In this episode, hosts Mike and Rob sit down with Jake Miller, RRT-ACCS, MBA, just before the California Society for Respiratory Care (CSRC) annual conference. Jake is the Manager of Respiratory and Interventional Pulmonary at Keck USC Medical Center and the current president of the CSRC.

Jake shares his 13+ year journey in respiratory care, starting out in EMS doing Orange County 911 work before transitioning into hospital-based practice. He opens up about how the burnout and exhaustion of working six to seven days a week during COVID pushed him to seek something more — leading him to get involved with the CSRC, where he found renewed purpose through committees, advocacy, and leadership.

The conversation digs into the real challenges facing state respiratory societies, including member burnout, retention struggles, and the push to grow initiatives like the Advanced Practice Respiratory Therapist (APRT) designation in California. The hosts also tackle the big question of why more of California's estimated 30,000 licensed respiratory therapists aren't engaged with their state society — and why they should be, given the legislative and professional issues directly affecting their licenses and patient care.

Jake's message is welcoming and low-pressure: show up to one committee meeting, give some feedback, and see what happens. A great listen for any respiratory therapist thinking about getting more involved in their profession.

What happens when an accidental Google search completely derails your life plan — in the best possible way? Ask Rachel Jenkins.

In this episode, Rob and Mike sit down with the MSRC Vice President and Ozarks Technical Community College faculty member ahead of the Missouri Society for Respiratory Care conference, and things get real fast. Rachel went from psychology and criminology student to respiratory therapist in the middle of a global pandemic, then pivoted to education, landed a spot in the AARC Emerging Leaders Program, and somehow still found time to plan a conference around Renaissance Fairs and dragon-themed ventilators. Yes, really.

But underneath the fun, Rachel pulls no punches about the state of the profession — calling out the therapists who want higher pay and a bigger scope of practice without doing the work to earn it, breaking down what it actually costs to get legislation moving, and making the case for why the next generation of RTs needs to be as comfortable talking to a physician as they are sending a text.

If you care about where respiratory care is headed and who's going to take it there, this is the episode for you.

Some lessons can't be taught in a classroom. They come from the bedside of a dying grandmother, from the weight of holding someone's hand when there's nothing left to do medically, from years of fighting to save lives and slowly learning that sometimes the most compassionate thing you can offer is peace.

In this deeply personal episode, Mike sits down with co-host Rob to trace the journey that shaped not just his career, but his humanity. From 14 years serving in the United States Navy — carrying skills that the civilian world didn't know what to do with — to becoming a pioneer in neonatal flight care, Rob's path has always been driven by a profound desire to help people in their most vulnerable moments. But it was the quiet, painful moments outside of the clinical setting that taught him the most.

Rob opens up about the experience of becoming his grandmother's healthcare decision maker, and how that deeply human moment forced him to confront the very questions he now dedicates himself to exploring — what does it really mean to do right by someone? When does fighting for a life become prolonging suffering? And how do we sit with families in their grief without losing ourselves in the process?

Together, Rob and Mike reflect on why ethics isn't just a policy or a licensure requirement — it's the thread that connects every difficult conversation, every family meeting, every moment a clinician chooses to pull up a chair, get to eye level, and truly listen. They also shine a light on a striking gap in the profession — only 11 states currently require ethics as part of licensure renewal — and make the case that checking a box is not the same as having the conversation that actually needs to happen. Because at the end of the day, our patients and their families don't need our sympathy. They need to know that someone genuinely sees them.

In this heartfelt and candid episode, hosts Rob and Mike getpersonal, stepping back from case discussions to share the "whys" behind their passion for healthcare ethics. Mike, a 30-year respiratory therapy veteran and expert witness on over 26 medical malpractice cases, opens up about what drives his commitment to ethical patient care — from seeing every patient as someone's family member to recognizing that even routine bedside tasks carry life-or-death consequences.

The two dig into questions that don't have easy answers — when should instinct override protocol? How do you hold colleagues accountable without losing compassion? And what separates a genuine ethical decision from simply following the rules? Rob reflects on his own defining moments, including a harrowing triage decision involving a child that tested the limits of ethical instinct.

Together, they explore why ethical thinking needs to become"muscle memory" for healthcare professionals, and how ethics extends far beyond medicine into our laws, relationships, and everyday choices. At the core of it all is a simple but powerful belief: that respectful disagreement and genuine compassion are the foundation of any meaningful ethical conversation.

Honest, unscripted, and occasionally interrupted by a barking dog, this episode captures exactly why these two started the podcast in the first place.

In this thought-provoking episode, Mike and Rob dive deep into one of the most ethically charged medical cases to make headlines in recent memory: the story of Adriana Smith, a brain-dead pregnant woman in Georgia whose family was stripped of their right to make medical decisions due to the state's 2019 Life Act.

Drawing on the four pillars of bioethics — autonomy, beneficence, non-maleficence, and justice — the hosts examine how a 10-page law with only three narrow exceptions can have profound and deeply personal consequences for real families. They explore the philosophical roots of moral autonomy through the lens of Immanuel Kant's categorical imperative, questioning whether keeping a brain-dead woman on life support against her family's wishes reduces her to nothing more than a vessel — a mere means to an end.

This isn't a pro-life vs. pro-choice debate. It's a conversation about what happens when legislation fails to account for the complex realities of medicine, and what it truly means to respect the rights of patients and their families.

Where is the line? Who gets to draw it? And how do we write better laws? Tune in and decide for yourself.

In this follow-up to Episode 2, GR returns with deeper insights on how healthcare providers can better serve veterans and their caregivers. After reflecting on their previous conversation, GR introduces the powerful concept of the "Triangle of Care"—a collaborative model where the medical provider, veteran, and caregiver work together as equal partners in healthcare decisions.

GR discusses the "shadow file"—the critical observations and patterns that caregivers notice in their 24/7 role that veterans themselves may not report to doctors. From navigating VA systems to understanding why veterans sometimes withhold information during appointments, this episode explores practical ways to ensure caregivers are heard and their expertise is valued.

The conversation tackles important questions: Should there be a philosophical shift in how we approach veteran care? How can AI and electronic health records better document caregiver involvement? What specific questions should providers ask to get the full picture of a veteran's health?

Whether you're a healthcare provider, caregiver, veteran, or simply interested in improving patient care, this episode offers actionable insights on creating more effective, compassionate healthcare partnerships.

It’s a Snow Day! On this episode we’re joined by our friends Matt, JJ, and Mindy from RT Sidebar to tackle a topic every hospital and respiratory therapist knows all too well—snow days.

From staffing challenges and patient safety to communication breakdowns and ethical decision-making, we dig into how hospitals and RT departments can better prepare, respond, and lead when the weather turns wild. Practical insights, real talk, and a few cold-weather lessons you won’t want to miss.

The episode examines what happens when deeply held patient autonomy conflicts with a clinician's desire to fight for more time with someone they love.

This deeply personal episode features JJ Valdez, a.k.a. JJ The RT, sharing the emotional journey of his father's battle with mantle cell lymphoma, a rare form of cancer diagnosed in late 2018, early 2019. The conversation explores the challenging intersection of being both a healthcare professional and a family member during a medical crisis.

JJ recounts how his father's diagnosis began with seemingly innocuous symptoms that eventually led to a cancer diagnosis. The episode chronicles the family's journey through treatment while JJ was simultaneously navigating the unprecedented challenges of the COVID-19 pandemic.

The discussion delves into profound ethical and emotional territory as JJ describes his father's firm wishes to never be placed on a ventilator, creating an agonizing conflict between his professional knowledge and his role as a devoted son. JJ paints a vivid picture of his relationship with his father—his "superhero"—who raised him as a single parent working multiple jobs while remaining constantly present, coaching his baseball teams, and providing wisdom without formal degrees.

Hosts, Mike and Rob, share their own experiences with similar dynamics, discussing how healthcare professionals often default to "solution mode" rather than sitting with emotions when facing family medical crises. They explore the challenge of compartmentalizing clinical knowledge from personal feelings, and whether this tendency to immediately focus on treatment plans is helpful or potentially problematic.