also the best safety practices for the entire staff.  Mellecker takes pride in how staff help each other with PPE as part of the ongoing response to COVID-19, saying it’s really noticeable when a patient is in crisis.

“If you’re having a patient that’s doing poorly and you want to run in the room, someone is helping you get the correct PPE on before going in,” Mellecker explains. “We look out for each other.”

“I’d go nowhere else…”

Over time, Mellecker has seen a number of techniques phase out. She recalls how they would pump air into someone’s body at a much higher tidal volume—about 15 cubic centimeters per kilogram of body weight—before research found patients recovered faster and easier with less volume.

She also believes not all recovery care takes place in a hospital room or in dire situations. Mellecker remembers a recent patient that staff helped get out of bed while she was still on a ventilator.

“She was a patient recovering from COVID-19,” Mellecker says. “Every day we’d walk her or take her out in a wheelchair, we would go down a different hallway, so that she could see experience new things.”

Although she says the work is challenging, especially in the past two years, it’s the focus on innovation that puts things into perspective for Mellecker.

And when it comes to what UI Health Care means to patients as a leader in medical innovation, Mellecker doesn’t hesitate to place her trust in the hands of her colleagues.

“If my husband has some health issues, I’d have him go nowhere else but University of Iowa Health Care,” she says.