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Respiratory therapy info?

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Healthcare102


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Hello everyone, I am really interested and looking into getting into a respiratory therapy program. I have a previous degree in education and after realizing that that teaching was not for me and having a passion for medical/ healthcare, I ddecided to look into respiratory because I like the idea of specializing in one area.

I have some concerns though. I have read that the market is terrible for resp. therapists and I also read that they might soon be replaced by nurses because nurses can do their jobs. Is this true?

What can a respiratory therapist do that a nurse can't? Also, as far as advancement, can they advance to be a pulmonary PA?
 

BreathDeep

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Hi there. I'm an RCP working at a Big Academic Medical Center in an overpriced Bay Area city, so perhaps I can answer some questions.

First of all yes, the market is terrible. But not just for us, from what I've heard it's pretty scarce for everyone in healthcare (at least on the west coast). Out here RN's, Rad Tech's, RD's, everyone is having a hard time finding a job. You just have to hustle, make connections, it's tough but you can make it work if it's what you really want to do.

Secondly, RCP's have been fearful of RN's taking over their jobs forever. It's been talked about forever. It's never going to happen. Just read about what happened at Henry Mayo Newhall Memorial Hospital way back in 1986. They cut their entire RT department and **** went crazy. The higher ups quickly saw the error of their ways and the department was reinstated.

That said yes, an RN can do 90% of my job. An RN can give a neb, or suction a patient, or look at an ABG and make a vent change. But an RN doesn't know anything about how a nebulizer works. Ask them about inertial impaction or brownian motion and they'll stare at you blankly. They understand the simple basics of respiratory physiology, but have no idea about what's really going on inside that ventilated patients lungs or how it is relevant to the patient as a whole. Vd/Vt, Compliance, Plateau, VCO2, Alveolar Minute Ventilation, O2 extraction ratios, and on and on and on...all important physiologic measurements that I track on every single one of my ICU patients. No ICU nurse has the time to deal with this part of the job. And that's where Respiratory Therapist's truly matter. Not with the mundane tasks, but with those truly sick patients where that 10% is the difference between a good or a bad outcome. So nah, we ain't going nowhere.

As far as what we can do that they can't, the answer is nothing. An RN's license covers everything we can do. That said you'll absolutely never see a nurse set up inhaled flolan, an oscillator, nitric oxide, place a patient on APRV, or give a patient an inhaled medication like ribavirin or amphotericin. They technically could. But wouldn't, and nor should they either.

Not much for advancement within the field though. There's plenty of lateral movement - you can specialize in PFT's, sleep diagnostics, or pediatrics/neonatal. You can also get involved in COPD case management, CF care and education, and Asthma education if your facility participates in that kind of stuff. But not much upwards mobility. My hospital has a couple RCP's who work in research, but that's definitely way outside the norm. Upward clinical advancement is pretty much becoming a PA or an MD.

We can become PA's yes, there are many RT's who have done it. I even intend to be one one day (or I'm mulling it over at least). Our pre-requisite sciences all cross over to PA school. At the very least you'd have A&P, Micro, Chem (if you didn't take a survey course), and Physics done.

Either way, RT can be a great career. You just really have to know what it's all about before you get started.

Good luck!
 

Funke

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This might be a special case, but I volunteer in a clinic that treats the uninsured. Every Thursday they have two respiratory therapists that come in to manage COPD and asthma patients. They do a diagnostic workup to categorize the disease and severity, prescribe medication (there is a doctor in facility that they work under), and teach the patient about how to manage their disease better. Then they schedule followups to adjust/change medications. One of them told me that most go into hospitals and work in ICU type places, but some can do clinical disease management as well.
 
H

Healthcare102

Hi there. I'm an RCP working at a Big Academic Medical Center in an overpriced Bay Area city, so perhaps I can answer some questions.

First of all yes, the market is terrible. But not just for us, from what I've heard it's pretty scarce for everyone in healthcare (at least on the west coast). Out here RN's, Rad Tech's, RD's, everyone is having a hard time finding a job. You just have to hustle, make connections, it's tough but you can make it work if it's what you really want to do.

Secondly, RCP's have been fearful of RN's taking over their jobs forever. It's been talked about forever. It's never going to happen. Just read about what happened at Henry Mayo Newhall Memorial Hospital way back in 1986. They cut their entire RT department and **** went crazy. The higher ups quickly saw the error of their ways and the department was reinstated.

That said yes, an RN can do 90% of my job. An RN can give a neb, or suction a patient, or look at an ABG and make a vent change. But an RN doesn't know anything about how a nebulizer works. Ask them about inertial impaction or brownian motion and they'll stare at you blankly. They understand the simple basics of respiratory physiology, but have no idea about what's really going on inside that ventilated patients lungs or how it is relevant to the patient as a whole. Vd/Vt, Compliance, Plateau, VCO2, Alveolar Minute Ventilation, O2 extraction ratios, and on and on and on...all important physiologic measurements that I track on every single one of my ICU patients. No ICU nurse has the time to deal with this part of the job. And that's where Respiratory Therapist's truly matter. Not with the mundane tasks, but with those truly sick patients where that 10% is the difference between a good or a bad outcome. So nah, we ain't going nowhere.

As far as what we can do that they can't, the answer is nothing. An RN's license covers everything we can do. That said you'll absolutely never see a nurse set up inhaled flolan, an oscillator, nitric oxide, place a patient on APRV, or give a patient an inhaled medication like ribavirin or amphotericin. They technically could. But wouldn't, and nor should they either.

Not much for advancement within the field though. There's plenty of lateral movement - you can specialize in PFT's, sleep diagnostics, or pediatrics/neonatal. You can also get involved in COPD case management, CF care and education, and Asthma education if your facility participates in that kind of stuff. But not much upwards mobility. My hospital has a couple RCP's who work in research, but that's definitely way outside the norm. Upward clinical advancement is pretty much becoming a PA or an MD.

We can become PA's yes, there are many RT's who have done it. I even intend to be one one day (or I'm mulling it over at least). Our pre-requisite sciences all cross over to PA school. At the very least you'd have A&P, Micro, Chem (if you didn't take a survey course), and Physics done.

Either way, RT can be a great career. You just really have to know what it's all about before you get started.

Good luck!

Thank you very much for the info! How broad is your scope of practice? Do you have to ever help with or know anything outside of the respiratory system? Can you give injectios and start Ivs and stuff like that?
 

BreathDeep

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Thank you very much for the info! How broad is your scope of practice? Do you have to ever help with or know anything outside of the respiratory system? Can you give injectios and start Ivs and stuff like that?

Scope of practice in respiratory care breaks down on legality vs. hospital policy.

Legally? I can administer any drug, by any method, as long as it related to cardiopulmonary function. I could run IV lasix, titrate vasopressors, or consciously sedate a patient. It is covered under my license, and I received the appropriate pharmacological/physiological education in school to it. That was a while ago though, I'm sure I would kill someone if I tried to do it these days. And not that I ever would anyway, 99.5% of hospitals don't allow and don't need RCP's to do this type of stuff. They have plenty of RN's around to handle it who I'm sure would do a better job of it than me. There are some transport teams out there still where the RCP and RN are essentially interchangeable and you will see RCP's managing drips and whatnot, but they are a very rare breed.

Inside the hospital an RCP's scope is typically: vent management, aerosol medication delivery, chest physiotherapy, airway management, ABG draws, lab sampling via sputum inductions or MiniBAL's, and medical gas administration (typically O2, Heliox, nitric oxide, and rarely CO2). Other specialized duties can be doing ECMO and IABP. Inserting A-line's, PICC's, or other CVC's. And lastly intubation. These are all much more facility dependent though (and I've found also very dependent on your geographical region as well).

I have to know plenty of things outside the respiratory system yes. Cardio-Renal-Respiratory especially are all tied very closely together, any RCP who doesn't have a strong physiological understanding of all three systems, how they work, and how they work together isn't doing their job very well. Where I work we typically round with the ICU NP or resident at night. We obviously discuss the ventilator, but also any labs (CBC/Chemistry/Coagulation/Micro/etc) or relevant studies/imaging that were performed (Echo, CXR, MRI, CT). In essence it's not about knowing the lungs, it about knowing how they're doing as a part of the bigger picture of the patient's global disease process. Considering I typically work MICU most of these patients "problem list" goes on for pages and pages, so you have to have a pretty broad view. The RCP's folks who work Rapid Response have to be able to rapidly assess their patients to determine why the patient in distressed, how to intervene, and who to call - so naturally they have to understand the whole patient too. The CT-surgery people have to know a ton more cardiac physiology as they work with a lot of heart and lung transplant patients, ECMO's, LVAD's, and whatever else nonsense they do down there. The neurosurgical people have to remember their neurophysiology of respiration so they know how to properly react/intervene when those patients start doing their different types of unsettling "neuro-breathing".

As far as injections/IV's, again we can legally but don't. About the only injection we do is the yearly PPD test. I can also flush a line if I use it to draw a lab or something, but injecting saline into a port doesn't really count as an "injection" haha. There is talk of allowing the Rapid Response RCP's to start PIV's to take a bit of the load off of the Rapid RN, but again this is just a unique facility circumstance, not the norm.
 
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Mad Jack

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Scope of practice in respiratory care breaks down on legality vs. hospital policy.

Legally? I can administer any drug, by any method, as long as it related to cardiopulmonary function. I could run IV lasix, titrate vasopressors, or consciously sedate a patient. It is covered under my license, and I received the appropriate pharmacological/physiological education in school to it. That was a while ago though, I'm sure I would kill someone if I tried to do it these days. And not that I ever would anyway, 99.5% of hospitals don't allow and don't need RCP's to do this type of stuff. They have plenty of RN's around to handle it who I'm sure would do a better job of it than me. There are some transport teams out there still where the RCP and RN are essentially interchangeable and you will see RCP's managing drips and whatnot, but they are a very rare breed.

Inside the hospital an RCP's scope is typically: vent management, aerosol medication delivery, chest physiotherapy, airway management, ABG draws, lab sampling via sputum inductions or MiniBAL's, and medical gas administration (typically O2, Heliox, nitric oxide, and rarely CO2). Other specialized duties can be doing ECMO and IABP. Inserting A-line's, PICC's, or other CVC's. And lastly intubation. These are all much more facility dependent though (and I've found also very dependent on your geographical region as well).

I have to know plenty of things outside the respiratory system yes. Cardio-Renal-Respiratory especially are all tied very closely together, any RCP who doesn't have a strong physiological understanding of all three systems, how they work, and how they work together isn't doing their job very well. Where I work we typically round with the ICU NP or resident at night. We obviously discuss the ventilator, but also any labs (CBC/Chemistry/Coagulation/Micro/etc) or relevant studies/imaging that were performed (Echo, CXR, MRI, CT). In essence it's not about knowing the lungs, it about knowing how they're doing as a part of the bigger picture of the patient's global disease process. Considering I typically work MICU most of these patients "problem list" goes on for pages and pages, so you have to have a pretty broad view. The RCP's folks who work Rapid Response have to be able to rapidly assess their patients to determine why the patient in distressed, how to intervene, and who to call - so naturally they have to understand the whole patient too. The CT-surgery people have to know a ton more cardiac physiology as they work with a lot of heart and lung transplant patients, ECMO's, LVAD's, and whatever else nonsense they do down there. The neurosurgical people have to remember their neurophysiology of respiration so they know how to properly react/intervene when those patients start doing their different types of unsettling "neuro-breathing".

As far as injections/IV's, again we can legally but don't. About the only injection we do is the yearly PPD test. I can also flush a line if I use it to draw a lab or something, but injecting saline into a port doesn't really count as an "injection" haha. There is talk of allowing the Rapid Response RCP's to start PIV's to take a bit of the load off of the Rapid RN, but again this is just a unique facility circumstance, not the norm.
Pretty much sums everything up. I'll attempt to address some other things about the profession for the OP.
Hello everyone, I am really interested and looking into getting into a respiratory therapy program. I have a previous degree in education and after realizing that that teaching was not for me and having a passion for medical/ healthcare, I ddecided to look into respiratory because I like the idea of specializing in one area.

I have some concerns though. I have read that the market is terrible for resp. therapists and I also read that they might soon be replaced by nurses because nurses can do their jobs. Is this true?

What can a respiratory therapist do that a nurse can't? Also, as far as advancement, can they advance to be a pulmonary PA?


The downsides to being an RT are:

Some job markets are tight, so you might have to be willing to move around if you want a decent job.

At many places, lazy RTs just skate by. A good RT is worth their weight in gold, but there's a great number of RTs that do the minimum and will skirt work at every given opportunity since much of what we do is not exactly life-saving (CPT, needless albuterol treatments, etc). This means you might have to pull some dead weight if your coworkers are in this category, and that you might be working alongside some people that have let their understanding of basic science concepts stagnate as they simply do what is ordered like automatons rather than clinicians. You also will have to deal with the stigma these RTs create for your department whenever you enter a new unit or are working on a new floor and people don't know you.

Disrespect from the nurses and some physicians, as the nurses will often basically try to give you orders or push you around into doing what they believe is best for the patient. I can't even count the number of times I had a nurse without a stethoscope tell me to give albuterol to her "wheezing" patient and get furious at me when I refused because, on auscultation, it turned out they were crackly up to their nipples and were horribly fluid overloaded. Respiratory departments are typically lower on the power end of things than nursing, so if a dispute arises, generally they will win. Physicians generally will respect you if you do good work, but occasionally a new resident will view you as some untrained monkey of a technician that should only be doing as they say, regardless of whether their treatment plan is incorrect. All this having been said, most nurses and physicians will respect you if you both respect them and do well at your job.

Lack of understanding for what you do is a bit of a nebulous thing, but you're going to be fielding questions about what you do for a living for the rest of your life, and it gets tedious. I wish people knew and understood what RTs are and their importance in healthcare just so I wouldn't have to keep explaining it. Not a big downside, obviously, but it's just kind of annoying. Like saying you're a "consultant," the majority of people outside of your field just get confused at the mention of your title.

Limited upward mobility, as most hospital management positions require a nursing degree or medical degree.

Upsides of being an RT are:

Critical care, getting to deal with legit emergencies like codes and patients in the ED, and basically getting to be a part of all the awesome teams in the hospital if you so choose.

Getting to hop from unit to unit in most hospitals, which keeps things fresh- you can be doing neonatal ICU one day, MICU the next, and CT the following if you want. Nurses, physicians, and basically everyone else in the hospital is trapped in one unit or practice environment for the majority of a career, but not so as an RT. This, combined with the constant emergencies and the intense nature of critical care makes the job perfect for a person that gets bored easily.

You don't have to deal with the more intensely emotional aspects of care if you choose not to. Nurses do all the juggling of often irate or unstable family, friends, and relatives, the angry phone calls, etc, while you get to just deal with the patient themselves and leave when your treatment is done.

You'll never have to change a bedpan, insert a urethral catheter, administer a suppository, or do an enema. You trade all of that for having to deal with phlegm all day. I heard it joked once that god put all of the potential nurses and RTs in a room that was waist deep in feces, then made it rain phlegm. The ones who dove became nurses, the ones who stayed standing became the RTs.

You've got an area where you're a specialist. You will actually know more about mechanical ventilation than the vast majority of the physicians and basically every nurse that isn't a former RT in the hospital. Pulmonologists will have you beat hands down, and a lot of anesthesiologists will know the physics and how to ventilate patients in surgery better than you ever will, but that's about it. This specialization and knowledge makes you a critical member of the decision making process in a lot of situations.

I honestly don't think we work as hard as nurses overall. A floor nurse has no such thing as a slow day, an ICU nurse is always at a patient's bedside in case SHTF. As an RT, once your rounds are done, you kind of just wait until your next rounds begin, and just sort of are on standby in case of emergencies. Some days you'll have zero downtime because of things that come up, some days you'll have a few hours of downtime. It's kind of unpredictable, but I'll take it over the endless mundane tasks a floor nurse has to perform day in and day out any day of the week.

Great experience if you want to become a PA someday or go to medical school.

The pay is pretty good for the work you do, generally only a couple bucks less than the nurses are making per hour. I'll take the two dollar pay cut to not have to deal with diarrhea or irate family.

As to the future, RTs aren't going anywhere. Nurses are not capable of troubleshooting and operating a vent, plain and simple. It's a very technical thing, and requires a couple years of training to do successfully. That's our biggest saving grace, really- a nurse may be able to administer all of our meds, but the technical side of respiratory therapy and the fine art that is mechanical ventilation are far beyond their capability. HMOs tried to wipe out RT departments in the early 90s and mortality rates and VAP shot up as a result, so I really doubt the same thing will happen again. As to the job market, that depends on how willing you are to move. It's good in some areas, horrible in others. Do some research on your area if you want to find out.
 
H

Healthcare102

Pretty much sums everything up. I'll attempt to address some other things about the profession for the OP.



The downsides to being an RT are:

Some job markets are tight, so you might have to be willing to move around if you want a decent job.

At many places, lazy RTs just skate by. A good RT is worth their weight in gold, but there's a great number of RTs that do the minimum and will skirt work at every given opportunity since much of what we do is not exactly life-saving (CPT, needless albuterol treatments, etc). This means you might have to pull some dead weight if your coworkers are in this category, and that you might be working alongside some people that have let their understanding of basic science concepts stagnate as they simply do what is ordered like automatons rather than clinicians. You also will have to deal with the stigma these RTs create for your department whenever you enter a new unit or are working on a new floor and people don't know you.

Disrespect from the nurses and some physicians, as the nurses will often basically try to give you orders or push you around into doing what they believe is best for the patient. I can't even count the number of times I had a nurse without a stethoscope tell me to give albuterol to her "wheezing" patient and get furious at me when I refused because, on auscultation, it turned out they were crackly up to their nipples and were horribly fluid overloaded. Respiratory departments are typically lower on the power end of things than nursing, so if a dispute arises, generally they will win. Physicians generally will respect you if you do good work, but occasionally a new resident will view you as some untrained monkey of a technician that should only be doing as they say, regardless of whether their treatment plan is incorrect. All this having been said, most nurses and physicians will respect you if you both respect them and do well at your job.

Lack of understanding for what you do is a bit of a nebulous thing, but you're going to be fielding questions about what you do for a living for the rest of your life, and it gets tedious. I wish people knew and understood what RTs are and their importance in healthcare just so I wouldn't have to keep explaining it. Not a big downside, obviously, but it's just kind of annoying. Like saying you're a "consultant," the majority of people outside of your field just get confused at the mention of your title.

Limited upward mobility, as most hospital management positions require a nursing degree or medical degree.

Upsides of being an RT are:

Critical care, getting to deal with legit emergencies like codes and patients in the ED, and basically getting to be a part of all the awesome teams in the hospital if you so choose.

Getting to hop from unit to unit in most hospitals, which keeps things fresh- you can be doing neonatal ICU one day, MICU the next, and CT the following if you want. Nurses, physicians, and basically everyone else in the hospital is trapped in one unit or practice environment for the majority of a career, but not so as an RT. This, combined with the constant emergencies and the intense nature of critical care makes the job perfect for a person that gets bored easily.

You don't have to deal with the more intensely emotional aspects of care if you choose not to. Nurses do all the juggling of often irate or unstable family, friends, and relatives, the angry phone calls, etc, while you get to just deal with the patient themselves and leave when your treatment is done.

You'll never have to change a bedpan, insert a urethral catheter, administer a suppository, or do an enema. You trade all of that for having to deal with phlegm all day. I heard it joked once that god put all of the potential nurses and RTs in a room that was waist deep in feces, then made it rain phlegm. The ones who dove became nurses, the ones who stayed standing became the RTs.

You've got an area where you're a specialist. You will actually know more about mechanical ventilation than the vast majority of the physicians and basically every nurse that isn't a former RT in the hospital. Pulmonologists will have you beat hands down, and a lot of anesthesiologists will know the physics and how to ventilate patients in surgery better than you ever will, but that's about it. This specialization and knowledge makes you a critical member of the decision making process in a lot of situations.

I honestly don't think we work as hard as nurses overall. A floor nurse has no such thing as a slow day, an ICU nurse is always at a patient's bedside in case SHTF. As an RT, once your rounds are done, you kind of just wait until your next rounds begin, and just sort of are on standby in case of emergencies. Some days you'll have zero downtime because of things that come up, some days you'll have a few hours of downtime. It's kind of unpredictable, but I'll take it over the endless mundane tasks a floor nurse has to perform day in and day out any day of the week.

Great experience if you want to become a PA someday or go to medical school.

The pay is pretty good for the work you do, generally only a couple bucks less than the nurses are making per hour. I'll take the two dollar pay cut to not have to deal with diarrhea or irate family.

As to the future, RTs aren't going anywhere. Nurses are not capable of troubleshooting and operating a vent, plain and simple. It's a very technical thing, and requires a couple years of training to do successfully. That's our biggest saving grace, really- a nurse may be able to administer all of our meds, but the technical side of respiratory therapy and the fine art that is mechanical ventilation are far beyond their capability. HMOs tried to wipe out RT departments in the early 90s and mortality rates and VAP shot up as a result, so I really doubt the same thing will happen again. As to the job market, that depends on how willing you are to move. It's good in some areas, horrible in others. Do some research on your area if you want to find out.

Thank you very much for the helpful info. What made you decide to get into resp. Therapy if you don't mind me asking?

are you able to start IVs and give injections and admibister conscious sedation and stuff like that? Or is it under your licence but rarely get to do so like the poster above stated?

Do you think the field will continue to grow and eventually there will be "advanced practice" RT's like in Canada where they can get additional training to function as an anesthesia assistant?
 

Mad Jack

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Thank you very much for the helpful info. What made you decide to get into resp. Therapy if you don't mind me asking?

are you able to start IVs and give injections and admibister conscious sedation and stuff like that? Or is it under your licence but rarely get to do so like the poster above stated?

Do you think the field will continue to grow and eventually there will be "advanced practice" RT's like in Canada where they can get additional training to function as an anesthesia assistant?
There's little point in there being a respiratory midlevel provider, as we already have Anesthesiologist's Assistants as a field which fill the anesthesia role, and Physician Assistants which can do anything a potential RT midlevel could do and much more.

As to IVs and injections, there are some RTs that do such things in my old state, such as the ones that fly on Life Star- the team consists of one RT and one RN (and of course a pilot). They can do everything form chest tubes to pericardiocentesis to emergency cricothyrotomies, and they start lines and administer meds in those patients with stable airways as well. Aside from ECMO RTs, there aren't many that give IV meds around here aside from them though, and really there isn't much reason for it with plenty of nurses around.

And I went to respiratory school because I wanted to do critical care but didn't want to be a nurse, for a number of reasons. Also, I thought I eventually wanted to be a PA and viewed it as excellent experience for my future application. There was also an excellent program at my local community college that, after grants, I ended up being paid about 400 bucks a semester to attend, so it was literally less than free. Five years in, I said screw being a midlevel and just went to medical school instead.
 
H

Healthcare102

There's little point in there being a respiratory midlevel provider, as we already have Anesthesiologist's Assistants as a field which fill the anesthesia role, and Physician Assistants which can do anything a potential RT midlevel could do and much more.

As to IVs and injections, there are some RTs that do such things in my old state, such as the ones that fly on Life Star- the team consists of one RT and one RN (and of course a pilot). They can do everything form chest tubes to pericardiocentesis to emergency cricothyrotomies, and they start lines and administer meds in those patients with stable airways as well. Aside from ECMO RTs, there aren't many that give IV meds around here aside from them though, and really there isn't much reason for it with plenty of nurses around.

And I went to respiratory school because I wanted to do critical care but didn't want to be a nurse, for a number of reasons. Also, I thought I eventually wanted to be a PA and viewed it as excellent experience for my future application. There was also an excellent program at my local community college that, after grants, I ended up being paid about 400 bucks a semester to attend, so it was literally less than free. Five years in, I said screw being a midlevel and just went to medical school instead.

Very interesting. So you completed your bachelors in pulmonary care and then applied to medical school? Do you feel your knowledge and experience as a rt has helped you in med. School?
 

Mad Jack

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Very interesting. So you completed your bachelors in pulmonary care and then applied to medical school? Do you feel your knowledge and experience as a rt has helped you in med. School?
Respiratory care is the actual degree name, and yes, after a few years of practice. My experience has helped enormously in medical school.
 
H

Healthcare102

Respiratory care is the actual degree name, and yes, after a few years of practice. My experience has helped enormously in medical school.

How difficult is this program? Did a lot of people fail out?

Is it possible to work at least part time in it
 

Mad Jack

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How difficult is this program? Did a lot of people fail out?

Is it possible to work at least part time in it
I worked weekends through school. It was pretty difficult, but not so bad looking back. Anyone can do it with enough effort. We did lose about 10% of the class.
 
H

Healthcare102

I worked weekends through school. It was pretty difficult, but not so bad looking back. Anyone can do it with enough effort. We did lose about 10% of the class.

Do you think it would be doable to work a little more than just on weekends if I had to?
 
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Mad Jack

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Do you think it would be doable to work a little more than just on weekends if I had to?
Depends on the program. Some are harder than others. Ours was known to be extremely difficult. Even with that, one guy in our class worked 60 hour weeks, sleeping only 4 hours a day to support his family. So I'd ask a program's students, and ask yourself how hard you are capable of working.
 

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Hello, thank you all for posting, they're helping me in my research in becoming a Respiratory Therapist. I am looking into enrolling in Fall 2016 at my college, but am really struggling whether or not to take the plunge. First, I have knee issues sometimes, and am really worried about standing/walking for the majority of my shift. Granted, I can look into the oh-so-comfortable nurses shoes I hear of, and wear a knee brace. I'm also nervous about the long hours, working weekends, and holidays. Up to now, I've been working in an office as an admin assistant. Weekends and holidays off. I'm choosing RT because it's something I have never considered as a career choice, and the more I look into it, the more I am interested. Plus, I want to start a career path to stick with. My ultimate goal would be to work with infants, when I was younger my dream job was to be a neonatal nurse :) Does anyone have any "motivational" stories for me? FYI, I am based in the Bay Area, if that helps anyone with their feedback or advice.

Thanks so much. I just want to calm my nerves.
 

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Hello, thank you all for posting, they're helping me in my research in becoming a Respiratory Therapist. I am looking into enrolling in Fall 2016 at my college, but am really struggling whether or not to take the plunge. First, I have knee issues sometimes, and am really worried about standing/walking for the majority of my shift. Granted, I can look into the oh-so-comfortable nurses shoes I hear of, and wear a knee brace. I'm also nervous about the long hours, working weekends, and holidays. Up to now, I've been working in an office as an admin assistant. Weekends and holidays off. I'm choosing RT because it's something I have never considered as a career choice, and the more I look into it, the more I am interested. Plus, I want to start a career path to stick with. My ultimate goal would be to work with infants, when I was younger my dream job was to be a neonatal nurse :) Does anyone have any "motivational" stories for me? FYI, I am based in the Bay Area, if that helps anyone with their feedback or advice.

Thanks so much. I just want to calm my nerves.

You're in luck my friend. I live smack dab in the middle of SF and Sacramento. I've also worked at both of the Big Academic Medical Centers located in each, plus rotated and/or have friends who work in pretty much all the others. I also know quite a bit about all of the Bay Area and Valley area schools, please feel free to PM me if you want some more info about them all!

As for the nerves? First of all, how bad is your knee? When you've been walking around for the day how do you feel afterwards? You know yourself better than anyone else, do you think you could handle 12 hours on your feet? For the most part you're just standing/walking anyway, nothing too strenuous. UCSF is the only place I've seen that people will literally sprint down the hallway to codes, but luckily that seems rare anywhere else, so don't fret about needing to improve your 100m dash time.

Granted it's not really that bad, you usually don't spend the whole 12 hours on your feet. I usually spend ~8 hours on my feet on an average night. Of course there are nights where it's non-stop, but then there are also nights where its full-stop and I'm sitting around having horrible thoughts like "Man, I wish someone would code or something so I could actually have something to do..." Maybe that's a little dark, but your mind wanders to strange places at 3am when you're exhausted and have nothing to do lol.

When you're busy the 12 hours aren't as terrible as they sound at first, especially if you work in the daylight hours. As for weekends? At least you get weekend differential and there are no bosses around to harass you. And holidays? Yeah they do suck, but 1.5 pay for 12 hours always makes for a very very nice paycheck, just sayin'.
 

PsychadelicTech

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My finances mom has been an RT for close to 20-25 year's. Always been told to stay away from respiratory therapy. Was considering it due to the fact enjoy exercise. Curious what can a bachelor's degree in repository therapy do for you over an associate's degree?
 

Mad Jack

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My finances mom has been an RT for close to 20-25 year's. Always been told to stay away from respiratory therapy. Was considering it due to the fact enjoy exercise. Curious what can a bachelor's degree in repository therapy do for you over an associate's degree?
Really not much. In some departments, a bachelor's is required to work your way up to charge or management, but otherwise it is useless. Get your bachelor's in literally anything else if you can help it.
 

bcreader

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If you do decide on RT school make sure you use the tools on this website. Very helpful. Free study guides, tests, and practice tests.
 
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Pretty much sums everything up. I'll attempt to address some other things about the profession for the OP.

As to the future, RTs aren't going anywhere. Nurses are not capable of troubleshooting and operating a vent, plain and simple. It's a very technical thing, and requires a couple years of training to do successfully. That's our biggest saving grace, really- a nurse may be able to administer all of our meds, but the technical side of respiratory therapy and the fine art that is mechanical ventilation are far beyond their capability. HMOs tried to wipe out RT departments in the early 90s and mortality rates and VAP shot up as a result, so I really doubt the same thing will happen again. As to the job market, that depends on how willing you are to move. It's good in some areas, horrible in others. Do some research on your area if you want to find out.

RT's are great, they are the experts in respiratory issues in our ICU. Generally though, there is a line in the sand, I don't touch their vent other then increasing FiO2 on a severely hypoxic patient when they are tied up, and they don't touch my pumps unless I'm tied up and my pressors are alarming.

Again, MadJack, the constant nurse aggression. Makes me think you have a personality disorder or something. Are you saying nurses aren't intelligent enough to understand respiratory patho, or are you saying we simply don't go deep enough in our education to do as good of a job as the RT's. Can't wait to hear your offensive, condescending response.
 

Mad Jack

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RT's are great, they are the experts in respiratory issues in our ICU. Generally though, there is a line in the sand, I don't touch their vent other then increasing FiO2 on a severely hypoxic patient when they are tied up, and they don't touch my pumps unless I'm tied up and my pressors are alarming.

Again, MadJack, the constant nurse aggression. Makes me think you have a personality disorder or something. Are you saying nurses aren't intelligent enough to understand respiratory patho, or are you saying we simply don't go deep enough in our education to do as good of a job as the RT's. Can't wait to hear your offensive, condescending response.
I'm saying that troubleshooting a vent is like troubleshooting a car. I've had nurses ask me to suction a patient when the problem was a blown circuit, condensation, or flow issues. I've had nurses turning up the O2 on patients without realizing a regular isn't working properly or oxygen sensor is blown, and the reason their oxygen changes aren't working is because of a machine malfunction. They often don't know old alarms from new, how to optimize PEEP/FiO2, when what mode works best for a patient (APRV, PRVC, HFOV, etc may as well be witchcraft to them), or many of the other intricacies of vent management. Physicians don't understand a lot of the mechanical concepts either, such as why washout flow on a BiPAP makes continuous nebulizers (which operate on a low flow system that can't even put out enough air to open the T-spring on high demand patients) completely useless on them. Or why certain modes of ventilation make either nebulized or MDI therapy less effective due to inspiratory times and dead space. So it's really not just nurses- respiratory therapy is a very technical field. If you don't know how the machines work (such as a pressure-triggered vent with no flow sensor that delivers volume-controlled breaths versus a flow-calibrated vent with a flutter valve and various modes) you can kill your patient. That's why nurses shouldn't be running vents.

And the only personality disorder I possess is my tendency to rustle the low hanging jimmies ;)
 
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BreathDeep

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Are you saying nurses simply don't go deep enough in our education

Well...nurses don't. They have less education in respiratory anatomy, physiology, pathology, pharmacology, and physics than an RT. I don't see how an objective fact is somehow offensive.
 
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Well...nurses don't. They have less education in respiratory anatomy, physiology, pathology, pharmacology, and physics than an RT. I don't see how an objective fact is somehow offensive.

If you had quoted my whole quote instead of half of it you would understand the question asked is either we aren't intelligent enough or we simply aren't educated enough. I wanted to know which one he thought.
 

BreathDeep

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Of all people Mad Jack wouldn't claim that nurses are unintelligent. In fact I doubt you would find anyone on this forum who would seriously claim that all nurses are in any way unintelligent.

I only quoted the part about education as that's the only part which was relevant.
 
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Of all people Mad Jack wouldn't claim that nurses are unintelligent. In fact I doubt you would find anyone on this forum who would seriously claim that all nurses are in any way unintelligent.

I only quoted the part about education as that's the only part which was relevant.

Had you quoted the whole thing you would not have needed clarification. And to your second point, I've had people on this forum tell me NP's aren't even mid-levels, they are "low-levels." There are plenty of militant PA's who go out of their way to rip on nurses. Please see the other threads to find out what I'm talking about.
 
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