Registered Respiratory Therapist Job Description

A registered respiratory therapist is the clinician a hospital calls when a patient cannot move air well enough alone. The job covers the whole arc of breathing care: working out why someone is short of breath, choosing the right support, running the machines that deliver it, and deciding when that support can come off. Physicians write the orders, but the RT is the person at the bedside adjusting the ventilator, reading the waveforms and paging the team when the numbers drift.

Critical care

In adult intensive care, the center of the job is the ventilator. An RRT sets the initial mode and pressures after intubation, checks plateau pressure and lung compliance, and titrates oxygen and PEEP as blood gases come back. Weaning demands the most bedside judgment: running spontaneous breathing trials, spotting patient-ventilator dyssynchrony, and judging whether a patient who looks ready on paper will actually tolerate extubation. RTs also manage noninvasive ventilation, heated high-flow nasal cannula and inhaled nitric oxide, and they answer rapid response calls and codes as the airway specialist in the room.

Emergency and floor work

In the emergency department, the work is fast triage of breathing problems: continuous nebulizers for a child in status asthmaticus, BiPAP for a COPD patient retaining carbon dioxide, and airway setup when the physician decides to intubate. On medical and surgical floors, therapists deliver scheduled treatments, draw arterial blood gases, perform airway clearance with chest physiotherapy or oscillating vests, and keep watch for the patient who is quietly getting worse.

Neonatal and pediatric units

Neonatal work is a discipline of its own. NICU therapists attend high-risk deliveries, manage conventional and high-frequency ventilation on premature infants, give surfactant alongside the neonatology team, and step babies down to nasal CPAP as their lungs mature. Tolerances are tight, and a small change in pressure or oxygen can matter a great deal to a fragile infant.

Diagnostics, rehab and home care

Away from acute care, RTs staff pulmonary function labs, where they coach patients through spirometry, lung volume and diffusion testing, and bronchial challenge tests that help physicians diagnose asthma, COPD and interstitial lung disease. Some work in sleep labs running overnight studies. Others lead pulmonary rehabilitation classes that pair supervised exercise with breathing retraining and inhaler coaching. In home care, therapists set up CPAP, BiPAP and home oxygen and teach patients and families to use and clean the equipment.

Across every one of these settings, charting never stops. Each treatment, setting change and patient response goes into the electronic health record, and a precise handoff at shift change is part of the job rather than an afterthought. Good therapists write notes the next shift can act on without a phone call.

The entry route runs through a respiratory therapy program accredited by the Commission on Accreditation for Respiratory Care (CoARC). An associate degree is the usual starting point and typically takes about two years, clinical rotations included. A bachelor's degree in respiratory therapy is a sensible choice for anyone who expects to move into management, teaching or advanced practice later.

The credential path

The National Board for Respiratory Care (NBRC) awards both entry-level credentials. Under the current system, the Therapist Multiple-Choice (TMC) Examination determines eligibility for the Clinical Simulation Examination, and candidates earn the Certified Respiratory Therapist (CRT) or move toward the Registered Respiratory Therapist (RRT) based on their TMC score. The RRT is completed by passing the simulation exam.

That structure is about to change. Beginning in January 2027, the NBRC moves to a single test, the Respiratory Therapy Examination, with two cut scores: the low cut score earns the CRT and the high cut score earns the RRT. The NBRC's detailed content outline splits it into 160 items, a Breadth of Knowledge portion of 100 items and a Depth of Clinical Judgement portion of 60 items. Students graduating in late 2026 should plan their testing dates with that switch in mind.

After passing, graduates apply for a license through their state board. Practice acts differ, so read the rules for the specific state before accepting an offer.

Specialty and support credentials

• Adult Critical Care Specialist (RRT-ACCS), awarded by the NBRC
• Neonatal/Pediatric Specialist (RRT-NPS), awarded by the NBRC
• Sleep Disorders Specialist (RRT-SDS), awarded by the NBRC
• Certified and Registered Pulmonary Function Technologist (CPFT, RPFT), awarded by the NBRC
• Basic Life Support (BLS), Advanced Cardiovascular Life Support (ACLS) and Pediatric Advanced Life Support (PALS), from the American Heart Association
• Neonatal Resuscitation Program (NRP), from the American Academy of Pediatrics

Skills worth building

• Ventilator management across volume control, pressure control, pressure-regulated volume control, airway pressure release ventilation and high-frequency oscillation
• Arterial blood gas sampling and interpretation, including mixed acid-base disorders
• Airway skills: bag-mask ventilation, suctioning, tracheostomy care and intubation assistance
• Pulmonary function technique and quality control on spirometry and diffusion testing
• Patient teaching for inhalers, CPAP and home oxygen, pitched at the patient's literacy level
• Clear, defensible charting

Experience

As a general guide, staff RRT roles on general floors are open to new graduates. Plan on roughly 1 to 3 years of acute-care work before targeting adult ICU, NICU, transport or ECMO teams, and use that time to sit for a specialty exam. Leadership roles such as lead therapist or department manager typically follow several more years on the floor, often alongside a bachelor's or master's degree.

The Bureau of Labor Statistics projects employment of respiratory therapists to grow 9 percent from 2025 to 2035, which it classifies as much faster than the average for all occupations. In its figures, that is an employment change of 12,100 on a base of about 142,000 jobs in 2025, with about 8,600 openings projected each year on average over the decade. Many of those openings, BLS says, will come from replacing workers who move to other occupations or leave the labor force, such as to retire.

What drives demand

BLS ties the growth to an aging population. It expects growth in the older adult population to raise the prevalence of pneumonia, chronic obstructive pulmonary disease (COPD) and other disorders that restrict lung function, and with it demand for respiratory therapy services, mostly in hospitals. It adds that a growing emphasis on reducing hospital readmissions and providing care in outpatient facilities may result in more demand for respiratory therapists in health clinics and doctors' offices.

The work schedule follows the hospital. BLS notes that most respiratory therapists work full time, and because many work in facilities that never close, shifts may include nights, weekends or holidays. Anyone weighing the field should plan around that schedule from the start.

The push for an advanced practice tier

One structural question for the profession is whether an advanced practice level takes hold. The American Association for Respiratory Care (AARC) describes the advanced practice respiratory therapist (APRT) as trained to provide a scope of practice exceeding that of the RRT. The path it lays out starts with a Bachelor of Science in respiratory therapy and the NBRC RRT credential, followed by a CoARC-accredited graduate-level education and training program.

Licensure is the open issue. The AARC's Strategic Direction 2026–2028 commits the association to support state legislative adoption of APRT licensure and program expansion. The same plan lists compact licensure and "RRT to entry" among the policies it intends to advance, and it pledges to partner with federal agencies to monitor and address RT workforce shortages. Those are association goals, not enacted law, so an RRT considering graduate school should check the rules in the specific state before counting on an APRT scope of practice.

Where careers branch

For a working therapist, the realistic growth paths are clinical depth, teaching and management, and advanced practice where the law allows it. Clinical depth means specialty credentials and a move into adult critical care, neonatal and pediatric intensive care, sleep medicine or pulmonary diagnostics. Teaching means clinical instructor or program faculty roles. Management means lead therapist, supervisor and department director positions, where the job shifts toward staffing, equipment budgets and protocol committees. Each path rewards the same foundation: sound ventilator judgment, careful charting and the ability to teach patients and colleagues.

Dear Director of Respiratory Care,

I am writing to apply for the Registered Respiratory Therapist opening in your adult critical care department at [Hospital]. I earned my RRT through the NBRC this spring, hold an active license in [State], and completed my associate degree in respiratory therapy at [College] with clinical rotations across two health systems.

The rotation that shaped me most was eight weeks in a mixed medical and surgical ICU at [Clinical Site]. Working beside a preceptor, I carried a ventilator caseload, ran spontaneous breathing trials each morning, and learned to read pressure and flow waveforms well enough to catch auto-PEEP before the alarms did. One night I helped manage a patient with severe ARDS through a prone positioning session, which taught me how much of critical care comes down to communication among the nurse, the intensivist and the therapist.

My rotations also included emergency department and general floor shifts, which gave me steady practice with arterial blood gas draws, BiPAP setups for patients in hypercapnic failure, and inhaler teaching for families going home with a new asthma diagnosis. I learned to explain a spacer to a worried parent in plain language and to confirm understanding with a teach-back.

Your department stands out to me because of its structured orientation for new graduates and its path toward adult critical care specialty training. I plan to sit for the RRT-ACCS exam as soon as I am eligible, and I would like to grow into a role on your rapid response team.

I can work rotating twelve-hour shifts, including nights, weekends and holidays, and I am ready to start after a standard notice period. Thank you for considering my application. I would welcome the chance to talk with you and your clinical leads.

Sincerely,

[Your Name], RRT