[Coronavirus Advisory] Respiratory Therapists: The hidden heroes in healthcare

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By Sue Davis MA Ed, RRT-NPS
Tim Cordes EdD, RRT-NPS
and Quincy Futrell MRC, MPH, RRT

Respiratory Therapists have been an integral part of healthcare since it was established in the 1950s.

The role of the Respiratory Therapist has changed over the past decades in keeping with advances in technology and healthcare. The modern Respiratory Therapist is very adept at integrating technology and therapeutic techniques in the care of complex medical conditions.

The value of a Respiratory Therapist is well known to the Intensive Care staff but relatively unknown to the public. While the skills of the Respiratory Therapist are valued, many people still refer to them as ancillary staff participating nominally in the care of patients.

When asked, many people think RCP’s (Respiratory Care Practitioners) are specialized nurses or just give breathing treatments. The role of the Respiratory Therapist is ever-expanding. They deliver oxygen therapy and inhaled medications, but they also manage highly technical mechanical ventilators. RCP’s are an essential part of the code team and land/air transport teams.

Respiratory Therapists perform and interpret pulmonary and sleep diagnostic studies, place and manage artificial airways, perform blood gas procurement and analysis, and manage ECMO (extracorporeal membrane oxygenation) therapy, among other things. All of these require extensive scientific and technical knowledge and skills.

From a business standpoint, the value of RCP’s has been shown to have reduced length of stay and reduced unnecessary procedures. Respiratory therapists assist in the development and implementation of respiratory protocols, which leads to decreased hospital length of stay and ICU length of stay, thus reducing hospital costs. With the potential of impending physician shortages, using a respiratory therapist as a physician extender can offset the physician workforce shortages, allowing the respiratory therapist to utilize their training in diagnostic, therapeutic, and critical care management patients.

However, we are seeing shortages of Respiratory Therapists within the United States, which has been especially noticeable during this pandemic. According to the U.S. Department of Labor Statistics, employment of respiratory therapists is projected to grow 21% from 2018 to 2028, much faster than the average for all occupations.

Growth in the middle-aged and older population will lead to an increased incidence of respiratory conditions such as pneumonia, chronic obstructive pulmonary disease (COPD), and other disorders that can permanently damage the lungs or restrict lung function. The aging population will, in turn, lead to an increased demand for respiratory therapy services and treatments, mostly in hospitals.

The growth of the Respiratory Therapy Profession is hampered in part by the lack of the general public’s understanding of job set and by the limited bachelor’s degree programs throughout the nation. Most programs are not at full student capacity, and it is difficult to convince potential students interested in other healthcare disciplines that this is not only a viable job option with similar financial benefits, but that would meet their vocation needs, primarily the desire to help others. It is hard to get students who are singularly focused on one field even to consider another that they have not heard of and do not understand their role in healthcare.

Despite this, respiratory therapists have demonstrated a strong commitment to the community during this pandemic. Respiratory Therapists have had to quickly adapt to increased volume, lack of equipment, increased patient acuity and increased stress and risk to themselves.

Respiratory Therapists are inventive and learn to change equipment and procedures to new and unusual needs while demonstrating a commitment to providing high quality and care and ingenuity in treating patients with complex SARS-like illness. They have demonstrated excellence in caring for critically ill patients while still delivering a personal touch in caring for their most fragile patients.

During this pandemic, there have been many stories about lesser qualified healthcare staff caring for very critical patients with very adverse outcomes. Perhaps due to increased awareness of the need for qualified practitioners, there will be a renewed interest in pursuing Respiratory Therapy as a vocation.

The Respiratory Therapist is an essential need in modern healthcare and those who have answered the call to become an RCP get great satisfaction from their work. Ralph Waldo Emerson said it best, “To know that even one life has breathed easier because you have lived. This is to have succeeded.” This is the mission of the Respiratory Therapist.

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