Healthcare organizations, industry associations, RT schools and even industry partners must come together and act now to invest in the field of respiratory care and those working in the profession.

Ed Coombs, MA, RRT-NPS, ACCS, FAARC

Respiratory therapists (RT) play a critical role in patient care. The demand for qualified RTs is steadily growing as the US population ages and requires respiratory support for a number of chronic conditions. Over the past two years, the need for RTs has skyrocketed with the COVID-19 pandemic.

But as demand grows, the number of RTs employed or available for employment is shrinking. RTs nearing retirement age, those leaving the profession because of high stress and long hours during the pandemic, and a sharp drop in RT education program participation has resulted in a significant and dangerous RT labor shortage that will likely accelerate in the years ahead.

Healthcare organizations, industry associations, RT schools and even industry partners (eg, respiratory equipment manufacturers and service providers) must come together and act now to invest in the field of respiratory care and those working in the profession.

How We Got Here

In a recent survey of respiratory care leaders by the American Association for Respiratory Care (AARC), nearly nine-in-10 (87%) agreed or strongly agreed there is a current, local shortage of RTs, and 84% think a shortage of RTs in the future is likely or very likely.1

There are three major factors that have resulted in the current RT shortage: A high rate of RTs reaching retirement age, RTs leaving the profession because of job dissatisfaction and burnout, and far fewer students pursuing careers in the respiratory therapy field.

Consider the following:

  • More than 92,000 RTs will retire by 2030
  • 93% of RTs say burnout is a major issue
  • There has been a 27% decrease in RT education program enrollment, with only 10% of programs at capacity2

While the RT profession has been facing these challenges for some time, it took the COVID-19 pandemic to bring them to the surface and underscore the serious patient care and safety ramifications of the shortage.

A survey by AMN Healthcare, the nation’s leader in healthcare total talent solutions, revealed that “respiratory therapists, who are essential to treating COVID-19 patients, top the list of most in-demand temporary allied healthcare professionals.”3 Among the 159 hospitals and other healthcare facilities surveyed, 75% were currently seeking temporary allied healthcare professionals to “to alleviate the burden on their permanent staff and thereby reduce turnover.”4

An interview with an RT from Vanderbilt University Medical Center (VUMC) highlights how the shortage is impacting respiratory therapists on a personal level. At the time of the interview, there were more than 60 openings for RTs at VUMC: “The increased workload we have experienced has put a higher stress than normal on respiratory therapist because they want to provide that care for their patients. Sometimes they feel the pressures of not being able to spend as much time with each individual patient because they’re being pulled in so many directions.”5

At the same time, health systems and hospitals face increased competition for experienced RTs from travel staffing firms. For those RTs who are willing to travel to healthcare facilities in other geographic regions, compensation is extremely lucrative. A job listing from one staffing firm for an RT with one year of experience offered $5,930 per week in taxable pay and non-taxable stipends.6

On February 2, 2022, the American Hospital Association (AHA) submitted a statement to the US House and Senate subcommittee urging an investigation into reports of anticompetitive conduct by travel staffing agencies “that are exacerbating workforce shortages and straining the healthcare system.”7

How We Can Act … Now

The National Board for Respiratory Care (NBRC), the AARC and the Commission on Accreditation for Respiratory Care (CoARC) have jointly launched a multi-year, national campaign to address the crisis with a goal to:

  • Raise public awareness of the value of the respiratory care profession
  • Recruit and retain more respiratory therapists
  • Identify, shape and inspire new leadership in the profession8

No one party can solve the current RT shortage crisis, it will take multiple stakeholders coming together to determine how to retain experienced RTs and attract a new generation of individuals to the profession, including healthcare organizations, industry associations, colleges and universities, and those who provide products and services to the field.

Here are three ways parties aligned to the respiratory care profession can come to together to keep experienced RTs engaged and nurture the new generation of respiratory care providers.

1) Support Today’s RTs

RT turnover is sharply increasing. The 2021 NSI National Health Care Retention & RN Staffing Report, based on findings from a January 2021 survey of over 3,000 US hospitals, revealed a turnover rate of nearly 17% in 2020, up from 12% in 2019.9

Retaining experienced RTs can benefit healthcare facilities from a clinical, operational and financial perspective. The continuity of seasoned respiratory care staff members offers stability to patient care and safety. The more staff members retained the less time and effort required of current RT team members to teach new employees.

As with most industries, it costs far less for a healthcare organization to retain a staff member than to attract and train a new one. The cost for healthcare staff turnover can run as high as 150% of the annual salary of mid-level employees.10

Strengthen Leadership

A 2021 survey of US RTs found poor leadership to be a top driver of burnout (32%).11 One way that the industry can help support practicing RTs is to provide opportunities to improve leadership skills and opportunities.

The AARC established its Leadership Institute to help RTs develop knowledge and skills beyond the clinical realm. It offers three educational tracks — research, education and management — and awards scholarships in each track. The Institute is a collaboration among the AARC, nationally respected respiratory care leaders who develop the courses and provide mentoring to participants, and industry partners like Dräger that provide grants for its support.

Provide Continuing Education

Every state in the nation, except for Alaska, requires RTs to earn and maintain certification for state licensure. Certified RTs must earn continuing education credits (CEU) each year, with the specific number set by the state in which they are licensed.

Within the current environment, where RTs are working long hours under stressful conditions to overcome staff shortages and support an increasing patient population with respiratory complications, they need convenient and flexible access to continuing education (CE) courses.

There are a growing number of online CE courses that RTs can take when and where it is convenient to their schedules:

  • AARC University offers online CE courses ranging from neonatal to adult care, on topics in the areas of clinical practice, patient safety and disaster preparedness, as well as management, leadership and education.12  
  • Dräger offers free, online respiratory continuing education units (CEU) through its website, A Breath Ahead, including webinars and presentations on adult and neonatal respiratory care topics.13
  • In January 2022, the NBRC announced that it was approved to award continued respiratory care (CRCE) education credits to credentialed practitioners who participate in its Credential Maintenance Program (CMP) by completing at least 90% of assessment questions available in a calendar year.14

2) Further Student Learning

To fill the pipeline with new RTs entering the profession, stakeholders must enhance and broaden current higher education offerings. These efforts should start at the high school level, educating students on the respiratory therapy field so they consider it as a career option.

Stakeholders should emphasize to students the personal satisfaction that can be gained through a career in respiratory care, and the professional benefits, including job security and competitive salaries. A recent Yahoo Finance article called out respiratory therapist as one of 20 careers where an individual can earn $60,000 out of college.15

Support RT Higher Education

Colleges with RT programs need the support of healthcare organizations, industry associations and industry partners to strengthen their curriculums so that students have the necessary skills to join the field upon graduation. Colleges are increasingly collaborating with healthcare facilities in their communities to understand patient needs and then tailoring RT curriculums accordingly or launching RT programs for the first time.

In January 2022, Blue Ridge Community College in North Carolina announced that it was launching a RT program “in response to healthcare employer needs” in its community, citing an increased need for RTs to care for “those living with acute or chronic lung illness or injury resulting from the effects of COVID-19.”16

At the same time, RT programs are working to offer specialized education tracks so that degree graduates have the knowledge and skills to care for patients with specific conditions.

One area where RT schools are responding to specialized patient needs is the neonatal intensive care unit (NICU). Babies are being born increasingly younger in gestational age with severely underdeveloped lungs incapable of breathing on their own. This has prompted RT schools to offer course tracks specific to respiratory care of neonates.

In February 2022, Middle Georgia State University announced a new neonatal track within its respiratory therapy degree program, with a focus on stabilizing newborns within the first 10 minutes of life.17

Equipping RT schools with advanced technologies is important to preparing students for real-world application of their skills. Students should be training on the same caliber of ventilators and other respiratory care devices and supplies they will be using in healthcare facilities upon graduation.

That is why Dräger has donated its adult and neonatal ventilators to US. RT schools for seven years in a row, with its most recent donation made to RT schools throughout the Commonwealth of Massachusetts in 2021, in memory Robert Kacmarek, a long-standing leader in the respiratory care profession who passed away in April 2021.

3) Back Research

Continued respiratory care research and innovation improves outcomes and saves lives. RTs who engage in research during their careers add significant value to research projects while advancing in their professional development. There needs to be greater support for participation in research initiatives.

As one RT researcher stated: “Many of the folks who have spent most of their career in RT research have spent a lot of time mentoring medical students, fellows, and resident physicians. However, there needs to be more emphasis on mentoring/training RTs in research, so that we develop new leaders and continue to promote our wonderful profession.”18

Reward Research Efforts

RT industry associations offer a variety of incentives for RTs to pursue a career path that involves clinical research. Industry partners can play their part by contributing financially to these programs.

The American Respiratory Care Foundation (ARCF) is dedicated to promoting respiratory health through the support of research, education, and patient-focused philanthropic activities in respiratory care. The foundation grants research funds to qualified investigators in the field of respiratory care, and fellowships to a select number of RTs who have research abstracts accepted for presentation at the AARC Congress each year. Dräger has provided two endowments to the fellowship program to support these efforts.

The ARCF also bestows literary awards to RTs who have authored papers published in the journal Respiratory Care. For example, the Dräger Literary Award, funded by a grant from the company, encourages research by respiratory therapists by recognizing the best paper focused on mechanical ventilation published in the journal.

The Path Ahead

Impacts of the RT shortage on patient care and safety are front and center in the mainstream media each day. Take for instance the January 21, 2022, USA Today article: “12 hours shifts, 37 ICU beds, 14,000 steps: How two Iowa respiratory therapists weather the crush of COVID.”19

We are already facing significant RT labor issues during the pandemic and all evidence points to far greater challenges down the road. More than 92,000 RTs will retire by 2030, 93% of RTs say burnout is a major issue and only 10% of RT programs are at capacity today.20 At the same time, employment of respiratory therapists is predicted to grow 23% from 2020 to 2030, much faster than the average for all occupations.21 If we do the math, it is clear we are a profession in crisis.

I call on all stakeholders to the respiratory care profession to do more in support of RTs on the front lines today, while making improvements so that the future generation sees the profession not as a burden but as an opportunity for personal and professional greatness. 

RT


Ed Coombs, MA, RRT-NPS, ACCS, FAARC, is the senior director of Marketing at Dräger in North America. This manuscript was prepared and submitted by Dräger. For more information, contact [email protected].


References

  1. Why We Need More RTs – and How to Help, https://www.morerts.com/growing-need/
  2. Why We Need More RTs – and How to Help, https://www.morerts.com/growing-need/
  3. AMN Survey: Respiratory Therapists Top List of Most In-Demand Temporary Allied Healthcare Professionals, Businesswire, December 29, 2021, https://www.businesswire.com/news/home/20211229005045/en/
  4. AMN Survey: Respiratory Therapists Top List of Most In-Demand Temporary Allied Healthcare Professionals, AMN Healthcare, December 29, 2021, https://news.amnhealthcare.com/press-releases/press-releases-details/2021/AMN-Survey-Respiratory-Therapists-Top-List-of-Most-In-Demand-Temporary-Allied-Healthcare-Professionals/default.aspx
  5. Vanderbilt Medical reports shortage of respiratory therapists due to pandemic burnout, MSN, October 4, 2021, https://www.msn.com/en-us/health/medical/vanderbilt-medical-reports-shortage-of-respiratory-therapists-due-to-pandemic-burnout/ar-AAP80CR
  6. Vivian website, accessed February 3, 2022, https://www.vivian.com/job/780-384561/
  7. AHA House Statement: Pandemic Profiteers: Legislation to Stop Corporate Price Gouging, AHA, February 2, 2022, https://www.aha.org/testimony/2022-02-02-aha-house-statement-pandemic-profiteers-legislation-stop-corporate-price
  8. Why We Need More RTs – and How to Help, https://www.morerts.com/growing-need/
  9. 2021 NSI National Health Care Retention & RN Staffing Report, NSI
  10. Peterson L. “The True Cost of Employee Turnover.” FQHC.org. 2014 Nov 14. https://www.fqhc.org/blog/2014/11/4/the-true-cost-of-employee-turnover
  11. Miller AG, Roberts KJ, Hinkson CR, et al. Resilience and Burnout Resources in Respiratory Care Departments. Respiratory Care. 2021 May;66(5):715-723. DOI: 10.4187/respcare.08440. PMID: 33262173. https://europepmc.org/article/MED/33262173
  12. AARC University, AARC, https://my.aarc.org/Education/AARC-University
  13. A Breath Ahead, Dräger, https://www.draeger.com/en-us_us/Hospital/A-Breath-Ahead
  14. Earn CRCE Credit for CMP Participation, NBRC, January 31, 2022, https://www.nbrc.org/earn-crce-credit-for-cmp-participation/
  15. 20 Jobs Where You Can Make $60,000 Out of College, Yahoo Finance, March 10, 2021, https://finance.yahoo.com/news/20-jobs-where-60-000-230000200.html?fr=sycsrp_catchall
  16. New, expanded healthcare programs coming to Blue Ridge Community College, Yahoo News, January 22, 2022, https://news.yahoo.com/expanded-healthcare-programs-coming-blue-103824782.html?fr=sycsrp_catchall
  17. MGA respiratory therapy program adds neonatal track to curriculum,WMAZ, February 6, 2022, https://www.13wmaz.com/article/news/local/mga-respiratory-therapy-program-expands-adding-a-neonatal-track/93-c191c851-f381-42e1-9d44-91b47ee2dfa0
  18. Why Respiratory Care Research is the Right Job for Me, AARC, https://www.aarc.org/careers/career-advice/professional-development/respiratory-care-research-right-job/
  19. 12 hours shifts, 37 ICU beds, 14,000 steps: How two Iowa respiratory therapists weather the crush of COVID, January 21, 2022, USA Today, https://www.usatoday.com/story/news/health/2022/01/21/covid-19-iowa-respiratory-therapsist-face-omicron-wave-staff-shortages-icu/8985178002/?gnt-cfr=1
  20. Why We Need More RTs – and How to Help, https://www.morerts.com/growing-need/
  21. U.S. Bureau of Labor Statistics, https://www.bls.gov/ooh/healthcare/respiratory-therapists.htm