Respiratory Therapist Career Assessment

2What is a Respiratory Therapist?

A Respiratory Therapist (RT) is a specialized healthcare provider who manages patients with breathing problems. You operate ventilators, provide oxygen therapy, perform diagnostic tests, and respond to respiratory emergencies.

The Reality: You're often in critical care settings. You manage complex respiratory equipment. You make rapid decisions about oxygen levels, ventilator settings, and interventions. Your knowledge directly impacts whether patients live or die.

Your Responsibilities:

• Manage mechanical ventilators (ICU)
• Provide oxygen therapy
• Perform airway management (intubation assistance, tracheostomy care)
• Conduct pulmonary function tests
• Interpret blood gas results
• Administer nebulized medications
• Perform chest physiotherapy
• Respond to code blues and respiratory emergencies
• Teach patients breathing techniques (COPD, asthma)
• Maintain and troubleshoot respiratory equipment
• Collaborate with physicians on respiratory care plans

You're the breathing expert. Doctors rely on your expertise.

3A Day in the Life

6:45 AM — Arrive at ICU. Handoff from night shift. Review patient census. Check ventilator settings and alarms.

7:30 AM — Patient 1: Post-op cardiac surgery on mechanical ventilator. Check settings, monitor ABGs (arterial blood gases). Patient ready for weaning. Begin weaning trial.

8:00 AM — Patient 2: COPD exacerbation. Nebulized medications (albuterol, ipratropium). Oxygen saturation monitoring. Patient education on breathing techniques.

8:30 AM — Code blue. Patient coding. Respond immediately. Assist with airway management. Prepare emergency equipment. Patient stabilized. Back to normal work.

9:30 AM — Patient 3: New admit, pneumonia, on high-flow oxygen. Assess respiratory status. Obtain ABG. Interpret results. Recommend increased support to physician. Physician orders ventilator.

10:15 AM — Pulmonary function testing. Non-ICU patient with asthma. FEV1, FVC, spirometry. Results guide treatment.

11:00 AM — Equipment maintenance. Check all ventilators and oxygen delivery systems. Troubleshoot alarm.

12:00 PM — Lunch (fast, might get interrupted)

1:00 PM – 3:30 PM — Afternoon assessments. More weaning trials. More patient education. Documentation.

3:30 PM — End shift. Handoff to next RT. Critical care, life-dependent work.

4Training in North Dakota

NBRC Credential Required. North Dakota requires an RT license from the ND State Board of Respiratory Care. You must pass the NBRC exam (CRT or RRT).

Training Pathways:

• 2-Year Associate Program: Community colleges in other states (none in ND right now). Classroom + lab + clinical rotations. Must be CoARC-accredited.
• 4-Year Bachelor's Program (BS): Universities. More breadth. Advanced skills. This is the route in ND. Cost varies by school.

In North Dakota: Two CoARC-accredited programs, both bachelor's degrees: University of Mary (Bismarck, clinicals at CHI St. Alexius) and NDSU/Sanford Health (Fargo). Limited seats; may require travel for clinical rotations.

Prerequisites: High school diploma/GED. Biology, chemistry preferred. Math and science competency.

Clinical Hours: Many hours of clinical rotations (NDSU/Sanford includes a 15-month program at Sanford Medical Center). Hospital rotations. Pulmonary labs. ICU. Operating room. Real patients. Real ventilators. Real stakes.

Curriculum: Anatomy, physiology, pharmacology, pathology, ventilator management, ABG interpretation, airway management, emergency procedures, patient assessment.

5Certification & Licensing

NBRC Exams (National Board for Respiratory Care). Starting January 2027, one new exam replaces today's two-exam path (TMC + CSE). The last day to apply for the TMC is December 15, 2026.

• Respiratory Therapy (RT) Exam: 185 multiple-choice questions (160 scored). 4 hours.
• Two passing scores: The lower passing score earns CRT (Certified Respiratory Therapist). The higher passing score earns RRT (Registered Respiratory Therapist).

North Dakota Requirements:

• Complete a CoARC-accredited RT program
• Pass the NBRC exam (CRT or RRT)
• Apply for a license from the ND State Board of Respiratory Care
• Renew your license every year with continuing education

Cost: $360 for the RT exam ($300 to retake)

Pass Rates: Vary by school. Ask each program for its NBRC results.

Continuing Education: ND license: at least 10 CE hours every year. NBRC credential: renew every 5 years.

Reciprocity: NBRC credentials are national. Each state still needs its own license (check the ND State Board of Respiratory Care).

6Salary & Job Outlook

North Dakota Respiratory Therapist Salary (BLS, May 2025):

• Lower pay (bottom 10%): $31.62/hour ($65,770/year)
• Middle pay (median): $39.06/hour ($81,230/year)
• Higher pay (top 10%): $48.31/hour ($100,490/year)

Benefits: Excellent health insurance, retirement, paid time off, shift differential pay, tuition reimbursement.

Job Outlook: Excellent. Aging population with lung disease. Increased respiratory conditions. Jobs expected to grow 9% nationally from 2025 to 2035 (BLS).

Work Environment: ICU, pulmonary labs, emergency rooms, operating rooms, hospitals. Shift work: 12-hour shifts common. Some on-call.

Physical Demands: Moderate. Standing, walking, lifting equipment, manual tasks. Not as physically demanding as some healthcare roles.

Growth Potential: Advance to RRT → Clinical Educator → Director of Respiratory Services → Hospital Administration.

7Where This Leads

Path 1: Specialization — Critical Care, Pulmonary Function Testing, Sleep Medicine, Neonatal/Pediatric.

Path 2: Leadership — Shift supervisor, respiratory manager, director of respiratory services.

Path 3: Clinical Education — Teach RT students. Clinical preceptor. Program development.

Path 4: Research — Respiratory care research. Clinical trials. Healthcare innovation.

Path 5: Home Health — Manage patients on home ventilators and oxygen. Flexible schedule. Patient advocacy.

Path 6: Medical Sales — Respiratory equipment and devices. Sales rep. Territory manager.

Path 7: Advanced Practice — NBRC specialty credentials like ACCS (Adult Critical Care Specialist). Some RTs earn a master's degree for leadership roles.

8The Real Talk

What's Great:

• Excellent pay and benefits
• Critical role in healthcare
• Job security (always in demand)
• Respected profession
• Diverse work settings (ICU, ER, OR, clinics)
• Intellectual challenge (complex cases)
• Teamwork and collaboration
• Seeing patients improve and survive
• Career advancement opportunities
• Shift work flexibility (can mean extra days off)

What's Hard:

• High-stress ICU environment (code blues, emergencies)
• Emotional toll (dying patients, trauma)
• Shift work (12-hour shifts, nights, weekends)
• Sleep disruption from shift work
• Difficult ethical situations (end-of-life care)
• Technical stress (equipment failures, complicated weaning)
• Dealing with frustrated, scared patients
• Responsibility for critical equipment and patient safety
• Continuing education demands (CE requirements)
• On-call and emergency callins

Be Honest: Can you handle ICU stress? Can you work nights and weekends? Are you comfortable with complex medical equipment? Can you make quick clinical decisions? Can you handle patient death?

9Part 1: What Attracts You?

10Part 2: Are You Ready?

11Part 3: Your Next Move

Your Respiratory Therapist Assessment Results