Abstract
To provide all staff members the opportunity to acquire a variety of work experience, the respiratory therapy department at Beth Israel Hospital, Boston, Massachusetts, has only five permanent positions. The balance of the staff work all shifts, cover intensive care units, and are eligible to fill rotating positions. These include: senior and junior positions as supervisor, student clinical instructor, and equipment manager, one position in the pulmonary function laboratory, and one position in the blood gas laboratory. Participation in the rotation is optional, and a therapist may apply for any number of rotations in any sequence. Therapists' annual per-formance review includes evaluation of work performed during rotations. One therapist from each rotation plus the Technical Director, technical coordinator, staff clinical instructor, and Medical Director constitute the "Senior Staff," which sits for preliminary deliberation of matters to be submitted to department meetings and which screens employment applicants. This system provides the wide variety of experience a therapist needs to be a leader in any department; to date 9 of the first 45 persons to participate in the process have assumed department director positions in other institutions.
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