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Respiratory Therapy Job Specifics

Are there certain times of the year that respiratory therapists are busier than others?

The busy season for respiratory therapists is typically autumn and winter since that is when asthma and flu seasons begin. Autumn and winter are also times when school is in session and the windows and doors are closed with heaters turned on. This causes rooms to become incubators for germs.

Learn more about repiratory therapy schools.

How do RTs handle terminally ill or other patients who have “do not resuscitate” orders?

Respiratory therapists often work with terminally ill patients and those who are on ventilators to help with breathing. RTs are limited in end of life care by "do not resuscitate" (DNR) orders. For patients who do not have a DNR order, everything must be done to help that patient breathe. There can be gray area when a patient has a partial DNR order; for instance, when the patient requests they not be given CRP but can have drugs for treatment, or when the patient allows CPR and drugs but requests no intubation. This means the respiratory therapist must mechanically ventilate with a bag mask rather than intubation by placing an endotracheal tube into the patient. Obviously, these orders can be very confusing for patients and often are not correctly explained by physicians prior to being instituted. However, the patient’s family members or the powers of attorney are allowed to make decisions for the patient at their time of need. These types of situations are traditionally handled by physicians, but families can seek education from the respiratory therapists who are helping their loved one.

Find more information regarding the respiratory therapy career path.

What are the main responsibilities of a respiratory therapist?

• Administering mechanical ventilation by setting up and adjusting life support machines that breathe for patients when they cannot breathe for themselves.
• Maintaining a patient’s airway by placing a tube in their lungs if they stop breathing, which is called intubation, bagging with an ambu bag, and administering aerosol therapy to improve airway patency.


• Administering nebulizers with a bronchodilator may be used to treat patients with COPD, bronchitis, and pneumonia.


• Administering Metered Dose Inhalers (MDI) to treat patients with COPD and bronchitis.


• Administering Chest Physiotherapy (CPT), which involves chest percussion and postural drainage to certain areas of the chest. This can be done manually or with a pneumatic percussor. CPT may be used in the treatment of pneumonia or cystic fibrosis to mobilizes secretions that are retained in the lung.


• Administering Incentive Spirometry (IS), which is also referred to as sustained maximal inspiration (SMI), and is important for post surgical patients to ensure the patient does deep breathing and coughing techniques for lung expansion.


• Administering Continuous Positive Airway Pressure (CPAP) and Bi-Level Positive Airway Pressure (BIPAP) are used for Obstructive Sleep Apnea to keep the airway open during sleep.


• Administering Positive Expiratory Pressure (PEP) Therapy, which is a breathing treatment that applies positive pressure during exhalation to keep the airway open. This therapy also helps with secretion removal or with collapsed areas of the lung.


• Administering Oxygen Therapy involves several different types of devices that are used to keep the patient’s oxygen saturation up so that their cardiopulmonary system can work more efficiently.


• Conduct arterial blood gas analysis, which involves drawing blood from an artery and interpreting the results.


• Perform Pulmonary Function Tests either in a pulmonary function lab or at the bedside of a patient in the hospital. 


• Perform weaning parameters on patients who are on mechanical ventilation to evaluate whether they are ready to be removed from the ventilator.


• Serve as a 1^st responder on rapid response teams.

What are the various employment settings for respiratory therapists?

• Hospitals
  Respiratory therapists generally rotate to various units of the hospital such as the emergency room, adult intensive care unit (ICU), neonatal intensive care unit (NICU), pediatric intensive care unit (PICU), post anesthesia intensive care units (PACU), coronary care unit (CCU), the general floors, and the hospice units. Therefore, it is important for RTs to remain versatile. Depending on the size of the facility, respiratory therapists may be able to stay in a specialty unit such as neonatal or pediatrics. 


• Helicopter transport units and ambulances
  With additional training, respiratory therapists who work in a large facility may become a member of the air/land transport team. Depending on the facility and need, patients may be picked up at outlying facilities or transported to them. For example, neonates who require vent management may be transported from a smaller hospital to a larger one where there is a NICU. 


• Pulmonologists’ offices
  Respiratory therapists at pulmonologists’ offices may perform pulmonary function tests, check resting/exercise pulse oximeter, obtain arterial blood gases, and educate patients. Currently RTs in the office setting are not reimbursable by insurance companies. However, there is legislation in Congress to allow for reimbursement


• Sleep Laboratories
  Respiratory therapists are involved in setting up of sleep testing, monitoring patients, scoring sleep studies, and providing patients with necessary education on their disease or condition. Obstructive sleep apnea is one of the more common sleep disorders an RT works with.


• Home Care
  RTs play an important role in the home care of patients in providing education of their disease process, medications, and modes of therapy. This may involve the education of caretakers with home ventilator patients from infants to geriatric patients.


• Cardio/Pulmonary Rehabilitation
  Experienced RTs with an advanced degree can work with respiratory and cardiac patients to help them improve their endurance and quality of life through exercise. Cardio and Pulmonary rehabilitation is typically located in a hospital setting but some are located in physical therapy practices.




• Pulmonary Diagnostics
  Respiratory therapists can perform pulmonary function diagnostic testing to help determine the type and extent of respiratory diseases. Typically these departments are located within hospital settings.


• Travel companies
  Contractual travel companies hire experienced respiratory therapists for a variety of facilities nationwide due to there being shortages for these professionals. The contracts may vary from 12 to 24 weeks or longer. Each contractual company is different so the need for self-education is a must.


• Sales representatives
  Experienced RTs with an advanced degree can become sales representatives for pharmaceutical companies or medical equipment companies.


• Education
  Respiratory Therapists can work as educators in colleges and clinical settings.


• Hyperbaric Chambers
  Some RTs work in hyperbaric chambers with individuals who need hyperbaric oxygen therapy as mentioned previously.