Respiratory Therapists

There are approximately 107,000 respiratory therapists in the United States. Job growth statistics suggest the occupation will grow by 21% over the next decade, a significantly greater number than the average rate of growth.
Respiratory therapists assess patients with breathing or cardiopulmonary disorders and determine proper treatment. While they work under the supervision of a doctor, respiratory therapists are the primary point of responsibility for diagnoses and therapeutic treatments. Patient care plans are created after the respiratory therapist confers with medical staff.

Respiratory therapists work with a wide age range, from newborns with insufficiently developed lungs to seniors with diseased lungs. They also work with a wide needs range, from asthma patients to those who have suffered a stroke, nearly drowned, or are on life support. They assess breathing capacity, measure pH to determine the degree of alkalinity or acidity in an individual’s blood, and establish blood oxygen concentration. Evaluating lung capacity involves measuring oxygen flow and volume with breathing. Lung insufficiency is determined with a comparison to the norm for the age, weight, height, and sex group that coincides with the patient’s data. Blood samples are evaluated using arterial samples with a blood gas analyzer. The physician caring for the patient receives the results and determines treatment. Treatment includes oxygen mixtures, inhaled medications, and chest physiotherapy. An oxygen mask can be used when a patient is having difficulty breathing. Ventilators carry oxygen into the lungs of patients who cannot breathe on their own. Ventilators involve the insertion of a tracheal tube that is connected to the ventilator. Oxygen concentration, rate, and volume are set so that the patient receives the correct mixture at the right pace. The settings are changed by doctor’s orders if the patient is having difficulty, assuming the equipment has been checked and no mechanical problems found. Chest physiotherapy is used to clear lungs of mucus. This is frequently done following surgery to encourage the patient’s lungs to return to normal function after being depressed by anesthesiology. Chest physiotherapy is also used for patients with lung disease like cystic fibrosis. Home care respiratory therapists teach family members how to operate ventilators or other life support systems.

Home care therapists make sure equipment is sanitary, that patients fully understand their condition and how to use equipment and medication, and assess the surroundings for patient comfort and safety. If equipment ceases to work properly, a home care respiratory therapist will make an emergency home visit.

Some therapists working in hospitals may be asked to participate in case management, pulmonary rehabilitation, quit-smoking counseling, disease prevention, and polysomnography to diagnose breathing problems like sleep apnea.
Most work 40 hours per week and their schedules can rotate, especially for hospital workers who may be required to work evenings, nights, weekends, or holidays at times. Some emergency work situations can be stressful. Risks include potential problems associated with pressurized gases, but frequent testing to ascertain that equipment is working properly minimizes the danger. Respiratory therapists, particularly those working in hospital or clinic settings, are around patients with infectious diseases.

At minimum, a respiratory therapist must have an associate degree; however, at least a bachelor’s may be required in order to advance. Forty-eight states mandate licensing. The Commission on Accreditation of Allied Health Education Programs (CAAHEP) has noted 31 entry-level as well as 346 advanced level respiratory therapy programs in the country.

Coursework includes anatomy and physiology, chemistry, patho-physiology, microbiology, physics, and pharmacology. Some offer classes concerned with diagnostic assessment, respiratory equipment, therapies, cardiopulmonary resuscitation and rehabilitation, patient care, disease prevention, and medical record-keeping. Because respiratory therapists calculate medicine dosage and gas concentrations, facility with math is important.

Most employers require therapists keep their cardiopulmonary resuscitation (CPR) certification active. For most states, licensure is to some degree dependent upon certification requirements as established by the National Board for Respiratory Care (NBRC). Entry and advanced level graduates are awarded a Certified Respiratory Therapist (CRT) credential by NBRC, as long as the program was accredited by CAAHEP or the Committee on Accreditation for Respiratory Care (CoARC); licensees must also pass an exam. Advanced level graduates who also pass two examinations can receive Registered Respiratory Therapist (RRT) certification. Advancement to a managerial or supervisory position, as well as most intensive care specialties, demands an RRT. Other forms of advancement are a promotion from general to critical care patients when organs in addition to lungs are involved, as well as taking a teaching position at a college or university. Some respiratory therapists move into pharmaceuticals or medical device development, marketing, or sales.

Respiratory therapists must pay careful attention to detail, understand and follow directives, and be able to mesh with a team. They require good manual dexterity, patience, and the ability to work under pressure.
The median annual income for respiratory therapists is approximately $53,000. Those at the midrange earn between about $45,000 and $62,000. Those in the lowest 10% earn less than $38,000, and those in the highest 10% earn more than $70,000.