Abstract
BACKGROUND: Workforce development for the respiratory therapy (RT) profession is a growing concern. Upcoming staffing difficulties are expected due to retirement, attrition from the profession, and decreased enrollment in accredited RT programs nationwide. This study assessed respiratory therapists’ perceptions of staffing needs and future trajectory of the RT profession.
METHODS: This cross-sectional study utilized a modified 39-question survey tool delivered via e-mail to 618 Louisiana members of the American Association for Respiratory Care (AARC) between November 2019–February 2020.
RESULTS: The response rate was 19% (118/618). Although 50% of respondents perceived understaffing, 77.6% indicated the importance to remain in the RT profession. A majority (93.1%) agreed on the importance of maintaining an active membership in the AARC. Respondents working in a hospital setting perceived understaffed work environments more often than other groups. Salary was most important to the employee (33.6%, 39/116), followed equally by room for growth (14.7%, 17/116) and scope of practice (14.7%, 17/116). For the future of the profession, the ability to assess patients and develop care plans and the ability to receive reimbursement for services were indicated as most important factors. Most (69.8%) agreed that the entry-level minimum should be increased to the bachelor’s degree, and 21.6% agreed the master’s degree in RT should be supported to increase scope of practice.
CONCLUSIONS: This study indicated a consistent perception of understaffed work environments in respiratory care, and respondents expressed a perceived importance of remaining in the RT profession. This study also indicated support for raising the entry-level standard in RT and a desire for higher education to achieve professional growth and advancement.
- respiratory therapy
- respiratory therapist
- staffing
- attrition
- workforce development
- professional development
- growth
- entry-level standard
Introduction
Over the past decade, the entire health care workforce has experienced shortages of adequately trained staff, placing a strain on the health care system.1 The demand for respiratory therapists is expected to increase over the next decade. This increase in demand coupled with an aging workforce and attrition from the profession potentially creates a major shortage in the respiratory therapy (RT) workforce.2,3 The Commission on Accreditation for Respiratory Care (CoARC) reported4 a 7% decline in enrollment to accredited RT programs from 2015–2017. This decrease in overall enrollment in RT programs could further complicate the already anticipated shortage of future respiratory therapists.
The RT profession has evolved since its origination nearly 80 years ago. Traditionally, respiratory therapists are primarily found in the acute care setting. Results from the 2018 American Association for Respiratory Care (AARC) Human Resource Study5 reported that 61.4% of those surveyed worked as a hospital staff therapist and the remaining were employed in various specialty areas and leadership roles. This statistic is changing as respiratory therapists become integrated in preventive care, disease management, and education as the location of care shifts from hospitals to the home and other care sites.6 Myers7 notes the future of RT must involve patient care outside of the acute care environment and respiratory therapists possess a unique skill set that is beneficial to maximizing safety and cost-effectiveness across the continuum of care for patients with chronic respiratory diseases.
It is of the utmost importance to assure a competent workforce within the health care environment, and our study focused on the RT workforce in Louisiana. The Southern region of the United States has a high prevalence of chronic lung disease, and respiratory therapists are vital members of the interdisciplinary team that treats these patients. No published studies have evaluated the staffing needs of RT departments or perceptions of the future of RT in Louisiana. A survey of respiratory therapists in New York state was published by Smith et al3 and similar research was encouraged across the United States by Kacmarek and Walsh8 in their Respiratory Care editorial. The current study intended to capture the perceptions of actively practicing Louisiana respiratory therapists regarding current staffing needs and the future of the RT profession.
With the global increase in chronic lung disease, the RT profession is currently faced with challenges to increase the workforce.9 The large, aging portion of the workforce anticipating retirement within the next decade and attrition from the profession add significant weight to this challenge already impacted by the growing prevalence of chronic lung disease.3,10 It is important to assess staffing perceptions from those currently in practice to develop policies that could drive workforce development for the RT profession. Respiratory therapists must be dedicated to cultivating and promoting change as we look forward to workforce expansion.6,8 Workforce development is important to health care assurance, and with the expected increase in demand for health care professionals, this study indicates what Louisiana respiratory therapists are currently experiencing and expectation for the future.
QUICK LOOK
Current Knowledge
The respiratory therapy (RT) workforce is projected to grow faster than most other allied health professions over the next decade. There is a need to be more competitive with comparable allied health professions in terms of salary, education, room for growth, and autonomy. The American Association for Respiratory Care is dedicated to moving the profession forward and recently recommended a bachelor’s degree entry level in RT beginning in 2030.
What This Paper Contributes to Our Knowledge
Respiratory therapists in a variety of environments were in support of advancing the profession via the bach-elor’s degree entry level. A majority also expressed a desire for future growth opportunities and workforce development.
Methods
After institutional review board approval, a cross-sectional study was performed utilizing an adapted version of the Survey for the Assessment of Employment and Clinical Role for the Respiratory Care Profession in the New Health Care Environment used in the Smith et al3 study. Prior to administering the survey, approval was obtained from the Louisiana Society for Respiratory Care (LSRC) Board of Directors and the AARC Board of Directors. The survey collected information on respondent demographic characteristics as well as information on their current perceptions of staffing, retention, attrition, and the future of the RT profession.
Information was collected as a convenience sample from current Louisiana members of the AARC. There were 118 respondents of the 618 eligible members meeting inclusion criteria. Respondent characteristics such as educational level, professional position, and years of experience as well as variables relating to current and future perceptions of respiratory therapists were organized and analyzed.
The survey included information organized along the following content areas: respondent characteristics, staffing, retention, attrition, and perceptions of the future RT profession. Variables were measured using a 5-point Likert scale, nominal categorization, and ordinal ranking. The survey was created in SurveyMonkey and administered by an AARC representative via AARConnect e-mail to all current Louisiana members of the AARC by accessible link. Once approved by the AARC Executive Committee, the survey remained open for approximately 8 weeks. During the official survey period, reminder e-mails were sent via AARConnect to maximize the responses. Additionally, the survey was promoted by posting an advertisement to the main LSRC and LSRC Chapter 1 Facebook pages during the same time frame. After accessing the survey link that provided informed consent, respondents gained access to the questionnaire that took approximately 10 min to complete.
Data analysis was conducted utilizing SPSS version 26 (IBM, Armonk, New York). During data analysis, 2 surveys were eliminated due to noncompletion of the questionnaire. All questions that were not answered by the respondents are listed as nonrespondent in the results. Statistical analysis included descriptive statistics for all study variables using frequencies, percentages, and means, as needed and appropriate. Inferential statistics were analyzed using chi-square, Mann-Whitney U, and Kruskal-Wallis statistical tests as indicated. An alpha level of 0.05 was used to indicate statistical significance.
Results
There was an initial 19% survey response rate (118/618); however, 2 incomplete surveys were removed, resulting in analysis of 116 surveys. Table 1 shows demographic characteristics of respondents. Most were female (59.5%), ages 45–54 (30.2%), work as staff therapists (45.7%) in community hospitals (43.1%), and have more than 20 years of RT experience (52.6%). Respondents reported the roles of respiratory therapists in their departments were predominantly in adult critical/acute care (69.8%) and working in urban areas (75%), with the least reported working in research (6.0%).
Characteristics of Survey Respondents
Most respondents (93.1%, 108/116) reported an active Louisiana state license to practice RT, and 94.8% (110/116) hold the National Board for Respiratory Care registered respiratory therapist credential. Most (79.3%, 92/116) reported full-time positions, and 26.7% (31/116) reported working a secondary position. Over one third (37.1%, 43/116) reported a bachelor’s degree as their highest level of education, followed by 35.3% (41/116) reporting an associate’s degree. In terms of degree advancement, 6% (7/116) of respondents reported current pursuit of a bachelor’s degree in RT, and 5% (6/116) of respondents reported current pursuit of a master’s degree in RT.
Staffing Adequacy
Half of respondents (50%, 58/116) reported understaffing; 44.8% (52/116) reported optimal staffing, and 3.4% (4/116) reported overstaffing. Total staffing levels (including staff therapists, supervisors, and managers) for a 24-hour period were surveyed, and levels ≥ 31 were the most reported of the category options (33.3%, 17/51). A majority (76.4%, 39/51) reported ≤ 4 supervisory positions for their respective department. Over half (56%, 65/116) reported no input into the hiring process, whereas 44% (51/116) either reported some input or were responsible for hiring decisions. When asked about a 5-y vision of hiring, nearly half (45.1%, 23/51) anticipated hiring ≤ 3 full-time equivalents, and more than half (56.9%, 29/51) reported anticipation of hiring ≤ 3 part-time or per diem respiratory therapists. Level of clinical experience was not considered an important hiring preference for 39.2% (20/51) of those who reported input into the hiring process. Nearly all respondents (92.2%, 47/51) reported an average level of ≥ 6 y of clinical experience in their respective RT departments.
Position/title was compared with perception of the current state of staffing within the workplace using the chi-square test for independence. Chi-square analysis revealed a statistically significant association between the variables (chi-square [21] = 42.191, P = .004). The association was weak-moderate11 (Cramer’s V = 0.348). Directors, supervisors, and staff respiratory therapists all chose understaffing as the primary perception of the state of staffing. Figure 1 shows the group perceptions of the state of staffing as indicated by the respondent’s position/title.
Respondents, grouped by position/title, plotted against their responses to the state of staffing in their workplace.
Respondents were asked to rank a group of variables by importance to them as employees, of which salary was designated as most important, followed by room for growth and scope of practice, flexibility in schedule, employee benefits, and increasing the educational standard of the profession. The Kruskal-Wallis test was applied to evaluate whether there were differences in the way age groups ranked their most important variables as employees. According to age group, there was a statistically significant difference in the most important variables as employees (chi-square [4] = 12.678, P = .01). The 35–44 y, 45–54 y, and 55–64 y age groups indicated salary as the most important variable as an employee. The 25–34 y age group selected salary and room for growth with nearly equal importance. The 65+ y age group selected increasing the educational standard, scope of practice, and room for growth with nearly equal importance.
The Kruskal-Wallis test was used again to evaluate differences in the way groups, based on their position/title, ranked their most important variables as employees. When these groups were compared to one another based on the ranking of the most important variable as an employee, the results indicated the distribution was not different across the different groups (chi-square [7] = 10.561, P = .16).
Attrition
Our survey identified current trends in attrition and the perceptions for reasons of attrition to inform future retention and workforce development efforts. Respondents were asked to report whether respiratory therapists from their departments had changed professions within the last 5 y, and 60.4% knew of at least one; 37.1% knew of at least 3; 20.7% knew of at least 5, and 8.6% knew of 8 or more. Over half (53.4%, 62/116) of respondents indicated their opinion that respiratory therapists leave the profession to pursue careers in nursing. Eighteen percent indicated an opinion that when respiratory therapists leave the profession they leave health care altogether. When respondents were asked if they would consider leaving the professi-on of RT, over half (52.6%, 61/116) indicated yes (34.5%, 40/116) or “I do not know” (18.1%, 21/116). Of those respondents, most indicated the top 2 reasons they wou-ld consider leaving the RT profession were salary (41.0%, 25/61) and limited opportunity to grow (34.4%, 21/61). Only 5% indicated that unhappiness within the profession is the main reason they would consider leaving. Most (77.6%) agreed or strongly agreed with the statement “It is important to me to remain in the profession of RT.” Age range was compared with a 5-point Likert scale response to the statement “It is important to me to remain in the profession of RT.” The chi-square test for independence was used for the analysis and did not reveal an association between the 2 variables (chi-square [20] = 25.185, P = .19).
Years of experience were also compared with a 5-point Likert scale response to the statement “It is important to me to remain in the profession of RT.” The chi-square test for independence was used for the analysis and revealed independence among the 2 variables (chi-square [25] = 22.519, P = .61). Respondents were asked to rank variables in order of importance for retention of respiratory therapists. Having a clinical ladder was indicated as the most important factor for retention (25.9%, 30/116), followed by increasing the scope of practice (24.1%, 28/116), awarding performance-based bonuses (23.3%, 27/116), awarding retention bonuses (13.8%, 16/116), and tuition reimbursement (8.6%, 10/116).
Professional Growth
Personal perceptions of professional growth were evaluated by survey items that allowed respondents to speculate their future trajectory in respiratory care. Respondents were asked to rate variables in rank order of perceived importance to the future of the RT profession. The ability to assess patients and develop a plan of care was ranked most important by over half of respondents (51.7%, 60/116). Respondents (30.2%, 35/116) indicated that the second most important variable to the future of the profession is receiving reimbursement for services provided. The Kruskal-Wallis test was used to evaluate whether groups, based on highest level of education, ranked the same variable as the most important for the future of the RT profession. When these groups were compared based on the ranking of the most important variable for the future of the RT profession, results indicated the distributions were similar across the groups (chi-square [4] = 1.588, P = .81).
The Kruskal-Wallis test was also applied to evaluate whether groups, based on years of experience, similarly ranked the most important variable for the future of the RT profession. When these groups were compared based on the ranking of the most important variable for the future of the RT profession, the results indicated a statistically significant difference among the groups (chi-square [5] = 11.545, P = .042). Only the 11–15 y of experience group did not favor the ability to assess patients and develop a plan of care. The group with 11–15 y of experience favored receiving reimbursement for services provided. Figure 2 shows the group perceptions of the variables deemed most important for the future of the RT profession according to years of experience.
Respondents, grouped by years of experience, plotted against their responses to the most important variable for the future of the respiratory therapy profession. ECMO = extracorporeal membrane oxygenation.
Respondents were presented with several statements associated with the future of the profession to indicate, via Likert scale, their level of agreement with each statement. Most respondents (93.1%, 108/116) agreed or strongly agreed it is important to be an active member of the AARC. Most (74.1%, 86/116) agreed that the RT profession is at risk of losing practitioners with the current health care environment. Almost half (49.1%, 57/116) indicated agreement with having opportunities to grow into managerial and leadership roles, but 44% (51/116) were either unsure, disagreed, or strongly disagreed with this statement. A majority (69.8%, 81/116) agreed or strongly agreed the AARC should support raising the academic standard for respiratory therapists to a minimum of a bachelor’s degree. More respondents disagreed (23.3%) than agreed (21.6%) to the statement that a master’s degree in RT should be strongly supported by the profession to increase the respiratory therapist’s clinical practice role. Nearly half of respondents (48.2%, 56/116) agreed or strongly agreed that they would likely complete a master’s program to increase their scope of practice. Position/title was compared with a 5-point Likert scale response to the statement “With the current healthcare environment, the practice of respiratory care is at risk of losing practitioners.” The chi-square test for independence was used for the analysis and revealed no association among the 2 variables (chi-square [35] = 27.111, P = .83). The highest level of education was compared with a 5-point Likert scale response to the statement “As a respiratory therapist, there are opportunities for me to grow into managerial and leadership roles.” The chi-square test for independence was used for the analysis and revealed no association among the 2 variables (chi-square [20] = 22.403, P = .32).
Position/title was compared with a 5-point Likert scale response to the statement “As a respiratory therapist, there are opportunities for me to grow into managerial and leadership roles.” The chi-square test for independence was used for the analysis and revealed no association among the 2 variables (chi-square [35] = 29.898, P = .71).
Level of education was divided into 2 main groups: less than a bachelor’s degree and bachelor’s degree or higher. The Mann-Whitney U test was used to evaluate for agreement between the 2 groups. The groups were compared with a 5-point Likert scale response (1 = strongly agree–5 = strongly disagree) to the statement “The American Association for Respiratory Care should strongly support the raising of the academic standard for respiratory therapists to practice to a minimum of a bachelor’s degree.” The distribution was not equal across both groups, as seen in Figure 3. Likert scale scores for increasing the minimum entry level for RT practice to a bachelor’s degree were significantly lower in the bachelor’s degree or higher group (mean rank = 50.87) than the less than a bachelor’s degree group (mean rank = 70.99); U = 1034.5, P < .001. Overall, respondents in the bachelor’s degree or higher group indicated stronger support for a bachelor’s degree minimum for entry-level practitioners.
Respondents, grouped by educational level (less than bachelor’s degree and bachelor’s degree or higher), plotted against the 5-point Likert scale responses to the statement “The American Association for Respiratory Care should strongly support the raising of the academic standard for respiratory therapists to practice to a minimum of a bachelor’s degree.” Likert scale rating legend: 0 = nonrespondent; 1 = strongly agree, 2 = agree, 3 = unsure, 4 = disagree, 5 = strongly disagree.
The Mann-Whitney U test was used again when comparing the 2 educational groups with their 5-point Likert scale responses (1 = strongly agree–5 = strongly disagree) to the statement “A master’s degree in RT should be strongly supported by the profession to increase the role of respiratory therapists in clinical practice.” The distribution was not equal across both groups, as seen in Figure 4. Likert scale scores for supporting a master’s degree in RT were significantly lower in the bachelor’s degree or higher group (mean rank = 53.52) than the less than a bachelor’s degree group (mean rank = 66.65); U = 1225.5, P = .035.
Respondents, grouped by educational level (less than bachelor’s degree and bachelor’s degree or higher), plotted against the 5-point Likert scale responses to the statement “A master’s degree in RT should be strongly supported by the profession to increase the role of respiratory therapists in clinical practice.” Likert scale rating legend: 0 = nonrespondent, 1 = strongly agree, 2 = agree, 3 = unsure, 4 = disagree, 5 = strongly disagree.
Discussion
This study of Louisiana members of the AARC highlighted the perceived staffing needs of RT departments as well as future perceptions of the profession. Respiratory therapists indicated the importance of remaining in the RT profession, and several indicators such as staffing adequacy for workforce development and perceptions of the future of the profession were identified. The profession has immense potential for growth, as the number of people suffering with cardiopulmonary disease is rising and the demand for preventive services is increasing.
Staffing Adequacy
Over half of the survey respondents reported understaffed work environments. Directors, supervisors, and staff therapists reported understaffed work environments more than the other groups (Fig. 1). Most respondents who reported a role in hiring indicated a 5-y anticipation of hiring ≤ 3 full-time, part-time, or per diem respiratory therapists, even though understaffed was the dominant perception of the state of staffing. Similar results were found in the Smith et al3 study that examined respiratory therapists in New York state. More than 20% of the respondents in our current survey reported working a second job. These survey results indicate that respiratory therapists in the state of Louisiana may face understaffed work environments in more than one setting, specifically if they work more than one RT position.
Most respondents across all age range groups, except for the 65+ y old group, indicated that salary was most important to them as an employee. Respiratory therapists are one of the least paid allied health professionals when compared to similar allied health providers. This could indicate why many respiratory therapists are working a second job. According to the Louisiana Workforce Commission (https://www.laworks.net. Accessed November 30, 2021), respiratory therapists earn a median wage of $55,640, whereas nurses and other comparable licensed and credentialed health care providers tend to earn more, respectively. This salary inequality is not isolated to Louisiana. Nationally, respiratory therapists earn a median income of $62,810, which is still generally lower than most all other comparable licensed and credentialed health care providers (https://www.bls.gov. Accessed November 30, 2021). The combination of lower pay and perceptions of understaffed working environments may have an impact on adequate staffing.
Our study revealed there is not necessarily a strong preference in the hiring process for the experienced respiratory therapist compared to the new graduate. This finding is exciting for new graduates as well as RT programs and could be an indicator that there is room for growth. CoARC4 reports indicated a decline of 7% in enrollment to accredited RT programs from 2015–2017.4 If this decline continues, the supply of respiratory therapists may not be able to meet the demand, and it could further compound the perception of working in understaffed environments. Another factor to consider is the aging RT workforce, with over 20% of the workforce being 55 y old or older.10 These respiratory therapists may be preparing to retire, and if so, there will be gaps to fill. Enrollment into and completion of accredited RT programs are of the utmost importance to ensuring workforce development.
Attrition
When asked if respondents knew of anyone in their department that had changed professions within the last 5 y, over half (60.4%) knew of at least one person. When asked their opinion on what they believe most respiratory therapists pursue as a career option after leaving the profession, most respondents indicated that nursing was the most common path. Nursing is a profession that is closely related to RT. Nurses and respiratory therapists are found primarily in the hospital setting working 8-h or 12-h shifts alongside one another. Again, when respondents were asked what was most important to them as employees, salary was indicated. The median salary for a respiratory therapist compared to a nurse in Louisiana is $55,540 and $66,236, respectively, (https://www.laworks.net. Accessed November 30, 2021). The median salary for a respiratory therapist compared to a nurse across the United States is $62,810 and $75,330, respectively, (https://www.bls.gov. Accessed November 30, 2021).
Respondents were also asked if they would consider leaving the profession of RT. Over one third (34.5%) answered yes, and 18.1% were unsure. Of those that answered either yes or indicated uncertainty if they would consider leaving the profession, 41% indicated that salary is the single most important reason they would consider leaving. They indicated a limited opportunity to grow as the second most important reason they would consider leaving. Even though many indicated they would consider leaving the profession, most of the respondents (77.6%) indicated agreement that it is important to remain in the profession of RT. This suggests that attrition from the profession could be prevented if appropriate action is taken to mitigate reasons for leaving. The workforce could be strengthened by having more experienced professionals in RT as well as encouraging satisfaction with the job. Based on the results of this survey, salary and opportunities for growth within the profession are the main areas of concern.
Respondents were asked to rank a group of variables pertaining to the importance of retention of respiratory therapists. Results indicated having a clinical ladder, followed by an increased scope of practice and performance-based bonuses were the most important incentives. These variables also indicate opportunities to mitigate flight from the profession.
Professional Growth
Respondents were asked to rank a group of variables by level of importance for the future of the RT profession, and results indicate that the ability to assess patients and develop a plan of care is most important, followed by receiving reimbursement for services provided. All years of experience groups except the 11–15 y group indicated the ability to assess patients and develop a plan of care was the most important variable for the future of the RT profession. The 11–15 y group indicated receiving reimbursement for services as the most important variable for the future of the RT profession. Results indicate that respiratory therapists may be ready to increase the level of practice and gain more autonomy. Therapist-driven protocol usage has been suggested to increase job satisfaction, which may in turn decrease attrition.12 In the 2014 Chest article by Fuhrman and Aranson,13 the idea that Medicare should reimburse for RT services, including educational services related to COPD, was examined and supported. These authors state the fact that other allied health professions receive reimbursement for their respective services and RT should be included and valued for the services the professionals are trained to provide.13
Myers7 examined the importance of expanding RT beyond the acute care setting. The notion of moving beyond the hospital will enable respiratory therapists to provide educational services to patients who may not be acutely ill and be more involved with preventive care services, like smoking cessation. In 2019, the Better Respiration Through Expanding Access to Tele-Health Act was introduced to the U. S. House of Representatives as a pilot program that would have allowed respiratory therapists to practice as telehealth practitioners under the Centers for Medicare and Medicaid Services.14 This bill would have enabled the respiratory therapist to move beyond the hospital setting, leading to a potential increase in professional morale. Unfortunately, the bill did not receive a vote and, therefore, was not enacted in Congress.15 Even though this bill was not enacted, there is still a chance that a bill with similar language could be introduced to Congress at a later time, as this issue will remain important moving forward for patients.16 If respiratory therapists can participate in telehealth in the future, they will have the chance to assess patients and develop plans of care while being reimbursed for rendered services, as desired.
Most respondents agreed that it is important to be an active member of the AARC. This is significant because it indicates the perceived value of membership in the profession’s national organization. Unfortunately, a disparity remains between the current number of licensed respiratory therapists and AARC members. According to the AARC (https://www.aarc.org. Accessed March 10, 2020), there are many reasons to become an active member, including a multitude of resources for all levels of experience.
Most respondents indicated agreeance that the practice of RT is at risk for losing practitioners. The majority of those in the New York state survey of respiratory therapists also agreed or strongly agreed with that same statement.3 This survey did not specifically investigate why respondents perceived this risk, but when asked if they would consider leaving the profession of RT, over half reported yes or “I don’t know”. The main reasons why these 2 groups would consider leaving were salary and limited opportunity to grow. When asked if they felt there are opportunities to grow into managerial and leadership roles, 25% disagreed or strongly disagreed.
There have been many debates surrounding raising the minimum academic standard to a bachelor’s degree for entry-level practice for respiratory therapists.3,17-19 Until 2019, there was no profession-wide, definitive stance on this issue; however, the AARC published their position statement that recommends “a bachelor’s degree in RT or health sciences with a concentration in RT” for entry into the profession in 2030 and beyond.20 Respondents in this Louisiana state survey were in agreeance that the bachelor’s degree should be the entry-level standard for practicing RT. However, respondents with a bachelor’s degree or higher were more supportive of raising the entry-level degree to the bachelor’s degree than those with less than a bachelor’s degree.
Rogers et al21 surveyed dental hygienists, a similar level professional to RT, and found agreement within this group on increasing the minimum entry-level standard for practice to a bachelor’s degree. They further concluded that the bachelor’s degree for dental hygienists would have positive professional and personal benefits. It is important to note that the “U. S. Public Health Service recognizes RT as a profession and offers officer status to bachelor’s level respiratory therapists in its commissioned corps”.6 Respiratory therapists are a vital part of the health care team, especially today with the threat of bioterrorism, pandemics, or other national or man-made disasters resulting in cardiopulmonary compromise.6
Over 40% of respondents were in agreeance that a master’s degree should be supported by the profession to increase the role of respiratory therapists in clinical practice, and nearly half of respondents indicated that they would be likely to complete a master’s degree to increase their scope of practice. Respondents with a bachelor’s degree or higher were more supportive of the master’s degree in RT than those with less than a bachelor’s degree. When respondents indicated what was most important to them as employees, scope of practice was second only to salary. This indicates a desire to increase the role of the respiratory therapist and suggests that those in practice may be willing to attain a higher degree level to achieve a broader scope of practice.
Experts predict there will be a shortage of cardiologists and pulmonologists upcoming.2 This is unfortunate as cardiopulmonary and cardiovascular diseases are increasing in the United States. To mitigate this shortage, the use of advanced practice providers, such as advanced practice respiratory therapists, is suggested and could open the door for wide-ranging acceptance of the master’s degree in RT.2 A recent study of practicing respriatory therapists and RT educators to determine perceptions regarding the role of therapists as physician extenders concluded that there is generally strong support from both practicing respiratory therapists and RT educators for the advanced practice respiratory therapist.22 However, our study findings did not completely align with this exact sentiment.
The sample population was limited to respiratory therapists in Louisiana who were members of their national organization. This indicates that this population may be biased about professional affiliation, and these respondents may, by nature, be more inclined to further their education. The sample population excluded other respiratory therapists who may have indicated a different perception of staffing and the future of the profession. The survey was administered during peak holiday and flu season, which may have interfered with response rate or perceptions.
Conclusions
Without an adequate supply of competent respiratory therapists, the overall health care system would be negatively impacted. Over half of respiratory therapists represented in this study perceived understaffing but agreed it is important to remain in the profession. Overall, respiratory therapists indicated the most important variables to employees were a need for salary increase, additional room for growth, and a desire for increased scope of practice. These self-reported concerns may indicate the profession is at risk for losing respiratory therapists to other careers that provide these missing variables.
The results of this study indicate support for raising the entry-level standard to a bachelor’s degree, which stands in agreement with the AARC’s current position statement. Additionally, these results indicate a general support for the master’s degree in RT. Increasing the educational standard to a bachelor’s degree as well as having the option to attain a master’s degree in RT could help increase salary, allow for professional growth, and provide an increased scope of practice. In summary, there is perceived growth opportunity in RT and a desire for a higher educational standard.
Footnotes
- Correspondence: Jillian N Danzy MPH RRT CPFT, 1450 Claiborne Avenue, Shreveport, LA 71103. E-mail: jillian.danzy{at}lsuhs.edu
The authors have disclosed no conflicts of interest.
- Copyright © 2022 by Daedalus Enterprises
