As a staff member in Rush University’s respiratory therapy program, Jonathan Brady Scott is keenly aware of the value of his work..
“What matters if you can’t breathe?” he said. “Nothing at all.” Director of clinical education and an assistant professor at Rush University Medical Center in Chicago, Scott finds his efforts to help patients breathe more easily incredibly rewarding.
“The feeling you get when you use knowledge and skills to ease someone’s troubled breathing is irreplaceable,” he said. “As a respiratory therapist, you’re appreciated by patients and families every day.” Respiratory therapists focus on the caring for patients with cardiopulmonary disorders ranging from asthma and emphysema to major lung trauma, cardiac arrest and other life-threatening conditions. RTs can do everything from operating breathing machines in the emergency room to supporting someone trying to quit smoking.
Scott spends the majority of his time teaching in Rush’s teacher-practitioner model, which ensures students learn directly from clinical practitioners, “(but) I do spend significant time involved with direct patient care,” he said. “My role also involves a leadership and research component. This allows me to participate in many different aspects of the respiratory care profession.”
RTs work in many different patient care areas, Scott said. Some spend time in labs performing breathing tests used to help diagnose respiratory disorders. Others are assigned to hospital intensive care units or emergency departments maintaining and operating breathing machines for patients who can’t breathe on their own.
Some care for patients battling cardiopulmonary disease at home, providing services such as oxygen, aerosolized medications and education on how to reduce symptoms and maximize energy. “We work very closely with all members of the health care team,” Scott said. “RTs work side-by-side with physicians, nurses, pharmacists and other providers to create care plans that best suit the needs of the individual patient.
Respiratory therapists are employed in a wide range of settings, from hospitals and medical centers to outpatient clinics and diagnostic labs, such as pulmonary function and sleep labs. Some care for patients in long-term care facilities. They also work in research, or in doctor’s offices teaching patients how to care for themselves.
RTs also ride in ambulances, planes or helicopters to help transport critically ill patients to medical facilities. Some hospitals have dedicated transport teams that may consist of a respiratory therapist and a registered nurse, for example, Scott explained.
Candidates can earn an associate’s, bachelor’s or master’s degree. Those seeking an associate’s degree in respiratory care may spend 2-3 years at a community college, while those seeking more advanced bachelor’s or master’s degrees may spend 4-6 years in school.
All training programs include both classroom and clinical work. Rush offers both master’s and bachelor’s degrees in respiratory care. Many students complete clinical fieldwork Chicago-area hospitals, and Rush also has clinical affiliations with out-of-state hospitals such as Duke University Medical Center, Durham, N.C.; Harborview Medical Center, Seattle; and Children’s Hospital of Philadelphia.
Anne Geistkemper, 26, a neonatal/pediatric respiratory therapist at Rush since earning her master’s degree in respiratory care there, did clinical rotations in adult therapy, pediatrics, pulmonary function, pulmonary rehabilitation and home care. Before graduation, two board exams are required: the CRT (certified respiratory therapist) and RRT (registered respiratory therapist). Geistkemper said some hospitals hire those with either credential, while others hire those with only the RRT.
Working on the pediatric side of respiratory therapy, Geistkemper helps care for both premature and full-term infants. She helps manage oxygenation/ventilation devices, assists with intubations, attends deliveries and helps transport sick children from one hospital to another.
“Personally, I find attending newborn deliveries an awesome experience because we get to start those infants’ care from their very first breath of life,” she said.
Because they deal with daily medical issues, RTs must be good problem-solvers and have good math, communication and analytical skills. They must also be skilled in the use of advanced technology and techniques when caring for patients.
Despite their best efforts, RTs are not always able to “erase all suffering or save every life,” Scott admitted, which can be frustrating. “Hospitals are busy environments that are full of stressful situations. In the midst of all of the hustle and bustle, the challenge may be to simply remain focused on the main task at hand … to provide compassionate care for each individual patient.”
On the other hand, Scott said each decade of the profession’s 60-plus years has brought new technologies and treatments.
“As a result, our sickest patients have increased survival, and those with chronic respiratory problems have improved quality of life because of contributions by their RTs,” he said.
While Geistkemper calls respiratory therapists the “unsung heroes of health care” because many people have never heard of them and don’t know how they differ from other health care providers, she finds it gratifying to know they make a difference in patients’ lives.
“We know and believe … our care positively impacts the lives of our patients,” she said. “We are a growing profession, and we will continue to grow. This growth will ultimately lead to continued improvement in patient outcomes.”
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Respiratory therapists care for people who have trouble breathing, whether the patient is a child suffering from asthma, a premature baby with undeveloped lungs, or a senior citizen with lung disease.
They also offer emergency care to those suffering from heart attacks, or patients in respiratory shock, such as someone who has nearly drowned.
RTs perform a variety of tests on patients to evaluate their lung capacity. Patients breathe into an instrument that measures the volume and flow of oxygen after inhaling. They may also take blood samples to test for oxygen and carbon dioxide levels. Treatment can include removing mucus from a patient’s lungs, making it easier for them to breathe. RTs also connect patients who can’t breathe properly to oxygen-delivering ventilators.
Respiratory therapists work in in hospitals, clinics, private homes and nursing homes. Those working in homes often teach patients and families how to use ventilators and other life-support equipment. In hospitals, they may be involved in diagnosing breathing problems in those with sleep apnea, or counsel patients trying to quit smoking.
The U.S. Bureau of Labor Statistics estimated that there were 119,300 people working as respiratory therapists in 2012, most in hospitals. Most RTs work full-time. Those with jobs in hospitals — which never close — may have schedules that involve night or weekend work.
To enter the field, candidates need at least an associate (2-year) degree, but a bachelor’s degree is often preferred. All RT programs — offered at colleges, universities, vocational-technical institutes and through the Armed Forces — include clinical work that allows therapists to get experience treating patients. Programs are available throughout the Chicago area, including at Rush University, the City Colleges of Chicago and the College of DuPage.
In all states but Alaska, respiratory therapists must be licensed. In addition, many employers prefer hiring respiratory therapists who are also certified. Certification requires completing an accredited program and passing an exam.
As of May 2013, the median annual wage for respiratory therapists was $55,870, according to the BLS. The lowest 10 percent earned under $40,980, while the top 10 percent made more than $75,430.
By the year 2022, the number of respiratory therapists is expected to grow 19 percent. The increase is expected to be fueled by the rising number of middle-age and elderly people in the population — which is expected to result in more respiratory conditions such as emphysema, chronic bronchitis, pneumonia and other disorders that can damage the lungs or restrict lung function.
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