Respiratory therapist Vs Nurses

Faeriewand, ASN, RN · Mar 29, 2009

jstbreathe what an awesome post! :) I really like the RT's job becuase they have so much autonomy and seem to really like their jobs. They have exciting jobs in the ER to do also. My friend was an RT and was always called in when a new baby needed his help after delivery. Well maybe this is a grass is always greener post but really I have no clue how to do the RT job. And today I was thanking the heavens for our RT! :heartbeat So many of our patients needed her! :)

cardiacRN2006, ADN, RN · Mar 29, 2009

Typical night at work: Shift change, called STAT to ED to resp distress coming in. Setup bipap on CHF pt. Leave go the floor to do resp tx, get called stat again to ICU to get ABG on vent pt. Run by ED to check on Bipap. Go back to floor to attempt to give Bronchodilator to asthma pt, get called stat to sx a pt on another floor. Trauma activation in ED, stab wound to chest, intubate, then to ct, then transport to ICU or surgery. Attempt to go give that bronchodilator (b/c RN keeps calling me) NOPE pager goes off. Need you stat in NICU! drop everything and run. Get that done, how about a bathroom break. Pager: cardiac arrest coming in ED. Code that pt. setup vent. get abg, go to ct, then transport to ICU. Rapid Response Team called. pt needs lasix, not resp. Eat granola bar. Go to give that bronchodilator to the asthmatic that the Rn keeps calling about. BBS Clear. Pts states tx helps her sleep better! What??? Its not ambien! gonna sit down, take a break. Eight hours left to go. Cath lab is calling me stat.....
I guess what I am trying to say is....Yes an RN can give resp txs. Yes an RN can make vent changes. But do you really know what it will effect?

Seriously....and I really mean this. I couldn't even possibly post on this website what a 'typical' day/night as a RN is like....

I have to be accountable for: Drs, other nurses, RTs, lab, pharmacy, dietary, speech therapy, radiology, the unit clerk, my own patients, all the other patients, nursing students, lab, pharmacy again...

Then I can concentrate on my own patients. Visitors, vital signs, residents, meds, charting, phone calls, house supervisor, admits, rapid response calls, donor network, meds missing from pharmacy, the unit clerk missing orders, the missing pct that we never have, the Q1hr blood sugars on my typical ICU pt,the vent settings on my pts, (that I do on my own and then notify RT),the constant calling and reminding of the physician to do the right thing, the constant calling and reminding of the physician to do the right thing, etc, etc...

Maybe in some way I might, just MIGHT be able to pee. If by 5pm, I need to do staffing and maybe, just maybe might get to eat.

Please.

jstbreathe · Mar 30, 2009

CardiacRN, I chose a different field than you, sorry?!

I was just answering the OP. I personally think I have a GREAT job! Sorry if you don't agree.

PLEASE!!!!

cardiacRN2006, ADN, RN · Apr 9, 2009

jstbreathe that post was classic...well done. I am a burnt out paramedic thinking of a career change into nursing...the more i look into it the more I think I might head down the RT path...it funny people really do hate you because you love your job.

That's a funny post.

If you or anybody else thinks I hate people because they love their job, then you're naive at best. To make that jump is a stretch.

I would prefer it if everyone loved their job, actually. Makes everyone's life easier. And, stop the presses, I love our RTs. I think we have the best in town.

But hey, whatever you have to tell yourself I guess.

Lol.

Firenurse81 · Apr 9, 2009

jstbreathe that post was classic...well done. I am a burnt out paramedic thinking of a career change into nursing...the more i look into it the more I think I might head down the RT path...it funny people really do hate you because you love your job.

imastudentnurse · Apr 13, 2009

so let's talk education? nursing school is more difficult than rt school right? from my own research and what i've read, it seems that rt program would be much easier. a program in my area offers an associate’s degree in just over a year, where in nursing i had to take many difficult preq.'s that were full term classes and not just brush over type classes before even applying for the rn program. for example a&p i and ii w/labs (8 hours) for my nursing vs. rt's program a&p version is heart and lungs, not near as in depth. same with microbiology. same with pharmacology, look at the nursing pharm. vs. rt pharm. maybe that explains the ceiling of pay rate also. i think the rn's education is more in depth and nursing school is a lot harder than rt school as it cover soooo much . just my opinion. what do you think?

marilynmom, LPN, NP · Apr 13, 2009

i don't think nursing school would be harder than rt.....i thought nursing school was pretty easy. the rt program here in my area requires the same pre reqs just about as the nursing program. nursing school may cover a lot more, but rt school is more in depth with what they cover.

nursing and rt jobs do have many similarities, we both suction patients, help with intubations, breathing treatments, chest pt, vents, abgs, airway assessment. it just depends on what you want to do. both are great fields! especially when i was a new nurse (well i still am) i depended on the rt a lot and was always asking questions (vent settings and problems, breath sounds, etc).

anyways, all the rt's i know like their jobs! just kinda depends on what interests you more. if i had to do nursing all over again, knowing what i know now, i wouldn't do it.

so let's talk education? nursing school is more difficult than rt school right? from my own research and what i've read, it seems that rt program would be much easier. a program in my area offers an associate's degree in just over a year, where in nursing i had to take many difficult preq.'s that were full term classes and not just brush over type classes before even applying for the rn program. for example a&p i and ii w/labs (8 hours) for my nursing vs. rt's program a&p version is heart and lungs, not near as in depth. same with microbiology. same with pharmacology, look at the nursing pharm. vs. rt pharm. maybe that explains the ceiling of pay rate also. i think the rn's education is more in depth and nursing school is a lot harder than rt school as it cover soooo much . just my opinion. what do you think?

BreatheFree · Apr 15, 2009

Wow is this a timely post. I am a pre-nursing student 2 semesters from applying for a BSN program. I have a fear of not getting into the program the first time since all of the schools around here are highly competitive. Since I am almost 30 and a mom of 4, I don't feel like I have time to re-apply over and over for a nursing program. So I have been thinking of applying for the RT program as well. I think I have a good shot of getting into the nursing program but I feel like I need a back-up plan. I have an old friend who is a RT so I emailed her today to talk to her about the program. The RT program requires students to shadow a RT before applying so I will do that as well. One of the (many) reasons I am drawn to nursing is because of the opportunities to advancement and all the different areas that are available. I guess I will apply to both and see what happens.

BTW, the RT program here has almost the exact same pre-reqs as the nursing programs.

may30 · Apr 22, 2009

Please does anyone know anything about the Upstate Medical UNiversity Respiratory Therapy school? Any information about tuition reimbursement in hospitals in NYS?

Thanks and thank in advance!

Iovian · Apr 29, 2009

I've wanted to write my take on RN vs. RT for a while now, but decided it wouldn't be a good idea to post a new thread on something repeated as much as this. First I'll describe school.

I didn't attend your regular 2 year program for Respiratory Therapy. I attended the U.S. Army's RT program. 2 years condensed to about 11 months, Monday through Friday, 7am-5pm. I was attending school at the same time as one of my friends was attending the Army's nursing program (LVN). His program was a little longer than mine, and on top of the length, we both had to be a Combat Medic (EMT-B) first. During the 1st phase of our programs, I cannot count the times I had to study with my LVN buddy, and help him understand A&P, Pharm, and some specialty education on Cardio-Pulmonary path/phys. Now it may look like I am "downing" him with this post, but let me assure you I learned a little from him as well! (IV flow rates, more pharm) Both of us coming from being (active) combat medics, we were more than proficient in IV insertion, Foleys, injections, CPR, wound care, and other medical knowledge. But I have to say that I felt like I read everything he had to (to help him understand, and for my own knowledge) plus my work. He did get to glance at my books, and was pretty intimidated when he saw how in depth our A&P was. We had to know general and cardio-pulmonary A&P, which was very very focused. (BTW, guess who tutored some PA students in Cardio-Pulmonary Diseases and Pathophysiology? So, we both get through Phase 1, and it just so happens my phase 2 (clinical) is in the same place as his. He had the obvious rotations (ICU, Floor, Rehab, LTC, ED, CCL, Pedi/NICU). My rotations were: Floor, ICU, PFT lab, NICU, ICU again, Burn Unit. Needles to say, we both graduated from our respective programs.

Now, both of us were in the Army Reserves, so we were able to get jobs as a civilian as soon as we left training. He worked as a medsurg LVN/LPN for a year, and was able to finish school online for his RN. Now he works Nuero ICU. Now this being said, I honestly believe ANYONE can physically be taught to do my job, but to understand it is a different story. I've proved this time and time again with MD/DOs, PA/NPs, RN/LVNs.

I picked up a job at a local Hospital, and was thrown into ICU/ER pretty fast, being that the RT Director was a prior Army RT, and held the program in high regards. Within that year, I became proficient in ECMO, IABP, Swan, NO2, Worked under MDAs or CRNA/AAs during surgery manipulating gas/vent settings in response to orders/status of pt. Became one of the 4 RTs that had intubation privileges during my shift with a 0% failed intubation rate. At my hospital, the ventilator was RTs SOLE responsibility. That being said, if a pt was desating, the nurses knew when I was there (but not there in person) all they had to do was page me with information, and do what they had to do to keep pt out of distress or within proper saturation range. I never had a problem with RNs changing "certain" settings on vents, but would be a little put out if they messed with setting such as: rate, pressure, volumes, flow, PS or PEEP. It wasn't that I didn't believe the RNs didn't have the knowledge, but I do have a license, and having one indicates it can be taken away if someone under my care decides to sue and I don't have proper information (this is what RNs and RTs call the need to Cover Your A$$). But, I cannot count the times I have walked into a pts room with a high ICP and my PEEP has been changed to 10 from 5, and Volume increased to 750 from 500 due to Gases that the RN drew, read, and decided to change setting because they believed themselves able. (BTW, peak pressure on that specific case was increased from a peak of 32 to 61 because of those changes. There is also the time I had my favorite end stage COPD regular. I had just left him after giving him his scheduled treatment (room air). He was on a BiPap with O2 set at 30% and a saturation of 86% (which is fine for him, he mostly lived in the mid to high 80s on 2L nasal cannula at home). I come back 1 hour later because the nurse calls me and wants me to assess the pt before she decides to call a rapid response on him. When I walk into the room, I notice he is very chalky in color, head down to chest, and non responsive except to pain. HR normal, RR 5 per minute (machine was set at 5), and SPO2 99%. I take a look at my Bipap and notice the O2 increased to 80%, and removed the Bipap, and started to assist pt with ventilation via ambu and air. Pt starts to wake up, and I place him back on BiPap at Room Air. His SPO2 marks 87%, and the RN asks what I am going to increase O2 to!! Needless to say, I wrote him up. Now, do I expect all RNs to know and understand how quick the drive to breathe can be depressed on a COPD pt? No. But if they have been an RN for as long as he (5 years), and didn't know, I see a problem. On top of this, if he would have just followed hospital protocol, he would have called me, and I would have explained to him why it is ok for his saturation to be where it was.

Now as far as work load, I do agree that nursing can be far more gruesome at time, but there are other times I have to manage vents in an ICU, and have 2 floors to cover as well. Mind you, some states do not allow concurrent therapy, and I have 22 treatments due in a 2 hour period. Normal treatment takes 7-10 min if the said hospital carries concentrated Albuterol or Xopenex. Lets Hope Pulmicort doesn't have to be given, since it cannot be mixed in with regular breathing tx. You do the math!

Shared responsibilities at my hospital are: suction, trach care, ABG if pt has A-line, and the occasional breathing treatment if I am not available. Mind you, it is possible for an end stage copd'er to go through the above with something as simple as receiving a neb treatment through O2.

Now, while practicing RT in the Army (when activated) I did ALL Foleys for my ICU, helped with IVs (mostly called to insert if RN needed help since it was known I was a combat medic before RT), inserted A lines (both Army and Civilian Hospital), and intubated with intubation protocol. Do I believe all RTs to be as proficient as myself? No. But I do believe every RT has the educational background to be.

Salary and glass ceiling:

Hourly wage: $41 per hour, differential for nights and weekends same as nursing. On top, we have special differential for "respiratory season". Last year it lasted from November to May. You get half of your hourly wage added during this season, plus any overtime and differential. For example, I make $41 an hour and work nights and mostly weekends. This ups my wage to $47 an hour, with overtime it goes up to $67.50 an hour. Add in respiratory season and I am making about $88 per hour! There are PA/NPs that don't make this. Actually, there are CRNAs that that don't make this. Why does my hospital pay so much, because they have realized how much more money they save utilizing RTs and other allied health to do extra jobs during their shift (such as ekgs, pfts, some nurse assisting if needed, transport). We don't have a transport team, we don't have CNAs (Nurses have a max of 4 pts on the floor and 2 pts in ICU if vented, 3 if none are vented), no perfusionist, and no ER tech. Nurses make about $35 per hour if staff, and I have seen some contract/travel nurses to make as much as $48 an hour.

Now as far as that glass ceiling, I happen to know a member of the ADCOM for a local PA program. I talked to him about RTs not being able to climb vertically, and he explained to me, really, neither can RNs. Yes, they can go into Admin/management, but so can RTs. In fact I know of more than 10 occasions an RT is in the ranks as top admin at a hospital. I know of 2 RT CEOs and countless RTs that went into sales and education for equipment companies as reps that make over 80k a year. You may bring up RNs opportunity to go into NP or CRNA School, but you need to remember that they have to be accepted into these programs and they are very competitive! If that is the case, it is the same as a RT going into PA school. In fact, said member of ADCOM, stated, I would take a RT based on statistics of RTs passing PA school over ANY allied health or nursing applicant. That being said, you may think, "well as a RN, I don't want to go to PA school." You would be surprised to how many DO, and don't get in to either PA or NP school. BTW, my old RT director at a previous hospital is now a PA, and has independent surgical privileges under general anesthesia and with written consent from the surgical group he is a part of. But let's not get into PA vs. NP, which is another atom bomb!! (My mom is a NP and poster here at this forum so I know and see the flame wars!! Love Ya Mom!

All this being said, I believe RT and RN to be on the same level as far as hierarchy is concerned. I believe RNs to be more of a generalist and RTs to be more focused and specialized than nurses. Can a ICU run without RNs? NO!! Can one run without RTs, sure, but the nurses at mine would quit the minute we were kicked out, rest assured!

PS, I do know of 1 hospital that tried to remove RTs in San Antonio, Tx. It lasted 3 months. Nursing decreased 33% during said 3 months, and demanded RT to return. That hospital is not the 3rd highest paying hospital, right behind Select Specialty and Texas Heart in San Antonio!

swirlything · May 7, 2009

One of my nursing instructors said the choice, for her, between RT and RN is this: do you mind phlegm???

She said she cannot tolerate phlegm. Blood, urine, vomit, feces, puss... no problem! But she HATES phlegm! So she's an RN.

If you don't mind phlegm, but cannot stand the other stuff, be an RT.

Another thing to consider is do you think you would enjoy being that specialized? Would you get bored doing respiratory treatments and tinkering with vents all day long?

LOLCA · May 4, 2010

Hi,

Loved your post! I'm debating RT vs RN. Partially because of the difficulty getting into nursing school, but also when I read your post I was really excited! I love the fact that you have the opportunity to run to so many different departments. Here's my dilemma... I'm 43 years old now. I want to make a difference but let's be honest, I have about 20 years to do so. I don't care about moving up. I just want variety - I love and thrive on change. What's the recommendation for the 2nd career professional... RT or RN??