Occupational Duties

Respiratory Therapists (RT) work independently and with doctors and nurses to provide care to individuals with breathing problems. RTs may provide emergency care to patients with heart failure, stroke, drowning, shock, head injuries, lung infection or drug poisoning. RTs may provide ongoing or continuing care for individuals with chronic diseases such as asthma or pneumonia. RTs also frequently provide intensive and ongoing care for premature infants.

RTs set up and operate ventilators, masks, incubators, and breathing machines designed to give respiratory assistance to patients. RTs also provide patient education on respiratory problems, teach breathing exercises, and set up equipment to suit their patients’ needs.

The majority of RTs work in hospitals. RTs also work in medical clinics, nursing homes, sleep-study centers, home-care, clinical research facilities, and as consultants for respiratory equipment companies. Some RTs with advanced degrees pursue careers in education.

Significant Points

• RTs provide life-saving care to patients that cannot breathe independently or safely. Many RTs feel a sense of pride and satisfaction when they help patients.
  

• RT salaries are climbing as a result of the shortage of qualified workers–this is encouraging more individuals to explore a career in respiratory therapy.

• The shortage of qualified RTs has led to difficulties for the incumbent workforce; many facilities are understaffed and RTs may have a larger caseload. Several RTs indicated that patient care is sometimes compromised when RTs are “stretched too thin” and this is disconcerting to most RTs.

• Respiratory Therapy training programs in California are not easily accessible for many students due to prerequisite requirements, admissions criteria and a prolonged waiting period

• Because of the prevalence of job vacancies, RTs may have the opportunity to earn overtime or to work per diem shifts at other facilities.

• RTs work with a diverse patient population because pulmonary problems affect people of all ages. Once experienced, RTs may have the opportunity to specialize in a particular area of respiratory therapy, such as neonatology, if they find they particularly enjoy working with a specific patient group.

• Respiratory Therapy is considered to be a stressful occupation due to the fast-paced nature of the work environment and the critical needs of patients.

• RTs must have stamina and be able to spend the majority of a scheduled shift standing and walking.
  

• RTs face a possibility of injuries from lifting or moving patients and equipment.

• RTs work with saliva, sputum cultures, and body fluids, all of which may expose RTs to infectious diseases. RTs adhere to strict safety protocol to minimize exposure to pathogens.

• RTs provide treatment to patients with a variety of health conditions and inevitably, a percentage of patients die. This is a very difficult aspect of the Respiratory Therapy profession, though individuals interviewed indicated that over time, most RTs find individual ways to cope with losing a patient.

• There has been some discussion about the possibility of changing the entry-to-practice educational requirement from an A.S degree to a B.S. degree. No formal steps have been taken from a legislative standpoint and no date has been proposed where this change might take place. Because of the workforce and training shortages impacting the Respiratory Therapy profession at this time, this change is unlikely to occur in the near future.

• Hospitals must staff RTs around the clock and as a result, day and night shifts, as well as holiday and weekend work, may be required. Most facilities have rotating schedules for holidays and weekends.
  
  

Demand

Demand for RTs is strong and is expected to escalate as the population rapidly ages and more RTs retire. Because many individuals were drawn to the Silicon Valley high tech industry in the 1980’s and 1990’s due to demand and higher wages, fewer individuals sought out careers in respiratory therapy in that time period. Largely due to the economic downturn of the tech market and the security that respiratory therapy provides, more individuals than ever are pursuing RT training. As a result, a disproportionate percentage of the Bay Area RT workforce is nearing retirement and many new graduates are entering the workforce. Though employers would prefer to hire experienced RTs, an RT that is licensed and possesses good communication and interpersonal skills should find full time employment.

Many students are offered jobs from the employer that sponsored their internship. Occasionally, employers--Stanford Hospital is one such employer--hire RT students to work on respiratory equipment or to perform ancillary duties with the hope that the students will agree to work for the facility after s/he becomes a licensed RT.

Demand for respiratory therapists in the South Bay Area has been steadily strong for several years, but has spiked in late 2007 due to the opening of Kaiser Santa Clara's new 347 bed hospital and planned Cardiovascular Center. Due to the services to be provided (heart/lung care and rehab for patients that have had a heart attack), the facility has an increased demand for respiratory therapists.

As a result of the aging population and increasing incidence of chronic lung diseases among the young and old, respiratory therapists are also increasingly in-demand in home care.

Wages

Click here to view the salary survey for RTs in Santa Clara County and here for San Mateo County. According to individuals interviewed for the Healthcare Navigator project, starting wages for new graduates of local RT training programs is approximately $31/hr.

It is common for employers to offer signing bonuses to incoming RTs.

RT salaries have nearly doubled since 1996 and are expected to continue to rise due to the shortage.

Education/Training

To practice as a Respiratory Therapist in California, individuals must complete a State-approved respiratory care training program; earn a minimum of an associate degree; pass the California State License Examination administered by the Respiratory Care Board of California (RCB); and be approved for licensure.

Admission to respiratory care training programs in California is competitive, particularly in the Bay Area where programs have impacted status. All local training programs report receiving more applications from qualified applicants than they can accommodate, with the acceptance rate for local training programs hovering between 20-30% per admissions cycle. As a result, programs may use a combination of admissions criteria to select students. Some schools rely on academic factors such as test scores, prerequisite grades and amount of prerequisite coursework completed and overall academic record; other schools take into account an applicant’s work experience and personal history; and other institutions employ the lottery to randomly select from a pool of qualified applicants. Students who are not accepted are required to apply every admissions cycle and individuals who are interested in a career in respiratory therapy are encouraged to apply to all schools in the area due to the competitive and often unpredictable nature of the admissions process. Local California state-approved respiratory care training programs are offered at Foothill College, Skyline College, and Ohlone College. Click here to view a list of all state-approved programs.

Employers indicated that since respiratory care programs are now primarily offered at community colleges (versus vocational training programs) the overall quality of candidates has risen and new graduates are better prepared for the demands of the occupation. Employers did not indicate a strong preference for graduates from any specific training program.

Respiratory care training programs typically take two years to complete. RT students take courses in the life sciences, such as pathophysiology and pharmacology, as well as respiratory care-specific courses that teach students about standards of care with regard to therapeutic and diagnostic procedures, patient assessment, cardiac and pulmonary resuscitation, and respiratory health casework, etc.

RT students also complete a required internship at a participating healthcare facility. Click here to view all of the education requirements from the California Respiratory Care Board.

All respiratory care training programs are considered to be academically rigorous; however, it may be possible for disciplined students to work part-time in the evenings or on weekends if they can maintain an acceptable grade point average. Students must earn a minimum grade of “C” to be eligible to sit for the California State License Exam and according to training providers, students who earn primarily “A’s” and “B’s” are more likely to pass the licensing exam.

Licensure

Immediately following the completion of a state-approved respiratory care program, graduates apply to take the California State License Examination administered by the Respiratory Care Board of California (RCB). Once licensed, individuals can practice as Respiratory Care Practitioners (RCP). Many individuals also choose to pursue optional national certification by examination through the National Board for Respiratory Care (NBRC). Individuals that pass the national exam are awarded a Certified Respiratory Therapist (CRT) credential. Both credentials are considered entry-level; RCP is mandatory and CRT is optional.

California State licenses are renewed every two years through the RCB. RCPs must complete 15 continuing education units every two years. Click here for information on continuing education units and license renewal through the RCB.

Career Ladder

Click here to view a Respiratory Therapy career ladder diagram designed by the Healthcare Navigator.

RCPs/CRTs that would like to specialize in a particular area of respiratory care or who intend to apply for supervisor-level positions should take the voluntary Advanced Level Practitioner Examination administered by the NBRC. Individuals that pass the examination are awarded the Registered Respiratory Therapist (RRT) credential. Click here to read the eligibility requirements for the Advanced Level Practitioner Examination.

Individuals who hold administrative positions in the respiratory care field are usually RRTs. Employers may prefer that department managers or director-level staff have bachelor's degrees.

Some RTs may leave the respiratory care field to pursue a degree in Registered Nursing due to increased wages, a broader scope of practice and a desire to move into healthcare management outside of respiratory care. This is not common. Some individuals may choose to pursue Physician Assistant training programs after working in the respiratory care field.

Additional Resources

Professional Associations

American Association for Respiratory Care

American Respiratory Care Foundation

California Society for Respiratory Care

Committee on Accreditation for Respiratory Care

Additional Information

UCSF Center for the Health Professions Article: “Respiratory Care Practitioners in California”

Respiratory Care Board of California, “Respiratory Care: A Medical Career Giving a Breath for Life,”

Silicon Valley Roots: Foundation Occupations with Growth Potential-Respiratory Therapists