LOUISVILLE, Ky. (WDRB) - Whether it's from an asthma attack, drug overdose or cardiac arrest, patients having difficulty breathing will no longer be cared for by respiratory therapists at three Louisville-area emergency rooms as a result of the recent layoffs at KentuckyOne Health.

Instead, nurses at the three facilities -- Jewish Medical Centers South, Southwest and East -- will take over respiratory care after getting a "refresher training," KentuckyOne spokeswoman Barbara Mackovic confirmed.

While respiratory care is within nursing's legal scope of practice in Kentucky, some employees of the facilities are concerned the nurses don't have enough knowledge or practical experience performing functions like operating a ventilator, which sends oxygen into the lungs of patients who can't breathe on their own.

"They are not educated and they have no experience (managing a ventilator) whatsoever," said a respiratory therapist whose job is soon to be eliminated as part of the cuts. "This is not a game. If you do something wrong, you can kill a person."

The therapist spoke on the condition of anonymity so as not to jeopardize final weeks of employment or severance pay from KentuckyOne.

"It's dangerous for the nurse and the people in the community… They are definitely not giving us enough education," added a nurse at one of the facilities, who also requested anonymity for breaking KentuckyOne's policy against employees speaking to the media without authorization.

In a statement to WDRB, Mackovic said safety is KentuckyOne's No. 1 priority and "any changes within our health care facilities will not place our patients at risk."

She added that this model of care is "similar to the Saint Joseph Jessamine (in Nicholasville, Ky.) and ambulatory facilities across the region."

Within the KentuckyOne system, it's only Jewish Medical Centers South (in Shepherdsville), Southwest (in Valley Station) and East (Dutchmans Lane) that are losing respiratory therapists, Mackovic said. KentuckyOne is closing the entire emergency room at a similar facility, Jewish Medical Center Northeast, at the end of the month.

KentuckyOne's inpatient hospitals – Jewish Hospital, Sts. Mary & Elizabeth Hospital, University Hospital and Jewish Hospital Shelbyville – are apparently unaffected by the move to cut respiratory therapists.

Mackovic did not specify exactly how many hours of "refresher training" the nurses at the ambulatory care facilities are getting, but employees say it's a four-hour class.

Respiratory degree programs "include over 500 hours of didactic, lab and clinical experience on mechanical ventilation alone," said Janet Vogt, director of clinical education in the respiratory therapy program at Bellarmine University.

Some respiratory programs are two-year degrees; some are four years, she said.

In her role as chairwoman of the Kentucky Board of Respiratory Care, Vogt said she's answered calls voicing "concerns about (KentuckyOne) nurses and the limited education that they will be getting" in respiratory care.

"The nursing profession under their license can perform our scope of practice, but the concern is the education and (the) issue of competency," Vogt said.

The Kentucky Board of Nursing has also received "a couple of calls" expressing concern about the situation, according to Paula Schenk, the nursing board's executive director.

Schenk said the board's opinion is that registered nurses are licensed to perform respiratory care "provided they have necessary education, training (and) knowledge base."

"The legal scope of the (nursing) practice does encompass (respiratory care), but some individuals may have greater knowledge base and competence" in the field, she said.

Concerns about KentuckyOne's move are evident on the Facebook page of the Kentucky Society for Respiratory Care, where comments indicate about 20 respiratory therapists are being cut.

The layoffs began in mid-February shortly after KentuckyOne, a unit of Denver-based Catholic Health Initiatives, said it needed to improve its financial performance by $218 million by mid-2015.

KentuckyOne was formed in 2012 by the merger of Jewish Hospital & St. Mary's HealthCare in Louisville with the Saint Joseph Health System, based in Lexington. KentuckyOne then took over most of the operations of University Hospital and the James Graham Brown Cancer Center last year through a long-term partnership with the University of Louisville.

KentuckyOne had the largest operating loss of CHI's 12 key regions in the fiscal year that ended in June 2013, according to an October report by Standard & Poor's, one of the firms that rates CHI's creditworthiness for bond investors.

KentuckyOne generates about $2 billion in patient revenue annually, the report said.

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