Coping with the Growing Demand for RTs

 Updated: September 12, 2019

According to the Bureau of Labor Statistics (BLS), employment of respiratory therapists is growing much faster than the national average for all occupations. During the 10-year period between 2016 and 2026, BLS expects the need for RTs will increase by 23%.

How is this growth impacting respiratory care departments today? We asked managers to share their experiences.

Tipping point in sight

Tom Cahill, RRT, RRT-NPS, EMT-P, has seen an uptick in demand in his area as the need for RTs to work in specialty roles like COPD navigators, pediatrics, the NICU, ECMO, PFTs, pulmonary rehabilitation, and the adult critical care areas has increased.

“Our system is growing rapidly, and this is causing issues with us keeping up with demand on even our acute care floors,” said the department manager at St. Elizabeth Healthcare in Edgewood, KY.

While they are doing fine, he believes they will soon reach a tipping point as demand and competition for therapists outstretches the ability of local schools to produce graduates.

“We are seeing more competitive wages and the addition of sign on bonuses in our area,” Cahill said. “Our HR is doing outreach at about a 100 mile radius to help with recruitment.”

Theodore L. Nilsson, MS, RRT, director of respiratory care services at Mather Hospital in Port Jefferson, NY, says demand for therapists has increased rapidly over the past few years in his area, which encompasses Suffolk County on Long Island. He credits the increase to a good economy and retiring baby boomers, along with having only one local school that graduates about 25 therapists a year, most of whom head to New York City for jobs.

New cardiac cath labs and expanded neonatal units in the county have driven up the need as well.

“It has not affected the services we need to offer here at this time,” Nilsson said. But other hospitals in the area have given floor aerosol/MDI therapy to nursing due to respiratory staffing shortages and one large hospital system is looking into setting up a group of system therapists willing to work extra hours at other system hospitals at a premium salary. There is also talk of offering sign-on bonuses in the future.

25-30% increases

The demand for RTs is definitely increasing in southeast Wisconsin, says Tim Buckley MSc, RRT, FAARC, director of respiratory care, the Sleep Disorders Center, and neurodiagnostics at Froedtert South, Inc., in Kenosha.

“In our case we have added staff to accommodate growth within our hospitals as well as expand the role of the RT,” he said. “For example standing by for all high risk deliveries, providing intubations, and having staff dedicated to the CCUs as opposed to floating in and out to cover vent checks and treatments.” He estimates they’ve increased staffing by about 25-30%.

Buckley attributes the rise to job growth and tax incentives that have made the whole area boom, and it’s all occurring at a time when a significant number of his staff are reaching retirement age. Further complicating the problem is the fact that there are no local RT education programs — they draw new grads from Milwaukee, Chicago, or Madison.

Travel RTs are being used to fill the gaps, but Buckley notes that has made it more difficult to implement some programs, such as intubation, because intubation can only be done by a fulltime employee of the hospital. Increasing salary levels for RTs only partly helps.

“We have continued to increase our salary scale, only to find the hospital up the road increased theirs by a dime the week after we did ours,” he said. “HR is slowly responding but they do not want to just chase the guy across the street.”

Connor Hardy, RRT, CPFT, respiratory care manager at SCL Health/St. Mary’s Medical Center in Grand Junction, CO, credits the increasing demand for RTs being seen in his area to population growth.

“Some of it is business development,” he said. “Some of it is spill over from the incredible flock of people who have been landing in the Denver/front range area that seems like it’s just out of control.” It has all meant more traumas, more elective surgeries, and more critical illnesses.

“Last winter, as we headed into respiratory season, we had an incredible spike in the respiratory census, with scheduled therapies increasing 50% greater than the previous four years,” Hardy said. “While that spike subsided, our slow period is rivaling previous winter census spikes.” His department is having a hard time maintaining adequate staffing levels to just take care of the ‘business at hand,’ and ensuring growth into new and expanded services is even more difficult.

“With the very few applicants we have received this past year there is no other option than to bring travelers on,” Hardy said. “We have many protocols and pathways to learn and that is difficult to do given the short amount of time a traveler is contracted for.”

In the same boat

As clinical manager of respiratory therapy at Memorial Hospital in Colorado Springs, CO, Rob Scott, BSRT, RRT, RRT-ACCS, CPFT, is in the same boat.

“We have increased the department by 25% over the past several years, from 74 RTs to 96 RTs,” he said. In his case, the growth can be attributed in part to the hospital obtaining level 1 trauma designation, but overall population growth in the city is playing a role as well.

While he has managed to hang on to all of the essential duties performed by his staff, he says it’s taken significant overtime and other incentives to do it.

“We are hiring at an all-time pace,” Scott said. “Over FY 2019 — July 2018 to June of 2019 — we have hired 25 RTs and still need to hire 4-6 more to meet the demands.”

Training all these new therapists has put a strain on the department as well.

“We are growing so fast I have limited space to orient them,” he said. “That is a limitation that we have that probably should be noted.”

According to Lisa Braden, RRT, CPFT, manager of respiratory at Mercy Heath St. Vincent Medical Center in Toledo, OH, her ability to find new RTs is being hampered in part by declining university and college enrollment in the area. The fact that the University of Toledo has a lot of foreign students who return to their home countries once they graduate isn’t helping either.

“I personally believe that there is a lack of interest in respiratory in the younger generation,” she said. “They do not want to work weekends, holidays, and the nightshift.”

Her department is struggling to keep up with the services it needs to provide and staff are feeling the stress.

“We are currently using agency,” Braden said, “which is expensive.” But she knows they are not alone. “It’s been a battle not just at my hospital but also the surrounding hospitals in the Northwest area,” she added.

Harry Morris, MS, RRT, senior manager of respiratory care for AdventHealth in Orlando, FL, has been more fortunate than most.

“We have seen a surge in part due to the population expansion in Central Florida in general,” he said. “My location is a tertiary and quaternary center and our acuity has increased accordingly.” But thanks to the two RTs programs in his metro area, finding people to take these jobs has not been a big problem.

“We are fully capable of meeting demand,” Morris said. Over the past two years he has hired about 20 RTs, with a separation rate of 2.33%. Today he has 141 therapists on staff.

Forward march

Clearly, respiratory care is booming, but with that boom comes some major headaches for RT managers and the departments they oversee. Balancing the need to expand services with a job market that’s on overdrive isn’t easy, but as these managers show, efforts must be made to ensure the profession continues to move forward into the new and exciting areas that will define respiratory care in the 21st century.