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

[incrediblehulk2016]

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

[roser13, ASN, RN]

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.

There's a world of difference between a facility or regional preference for BSN, and a global statement that BSN is REQUIRED. OP made a number of assertions that are incorrect.

[incrediblehulk2016]

There's a world of difference between a facility or regional preference for BSN, and a global statement that BSN is REQUIRED. OP made a number of assertions that are incorrect.

I did not intend to make assertions that something is true but more the less predictions of what I believe my opinion is of what may happen.......I apologize for that.

I do believe that a BSN will someday become the norm in Nursing.

[LadyFree28, BSN, LPN, RN]

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.

BSN has prereq's, including Stats to prepare you for research and evidenced based courses in the BSN program. Our requirements provide the "Art" in the Art and Science that describes our profession. Most bachelor prepared programs regardless of profession want to prepare a base of inquisitive thinking, oration, diction, and logic-based perspectives. There are nurses who end up going the PA school route...I personally think that stating that "it is difficult to get in" applies to nursing schools, as well as graduate schools in general. Your perspective is different in terms if not going through the process of nursing school, so yes, most are inclined to disagree because you have never went into a nursing theory path. You have no idea of "nursing thought" and the many people who are successful, and are not successful can attest how difficult nursing education is.

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.

The Pulmonologist aspect can be a great horizon that can be fulfilled at the Practitioner level already in place, such as an NP. Again, I stated Respiratory care was born out of the fact that bedside nursing hours related to nursing care for units was not adding up to the load that nurses had to manage. I worked at several facilities where if there is no RT, there is a respiratory nurse, because, in theory and history, respiratory care was (and still is) a portion of nursing care.

That's my two cents on those points.

[incrediblehulk2016]

No I do understand, I've known people who have done it, and worked with many who fell at the feet of Nursing Theory is incredibly hard, in fact, the Nursing Model was the reason why I stayed clear of Nursing, people definetly know this.

A lot of people dont get that when youre a nurse, you're not just simply treating the patient and getting the heck out of there, you're responsible for every single thing with that patient as a nurse from psychosocially to physically as well as being responsible for everyone else's jobs as well....RN's need to know how to question other people's jobs....plus RN's can be called upon to do the PT, OT, RT, and even support/ Counseling. Those ADN and BSN programs are a physical and mental grind....you will be pushed to your limit for sure.

I know some people who aspire to want to go to med school, and think....hmm maybe I should go to Nursing School instead so it would look great on my Application....like its gonna be a peice of cake or something....HA .....ive seen those students at clinicals...I feel for them.

This is another topic for another thread, but I always preferred the medical model myself.

It's difficult to get into an NP as well as a PA program, but personally I feel PA school is tougher to get into because there are fewer PA Schools and just way more canidates from many different backgrounds including Nursing as well. Plus many of these programs also reserve 50 to 75% of spots for freshman as well. PA School is just a tighter window, but there is NO DOUBT NP is HARD

[incrediblehulk2016]

Well this was a great discussion from two diffferent viewpoints...

Thank you all for you're responses !!! Keep on posting if you have something to add

[PMFB-RN, RN]

CRNA's do not practice independently in every states. Most states still require Physician direction. Anesthesiologist

*** Only partly true. No state requires CRNAs to be supervised by an anesthesiologist. Since the suregon in the room literaly has absolutly no idea what the anesthesia provider is doing up at the head of the bed they in effect practice independentaly. Sure the may be a physician in the room but they are in no position to supervise a CRNA.

[PMFB-RN, RN]

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.

*** Maybe you are right. However as PA starts to rival MD school in lenghth, expence and sacrafice required but WITHOUT the financial and social standing rewards afforded MDs at the end fewer people will make that choice. I also think that the best and brightest will steer away from PA to a field where the compensation more closely matches the investment. At one time I wanted to go the PA route too. That is until I saw how PAs get treated by their physicians supervisors in the hospital and realized there was little if any differences between PA vs RN pay. I started another thread here on AN about this. Here is my post that makes my point:

"I am not an NP. I am a full time rapid response nurse at a teaching hospital. This morning I stopped in to residents office to update the night residents on what had happened with their patients and what I had done. They were in the middel of sign out to the day team including several interns, residents, the chief resident and the attending. After I was done an intern speaks up and says "PMFB you should become a PA!". This was met with a rousing round of "NOooos" & "no way!" from the residents and attending. The intern looked confused. The chief resident leans over to her and says "PAs are at the bottom of the medical word. PMFB should become and NP, they are at the top of the nursing world".

The attending and other residents all readily agreed. I thought it was an interesting insight into physician thoughts about mid levels. "

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.

*** As one who had investigated PA school I agree.

I know plenty of RT's who only want to be RN's so they can be CRNA's.

*** Same for a lot of RNs.

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?

*** First I am always very skeptical of predicted shortages. If you will remeber there was, and is, a lot of false "nurseing shortage" propaganda. I will believe in a pulmonologist shortage when I see it. Second I thin that if such a gap occures NPs and PAs are already perfectly suited to fill that roll.

[PMFB-RN, RN]

.but its my opinion that I personally believe that some changes and advancements will happen in the future to both Nursing and Respiratory Care

*** Requiring a higher degree / more investment for the same job is NOT "advancement" If it is your opion that there will be advancements in nursing and RTs please elobrate on what the advancement will be. Simply requiring a higher degree isn't advancement.

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."

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

*** At my hospital RNs start around $65K a year and have the potential to make well over $100K/year withing 5-10 years. RTs start around $45K and have the potential to make $65K after 10-20 years experience. I don't even know what a radiation therapist is. We radiation techs that only make around $20 an hour after years of experience. My hospital also views RT as not being required. The ICU nurses are fully capable of running their own vents, weaning and drawing ABGs and the floor nurses can do treatments and put people on their c-pap.

In fact when there have been times when there was no RT available for a shift (usually have 3 on nights) they float an ICU nurse to cover RT. I don't often have my own ICU patients anymore but when I do I run my own vents and the RT does the once a shift vent checks and serves as a vent consultant in the unlikely event I need one. Other than that they leave my patients alone.

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.

*** Pretty much true for all non physicians in health care.

[SycamoreGuy]

Just what the public needs, another credential in the alphabet soup of health care providers. Heck, even dental hygienist are trying to get there own mid-level (I hate that term). NPs make sense, PAs make sense (although I think it would make more sense to significantly shorten MD/DO residencies for non specialists) advanced practice RTs and dental hygienists don't make sense. But who knows maybe I will live long enough to see the day when we have advanced practice physical therapy assistants that have the same degree as the original PTs.

[ktliz]

It's funny to me that while professions such as nursing are pushing for academic inflation, the medical profession is experimenting with SHORTENING its academic training, from 4 years to 3.

[RNperdiem, RN]

Sometimes I wonder if the academic inflation and student loans(the two are co-dependent) is like the housing bubble a few years ago. Everyone thought housing was an investment that couldn't go wrong.

[SycamoreGuy]

There is a push in some states to offer $10,000 bachelor degrees (non nursing degrees) Some of the suggestion to make these degrees feasible include shortening it to 6 semesters and doing the first 2-4 semesters at a community college.