Respiratory Therapist Job Description — Duties, Skills, Salary & Career Path

Respiratory therapists held approximately 134,500 jobs in 2024, with the BLS projecting 12 percent employment growth through 2034 — much faster than the national average — and roughly 8,800 annual openings [1]. The median annual wage reached $80,450 in May 2024, positioning respiratory therapy among the highest-paying healthcare professions accessible with an associate degree [1]. As the U.S. population ages and chronic respiratory conditions like COPD affect an estimated 16 million Americans, respiratory therapists serve as the frontline clinicians managing airways, ventilators, and cardiopulmonary diagnostics across ICUs, emergency departments, neonatal units, and outpatient clinics [2].

Key Takeaways

• Respiratory therapists assess, treat, and manage patients with breathing disorders, operating mechanical ventilators, administering inhaled medications, and performing cardiopulmonary diagnostics.
• The median annual wage was $80,450 in May 2024, with the top 10 percent earning more than $108,820 [1].
• Employment is projected to grow 12 percent from 2024 to 2034, driven by the aging population and the prevalence of COPD, asthma, and other chronic respiratory conditions [1].
• The Registered Respiratory Therapist (RRT) credential from the NBRC is the standard of excellence and is required by most employers [3].
• All 50 states require licensure, and most mandate the RRT credential [1].
• Respiratory therapists work in hospitals (primarily ICUs and emergency departments), long-term acute care facilities, sleep labs, pulmonary rehabilitation centers, and home health settings.

What Does a Respiratory Therapist Do?

A respiratory therapist (RT) is a licensed healthcare professional who evaluates, treats, and manages patients with cardiopulmonary disorders. The scope of practice includes managing mechanical ventilators for critically ill patients, administering aerosolized medications (bronchodilators, mucolytics, corticosteroids), performing arterial blood gas (ABG) analysis, conducting pulmonary function tests (PFTs), managing artificial airways (endotracheal tubes, tracheostomies), and providing patient education on disease management [1].

The role varies by clinical setting. In the ICU, respiratory therapists manage ventilator settings, perform spontaneous breathing trials, assist with intubation and extubation, and respond to rapid response and code blue emergencies. In the emergency department, they manage acute asthma exacerbations, COPD flares, and trauma-related respiratory failure. In the NICU, they specialize in neonatal ventilation, surfactant administration, and high-frequency oscillatory ventilation for premature infants [3].

Respiratory therapists work under protocols established by physicians (typically pulmonologists, intensivists, or emergency medicine physicians) but exercise significant clinical judgment in adjusting treatments based on patient assessment. Many hospitals use therapist-driven protocols (TDPs) that give RTs autonomy to modify ventilator settings, wean patients from mechanical ventilation, and titrate oxygen delivery based on clinical data [2].

Core Responsibilities

1. Assess patients with respiratory conditions by reviewing medical histories, performing physical assessments, interpreting chest X-rays and CT scans, and analyzing arterial blood gas (ABG) results.
2. Set up, manage, and wean mechanical ventilators for adult, pediatric, and neonatal patients, adjusting settings (tidal volume, PEEP, FiO2, respiratory rate) based on patient response and ABG values [3].
3. Administer aerosolized medications including bronchodilators (albuterol, ipratropium), corticosteroids (budesonide), and mucolytics (acetylcysteine) via nebulizer, metered-dose inhaler, or dry powder inhaler.
4. Perform and interpret pulmonary function tests (PFTs) including spirometry, lung volume measurements, and diffusion capacity (DLCO) studies to diagnose and monitor chronic lung disease.
5. Manage artificial airways — assist with endotracheal intubation, perform tracheostomy care, suction airways, and monitor cuff pressures.
6. Respond to emergency situations including code blue (cardiac arrest), rapid response calls, and trauma activations, providing airway management and manual resuscitation (bag-valve-mask ventilation).
7. Conduct arterial blood gas (ABG) sampling and analysis to assess oxygenation, ventilation, and acid-base status.
8. Administer oxygen therapy via nasal cannula, high-flow nasal cannula (HFNC), Venturi mask, non-rebreather mask, and CPAP/BiPAP devices.
9. Provide patient and family education on inhaler technique, home oxygen use, disease self-management (COPD action plans, asthma action plans), and smoking cessation.
10. Participate in multidisciplinary rounds in the ICU, collaborating with physicians, nurses, pharmacists, and case managers on ventilator weaning plans, tracheostomy decisions, and discharge planning.
11. Perform cardiopulmonary diagnostics including EKGs, pulse oximetry monitoring, capnography, and exhaled nitric oxide (FeNO) testing.
12. Document all assessments, treatments, and patient responses in the electronic health record (EHR) — Epic, Cerner, or Meditech — per Joint Commission and CMS documentation standards.

Required Qualifications

• Associate degree in Respiratory Therapy from a program accredited by the Commission on Accreditation for Respiratory Care (CoARC) — this is the minimum educational requirement [1][3].
• Registered Respiratory Therapist (RRT) credential from the National Board for Respiratory Care (NBRC), earned by passing the Therapist Multiple-Choice (TMC) Examination and the Clinical Simulation Examination (CSE) [3].
• State licensure — all 50 states require respiratory therapists to be licensed; requirements vary but typically mandate the RRT credential [1].
• BLS (Basic Life Support) and ACLS (Advanced Cardiovascular Life Support) certifications from the American Heart Association.
• Working knowledge of mechanical ventilation — conventional and advanced modes (SIMV, pressure support, APRV, NAVA).
• Proficiency with ABG analysis and acid-base interpretation.
• Physical ability to stand for 12-hour shifts, respond to emergencies rapidly, and assist with patient positioning.

Preferred Qualifications

• Bachelor's degree (BSRT) in Respiratory Therapy — increasingly preferred by large hospital systems and required for some leadership positions.
• NBRC specialty credentials: Adult Critical Care Specialist (ACCS), Neonatal/Pediatric Specialist (NPS), Sleep Disorders Specialist (SDS), or Pulmonary Function Technologist (CPFT/RPFT) [3].
• NRP (Neonatal Resuscitation Program) certification for NICU-focused positions.
• PALS (Pediatric Advanced Life Support) certification for pediatric roles.
• Experience with advanced respiratory technologies: high-frequency oscillatory ventilation (HFOV), inhaled nitric oxide (iNO), extracorporeal membrane oxygenation (ECMO) support.
• Pulmonary rehabilitation experience — exercise prescription, patient education, and outcomes tracking for COPD and post-COVID patients.
• EHR proficiency — particularly Epic Respiratory Care module or Cerner respiratory documentation.

Tools and Technologies

Work Environment and Schedule

Respiratory therapists work primarily in hospitals — ICUs, emergency departments, NICUs, and general medical-surgical floors — which operate 24 hours a day, 7 days a week. Shift patterns typically follow 12-hour schedules (7am-7pm days, 7pm-7am nights), with rotating weekends and holidays required. Some facilities offer 8-hour or 10-hour shift options [1].

The work is physically and emotionally demanding. RTs spend significant time on their feet, respond to emergencies at any hour, manage critically ill patients including those at end of life, and work in environments with infectious disease exposure (tuberculosis, COVID-19, influenza). Personal protective equipment (PPE) — including N95 respirators, gowns, and gloves — is standard for aerosol-generating procedures.

Outpatient settings (pulmonary function labs, sleep disorder centers, physician offices) offer more predictable schedules — typically Monday through Friday, 8-hour days — though the work may be less clinically varied.

Salary Range and Benefits

The BLS reports a median annual wage of $80,450 for respiratory therapists as of May 2024 [1]:

The lowest 10 percent earned less than $61,900, while the highest 10 percent earned more than $108,820 [1]. Geographic variation is significant: California, New York, New Jersey, and Hawaii consistently pay above-median wages. Travel respiratory therapists (short-term contracts at understaffed facilities) earn substantial premiums, often 40-80 percent above permanent staff rates.

Benefits typically include employer-sponsored health, dental, and vision insurance; retirement plans (401(k) or 403(b) with employer match); shift differentials for nights, weekends, and holidays (typically $2-$6/hour); tuition reimbursement for BSRT completion; paid CEU allowances for credential maintenance; and clinical ladder programs for career advancement.

Career Growth from This Role

• Senior Respiratory Therapist / Clinical Specialist — Serves as clinical resource, precepts new hires, and manages complex ventilator patients.
• ECMO Specialist — Manages extracorporeal membrane oxygenation circuits, a highly specialized critical care skill commanding significant pay premiums.
• Neonatal/Pediatric RT Specialist — Focuses on NICU and PICU populations, earning NBRC NPS specialty credential.
• Pulmonary Function Technologist — Specializes in diagnostic testing (spirometry, DLCO, lung volumes), earning the RPFT credential.
• Sleep Lab Technologist / Polysomnographer — Transitions into sleep disorder diagnostics and CPAP/BiPAP titration.
• RT Supervisor / Manager — Leads a department of respiratory therapists, managing staffing, budgets, and quality improvement.
• Director of Respiratory Care — Oversees the entire respiratory care department at a hospital or health system.
• Education / Clinical Instructor — Teaches in CoARC-accredited RT programs, combining clinical practice with academic instruction.

With 8,800 annual openings and growing demand from an aging population, respiratory therapists who earn specialty credentials and expand into critical care, ECMO, or pulmonary rehabilitation will find the strongest career trajectories [1].

FAQ

What is the difference between a CRT and an RRT? The Certified Respiratory Therapist (CRT) credential is earned by passing the TMC Examination at the low-cut score. The Registered Respiratory Therapist (RRT) requires passing both the TMC at the high-cut score and the Clinical Simulation Examination (CSE). The RRT is the "standard of excellence" and is required by most employers. Note: the NBRC will phase out the CRT-to-RRT admission pathway by December 2026 [3].

Do I need a bachelor's degree? An associate degree from a CoARC-accredited program is the minimum requirement. However, the AARC (American Association for Respiratory Care) recommends the profession transition to a bachelor's degree entry level, and many hospital systems are beginning to prefer or require the BSRT, particularly for leadership roles [2].

What are the working hours like? Hospital-based RTs typically work 12-hour shifts on a rotating schedule that includes nights, weekends, and holidays. Outpatient settings (PFT labs, sleep centers) generally offer Monday-Friday, 8-hour schedules. On-call requirements vary by facility [1].

How long does it take to become a respiratory therapist? An associate degree in respiratory therapy takes approximately 2 years of full-time study. A bachelor's degree takes 4 years. After graduation, candidates must pass the NBRC TMC and CSE examinations and obtain state licensure before practicing — a process that typically takes 2-3 months after graduation [3].

Is respiratory therapy a good career during economic downturns? Yes. Healthcare employment is generally recession-resistant because demand for medical services does not decline with economic cycles. Respiratory therapy is particularly stable because the conditions it treats — COPD, asthma, pneumonia, respiratory failure — are not economically cyclical [1].

What is the hardest part of the job? Managing critically ill and dying patients is the most emotionally demanding aspect. Respiratory therapists frequently manage end-of-life ventilator withdrawals, code blue resuscitations, and trauma situations. Burnout and compassion fatigue are real concerns, and hospitals increasingly offer employee assistance programs and resilience resources.

How is technology changing the role? Advancements in ventilator automation (auto-weaning protocols, closed-loop FiO2 management), remote patient monitoring for home ventilator patients, and AI-assisted diagnostic tools are enhancing RT practice. These technologies augment clinical judgment rather than replace the therapist, and RTs who adopt new technologies will be more effective and in higher demand.

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Citations: [1] U.S. Bureau of Labor Statistics, "Respiratory Therapists," Occupational Outlook Handbook, https://www.bls.gov/ooh/healthcare/respiratory-therapists.htm [2] American Association for Respiratory Care (AARC), "Why Be an RT," https://www.aarc.org/your-rt-career/why-be-an-rt/ [3] National Board for Respiratory Care (NBRC), "RRT Examination," https://www.nbrc.org/examinations/rrt/