I think everyone at some point feels like this even for a moment. With increased workloads you often have to question how important some aspects of our jobs are in order to do the other "important" jobs awaiting our attention. I agree regards the respiratory aspect to a point. I belive that in another 20 years nurses with have enveloped this role. I would question the placebo effect in outrpatients. This is usually a view held by people with limited experience - I hate to say this but Some of the best specialist outpatient therapists I know at 50 are still learning and the detail and results they get are amazing. What I get dissillusioned with is the limited resources that often forces us to do the "get out of beds and walk" bit. I could do some fantastic and rewarding work if i had the time. I'm sure i could do some reall wonders with say 5-8 patients a day only - intense - and frequent. Instead I'm personally spread covering 108 patients with say one assistant with at best seeing 21 a day - mostly assessments only. You can only see proud and happy with your job f you can do the job you've been trainned for. Be disillusioned with the system not your profession would be my advice. You get out what you put in!!