How to Become a Respiratory Therapist


By Sarah Maurer
respiratory therapist listens to breathing

When a heart or lung problem strikes, respiratory therapists step in to help patients breathe easier. These professionals, also known as RTs, are experts in breathing therapies, treatments and emergency response.

Respiratory therapists provide care and comfort to people with asthma, emphysema, chronic obstructive pulmonary disease (COPD), heart disease, premature birth and other medical conditions that affect the heart and lungs. They also respond to breathing-related emergencies due to drowning, heart attack or trauma.

Typical duties of a respiratory therapist include:

  • Take histories and conduct physical exams.
  • Aid in the diagnosis of breathing disorders and work with the treatment team to create a plan of care.
  • Conduct lung capacity testing, blood gas capacity testing, and other laboratory procedures.
  • Monitor oxygen and carbon dioxide levels in patients' breath, blood, and tissues.
  • Perform chest physiotherapy to remove mucus from patients' lungs.
  • Administer aerosol (inhaled) medications and other breathing treatments.
  • Insert airways and supervise ventilation for people who can't breathe on their own.
  • Provide patient and family education about lung health, breathing equipment use and more.
  • Service ventilation equipment used by patients at home.
  • Respond to breathing emergencies in hospitals, nursing homes, patients' homes, and the community.
  • Consult with physicians and other health care professionals to ensure the very best care.
  • Supervise respiratory therapy technicians as they care for patients.

While there's always been a need for excellent respiratory care, the RT profession has grown significantly in recent years. Because older people are more prone to heart and lung illness, respiratory therapists are needed to meet the needs of America's growing elderly population. Advances in science and new treatments have also played a role. Today, respiratory therapists treat more patients and types of conditions than ever before.

Respiratory therapists get the benefits of working in a growing field that demands their skills. Many enjoy the intellectual challenge of keeping up with new advances in science and technology. Best of all, they get the personal satisfaction of bringing comfort and relief to seriously ill patients who are struggling to breathe.

Work Environment

Most RTs work in hospitals. Common settings include emergency departments, neonatal (newborn) units, intensive care units, pediatric units, and sleep labs. Nursing homes and home health services also employ a significant number of respiratory therapists, as do emergency medical transport services.

Most respiratory therapists work full-time. Because their skills are needed around the clock, night, weekend, and holiday hours are the norm, especially for those employed by hospitals and other 24-7 healthcare facilities.

Respiratory therapy is a high-tech field, and the science of care is constantly changing. RTs work with laboratory equipment, including blood gas analyzers and spirometers. They also treat patients using nebulizers, oxygen tents, ventilators, monitoring equipment, and oxygen therapy systems.

In addition to technology, therapists spend a large percentage of their working hours with people. As part of a multidisciplinary health care team, they work with physicians, nurses, dietitians, social workers, and others to carry out the plan of care. They are generally supervised by the patient's physician and in turn may supervise the work of respiratory therapy technicians.

An RT's caseload can include patients of all ages, from premature babies to elderly people. Patients with breathing problems are often suffering from serious or life-threatening illness, so RTs need to be comfortable interacting with people who are stressed or in pain. Some lifting of patients may be required, especially for therapists working with disabled or homebound populations.



It's possible to become a licensed, certified respiratory therapist with an associate degree. Many employers prefer a bachelor's degree, and supervisory and teaching positions may require a master's.

High school students considering a career in respiratory therapy can prepare by taking courses in health, biology, math, chemistry, and physics. Volunteer or shadowing experience in a health care setting is a great way to get a feel for the health professions.

The National Board for Respiratory Care (NBRC), which oversees national certification, recognizes the following accrediting bodies for educational programs:

  • Commission on Accreditation for Respiratory Care
  • Commission on Accreditation of Allied Health Education Programs

Accredited programs can be found at colleges, universities, vocational/technical schools and the military. The NBRC maintains an online database of accredited programs. The American (AARC) has developed a template to assist students in evaluating potential training programs.

Respiratory therapy training covers anatomy and physiology, chemistry, physics, microbiology, pharmacology (medication science), math and CPR/life support certification. Students also complete supervised clinical rotations.


Respiratory therapists in training must complete a supervised clinical training program in which they learn to assess and diagnose patients and deliver common therapies and treatments. In addition, some advanced certifications in the field require work experience.

Licensing and/or Certification

At present, practicing respiratory therapists must be licensed in all states except Alaska. Licensure typically requires fulfilling educational requirements and passing a knowledge exam. For the requirements near you, contact your state health board.

Certification as a respiratory therapist is voluntary but is preferred by many employers. Many health care settings require newly hired respiratory therapists to earn their advanced credential, or RRT, within one year.

Credentialing for respiratory therapists is administered by the NBRC, which offers two certification levels:

  • Certified Respiratory Therapist (CRT) is the entry-level credential. Candidates must hold an associate degree or higher from an accredited program and pass an exam covering clinical data, equipment and therapeutic procedures.
  • Registered Respiratory Therapist (RRT) is the higher-level credential. Candidates must hold a CRT credential and pass clinical knowledge and paper-and-pencil "simulation" exams.

To earn the following advanced certifications, therapists must hold a CRT or RRT credential and pass an additional knowledge exam. Some credentials have additional requirements:

  • Adult Critical Care Specialty (RRT-ACCS)
  • Neonatal/Pediatric Specialty (CRT-NPS and RRT-NPS)
  • Certified Pulmonary Function Technologist (CPFT)
  • Registered Pulmonary Function Technologist (RPFT)
  • Sleep Disorders Specialty (CRT-SDS and RRT-SDS)

Necessary Skills and Qualities

If you enjoy science and math, a career in respiratory may be a natural fit. Strong calculation skills are necessary in order to set appropriate medication doses based on patient's body weight and health history. And an affinity for technology helps therapists stay on top of rapid changes in treatment and equipment.

RTs also need to pay attention to detail. Treating seriously ill patients means following treatment protocols closely and sticking to a strict schedule. Therapists also need to maintain detailed patient records in order to prevent medical errors and duplications.

Problem-solving skills are another key quality. Success as an RT means identifying the best treatments, recognizing early signs of distress, and adjusting treatments to meet individual patients' needs. Therapists also consult frequently with colleagues to overcome obstacles and determine appropriate courses of treatment.

Respiratory therapy is as much about people as it is about science. Natural warmth and empathy helps RTs comfort distressed patients and their families. Patience is an asset when working with children, people with cognitive disabilities, and others who may not be able to assist with their own treatments. And as an integral part of the medical team, therapists take direction from physicians while supervising the work of technicians.

Opportunities for Advancement

In the healthcare setting, experienced RTs can advance to the position of respiratory care manager. In this role, they oversee performance, scheduling, staffing, supervision, billing, and budgeting for the entire respiratory therapy department.

Some therapists also go on to work in the related area of case management, where they help to coordinate the care of people with chronic heart and lung disease. RTs who prefer to remain at the bedside can pursue specialty certification in sleep disorders, critical care or pediatric/neonatal care.

The public sector also offers opportunities for respiratory therapists. Community programs aimed at asthma management and smoking cessation often employ RTs.
Teaching is another option for seasoned respiratory therapists. Those with advanced degrees can become professors, instructors or researchers at colleges or universities. An RT who supervises students during clinical rotations is known as a preceptor.

If you would like to gain the necessary education to become a respiratory therapist, we highly recommend that you check out our free School Finder Tool located HERE.

Salary and Job Outlook

According for the US Bureau of Labor Statistics, the median annual salary for respiratory therapists is $57,790, or $27.78 per hour. Salaries range from below $41,970 for the lowest-paid 10 percent to above $80,440 for the highest-paid 10 percent.

Salaries are highest for RTs working in outpatient facilities or at colleges, universities and professional schools (all of which generally require certification and a bachelor's or master's degree). Salaries also varied by geographic location. California currently pays the highest average wage.

According to the Bureau of Labor Statistics, employment of RTs is expected to grow by 12 percent between 2014 and 2024, which is faster than the average for all occupations. One reason for this growth is the aging of the US population. Older and middle-aged people are more susceptible to heart and lung conditions that require breathing treatments. The number of babies born prematurely has also been on the rise in recent years. Many "micro preemies" have underdeveloped lungs that require high-tech care. On top of these demographic trends, advances in science are creating new uses for respiratory therapy in patient care.

As a job hunter, you can increase your prospects by pursuing advanced certification (earning an RRT within a year of graduation is desirable). Holding a bachelor's degree can also make you more competitive for entry-level jobs. It also helps to be flexible about location, because the need for respiratory therapists is greatest in rural areas.

The American Association of Respiratory Care maintains an online career center where job seekers can learn what's new in the field, view job openings, post resumes and more.

Further Reading

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