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How did you become interested in respiratory therapy?

My dad is a respiratory therapist by trade, although he is currently in a different position outside of respiratory care. Because of my father’s job, I grew up hearing a lot about the field of respiratory therapy. This was a large reason why I always knew that I wanted to help others. However, I never actually thought that I would become a respiratory therapist. 

 

In 2004, I graduated from college with a bachelor’s degree in kinesiology (exercise science). At that time, however, the exercise science and physiology world was not as big as it is now. Most graduates would either go to physical therapy (PT) school, become a PT assistant, or become a personal trainer. To get into PT school, you needed to have really good college grades. Because I did not have high enough grades to get into PT school, I worked as a PT assistant for a while. However, I was not earning a very livable wage from that job, especially because it was hard to find a job with benefits. After reevaluating what I wanted to do, I considered going back to school. I started by taking a couple of courses, including microbiology, anatomy, and physiology. After talking to my dad and learning about the various settings he worked in (in-patient, out-patient, in-home health), I started to consider becoming a respiratory therapist. Because there are so many settings that you can work in as a respiratory therapist, I felt like it would be a good fit because I would have many opportunities compared to my previous job. In the end, I went back to respiratory school, where I graduated with my second bachelor’s degree in two years because I had enough prerequisites from my first degree in kinesiology.

What does a day in your life as a respiratory therapist look like?

I typically wake up pretty early (around 3 a.m.) because I am working on my master’s in respiratory therapy. Between 4 a.m. and 5 a.m., I do my homework before getting ready for work. Usually, my shifts start at 7 a.m. When I work an 8-hour shift, I work from 7 a.m. to 3 p.m., and when I work a 12-hour shift at the bedside, I work from 7 a.m. to 7 p.m. 

 

During my 12-hour bedside shift at the hospital, the first thing that I do is get a report from the night shift therapist. My respiratory therapy shifts are very similar to those of nurses and physicians where there is someone working during the day for 12 hours and someone working during the night for 12 hours. After I get a report on the patients I will be seeing that day, I take some time to see what my day will look like and where the higher need patients are. I typically do therapies for a patient every 4 to 6 hours. For example, this can mean that I will need to see all of my patients in a certain time frame (like 7:00 a.m. to 8:30 a.m.) in order to administer treatments. 

 

When I am working in the ICU, I participate in something called rounds. I typically round on patients with a variety of healthcare providers, including nurses, pulmonary critical care doctors, anesthesiologists, residents, nurse practitioners (NPs), physician assistants (PAs), pharmacists, and nutritionists. By meeting together to round on the patients, we are all able to get an understanding of our plan for the day and how we can best help our patients.

 

After completing my initial rounds, I jump right into my 11:00 a.m. rounds. During this time, I check on every patient again and often complete procedures on them. One of the main procedures that I complete on patients during this time is known as a bronchoscopy. This is a procedure where I take a video scope and put it down patients’ endotracheal tubes/airways to better understand how I can help them. With these scopes, we can take pictures, clean mucus out, or even take a biopsy or mucus sample from patients’ lungs. Sometimes a patient will need to go on a scan, and if they are on a very high level of oxygen or needing any type of high respiratory support (including a mechanical ventilator), then the respiratory therapist will need to go with to monitor the patient, equipment, and assist in case there are any major emergencies during the scan. 

 

After my 11:00 a.m. round, I jump into my 3:00 p.m. round. This is my last set of rounds for the day, so everything is typically done by then. However, this can vary because sometimes patients are just getting admitted from surgery, they are coming from the Emergency Room, or they are getting transferred from another hospital. Every day can be a little different depending on the needs of patients. This can be a little tricky at the end of my shift because I also need to document my work from the day as well as prepare to give a high-quality report to the person coming on the night shift. 

 

In terms of work-life balance and the number of days a week that I work, there are a few different options. Respiratory therapists typically work every other or every third weekend. If you are working a weekend, then that means that you might have a few consecutive days off in a row, such as Monday through Wednesday. I used to only work 12-hour shifts, and I would work 3 days a week. I would definitely say that the stress level associated with this job can vary depending on if you are furthering your education and/or taking care of family. This job can be very physically demanding, so getting lots of rest is also important. It is also important to take care of yourself because this field can be mentally stressful. Although having multiple days off in a row can be very nice, having a 12-hour day can be a lot, especially considering that everyone will have different commute times to and from work.

 

I am currently working a job where I work 8-hour shifts 4 days a week, which is a little more steady. However, I still follow my same schedule where I wake up early to do my homework before going to work. Because I am working in pulmonary rehab, I am more commonly helping patients at the bedside. In the morning, I work with pulmonary rehab patients who have had surgery and are trying to work on sustaining their energy, lung function, and mobility. I also help patients who are waiting on a lung transplant or have recently received a lung transplant. With these rehab patients, it is important to get them moving, through education, physical activity, flexibility, and strength training. I would definitely say that the 8-hour shifts make it easier for me personally to maintain a good work-life balance.

 

In respiratory care, there are a wide variety of career paths you can pursue. This flexibility especially drew me to the field because you can work in in-patient, out-patient, educational, and research settings. These various options are very nice because they allow healthcare providers who work in respiratory care to be able to work in areas that allow them to have the work-life balance they desire. For example, you can always look for something in respiratory care with either an 8-hour schedule, 10-hour schedule, or 12-hour schedule. 

Can you tell us about yourself?

I have been a respiratory therapist for 16 years now. To become a respiratory therapist, there are a few different routes you can take. You can either earn an associate’s degree or a bachelor’s degree. Personally, I chose to earn a bachelor’s degree. 

 

Throughout my career, I have worked in a variety of in-patient and out-patient settings. Although I have spent a lot of time in both settings, I have probably worked slightly more in the in-patient settings. 

 

At the hospital, I see patients from all levels of care. For example, I could be treating a patient who is in a regular hospital bed and does not need as much assistance from machines or healthcare providers. With these patients, we can use a variety of treatment methods. These methods include medication, lung expansion therapy, and the clearing of mucus or infection from patients’ lungs. I also treat high acuity (critical care) patients who are hooked up to multiple machines for life support. When I am assisting these patients, I use tools like mechanical ventilation, non-invasive ventilation, and nitric oxide and work with patients on ECMO and other supportive devices like LVADS and balloon pumps. All of these tools help keep patients alive in their critical states. 

 

My out-patient work has mainly been in cardiac and pulmonary rehabilitation. During COVID-19, I worked in an out-patient setting where I not only assisted post-COVID patients but also helped initiate, coordinate, and monitor a novel COVID vaccination clinic. During this time, healthcare providers had to be especially careful after administering vaccinations to ensure that patients did not have side effects. By keeping clinic chairs spaced out and monitoring patients for 15 minutes, we ensured that patients did not have underlying health issues that could have affected them after their vaccination. Because of things like high-flow oxygen and mechanical ventilation, COVID-19 brought respiratory care to light. COVID-19 was definitely an interesting time to work in healthcare.

Full Q&A With Caitlin Macmillan

What are the biggest challenges of being a respiratory therapist?

The biggest challenge is that you cannot fix everything and everyone. Even though you want to help everyone, not everything can be fixed in the medical field. Understanding that you can only do so much to help someone is definitely hard. 

What does respiratory therapy mean to you? 

A lot of people who decide to go into healthcare say that they are doing it because they want to help people. This is not wrong at all, and I love helping people. As a kid, I spent a lot of time in hospitals. During this time, I had a physician who was very smart and cared a lot for her patients. This inspired me to want to pursue medicine. I wanted to be able to use gifts I was given (especially the gift to have the ability to learn) to make others’ lives better. However, there are also challenges associated with this because sometimes you cannot help patients once they get to a certain point. Although it is not possible to save every life, I can still be a support to many different people and their families. 

How much education is required to become a respiratory therapist?

You can either attend an associate’s or bachelor's program. An associate’s program is usually around 2 years, while a bachelor’s program is typically 4 years. During your schooling, you will have both class and clinical/lab time. For example, many students will participate in simulations using life-like mannequins to learn and make mistakes in a safe learning environment. 

 

After you graduate from one of these programs, you are eligible to take the national board exam. This is similar to how nurses, doctors, and pharmacists have to take these exams. Currently, there are two board exams that you can choose from. You can either take the exam to become a certified respiratory therapist or a registered respiratory therapist. However, I think that the board exams will change next year so that there is only one exam that you can take. Once you pass your board exam, you also need to apply for state licensure so that you can work in the state you reside in. This process is very similar to other healthcare careers where you must get a degree, pass your board exam, and earn your state licensure. 

 

After you become fully certified to practice as a respiratory therapist, you can choose to do what is known as degree advancement. For example, maybe you got an associate’s degree but want to go back to school to earn your bachelor’s. Or you might have earned your bachelor’s degree and want to go back to school to earn your master’s degree. Although earning your master’s degree is not a requirement to be a respiratory therapist, I have decided to go back to school to earn my master’s degree from Boise State University. I also know some co-workers who have just earned their master’s degrees in respiratory care. 

 

Recently, a new educational program has been created in respiratory care. The idea for the program came about because of the fact that there are never quite enough doctors to meet all of the needs of patients. As a result, there are lots of PAs and NPs in healthcare who can write medications and do a lot of the same things as doctors. To continue to meet the demand for physicians, they created an Advanced Practice Respiratory Therapy (APRT) career (similar to advanced practice providers like PAs and NPs). These respiratory therapists are required to have more schooling and clinical hours, but they are on the same level as PAs and NPs. Advanced practice respiratory therapists can prescribe medications and do certain tasks that general respiratory therapists cannot do. This is a pretty new field, and there are only a few programs that currently exist to educate students in this specialty. However, I do know that one of the programs that educates students in this field can be found at Ohio State University. 

 

I have heard of quite a few respiratory therapists who work in the hospital for a few years before going back to PA school. Some respiratory therapists may even go to perfusion school, which is a master’s degree where you learn how to run the cardiopulmonary bypass machine that is used to stop the heart during certain heart surgeries. Perfusionists help to keep patients alive during these heart surgeries by ensuring that the patient is taken care of after their heart is stopped for surgery.

What advice would you give to someone who is interested in healthcare and is trying to figure out what profession is best for them?

Ask as many questions as you can, especially about a variety of fields. I also suggest looking into the different educational programs available to you and trying to get shadowing opportunities when possible. Although it can be difficult to shadow providers if you are under 18, lots of educational programs exist that allow you to observe the procedures in various settings. Getting opportunities like these even in high school can be very beneficial as they will allow you to potentially meet the faculty and students at various programs. By exploring all of your options, you will get a better sense of what profession is the best fit for you. 

What is the career outlook for respiratory therapists?

Respiratory therapy is a rapidly growing field. In fact, the U.S. Bureau of Labor Statistics says that the respiratory therapy profession will grow by 12% in the next 10 years (projected between 2024-2034). This increasing demand for respiratory therapists can be attributed to the fact that respiratory therapists are retiring and that our population is aging. 

 

In terms of AI, there are definitely some changes in how hospitals are run in association to all of the recent technological advances. For example, there are now some hospital beds that can move on their own to transport patients. However, I believe that AI can never replace the human connection that you get with real healthcare providers. We can use all of the AI tools available to us, but they will never replace the human connection that compassion that healthcare providers bring to their patients. Concerns can also arise with AI usage because its technology sometimes operates off of incorrect information. As a result, I never foresee technology and AI replacing healthcare workers. 

What is your favorite part of being a respiratory therapist?

Over the last few years, I have discovered that one of my favorite aspects of my job is the fact that I have the ability to learn from and work with a variety of healthcare providers. For example, I work with physicians, nurses, PAs, and so many other providers. Every day, I am able to come together with these providers to work through various situations. This is so special because we learn from one another and have very interesting conversations while we work through the different cases we are given every day. 

 

Not only do I love learning from others, but I also have discovered that I enjoy teaching others. This is a big reason why I have been working towards my master’s degree. My goal is to one day teach undergraduate respiratory students and support them in their learning. By passing knowledge onto other healthcare providers, I will be able to indirectly support more patients.  

Interview Summary

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  • Caitlin Macmillan has been a respiratory therapist for the past 16 years, where she has worked in a variety of in-patient and out-patient settings. She is also currently in the process of earning her master’s degree in respiratory therapy. 

  • Caitlin emphasizes how she enjoys not only learning from others but also having the opportunity to teach others in her role. By earning her master's degree, Caitlin hopes to be able to indirectly help more patients by educating the next generation of respiratory therapists.

  • To become a respiratory therapist, one can either attend an associate’s program (~ 2 years), or a bachelor’s program (4 years). Afterwards, you must pass your national board exam and acquire your state licensure. After becoming certified to practice as a respiratory therapist, there are also options to go back to school to do what is known as degree advancement. For example, you could try to earn your bachelor’s degree or master’s degree.

  • Caitlin sees respiratory therapy as an opportunity to use the gift of learning to help others. Although she cannot help every patient, by educating respiratory therapy students to do so, more patients can be helped. 

  • Respiratory therapists can work in a variety of settings, including in-patient, out-patient, and in-home health. They work with a variety of other healthcare providers to support patients with respiratory problems by utilizing various procedures and medications. One common procedure done by respiratory therapists is a bronchoscopy, which is where a scope is placed down into a patient’s endotracheal tube/airway to give healthcare providers a better idea of how to best support that patient.  

  • One of the reasons why Caitlin chose to go into respiratory therapy is because of her dad, who is a respiratory therapist by trade. Although she initially earned a degree in kinesiology, Caitlin decided to go back to school to become a respiratory therapist in order to open the door to more opportunities in her career.  

  • In the future, the field of respiratory therapy is projected to grow rapidly (12% in the next 10 years). This can be attributed to the fact that our population is aging and that more respiratory therapists are beginning to retire. 

Respiratory Therapy Interview With Caitlin Macmillan

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