California and Ohio have made it official: all new therapists entering the profession must earn the RRT credential to become licensed to practice. But in many other places around the country, the RRT has unofficially been what it takes to get ahead in respiratory care for some time now.
Here’s what five managers have to say about why they only seek out RRTs for their departments —
When and why did you decide to hire only RRTs to work in your department?
Amy Owens, BS, RRT-NPS: I began trending towards only hiring RRTs about five years ago. It was a gradual change. One reason was I feel that the new grads should sit for their RRT as soon as possible. I have found that the students who put it off for any time generally do not go back and get it. Those are usually the RTs that I feel are not as engaged to succeed, but are more here to punch a clock.
The second factor was that my HR department does job scans annually to determine pay grades. The CRT level has been deemed a “cold job” by my HR and they have made the decision to drop it a number of pay grades. So what was once a one pay grade difference is now a four pay grade jump. The pay I can offer to new grads or new hires at the CRT level is embarrassing. Who wants to make, on average, $5 less than their peer doing the same job?
Jack Fried, MA, RRT: I made the decision about five years ago. New hires are given six months to become registered, but RRTs are given a preference. The reason for requiring the advanced practitioner status, which the RRT confers, is the role we play. Physicians delegate a lot of responsibility, respect our judgment, and have a great deal of trust in the department. Given that level of confidence, it is difficult to ask them to have such faith in someone with an entry level credential, which the CRT represents.
Kathy Sebastian, MBA, RRT: When I became a manager about five years ago I mandated that all new hires be RRTs. It just seemed like too much work to hire a CRT that needed to have their RRT within six months. Then I would have to make sure they got it or terminate them. Better to just require it up front.
Joy Hargett, MBA, RRT: While we have focused on hiring RRTs for many years, we would occasionally hire a CRT, depending on the person’s experience, personality, and fit into the organization. About the ten years ago, we began hiring only RRT credentialed therapists. With the job market in Houston, we usually have a lot of success in finding suitable RRT candidates.
Lee Ann Gutleber, RRT: Our current practice is to hire only RRTs or RRT eligible staff. If they are RRT eligible, we require that they obtain their RRT within six months of hire. We have served as an education site for the respiratory program at our local college. Since we develop a relationship with these students, we are able to hire them directly out of the program. For this reason, we will conditionally hire a CRT.
Sally Whitten, MHS, RRT: At Maine Medical Center we made the decision to only hire those with the RRT credential about 20 years ago. Employees were given support and time — two years, if I remember correctly — to attend a second year at our local college to become eligible to take the RRT exam or to review and prepare to take the exam. As the largest hospital in Maine, this decision was viewed as a way to set the professional standards required for a tertiary care academic medical center.
How do you believe hiring only RRTs is helping you deliver better patient care and expand the skills set of your RTs and services offered by your department?
Amy Owens: I think the graduates who have set out with the desire to succeed and obtain their RRT right away show initiative and hard work. They want to be the best. It also gives the department a feel of being more professional and reaching a level of excellence.
Jack Fried: No doubt the professionalism of the department gives physicians the confidence to have us provide nontraditional respiratory services in our freestanding ED and to provide one on one care to patients requiring Flolan in the OR and ICU.
Kathy Sebastian: I required that all CRTs that were hired before this change get their RRT. I gave them 18 months — which I thought was generous — and they had to complete by July 2015. They were all very upset by this initially, but now all 12 of them are registered and all are very proud of themselves and grateful to have been pushed.
Joy Hargett: Today, we work with other health care disciplines who have advanced education, including physical therapists, pharmacists, nurse practitioners, and physician’s assistants, as well as physicians. Many of these disciplines require master’s degree personnel to qualify for jobs. More education is essential to understand the complexity of the health care system and to care for patients. Experience is certainly very important as well, but experience with the credential will make the RRT much more valuable at the bedside.
Lee Ann Gutleber: There is a distinct difference, for the most part, in staff who are focused on their career and advancement. We see a willingness to learn and to be current in their field.
Sally Whitten: Our RRTs are given significant autonomy in their practice and are an integral part of the care team. As an academic medical center, our RRTs are constantly teaching the next generation of physicians, nurses, and RT students about respiratory care. We expect the RRT to advocate for their patients and communicate professionally and effectively with every member of the care team. Having an RRT credential means you’ve reached a higher level of success in the field and says something about you as a professional and about us as an organization.
What would you say to the new grad just getting out of school today about the importance of earning his/her RRT credential as soon as possible?
Amy Owens: Go get it! The tests will only get harder the longer you are out of school. Anyone young in the field should take the proper steps to ensure they are a strong candidate for positions and hiring. Most supervisor/team lead/management positions require the RRT.
Jack Fried: Do you want to be a professional or a technician? Do you want a job or a career?
Kathy Sebastian: I would explain the shift in the job market, suggesting that it will be harder to get a job with only a CRT and the longer you wait the less likely you will be to push yourself to get it if you already have a job. When the time comes to change jobs you will be at a disadvantage because very soon no one will be hiring CRTs.
Joy Hargett: In today’s competitive market, potential employees must do everything they can to make themselves marketable. If a new grad does not obtain their credential soon after graduation, they may find themselves not qualifying for many jobs that simply require that RRT credential. The human resource departments that screen applicants will immediately discount applicants if the minimal qualifications are not met. Also, depending on the institution’s pay practices, compensation may be higher for an RRT. While this may only be a dollar or two, over the course of a career, that can be substantial. If an RRT makes $2 per hour more than a CRT, and that person works full time for 20 years, they would make approximately $80,000 more just in salary.
Lee Ann Gutleber: Don’t wait! Take your exam as soon as you graduate. The longer you wait, the more challenging the exam will be. And most importantly, get your bachelor’s degree!
Sally Whitten: A couple of years ago, I had a position open for a new grad and received an application from someone who had attended school thousands of miles away and was now moving to Maine. Even though she had just graduated, the applicant had already achieved her RRT credential and I felt it showed a great deal of drive on her part. Even though she was an unknown to us, I scheduled the interview.
During the interview, the applicant discussed how much it meant to her personally to have obtained her credential and that she was seeking employment where she could continue to learn and grow professionally. Having that RRT credential and sharing her personal goals for continued professional development made it easy for us to offer her a position. I share that story with the students from Southern Maine Community College as an example of what I’m looking for in a new grad.