By Debbie Bunch
December 2025
If you’re getting ready to graduate from your RT program at the end of the Fall semester, you are most likely in the process of interviewing for jobs right now. Given the current shortage of RTs in many parts of the country, getting that first job probably won’t be a big problem.
Making the most of your first days on the job, however, might take a little more thought. What can you expect from the onboarding experience that will start on day one? And more importantly, how can you make the most of it?
It may depend in part on where you go to work and what kind of onboarding they offer.
Marlene McKinley, BA, RRT, manager of respiratory care and neurodiagnostic services at Saint Joseph Hospital in Lexington, KY, offers a fairly traditional onboarding experience for her new grads. Scott Pettinichi, MEd, RRT, RRT-NPS, AE-C, director of respiratory therapy and PFT at Norton Children’s Hospital & NCMC in Louisville, KY, has instituted a more formal residency concept. They both offer their insights in the following short interview.
How long does onboarding for new grads hired in your department last, and what are the key components of the program?
Marlene McKinley: This would depend on whether they worked in a student capacity. The majority of the orientation will be geared towards critical care skills and critical thinking.
Scott Pettinichi: Our residency is a 10-month program. The key components of our program are combining classroom training with simulations. We host classes for residents to go over topics such as vent strategies, bagging, surfactant delivery, etc., and then we take what they learn in the classroom and apply it in the simulation environment.
Why are these components considered essential to ensuring new grads are ready to take on bedside care?
Marlene McKinley: In high-acuity patient populations, the new grad may be in a situation where they must act quickly before someone a phone call away can arrive to assist them. They need to know what to do in the moment of an emergency or if a patient is in distress.
Scott Pettinichi: These components are essential because the new grads are getting to learn a skill in the classroom and immediately practice that skill in a realistic situation, which will better prepare them for the experience at bedside.
How can new grads make the most of their onboarding experience, and how can their performance during this time help them get off to the right start in their new career?
Marlene McKinley: We encourage them to go to Codes, rapid response calls, watch intubations, etc., even if they are not assigned to that area. The more they are exposed to emergent scenarios, the more comfortable they will be when it happens to them. I share with them that we all continue to learn and ask questions daily, so never feel ashamed to ask — I honestly am more concerned when they do not have questions.
Scott Pettinichi: New grads can make the most of their onboarding experience in residency by being focused, investing their time, and taking every opportunity to get their hands on equipment and practice as many realistic simulations as possible in the safe environment provided in the classroom. Their experiences during residency will help them grow as therapists, become more confident in themselves, and become more competent in their profession.
