Should Respiratory Care get its own mid-level provider credential?

Nurses General Nursing

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I know this is primarily a nursing forum, but Respiratory and RRT/RN dual title holders are also very prominent in this forum, but me being an RRT/and current PA student, I have an interest in this particular question:

Every profession in allied health has been trying to do everything humanly possible to try and advanced their professions (Except Radiology it seems), PT now requires a doctorate to practice, PA's will soon follow the NP's whom are also going to require the doctorate to practice at an advance level and for RN's, the entry level degree will now be the BSN. For respiratory the profession will also eventually go BSRT just like Nursing is, and by 2015 the CRT exam will be retired. There also has been talk about the possibility of giving RT its own mid level provider possibly called a CPP or Cardiopulmonary Practicioner or ACPS- Advanced Cardiopulmonary specialist, and also trying to expand the reach of the current and much lesser known cousin to the CRNA in the anesthesiologist assistant, which only has 37 states that use A.A's and only a handful of programs in the country.

What do you think of the prospect of giving RRT's its own mid level provider similar to the NP or PA?

I'd love to hear from anyone but particularly RRT-RN's on here

CRNA's do not practice independently in every states. Most states still require Physician direction. However in 16 states, they do practice independently, and other states could opt out of this requirement of MD supervision. A.A's do not that, they MUST practice under an MD's direction. However,

The AA profession is the newest kid on the block, but more than likely, additional states will allow AA to practice within them.

Is the CRNA the cousin of the A.A sure is? I said cousin not identical twin!

There is some overlap however, there are vast differences of course

1. AAs and CRNAs make the same money when they work in the same hospital in ACT practices.

2. Scope of practice for CRNAs and AAs is different. CRNAs can and do work independently in some states, 16 to date. CRNAs are the oldest nursing speciality in the US. CRNAs can provide the exact same anesthetic services/care that an anesthesiologist does. AAs on the other hand have extremely limited scope of practice. AAs usually are not trained/cannot do any kind of regional techniques.

Personally on this subject, I think it's dangerous for a CRNA to be able to practice independently of MD's because CRNA Does not= Anesthesiologist

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"What would these proposed new titles for RTs mean? What would RTs be able to do that would be different from what they do now?" Good Question:

This is also speculation and proposed idea, but there is a movement upon the NBRC and AARC with the RT profession that started my bridge into PA school and that im ever so thankful for. RT will make a strong push to go BSRT and try to develop Advanced Practice RT's of the future. There are definetly changes coming to the profession for the better within the next 10-15 years.

What will these new titles mean exactly? As such, the respiratory therapist of the future will focus more on patient assessment, care plan development, protocol administration, disease management and rehabilitation, and patient and family education, and most importantly prescribing medications, and not just a task-oriented technical field, focused on procedures and the technical aspects of oxygen and aerosol therapy, mechanical ventilatory support, and related diagnostic and monitoring techniques.

The goal will be the same as every mid-level provider, there's shortages all over the place in healthcare/ medicine, especially with an aging population, many of which suffer from respiratory complications and it's just another method to alleviate them.

Is it going to happen tommorrow? No, it's going to be some time.......before it does happen, but the main question im asking is:

Do you think it would be beneficial to healthcare for the future to bridge physican shortage gaps in general to have Advanced Practice RT's/ Cardiopulmonary PA's and Critical Care Specialists?

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There are also Radiologist Assistants for Rad Techs and Radiation Therapists with B.S degrees to pursue advanced practice

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I think that YES we should! However, it should be Advanced RT not entry level, in my opinion.

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Specializes in Pediatrics, Emergency, Trauma.
"What would these proposed new titles for RTs mean? What would RTs be able to do that would be different from what they do now?" Good Question:

This is also speculation and proposed idea, but there is a movement upon the NBRC and AARC with the RT profession that started my bridge into PA school and that im ever so thankful for. RT will make a strong push to go BSRT and try to develop Advanced Practice RT's of the future. There are definetly changes coming to the profession for the better within the next 10-15 years.

What will these new titles mean exactly? As such, the respiratory therapist of the future will focus more on patient assessment, care plan development, protocol administration, disease management and rehabilitation, and patient and family education,

^Pt assessment, care plan development, protocol administration, etc., go under the umbrella of Nursing/the Registered Nurse.

and most importantly prescribing medications, and not just a task-oriented technical field, focused on procedures and the technical aspects of oxygen and aerosol therapy, mechanical ventilatory support...

^ the role of the RT was to support bedside nursing care related to pts who have complex respiratory courses. The "skilled hours" did not balance with the pt loads and nursing scope (teaching, assessment, care plan, etc). In most states, NPs can prescribe meds.

Do you think it would be beneficial to healthcare for the future to bridge physican shortage gaps in general to have Advanced Practice RT's/ Cardiopulmonary PA's and Critical Care Specialists?

Critical Care Specialists have APN credentialing. If there is a need for Pulmonogists , I think that RT's have a seat at the table perhaps; but IMO, the mid-level practitioner place is already here. The scopes and roles are in place...you said you were in PA school, so you have bridged into that area, quite well. I know a couple of RTs who wanted to expand their scope and went on to he excellent nurses, perfusionists, one a CC APN. It depends on the path you choose.

I'm not sure what else would you want to occur, besides the Bachelors aspect of RT...more aspects to bridge over to advance mid-level practitioner ? To me, it is already in place; should it be more of an opportunity, aka "the norm"??

I can understand that aspect; that can happen, absolutely.

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Specializes in burn ICU, SICU, ER, Trauma Rapid Response.

Personally on this subject, I think it's dangerous for a CRNA to be able to practice independently of MD's because CRNA Does not= Anesthesiologist

*** Wow, you just keep saying one highly controversial thing after another, some of them false. I started off thinking you were a troll just seeking to start fights. Of course you are entitled to your opinion but it happens t be factualy wrong, but that's OK.

Every profession in allied health has been trying to do everything humanly possible to try and advanced their professions (Except Radiology it seems), PT now requires a doctorate to practice,

*** In what way has degree inflation "advanced" those professions? What can the doctoraly prepared PTs do that the master prepared could not do? How much more are doctorat prepared PTs paid vs masters prepared PTs? Please explain how those professions who have required a doctorate have advanced.

PA's will soon follow the NP's whom are also going to require the doctorate to practice at an advance level and for RN's,

*** A falsehood.

the entry level degree will now be the BSN.

*** A falsehood.

What do you think of the prospect of giving RRT's its own mid level provider similar to the NP or PA?

*** I don't see a need.

I do think a time will come when my field of PA's and my mid level counterparts in NP's will have a doctorate level entry degree.

*** PA seems to me like a profession that has truely lost it's way from where it started and why it was created. What would be the point to a doctorate PA program? Why would anyone do a doctorate PA rather than simply go to medical school? PAs don't make very much money to require a doctorate. I mean really, get a doctorate to make $80K a year? Some of the best PAs I have worked with had associates degrees. If I was interested in PA school I would first look to the associates degree programs.

There are COUNTRIES which require a baccalaureate degree in order to practice nursing they are: Canada, Sweden, Portugal, Brazil, Iceland, Korea, Greece, and Philippines.

*** And many of the countries who require a BSN have a 3 year BSN that closely matched the associates degree nursing programs in the USA. IMO we should simply declare most of the associats degree programs as bachelors degree programs.

The AA profession is the newest kid on the block, but more than likely, additional states will allow AA to practice within them.

*** I doubt it. The AANA is pretty powerful.

RT will make a strong push to go BSRT

*** It will be shame if they do. RTs don't make much money now. Greatly increasing the cost of training might be a death knell for RTs. I mean after all why would anyone spend the money and years getting BSRT when they could spend the same time and money getting a qualification that pays much better? I think RTs are paid OK for people who went through a 2 year community college program.

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Specializes in Surgery, Family Practice.
Both of those rumors have been around for years, particularly the RN BSN rumor. Don't see either of those taking place anytime soon.

I live in Dallas, TX and several hospitals have gone to/are going to BSN only for new grad applicants and for experienced RN positions it states BSN preferred.

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Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
I live in Dallas, TX and several hospitals have gone to/are going to BSN only for new grad applicants and for experienced RN positions it states BSN preferred.

*** Lots of hospitals prefer or require BSNs. That however has absolutly nothing to do with state boards of nursing requiring a BSN for a license.

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Thank you for the input!

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To Respond, you clearly have misunderstood and misinterpreted everything I have said. It's ok, it happens, lots of words tossed out there, some get overlooked/ missed.

I am NOT supporting "degree inflation" or saying that BSN's are better than ADN's or that DPT's are better than Masters educated PT's.......... but like you said it's an opinion, and if I mislead you, I apologize, .....but its my opinion that I personally believe that some changes and advancements will happen in the future to both Nursing and Respiratory Care

To respond to another part of your post:

*** In what way has degree inflation "advanced" those professions? What can the doctoraly prepared PTs do that the master prepared could not do? How much more are doctorate prepared PTs paid vs masters prepared PTs? Please explain how those professions who have required a doctorate have advanced."

I said: "seems to be doing everything humanly possible" to "try" keyword is "try" to advanced their professions. And I actually was trying to say that even though professions go on movements to advance, they dont always prove "necessary" or "worth-it". I 100% completely and totally agree with you...... PT's have doctorate level education but has the respect come with it? No! Pay Increase? Hardly?

I also must say I love... I mean really love your term of : DEGREE INFLATION!!!! if there was ever a word that summed it up better about some of these "movements" to try and mandate or require further education.

And your also absolutely right about the profession going BSRT: It's the #1 thing that current RT's ask? Are we getting a pay increase? The answer to that will be a big N-O!

BTW I think Nurses are paid ok for going through a two year community college program as well! At my former facility where I worked before PA School, I started out at 21.50/hr and the ceiling was 32.00 to my knowledge.....Nurses started out at 3-4 dollars more and had a higher ceiling at around 40. So i'd say they're both pretty well paid.....And I was always amazed at how much money those Radiation Therapists made

However for RT's it all depends on your location and facility. I DO NOT know this as a fact but I have heard that anywhere that is located in the Northeast, Pacific Northwest, and Northern Midwest tend to pay better and gain more respect than RT's in the south.

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Specializes in ICU + Infection Prevention.
and also trying to expand the reach of the current and much lesser known cousin to the CRNA in the anesthesiologist assistant, which only has 37 states that use A.A's and only a handful of programs in the country.

Let's be clear: the A.A. system is a Anesthesiology pushed foil to counter the growing independence of CRNAs.

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I wanted to respond to this in its own thread because what you said right here is the #1 reason why I posted here, not to start fights and troll as far as you seem to believe", and I should have just said this from the beginning.

"*** PA seems to me like a profession that has truely lost it's way from where it started and why it was created. What would be the point to a doctorate PA program? Why would anyone do a doctorate PA rather than simply go to medical school? PAs don't make very much money to require a doctorate."

Absoultely agree and thats my biggest concern actually. I do believe that eventually there will be a movement similar to the DNP movement to go get Doctorate of some sort. and it concerns me. I do disagree that even if the doctorate degree was the required degree for PA's, I believe that many PA's would still go to PA School, and i'd assume it's be similar to the DNP where it would likely be somewhere around 36crs beyond the Masters Cert. But People would choose the doctorate PA over medical school because Med School is still Med School and takes a over a decade of committment and sacrifices.

But Yes im greatly concerned that a movement like this will follow considering im already looking at 70k in debt.

Now Why did I make the thread about should RT's have it's own Mid Level? It was mainly based off of this concern. The Path to becoming a PA Student is already a pain in the you know what enough.

Many of you may completely disagree with me on this but I honestly believe its a lot harder to become a PA than an NP. Why? Because There are way more NP Schools and the NP canidates are competing with other RN's whereas PA's are competing with everyone and anyone who has the proper prereqs. RT's can become PA's but that also doesnt mean that its an easy transition, as I had to fulfill those prereqs such as org chem, and multiple Biology, Physics, and Calculus courses.

I wasnt certain that I would get into PA School with my stats of 3.58 gpa (3.63 sciences, and 4 years experience as a Respiratory Therapist, 1 as a lead therapist, and certified in Pulmonary Function.

I was so skeptical i'd get in that I literally thought about applying to an accelerated BSN program and then applying to NP School. I know plenty of RT's who only want to be RN's so they can be CRNA's.

So I thought to myself a few days ago/......how much easier would it have been if RT had its own Mid Level Provider that allowed me to make an easier transition similar to Nurses with the NP. for me to be a Cardiopulmonary PA/ Pulmonologist Assistant? And why shouldn't they? I mean RT's tackle some of the most challenging situations around and have a vast wealth of training with Cardiopulmonary, so why not make it even more vast, and expand it's scope of practice and making it more of a physican extender?

And Lastly, is there a need? You dont think there is? I STRONGLY Disagree. I think there is a strong shortage on the horizion looming for PULMONOLOGISTS among many other physician types and actually could be one of the most heavily affected specialties. A Mid Level Provider could help bridge the gap and who'd be better to bridge that gap then Respiratory Care?

We're all on the same team here, so im apologize if you thought i was a troll, but this is really just a matter of speculation, idea sharing and discussion. Nurses, Resp Care, PA's, MD's, PT's, Rad Tech, Radiation Therapy....no matter who you are or what you do, we are all going to play a role in healthcare in the future. Nurses play a huge role in healthcare, I just think to address these upcoming physician shortages, that Respiratory Care is equipped to handle more responsibility and it should.

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