Key Responsibilities and Required Skills for Registered Respiratory Therapist

🎯 Role Definition

A Registered Respiratory Therapist (RRT) provides advanced respiratory care to neonates, pediatrics, and adult patients across acute and ambulatory settings. The RRT assesses cardiopulmonary status, manages mechanical ventilation and noninvasive support, performs diagnostic testing (ABGs, PFTs), responds to codes and trauma events, educates patients and families, documents care in the EMR, and collaborates with multidisciplinary teams to optimize pulmonary outcomes. Ideal candidates hold NBRC RRT certification, a state respiratory care license, and current BLS/ACLS (and PALS/NRP where applicable).

📈 Career Progression

Typical Career Path

Entry Point From:

Respiratory Care Associate / Respiratory Therapy Student / New RRT graduate
Certified Respiratory Therapist (CRT) transitioning to RRT
Medical/Surgical or Emergency Department technician with cardiopulmonary exposure

Advancement To:

Lead Respiratory Therapist / Shift Supervisor
Clinical Education Specialist – Respiratory Care
Pulmonary Rehabilitation Program Coordinator
Manager / Director of Respiratory Care Services
Advanced Practice roles (e.g., Pulmonary/Respiratory Clinical Specialist)

Lateral Moves:

Sleep Technologist / Sleep Program Coordinator
Home Respiratory Care Specialist / Durable Medical Equipment (DME) Clinician
Pulmonary Function Technologist (PFT lab)
Clinical Research Coordinator in pulmonary studies

Core Responsibilities

Primary Functions

Perform thorough respiratory assessments and cardiopulmonary examinations for adult, pediatric, and neonatal patients, synthesizing history, physical exam, lung sounds, oxygenation, and ventilation status into a prioritized treatment plan.
Initiate, titrate, and manage invasive mechanical ventilation (adult/pediatric/neonatal) including setting modes, adjusting tidal volumes, PEEP, FiO2, and alarms; apply evidence-based ventilator strategies and lung-protective protocols.
Implement and manage noninvasive ventilation (CPAP/BiPAP/high-flow nasal cannula) and troubleshoot patient–ventilator asynchrony to optimize comfort and gas exchange.
Perform arterial blood gas (ABG) sampling, analysis, and clinical interpretation; reconcile ABG results with ventilator settings and recommend adjustments to physicians and care teams.
Conduct weaning protocols and spontaneous breathing trials; coordinate extubation readiness assessments and support post-extubation respiratory care (oxygen therapy, bronchodilators, incentive spirometry).
Respond as a core member of code blue/resuscitation teams and rapid response teams—perform airway management, bag-valve-mask ventilation, assist with intubation, and manage advanced airways and ventilatory support during emergencies.
Provide airway management including endotracheal suctioning, PASSY-Muir valve trials, tracheostomy care, cuff management, and decannulation planning in collaboration with surgical teams.
Administer aerosolized medications, bronchodilators, mucolytics, and inhaled therapies via MDI, SVN, and nebulizers; monitor therapeutic response and side effects.
Perform pulmonary function testing (PFTs), including spirometry, lung volumes, diffusion capacity (DLCO) where applicable; ensure quality control and accurate test interpretation for clinical decision-making.
Manage oxygen therapy modalities (low-flow, high-flow nasal cannula, venturi masks), oxygen conservation strategies, and patient-specific oxygen titration to maintain target saturations while minimizing oxygen toxicity.
Provide bedside monitoring and continuous assessment of ventilator parameters, hemodynamics, oxygenation indices, and sedation impact; escalate changes and collaborate with critical care teams on care plans.
Deliver respiratory care in specialized units (ICU, NICU, PICU, ED, OR, PACU) according to unit-specific protocols and scopes of practice, ensuring continuity of respiratory support across settings.
Educate patients and families on chronic disease management (COPD, asthma, cystic fibrosis), inhaler technique, home oxygen use, and preventive strategies—develop individualized discharge teaching and written care plans.
Prepare, calibrate, troubleshoot, and perform preventive maintenance and safety checks on ventilators, oxygen delivery systems, humidifiers, suction devices, blood gas analyzers, and other respiratory equipment.
Document all respiratory assessments, interventions, ventilator changes, ABG interpretations, and patient education in the electronic medical record (EMR) in a timely, clear, and compliant manner.
Participate in multidisciplinary rounds, present respiratory status and recommendations, and contribute to daily care planning and goals for ventilator-dependent patients.
Support infection control practices and isolation precautions—manage respiratory equipment cleaning, filter changes, and single-patient devices to prevent cross-contamination.
Apply evidence-based protocols for bronchoscopy support, inhaled nitric oxide therapy, chest physiotherapy, secretion management, and recruitment maneuvers under physician directives.
Undertake transport of ventilated or high-acuity patients within the facility and during inter-facility transfers—secure airway, monitor ventilator and hemodynamic stability, and coordinate with transport teams.
Implement quality improvement projects and performance improvement initiatives focused on ventilator-associated events (VAE), extubation failure reduction, and adherence to respiratory care bundles.
Mentor and precept students, new graduates, and cross-trained staff; maintain competency checklists and participating in staff education, skills validation, and in-service training.
Coordinate home ventilation discharge planning including equipment selection, caregiver teaching, home oxygen prescriptions, DME setup, and liaison with home health agencies and case management.
Maintain up-to-date credentials and competency—complete mandatory training (BLS, ACLS, PALS, NRP where needed), NBRC recertification, and state licensure renewals.
Participate in research and clinical trials related to pulmonary therapies and ventilator strategies when applicable; collect data and ensure protocol adherence.

Secondary Functions

Assist in inventory control and ordering of respiratory supplies, meds, and disposables, recommending cost-effective alternatives without compromising patient safety.
Support departmental scheduling, float coverage, and surge planning for high census events such as pandemics, mass casualty incidents, or seasonal respiratory surges.
Contribute to policy and protocol development for respiratory care services, EMR templates, and clinical pathways to standardize care and reduce variability.
Track and report respiratory care metrics (ventilator days, ABG turnaround, oxygen utilization) and collaborate with leadership to drive performance improvement.
Serve as a point-of-contact for vendor equipment service coordination and warranty issues, ensuring minimal downtime for critical respiratory devices.

Required Skills & Competencies

Hard Skills (Technical)

NBRC Registered Respiratory Therapist (RRT) credential (or eligibility) and valid state respiratory care license.
Mechanical ventilation management across adult, pediatric, and neonatal populations including conventional and advanced ventilator modes (AC/VC, SIMV, PRVC, APRV).
Proficient arterial blood gas (ABG) sampling, analysis, and clinical interpretation; use of blood gas analyzers and troubleshooting pre-analytical errors.
Competent in non-invasive ventilation (CPAP/BiPAP), high-flow nasal cannula therapy, and oxygen delivery modality selection and titration.
Airway management skills: endotracheal suctioning, tracheostomy care, ventilator circuit management, and intubation assistance.
Experience performing and interpreting pulmonary function tests (spirometry, lung volumes, DLCO) and cardiopulmonary testing.
Familiarity with ventilator weaning protocols, spontaneous breathing trials, extubation procedures, and post-extubation support strategies.
Emergency response proficiency: code blue participation, neonatal/pediatric resuscitation as required, and advanced airway maneuvers.
Medication administration via inhalation devices and knowledge of bronchodilators, corticosteroids, mucolytics, and nebulized therapies.
EMR documentation proficiency and clinical informatics literacy (Epic, Cerner, Meditech, or similar).
Equipment competency: ventilators, oxygen concentrators, transport ventilators, blood gas analyzers, PFT systems, and suction/airway devices.
Infection prevention practices specific to respiratory equipment and aerosol-generating procedures.

Soft Skills

Strong clinical judgment and critical thinking under pressure when managing unstable respiratory patients.
Clear, compassionate patient and family education skills focusing on disease management and adherence.
Effective interdisciplinary communication and collaboration with physicians, nurses, respiratory therapists, and allied health professionals.
Leadership and mentoring ability to precept students and junior staff, facilitate skills training, and drive team performance.
Adaptability and resilience in fast-paced acute care environments with fluctuating acuity and census.
Attention to detail for accurate documentation, equipment checks, and medication administration.
Time management and prioritization when balancing multiple high-acuity patients and competing urgent tasks.
Problem-solving mindset to troubleshoot equipment, alarms, and complex ventilator/patient interactions.
Professionalism, ethical practice, and commitment to patient safety and confidentiality.
Continuous learning orientation and openness to updated guidelines, technology, and best practices.

Education & Experience

Educational Background

Minimum Education:

Associate of Science (A.S.) in Respiratory Therapy or equivalent respiratory care program and NBRC Registered Respiratory Therapist credential plus state licensure.

Preferred Education:

Bachelor of Science in Respiratory Therapy (BSRT) or Bachelor’s degree in Respiratory Care, Pulmonary Science, or a related health science.

Relevant Fields of Study:

Respiratory Therapy / Respiratory Care
Cardiopulmonary Science / Pulmonary Medicine Technology
Nursing, Health Sciences, or Allied Health (supplemental)

Experience Requirements

Typical Experience Range: 0–5 years (many positions accept new RRT grads; ICU/critical care roles commonly require 1–3 years of acute ventilator experience)

Preferred:

1–3 years of critical care or NICU/PICU ventilator experience for hospital ICU roles
Prior experience with OR/PACU/ED transfers, home ventilation setup, or pulmonary function labs for specialized positions

Certifications commonly required or preferred: NBRC RRT, state respiratory care license, BLS, ACLS (adult critical care), PALS/NRP for pediatrics/neonates, and any facility-specific competencies (e.g., inhaled nitric oxide, ECMO/transport ventilator training).