Respiratory Therapist Job Description

A respiratory therapist is the clinician a hospital calls when breathing is the problem. The patient might be a newborn in the neonatal intensive care unit, a teenager in the emergency department with an asthma attack that will not break, a post-surgical patient on a ventilator, or an older adult with chronic obstructive pulmonary disease (COPD) who keeps coming back through the doors. The therapist assesses the patient, works out a plan with the physician, delivers the treatment and watches what happens next.

The core work

Bureau of Labor Statistics duties for the occupation read like a shift outline: interview and examine patients with breathing or cardiopulmonary disorders, consult with physicians on treatment plans, perform diagnostic tests, treat patients, monitor and record progress, and teach patients how to take medications and use equipment. In practice that means a handful of recurring tasks:

• Ventilator and airway management. Connecting patients who cannot breathe on their own to a ventilator, setting it up, checking that the patient gets the right oxygen at the right rate, and later judging when the patient is ready to come off it.
• Diagnostics. Drawing arterial blood and running it on a blood gas analyzer, and administering pulmonary function tests in which the patient breathes into an instrument that measures volume and flow.
• Treatment. Nebulized and inhaled medications, oxygen titration, and chest physiotherapy to loosen mucus so the patient can cough it out.
• Teaching. Inhaler technique, home oxygen safety, CPAP habits and smoking cessation.

Where the job happens

Inside a hospital the work spreads across the emergency room, critical care units and neonatal intensive care units, plus the general floors where therapists run scheduled treatments. Outside the hospital, home care therapists teach patients and families to use ventilators and other life-support systems, inspect and clean equipment, check homes for environmental hazards, and make emergency visits when needed. Some facilities also use respiratory therapists to help diagnose sleep apnea and to counsel people who want to quit smoking. The American Association for Respiratory Care (AARC) points out that therapists also turn up in research labs, in department management and in teaching, and in helicopters or Learjets transporting critically ill patients.

The physical side

This is a job done on your feet. BLS notes that therapists may stand for long periods and may need to lift or turn patients, which brings a risk of strains and sprains, and that they may be exposed to patients with infectious diseases. Personal protective equipment, safe-lifting habits and a working relationship with nursing staff matter on every shift.

Who they work with

Therapists work closely with registered nurses, physicians and surgeons, and medical assistants. In a critical care unit the therapist brings the ventilator picture to rounds: what the blood gas shows, whether the patient tolerated a spontaneous breathing trial, and what to change overnight. On the floor, the same therapist may be the person who notices that a patient is tiring before anyone else does. That mix of hands-on skill and clinical judgment is the heart of the job.

Education

The usual entry point is an associate degree in respiratory therapy from an accredited program, and BLS notes that some employers prefer candidates with a bachelor's degree. Programs combine anatomy and physiology, cardiopulmonary pharmacology, and therapeutic and diagnostic procedures with supervised clinical rotations in adult, pediatric and neonatal units. Some programs set prerequisites, and BLS suggests high school students take biology, algebra, chemistry and physics. An accredited program in the Armed Forces also leads to an associate degree.

A bachelor's degree is worth weighing if you expect to move into education, management or pulmonary diagnostics, or if you plan to work at an academic medical center. Graduate study opens teaching and research roles later in a career.

Licensure

Respiratory therapists must be licensed in every state except Alaska, where national certification is recommended, and requirements vary by state. Licensure usually involves passing a state or professional certification exam. In some states the RRT, not the CRT, is the minimum credential for a new license, so confirm the rule with the board in the state where you plan to work before you schedule anything.

Credentials and the 2027 exam

Credentials come from the National Board for Respiratory Care (NBRC). For exams taken through 2026, the path runs through the Therapist Multiple-Choice Examination and the Clinical Simulation Examination. Starting in January 2027, the NBRC credentialing exam is a single test, the Respiratory Therapy Examination: 185 multiple-choice items (160 scored and 25 pretest), a 4-hour time limit and a $360 fee for new applicants. It has two cut scores, with the low cut score earning the Certified Respiratory Therapist (CRT) credential and the high cut score earning the Registered Respiratory Therapist (RRT). Students who will sit for the credentialing exam in 2027 or later should plan on this exam from day one.

Beyond the entry credentials, the NBRC's specialty credentials mark depth in a particular area:

• Adult Critical Care Specialist (RRT-ACCS) for ICU-focused therapists
• Neonatal/Pediatric Specialist (RRT-NPS) for NICU and pediatric work
• Sleep Disorders Specialist (RRT-SDS) for sleep medicine
• Certified Pulmonary Function Technologist (CPFT) and Registered Pulmonary Function Technologist (RPFT) for pulmonary function labs

Plan to keep life support certifications current as well: Basic Life Support (BLS) and Advanced Cardiovascular Life Support (ACLS) from the American Heart Association, and the Neonatal Resuscitation Program (NRP) from the American Academy of Pediatrics if you will cover deliveries or the NICU.

Experience

New graduates usually start on general floors and rotate into critical care after a year or two of steady practice, and specialty credentials typically follow several years in that setting. Plan on three to five years of practice and the RRT before aiming for a supervisory role.

Projected growth

The Bureau of Labor Statistics projects employment of respiratory therapists to grow 9 percent from 2025 to 2035, which it rates as much faster than the average for all occupations. In its projections table that is a move from 142,000 jobs in 2025 to 154,200 in 2035, a change of 12,100. BLS expects about 8,600 openings a year on average over the decade, and says many of them will come from replacing workers who transfer to other occupations or leave the labor force, such as to retire.

What drives demand

BLS ties much of the growth to age. A larger older adult population means more pneumonia, COPD and other disorders that restrict lung function, and with them more demand for respiratory therapy, mostly in hospitals. It adds that a growing emphasis on reducing hospital readmissions and on outpatient care may result in more demand for therapists in health clinics and doctors' offices, and that problems tied to smoking, air pollution and emergencies will keep creating work across every age group.

Pay by setting

Setting moves the median. In May 2025 BLS data, therapists in offices of other health practitioners had a median annual wage of $88,020, against $82,730 in hospitals, $79,270 in skilled nursing facilities and $77,890 in offices of physicians. Shift differentials, overtime and per-diem rates sit on top of base pay and vary by employer, so compare total compensation rather than the hourly rate alone.

Hospital staffing

The AARC's 2024 human resources study gives a view from department directors. In 2024, directors of acute care respiratory departments reported a further increase in vacant staff therapist positions, with a mean close to four and a median of almost one per hospital. The authors read that as some hospitals carrying a large number of vacancies while half of responding hospitals had one or less. For a job seeker, that points to wide variation by employer: one hospital may be short-staffed while the next has no openings at all.

Working across state lines

As of 2026, a therapist needs a separate license for every state where they work, including for telehealth, and the AARC notes that takes time, money and paperwork. The Respiratory Care Interstate Compact is meant to change that. In April 2026 the AARC reported that the 7th state had enacted the compact, officially triggering its activation, and that further approvals soon brought the number of states that passed it to 10. The AARC says the next steps are creating the compact commission, writing rules and building a shared database, then launching applications; that setup typically takes about 2-3 years after the threshold, and the earliest therapists may be able to obtain compact privileges would be late 2027. Until then, every state still requires its own license.

Where careers branch

Clinical depth is the most direct path: adult critical care, neonatal and pediatric care, or pulmonary function and sleep diagnostics, each with its own NBRC specialty credential. Others move into department leadership, clinical education or faculty roles in respiratory therapy programs. Whichever direction you choose, a solid base of bedside experience makes the move easier.

Dear Director of Respiratory Care,

I am applying for the Respiratory Therapist position on your adult critical care team. I graduated from my respiratory therapy program this spring, hold a state license, and earned the RRT credential in August. For the past two months I have worked per diem on the general floors at a community hospital while I looked for a full-time role in a busier ICU.

My clinical rotations gave me a wide base. In the medical ICU I managed patients on pressure-control and volume-control ventilation under supervision, ran spontaneous breathing trials each morning, and presented blood gas trends at rounds. In the NICU I set up bubble CPAP and helped the team at high-risk deliveries. In the pulmonary function lab I ran spirometry and diffusion testing and learned to reject a test when effort was poor instead of sending a weak result to the physician.

The moment that shaped my plans came on a night rotation. A patient on BiPAP for a COPD flare was working harder every hour, and my preceptor walked me through the signs she was watching: rising respiratory rate, accessory muscle use, a blood gas drifting the wrong way. We called the intensivist early, and the patient was intubated calmly rather than in a code. I want to build that kind of judgment, and your unit's case mix and preceptor model are the reasons I am applying here.

I am comfortable with rotating twelve-hour shifts, including nights and weekends, and I plan to pursue the Adult Critical Care Specialist credential once I meet the experience expected for it. I would welcome the chance to shadow a shift or meet your team.

Thank you for considering my application.

Sincerely,

[Your Name], RRT