RT vs. RN? Is RT a useless profession?

suga_junkie, BSN, RN · May 28, 2015

I live in Australia, we do not have RTs. Nurses do all the respiratory stuff including manage patients on ventilators. As far as I know, RTs only exist in North America.

RT LACEY · May 28, 2015

You know I've heard that before. That RTs are mainly just in the states. Has Australia ever had RTs or ever tried to introduce them as far as you know?

calivianya, BSN, RN · May 28, 2015

I like my RTs; they are awesome.

How necessary they are depends on unit culture, IMO. My first ICU job, we might only have 1 RT for all of the ICU beds if they were short. They were managing 50 critically ill patients so they barely had time to do anything. Nurses gave most of the breathing treatments, etc., and it was a routine part of our orientation to learn in detail all of the ventilator modes, what they did, what idea volumes/pressures would be, etc. We didn't make vent changes independently but we had a very good idea of what was going on with the vents and what settings would probably improve oxygenation for the patient. We stuck our own ABGs sometimes when RTs were too busy to get everyone, which was often.

I feel like I've lost a lot of that knowledge at my current job because the RTs only have a max of 10 ICU patients each and do everything. The nurses I work with now have no idea how to do anything but silence and hit the 100% O2 button. It's kind of sad.

TiffyRN, BSN, PhD · May 28, 2015

First of all, not s useless profession. Everyone has value in the healthcare team. In my current environment, I utilize the RTs mainly as equipment techs. They are the ones in charge of bringing, setting up, and managing respiratory equipment. That and running ABGs (which I draw).

Now if one were choosing a profession to pursue, I would add that in my experience, RT's job security is much more tenuous than an RNs. In my 20+ years of experience in a variety of hospitals, I've only ever seen nursing job reductions done by attrition. RTs however, are off and on flat out laid off. They are also subject to having their job responsibilities redefined and after that, they are responsible for many more patients which translates to fewer of them scheduled per shift.

RNs have a much better potential for advancement, and better job security, in my experience.

suga_junkie, BSN, RN · May 28, 2015

You know I've heard that before. That RTs are mainly just in the states. Has Australia ever had RTs or ever tried to introduce them as far as you know?

Not that I know of. We have respiratory physiotherapists though. They get patients up and moving, do deep breathing/coughing exercises, peak flow measurements, chest physio, incentive spirometery etc etc. They don't do any medications though, definitely don't touch vents, do ABGs, suction patients or administer 02 without the consulting the RN etc. They are physiotherapists specializing in the respiratory system. Nurses do all of the respiratory tasks as resp physios only see a select few patients and only once a day at the most.

Immanuel68 · Aug 5, 2015

It seems that a lot of RT's have this hobby of fault finding, when it comes to charting and doing write ups. I speak from experience, I'm a Respiratory Therapist that's in Nursing School.

BreatheDeep · Aug 11, 2015

I would say a good bit of that comes from either insecurity, or annoyance.

Where I work far too many of the RCP's have some weird insecurity against nurses, and thus lash out when the opportunity presents itself.

As well, many RCP's are used to getting dumped on or dismissed by nurses (I've encountered far too many "Oh wow, you went to school as long as me???" type reactions) and it gets pretty grating. So once again, your jaded RCP will lash out when they see weakness somewhere.

But most of us RCP's who love our jobs also hate these kind of folks and attitudes, so please, don't judge us all by the sins of our coworkers =)

DatMurse · Aug 11, 2015

I would say a good bit of that comes from either insecurity, or annoyance.
Where I work far too many of the RCP's have some weird insecurity against nurses, and thus lash out when the opportunity presents itself.
As well, many RCP's are used to getting dumped on or dismissed by nurses (I've encountered far too many "Oh wow, you went to school as long as me???" type reactions) and it gets pretty grating. So once again, your jaded RCP will lash out when they see weakness somewhere.
But most of us RCP's who love our jobs also hate these kind of folks and attitudes, so please, don't judge us all by the sins of our coworkers =)

I guess if the most of RT's work can fall in the nurse's scope of practice it is kind of crazy. Dont get me wrong, the airway scares me. But technically couldnt they train a nurse to do RT's job?

BreatheDeep · Aug 16, 2015

Technically yes they could, anyone can adjust a ventilator.

But here's the real difference:

I had to take physics as a prerequisite before I became an RT. My ventilator class was 8 months long. My cardiopulmonary specific physiology classes were all 6 months long, that's in addition to traditional anatomy/physiology/pathophysiology.

Why does this matter? Because this extra education is required to understand not just the ventilator, but the physiology of ventilation.

I didn't just learn ventilator modes what they do and what disease to use them on, but how the physics of ventilation, coupled with physiologic and anatomic changes effect both ventilation/oxygenation and how we ventilate/oxygenate not the disease, but the physiologic/anatomic state that is presented via the disease process in question.

This isn't something nurses learn in school, and it's not something you can inservice or teach over a couple day course.

A simple example is Mean Airway Pressure and oxygenation. The variables that can be adjusted to increase your MAP via the MAP equation. Do you adjust PEEP? I-Time? PIP? Flow rate? Maybe one, or the other, or all of them, just depending on the lung anatomy and disease pathology.

Or anatomical deadpace and mechanical ventilation. How to use the Bohr equation to adequately ventilate high deadspace patients.

And on and on and on.

Short answer is, can you train a nurse to do an RT's job? Yes. And 90% of the time they could do it. It's the 10% that they can't where patients die. Because while you can train an RN to do an RT's job, you can't train an RN to think like an RT. Because it's not training that makes the RT, it's the specialized knowledge through our formal education that differentiates us. And that's not something that can be trained.

I.e., we're highly educated, albeit narrowly, specialists. And that's just where we want to be =)

seanpdent, ADN, BSN, MSN, APRN, NP · May 6, 2016

Sigh.... We actually have Nurses who question and undervalue other members of our medical team? Especially a Respiratory Therapist, a trained specialist in pulmonary medicine and respiratory therapeutics? A professional who augments the very care we provide to our patients?

As Nurses we are held to a higher professional standard. I'm trying to maintain some order and respect here, but how does a Nurse come to the frame of mind that RT's are not needed? What planet do you practice Nursing? And what Galaxy .....

..sigh..

Sorry. I can't seem to maintain my composure to answer this question respectfully.

I'm going to stop now.

Thankfully I posted a vlog post recently that supports our amazing RT colleagues. For anyone that is interested in viewing and sharing the vlog, let me know.

jifferte, BSN, MSN, RN · May 6, 2016

Imagine intubating your almost dead ICU patient, having to bag them AND set up the vent.
See the value????

***This This This x 10000! As clinicians they are invaluable! I have learned so much from the great RTs I've had the pleasure of working with.

Asher804RRT-ACCS · May 8, 2016

Just because you CAN do it doesn't mean that it's safe. As an RT I have 4+ years of Cardiopulmonary Specific learning, I specialize in respiratory meds, the best way to deliver them, intubation, ABGs insertion of A-Lines, Nitric Oxide, heliox, O2, NIPPV, ventilators, PFT's, oscilators, Trachs etc etc. where you may have an extremely basic knowledge of these things, I have an extensive knowledge. If you are a BSRT, as I am-then you spend more classroom hours on this than doctors do in medical school. RT became what it is today because an RN couldn't handle it all, you couldn't then and you couldn't now. Or would you like to take over Xray and Lab, dietary, housekeeping etc etc? Because those too were born because a Nurse couldn't handle it all.