A Respiratory Therapist (RT) is a licensed health care professional who focuses on the assessment, treatment, and management of patients experiencing cardiopulmonary disorders. RTs apply scientific principles to identify, treat, and prevent acute or chronic dysfunction within the respiratory system. They work with patients of all ages, from premature infants to elderly individuals managing long-term lung diseases. Their work is centered on restoring or maintaining optimal lung function and helping individuals breathe easier.
Core Responsibilities in Patient Care
Mechanical Ventilation and Life Support Management
Respiratory Therapists manage the complex technology that supports a patient’s breathing when they cannot do so adequately. This involves initiating mechanical ventilation by setting initial parameters on ventilators, continuous positive airway pressure (CPAP), or bi-level positive airway pressure (BiPAP) machines. The therapist continuously monitors the patient’s physiological response, making precise adjustments to settings like pressure, volume, and oxygen concentration. A primary goal is to guide the patient through a weaning process, gradually reducing mechanical support until the patient can transition back to spontaneous breathing.
Diagnostic Testing and Patient Assessment
Providing effective care involves a detailed and ongoing evaluation of the patient’s cardiopulmonary status. RTs perform key diagnostic procedures, such as drawing and analyzing arterial blood gas (ABG) samples to measure oxygenation, ventilation, and acid-base balance. Therapists also conduct Pulmonary Function Tests (PFTs), including spirometry, to measure airflow and lung volumes. They use physical assessment techniques, like auscultation and pulse oximetry, to monitor oxygen saturation and inform treatment plan adjustments.
Emergency and Critical Care Response
In acute and critical care settings, Respiratory Therapists serve as primary responders for cardiopulmonary crises. They are active members of rapid response teams and code teams, where their expertise in advanced airway management is necessary. During a respiratory or cardiac arrest, the therapist may perform or assist with procedures like endotracheal intubation to secure an airway for mechanical ventilation. Crisis management involves stabilizing the patient, administering emergency aerosol medications, and managing life support devices.
Disease Management and Patient Education
RT work involves helping patients manage chronic conditions to improve their quality of life. Therapists develop individualized treatment plans for individuals living with diseases such as Chronic Obstructive Pulmonary Disease (COPD), asthma, and cystic fibrosis. Management includes administering aerosolized medications and teaching patients proper airway clearance techniques and breathing exercises. Patient education covers the correct use of handheld inhalers, nebulizers, and home oxygen equipment. Therapists also provide guidance on recognizing symptoms and making lifestyle modifications to minimize exacerbations.
Work Settings for Respiratory Therapists
Respiratory Therapists practice across a wide spectrum of health care environments. The majority of RTs are employed in acute care hospitals, working in high-intensity areas like the Intensive Care Unit (ICU), Neonatal Intensive Care Unit (NICU), and Emergency Department. In these settings, the focus is on stabilizing and treating patients with sudden, severe respiratory failure.
Other environments cater to chronic disease management and rehabilitation, such as long-term acute care facilities, skilled nursing facilities, and pulmonary rehabilitation clinics. RTs in these locations provide ongoing care, ventilator management for long-term support, and therapeutic exercise programs. Specialized settings like sleep disorder centers rely on RTs to conduct and interpret overnight sleep studies. Home health agencies also employ therapists to deliver respiratory care and equipment management directly to patients’ residences.
Essential Skills and Professional Qualities
Successful performance requires a blend of technical proficiencies and interpersonal skills. Technical skills include an understanding of cardiopulmonary anatomy and physiology, allowing the therapist to correlate physical symptoms with underlying pathology. Therapists must be proficient in operating, troubleshooting, and maintaining complex medical equipment, such as mechanical ventilators and blood gas analyzers. Mathematical aptitude is necessary for calculating drug dosages, determining ideal body weight, and assessing pulmonary mechanics.
Soft skills are equally important for navigating the collaborative health care environment. Critical thinking is necessary, as therapists must rapidly analyze a patient’s deteriorating condition and make adjustments to therapy based on clinical data. Clear communication is required to convey treatment plans to patients, educate families, and collaborate with physicians and nursing staff. Emotional stability and empathy are necessary to provide compassionate care to patients experiencing respiratory distress while maintaining composure during crises.
The Path to Becoming a Respiratory Therapist
Entry into the profession requires completing an Associate of Science (AS) or Bachelor of Science (BS) degree in respiratory therapy from a CoARC-accredited program. These academic programs combine classroom instruction in subjects like pharmacology and physics with extensive hands-on clinical rotations. Clinical experience allows students to develop practical competence under the supervision of practicing therapists.
After graduation, candidates must pass the national board examinations administered by the National Board for Respiratory Care (NBRC). The first step is the Therapist Multiple-Choice (TMC) Examination, which awards the Certified Respiratory Therapist (CRT) credential upon passing the lower cut score. Achieving a higher score on the TMC exam makes the candidate eligible for the Clinical Simulation Examination (CSE). Successful completion of both exams results in the advanced Registered Respiratory Therapist (RRT) credential, often preferred for advanced clinical roles.
The final step is obtaining a state license, which is required for practice in nearly all states.
Career Outlook and Advancement Opportunities
The demand for Respiratory Therapists is projected to grow much faster than average, with a projected employment change of 12 percent between 2024 and 2034. This strong job market is fueled by the aging population and the increase in chronic respiratory conditions like COPD and sleep apnea. The median annual wage was approximately $80,450 as of May 2024, with opportunities for higher earnings based on location, experience, and specialization.
Professional growth extends through several avenues beyond general practice. RTs can pursue advanced NBRC specialty credentials, such as the Neonatal/Pediatric Specialist (NPS) or the Sleep Disorders Specialist (SDS), qualifying them for specialized patient populations. Therapists may also advance their careers by moving into supervisory roles, becoming department managers, or transitioning into educational positions to train new professionals.