Top 10 Things to Know Before Starting a Career in Respiratory Therapy
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“You can really positively impact their lives in a really significant way. If you can do that, that’s like the purest gold. If you can make somebody happier, healthier, or more relaxed, then that’s such a blessing. That’s just magic.”
Damien Wiggins, Retired Respiratory Care Practitioner
Since the onset of the pandemic, hospitals across the country have experienced staffing shortages among frontline workers, but one profession, in particular, has seen a huge increase in demand: respiratory therapists (RTs) or respiratory care practitioners (RCPs).
In the past few months, a spotlight has been placed on these professionals, who are trained to help people with lung diseases or disorders and are also in charge of operating equipment such as ventilators, which are used when patients with respiratory diseases can’t breathe on their own, as is the case of the severely ill coronavirus patients.
In the past, RCPs have gone largely unrecognized outside of the medical community. At hospitals, they are often mistaken for doctors or physician assistants by patients. But now, they are gaining the recognition they have long deserved, generating interest from prospective healthcare workers looking for the right niche.
We talked to a seasoned professional in respiratory therapy to learn about what you should know before jumping into the field with both feet. Meet Damien Wiggins, a retired Portland, Oregon-based RCP with 27 years of experience in respiratory care under his belt.
Meet the Expert: Damien Wiggins
Damien Wiggins received his associate’s degree in respiratory therapy from Ohlone Community College in Fremont, California. He started his career working in all aspects of respiratory therapy—in critical care, the emergency burn unit, the intensive care nursery and the outpatient pulmonary rehabilitation at Sutter Health.
In 2006, Wiggins moved to Portland and took on a role in adult care, where he conducted patient assessments, ventilator management, airway management, intubation and blood draws. From 2008 through 2018, he became a pulmonary function technician for the Portland VA Medical Center, where he worked in all aspects of pulmonary function.
Without further ado, here are Wiggins’ top 10 things to know before starting a career in respiratory therapy.
1. You’ll enjoy collaborative working…
While some RTs work in diagnostic labs, rehabilitation centers, nursing homes, or for home health agencies, most work in hospitals (75 percent). As an RT working in a hospital, you will be part of a multidisciplinary team.
“You’re working with a ton of different groups of people—physicians, nurses, speech therapists, and others,” Wiggins said.
RTs consult with doctors and nurses starting from discussing patient treatment options to completing discharge planning. So if collaborative working isn’t your cup of tea, respiratory therapy may not be the profession for you.
2. …but deal with a hierarchical work environment
“There is this weird patriarchal power structure that gets absurd. In California, it’s much better than in some places. We could question orders in California, but on the east coast, it is much worse, where the doctor is God,” Wiggins said. “The biggest problem I would have was if I didn’t agree with the order, I would question the doctor.”
One of the leading causes of medical errors and patient harm is ineffective communication among healthcare teams, according to an article from the University of Cincinnati Medical Center. Communication failures account for more than 70 percent of these instances.
“You can and should challenge physicians. In fact, I felt ethically obligated to,” Wiggins continued. “I wouldn’t pretend to know more than I knew, but I’d just point out the obvious things. Who’s going to defend that patient? Because it’s a dangerous place, the hospital. There’s a precariousness of being in that situation.”
Despite potential pushback from higher-ups, advocating for the patient’s well-being is your first priority as an RCP. So, being comfortable with conflict is part of the job.
3. You will wear many hats
RCPs are probably most well known for their work with ventilators or breathing machines, but the role has a broad scope of practice, including meeting with and examining patients who have pulmonary diseases, disorders, or complications; conducting, performing, and analyzing diagnostic and function tests to assess lung capacity and capability; treating patients with aerosol medications and chest physiotherapy; evaluating the progress of treatment; documenting care by updating charts and records, and more.
“I worked in all areas. My thing was to do everything from the nursery to emergency to adult critical care, the whole gamut, which made it far more interesting, and makes you valuable as an employee,” Wiggins said. “ER, which was probably my favorite, meant a lot of emergencies—constant go, go, go. You get hooked on that adrenaline.”
4. Educational requirements vary
An associate’s degree from an accredited school is the minimum educational requirement to practice as an RCP, but according to the U.S. Department of Health and Human Services, employers often prefer applicants with a bachelor’s or master’s degree in respiratory therapy from a post-graduate program.
“In fact, according to statewide surveys by the Health Workforce Initiative (HWI) and the California Hospital Association (CHA), almost a quarter of hospitals in California (225) require respiratory therapists to have a bachelor’s degree,” SJVC wrote.
At present, you can practice with an associate’s degree, but having a bachelor’s degree or higher can make you more competitive and lead to greater advancement opportunities. And the tides may be changing soon. Recently, the AARC has stated that all new RT programs should offer a minimum of a four-year degree in respiratory care.
5. Death is a part of the job
Unlike sleep disorder specialists or dental technicians—careers within healthcare that require the same number of years in school to enter the field as the path of respiratory therapy does—RCPs face patients in critical condition often. So, being an RCP requires resilience for dealing with being in the presence of intense physical and emotional pain, and a high degree of empathy.
“It’s really about love. You have to love people even if you don’t know them and you appreciate human life; the power of that energy is really critical,” Wiggins said. “If a person dies, you don’t want them to go out feeling cold and unloved. Often the family isn’t around and it’s your job to take care of them.”
6. Hours can be a perk
Your hours will depend on the institution where you work, but RCPs often have enviable hours. Many hospitals schedule their RCPs to work shifts only three days a week, leaving four days open for hobbies, part-time work, and family life.
“It was all about coordinating childcare for me, so it was a pretty great schedule,” Wiggins said. “I liked to do Friday, Saturday, and Sunday 12-hour shifts. So on Monday, Tuesday, Wednesday, and Thursday, I could take the kids to school. It was great. My first day off would be heaven. I’d wake up and spend time with the kids. I really enjoyed that schedule.”
7. Pay fluctuates dramatically
According to the Bureau of Labor Statistics, RTs made an average of $61,330 per year in 2019. But your true salary depends on the state in which you work and the institution. For instance, the average RT’s salary in California is $77,444 per year, while in New York, it’s closer to $65,000.
“I think RTs are underpaid, but it’s so dependent on where you are. It’s all a market force,” Wiggins said. “In Berkeley, I did think the pay was fair. When I started, nurses were almost on par, but because nurses are unionized, their wages have since gone way up.” (Nurses now make an average of $73,300 per year according to the BLS.)
“When I came to Portland, Oregon it was an incredible drop—it was like less than half. And that’s the going rate,” Wiggins said.
You can check the average wage of RCPs in your state by visiting Salary.com or creating a state-based customized table with the BLS.
8. RTs are in high demand
While the pandemic has boosted the immediate need for RCPs, demand in coming years is expected to continue to soar.
According to the BLS, the employment of respiratory therapists is projected to grow 19 percent nationally between 2019 and 2029, much faster than the average for all occupations during the same time period (4 percent).
“Growth in the middle-aged and elderly population will lead to an increased incidence of respiratory conditions such as chronic obstructive pulmonary disease (COPD) and pneumonia. These respiratory disorders can permanently damage the lungs or restrict lung function,” the BLS wrote.
Respiratory therapy also comes in at #16 in “Best Healthcare Jobs” of 2018 in U.S. News & World Report. The same publication in 2017 listed Respiratory Therapy as #21 in “The 100 Best Jobs.”
9. The role is evolving and growing
Traditionally, RCPs’ “place to shine” has been in hospitals and in critical care. While this is still true, the scope of the profession is broadening.
“With improving and ever-changing technology, healthcare reform, and an increase in various pulmonary diseases, the role of the RT is not only changing but becoming more imperative to the health care system,” Respiratoryedu.org writes.
“From infant to elderly, patients with various pulmonary impairments need respiratory care—including those with COPD, sleep apnea emphysema, asthma, bronchitis, pneumonia, cardiac failure, chest trauma, lung disease, lung cancer, cystic fibrosis, pleural effusion, breathing disorders, and post-surgical related breathing issues.”
10. Patient care will be your greatest joy
“It’s super personal, the long-term relationships with patients,” Wiggins said. “You can really positively impact their lives in a really significant way. If you can do that, that’s like the purest gold. If you can make somebody happier, healthier, or more relaxed, then that’s such a blessing. That’s just magic.”
He continued, “It’s super rewarding and I love that. You love it when people recognize you and come in after a few months. It’s all about relationships in my book.”