Filling the Void in Respiratory Care (2024)

Staffing respiratory care positions has long been challenging for health care leaders, and the COVID-19 pandemic only exacerbated those concerns. A 2021 National Board for Respiratory Care report highlighted two troubling trends: nearly 100,000 respiratory therapists (RTs) will leave the profession by the end of this decade, and enrollment in respiratory care education programs in the U.S. has declined 27% since 2010.

Leadership at Riley Children’s Healthsaw the signs firsthand. Indiana University Health (IU Health), of which Riley is a part, lost 70 RTs in 2022, many citing the emotional toll of the position. Vacancy rates reached 50%, calling for an overhaul of the organization’s recruitment and retention practices.

“We needed to get team members in here so we could decrease the amount of contract labor,” said Beth Summitt, RRT-NPS, MA, executive director of Respiratory Care and Diagnostic Services at IU Health Academic Center. “There’s a cost savings, but most importantly, it's the very best for patient care.”

To address these challenges, Summitt and leaders and team members from across the organization launched a focused recruitment project in late 2022. The group devised a series of initiatives in three areas: education, culture, and advocacy.

Educational programs

The pandemic led to low enrollment and graduation rates at the two respiratory care educational programs in the health system’s region. Of those, only 17 — about 36% — took jobs at IU Health. Nurturing that RT pipeline was a priority for Summitt and her team.

IU Health surveyed educational program directors to understand what the students wanted and adjusted their recruitment efforts accordingly. Adjustments included:

  • Switching recruitment presentations to the fall semester — instead of the spring — to get a foot in the door with graduating seniors sooner.
  • Holding respiratory therapy assistant (RTA) and registered respiratory therapist (RRT) openings for qualified candidates until after graduation.
  • Increasing knowledge sharing from RT professionals — including guest lectures and Q&A sessions with RTs that attracted more than 100 respiratory care students.

These initiatives contributed to more students staying in school and graduating. The associate degree programs reported a 29% increase in retention rates and, for only the second time in program history, 100% of the bachelor's degree students advanced to their senior year.

Those gains paid dividends for IU Health: 37 students accepted respiratory care jobs (including student positions) in the health system in 2023, compared to just 29 the prior year.

Internal culture

The recruitment project initiated significant changes on-site to ensure a top-notch clinical experience for respiratory care students. These changes included:

  • A dedicated preceptor team and preceptor recognition program, which includes credits for professional development activities, such as continuing education courses or professional conferences.
  • More touch points between staff members and students. In one semester, the project team recorded 88 deliberate meetings with 47 seniors in the program — with each student making at least one connection.
  • Online student hubs specific to each location, giving students easy access to information on the hospital, their preceptors, important contacts, and job opportunities.
  • A new peer recognition platform.
  • A revised mentoring program.

Additionally, the respiratory care team rounds more frequently with physicians to assist with care decisions. “Being able to voice our opinion using our clinical expertise helps our team feel valued and appreciated,” Summitt said. “And in building that welcoming environment for students and new graduates, we find it nurtures a welcoming culture for experienced team members as well.”

The numbers bear that out, in the project’s first year, IU Health nearly doubled its overall number of respiratory care new hires — from 33 in 2022 to 60 in 2023.

Advocacy

The project led to a significant legislative win for respiratory therapy in the state. According to Indiana state law, students with permits to practice respiratory care cannot work in pediatric settings. Working with lobbyists from IU Health and the Indiana Society for Respiratory Care, Summitt got the restriction lifted.

“I'm so proud of that work, and the students are excited because some of them already know they want to work in pediatrics,” Summitt said. “It's a big win for the students and for the program.”

Next steps

Summitt plans to continue expanding the pipeline of available candidates. Her next step is to work with the region’s professional society to visit every high school in the state in the coming year.

“I'm really excited about that,” Summitt said. “Although we would ideally start reaching them at eighth grade, right now we need to really prioritize awareness at high schools.”

Filling the Void in Respiratory Care (2024)

FAQs

How many times can you take the NBRc TMC exam? ›

TMC Exam FAQs

As indicated in the table below, candidates may attempt the Therapist Multiple-Choice and Clinical Simulation Examinations three times, after which the candidate will be required to wait a minimum of 120 days between any subsequent attempt.

What four above and beyond tasks a respiratory therapist may be asked to perform at a hospital? ›

Determine appropriate therapy and treatment options with physicians. Analyze blood and sputum in the lab. Manage equipment and devices needed to help people who can't breathe normally on their own. Educate patients and families about lung diseases and breathing disorders.

Can respiratory therapists put in PICC lines? ›

Can respiratory care practitioners insert PICC lines? Yes, insertion of PICC lines is within the scope of practice of a licensed respiratory care practitioner.

Who is responsible for credentialing respiratory care? ›

The National Board for Respiratory Care offers specialty credentials in adult acute care (the ACCS), neonatal-pediatrics (the NPS), sleep (the SDS), and respiratory diagnostics (the CPFT and RPFT).

Is the TMC exam hard? ›

Generally, it hovers around 70-80%. But for repeated attempts, the percentage drops to about 45%. This means that nearly one-third of test-takers do not pass the exam on their subsequent attempt. The TMC exam is known for being comprehensive, and while the TMC exam is undoubtedly challenging, passing is possible.

What is the passing score for the NBRC RRT exam? ›

Respiratory therapists must score 66% to pass. If the second higher cut score of 72% is met, the NBRC awards a CRT certificate, and the therapist is eligible to take the Clinical Simulation Exam for RRT certification. The exam is scored electronically. Pass/Fail results are available immediately.

Where do respiratory therapists make the most money? ›

Highest paying cities for Respiratory Therapists near United States
  • San Diego, CA. $45.70 per hour. 217 salaries reported.
  • Columbus, OH. $45.50 per hour.
  • Phoenix, AZ. $44.76 per hour.
  • Pittsburgh, PA. $43.55 per hour.
  • Fort Worth, TX. $39.49 per hour.
  • Show more nearby cities.

Is respiratory therapy a dying field? ›

Employment of respiratory therapists is projected to grow 13 percent from 2022 to 2032, much faster than the average for all occupations. About 8,600 openings for respiratory therapists are projected each year, on average, over the decade.

What is the hardest part of being a respiratory therapist? ›

Balancing Patient Loads Can Be Tough

Balancing patient loads is a crucial aspect of a respiratory therapist's role, and it can be particularly challenging. Respiratory therapists often find themselves juggling the care of multiple patients, each with varying degrees of respiratory distress and medical needs.

Can an RN do everything an RT does? ›

It is within the scope of practice of an appropriately trained and competent registered nurse too perform respiratory therapy procedures, It may be within the scope of practice for the registered nurse to perform respiratory therapy procedures and activities such as administering or adjusting oxygen settings, adjusting ...

Are respiratory therapists allowed to intubate? ›

Endotracheal intubation is common procedure performed by respiratory therapists (RTs).

Can RT draw blood? ›

Respiratory therapists are experts in helping people breathe, but they also perform a wide range of other duties. An RT might draw blood specimens to check the level of gases like oxygen in the blood.

What is another name for a respiratory therapist? ›

Common titles include cardio-respiratory physiotherapist, clinical respiratory physiologist (as well as other healthcare scientists), respiratory nurse and cardio-respiratory occupational therapist.

What is the ratio for respiratory therapists? ›

(g) Sufficient respiratory care practitioners and/or respiratory care technicians shall provide support for resuscitation and maintenance of the mechanical ventilators in a ratio of 1:4 or fewer on each shift. (h) A physical therapist and a social worker should be available on a regular basis. § 70407.

What does RCP mean in medical terms? ›

A Respiratory Care Practitioner (RCP), also known as a Respiratory Therapist, is a licensed specialist trained in providing care to patients with heart and lung disorders. There are more than 100,000 RCPs in the United States.

What is the time limit for the TMC exam? ›

The TMC Examination consists of 160 multiple-choice questions (140 scored items and 20 pretest items). You will be given three hours to complete the TMC Examination. For specific exam content, refer to the Detailed Content Outlines.

How many people pass the TMC? ›

Come learn with Joe as he helps you overcome the last hurdle in becoming an RRT and passing your NBRC board exams. Only around 70% of candidates pass the TMC exam with the high cut score and get to move on to the Clinical Simulation Exam on the first attempt – repeat candidates are passing at only 30% or less.

What happens if you fail the CSE? ›

There is no limit to the number of times a candidate can take the CSE. If I don't pass the CSE, is there a waiting period before I can take it again? Yes. To ensure the security of the CSE, a waiting period of three months from examination date is required.

How many times can I take the AMT exam? ›

A retesting fee is required. Candidates may take an examination for a specific certification discipline a maximum of four times.

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