# Respiratory Therapy



## JCEMTB (Apr 20, 2010)

Hello! I'm currently going be finishing up medic school very soon....and while getting experience and working as a medic, i'm trying to decide what to next school wise. I was thinking working towards my RN, but I've recently been looking into respiratory therapy. I'm wondering from anyone out there who may be an RRT, what kind of opportunities are there within EMS for RRTs? How does it tie in? If I went nursing my long term goal is to be a flight RN ( I know it's VERY competitive but I'm willing to work as hard as it takes to get there). Is this possible with RRT as well? Any information anyone could provide me with is greatly appreciated. Thanks all!


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## Shishkabob (Apr 20, 2010)

Most flight medics I've seen are either Medic/RNs or Medic/RTs, and not just straight medics.


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## usafmedic45 (Apr 20, 2010)

There are very limited options with RT as compared to nursing and this holds true in the out-of-hospital emergency and critical care medicine setting as well.  Simply put- even as a veteran RT with nearly a decade of experience including a significant amount of aeromedical experience- I can not, in good faith, recommend a respiratory therapy degree over a nursing degree. The opportunities a nursing degree (with some experience after graduation) offers are vast and multi-faceted.  The only way to really advance in RT is to get out of the field (use the training as a stepping stone to med school, PA school, etc as an example), cubbyhole yourself into one of a handful of subspecialties (neonatal, pediatrics, home health, sleep lab) or pretty much wait around for someone in a department director spot to die or retire.  I'm not totally against the field and would not trade the education and experience for anything short of a sum of money followed by at least seven zeros, but at the same time I do not chug the profession's Kool-Aid and sport the rose-colored glasses a lot of RTs seem to have.  All fields have their limitations and should recognize them. These are respiratory therapy's limits, like it or not.

Also, please carefully consider the hazards of the career path(s) you are looking into.  There is very little clinical benefit to most aeromedical transports (outside of very long distance transfers and emergency response in a handful of rural areas) and such work entails being in one of the most hazardous jobs in the world.  For more information on this, please see the following threads for starters.:
http://emtlife.com/showpost.php?p=219623&postcount=4
http://emtlife.com/showpost.php?p=219686&postcount=6
Feel free to ask any questions you might have on the subject.


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## John E (Apr 20, 2010)

*Ironic...*

I was in Respiratory Therapy school when I became an EMT...gotta go back and finish that one of these days.

John E


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## medic417 (Apr 20, 2010)

So online RT school or regular?


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## John E (Apr 20, 2010)

*If you're replying...*

to my post, I was attending a local community college working towards an AS Degree in RT when I took an EMT class. Found myself working as an EMT, got started working in the film/television industry as a "Set Medic" and haven't gone back to finish my RT degree as I'm making more money doing what I do now then I would make as an RT. 

Haven't ruled it out but for now, I'm happy.

If you weren't replying to my post, please disregard.

John E


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## usafmedic45 (Apr 21, 2010)

medic417 said:


> So online RT school or regular?


There are no truly online programs that hospitals will hire you out of.  Actually they are probably going to be shut down by the accrediting body (or rather graduates will not be able to sit for the credentialing examinations) in the next year or two as the standards are tightened. Most hospitals look down on "Independence University" (formerly California College of Health Sciences) for the reason that it is a diploma mill and turns out sub-standard students.  A few people who were trained by the military and were otherwise unable to sit for their boards have used it, but if you received your primary education through it you are pretty much going to be laughed at.  Any program that makes you find your own clinical sites and other questionable activities should make any potential student with any brain function other than those associated with the brainstem run screaming.  

The other "online"/distance ed programs (KUMC, San Jose Valley College and a couple of others) are geared towards folks who are already RTs and are looking to complete their bachelors (the KUMC program) or the dwindling number of holdovers from the days before an associate's degree was required to sit for the exam (SJVC, etc).  I happen to fall into the latter category but then again I have no desire to get my associates in respiratory therapy since it will not advance my career and I am working towards a bachelors in professional aeronautics before heading to graduate school for epidemiology.


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## VentMedic (Apr 21, 2010)

usafmedic45 said:


> I happen to fall into the latter category but then again *I have no desire to get my associates in respiratory therapy* since it will not advance my career and I am working towards a bachelors in professional aeronautics before heading to graduate school for epidemiology.


 
Do you think this has anything to do with your previous post about the "limitations" of Respiratory Therapy? 



> There are *very limited options with RT* as compared to nursing and this holds true in the out-of-hospital emergency and critical care medicine setting as well. *Simply put- even as a veteran RT* with nearly a decade of experience


 
Since the Associates degree is now required for Respiratory, YOU will not have many options.  This is also true since you do not have the higher credential of RRT (Registered).  Your comments are now more like those of an "experienced" LVN who is saying he/she knows has much as the RN but can not work in the ICU. Thus there are no opportunities. Or, the EMT with "years of experience" who konws just as much as a Paramedic but cannot intubate.

Also, at one time you stated for civilian life you only worked per diem at a very small hospital which has a very limited amount/type of patients and the RTs did practically nothing. That only gives you a very perspective on the RT field.  That is again like an EMT who works FT in another profession and just occasionally ride an ambulance giving advice to someone who wants to be a professional Paramedic.  

However, correct about the online programs.  RT no longer have the "Excelsior" type (RN) programs which California College once offered. That was RT's "medic mill" along with some of the other shoddy private 1 year  "tech" programs.

As with anything, you must first understand why you want to go into a profession.  Nursing is broad and general but can give one the opportunity to specialize although when it comes to PT, OT, RT and SLP or another of the highly concentrated areas of study and experience, probably nurses are at a disadvantage.   

RT is also petitioning for extra opportunities for reimbursement outside of the hospital for those with a Bachelors degree.  It is also highly recommended to have a Bachelors, Masters preferred,  if you want to work at a more progressive hospital especially one that does alot of research.   Also, for teaching at a college if that is something you want to do later the Masters will be needed.

Examples research:
Respiratory Care Journal
http://www.rcjournal.com/

If you want to choose Respiratory Therapy, it should not be due to some of the cool skills they can do such as intubation, A-line insertion, PICC insertion, ECMO, IABP or any of the complex medical technology they use.  You must have a desire to help someone breathe better whether they are on a sophisticated ventilator or they are receiving a nebulizer in the ED or getting a smoking cessation counseling.  What sets professionals apart in a specialized profession is their desire to educate and get past monkey skills.  But then that should be true of any profession.  Those entering RT should know that 90% of their time will be spent educating the patient and/or their family whether it is an asthmatic child in the ED or the parents of a child that you will be part the process of ending life support when there is nothing more that can be done.

There is also nothing wrong with being a neonatal/pedi specialist or want to be in Flight although to get there requires at least two years of general experience on the floors, in the ED and regular ICUs before you can get on the specialization track. This is generally true for nurses as well.  Once you get in the specialty unit, it may take another 2 - 5 years of experience before you can apply or will be invited to join another specialty team like ECMO or transport.  Then, you may start another year of education/training for that position while still being part of the ICU team.   Specialty transport can include both ground and air (FW and Helicopter) for short distances and long. Some transports many take you several hundred miles and a few may take you to other countries.  You may also be expected to have a Bachelors degree to hold a specialty position and you medical director will expect you to be present for every mandatory training session. 

In RT, most transport teams, including those that just involve Flight, are attached to a hospital.  RT is highly specialized so the Respiratory Therapist must stay current with the latest to succeed.  They can not simply rely on a couple of "skills".   Even RNs who do Flight (HEMS and/or IFT) must or it is highly recommended they spend time in a progressive ICU or they will loose some of that edge and knowledge that makes them valuable. 

Some flight teams with RRTs.

Medcenter Air in Charlotte, NC
Lifestar in Hartford, CT
Northwest Medstar in Spokane, WA
Airlink in Bend, OR
Florida Flight 1 in Orlando, FL
Starcare V in Lincoln, NE
Billings Medflight in Billings, MT
DHART in Lebanon, NH
Intensive Air in Sioux Falls, SD 

However, if a lot of long term patient contact with most of your time spent educating, many hours of extra education/training required, higher education requirements and expectations, and selective hiring process is not your thing, then going the Paramedic route might be best.  You can still get hired with just a cert and 2- 5 years of experience on an ambulance.  Some may hire you with one year if the service is HEMS with the same protocols as the ground crews.   Some HEMS just pluck whoever is on the ground crew to be on the helicopter and fly real fast.   Just like a good RT position that fits your "CAREER" plans, you might have to search for a Paramedic position that will help you acheive your goals.  Jobs are easy to come by but careers take a little extra effort. 

Professional association for RT.
AARC
http://www.aarc.org/

Specialties
http://www.aarc.org/sections/

National credentialing 
NBRC
http://www.nbrc.org/

In 2011 RT will also have another credential coming out since the RRT, although a good general critical care exam, is not keeping up with the more intense ICU specializations and technology.  For a test to include everything, it would take many hours to complete.  But, this knowledge is now important.


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