Career to Consider
Helping patients to breath more easily
Imagine being responsible for carefully managing the delicate and critical breathing of a premature infant, born four months early. This is the work of a neonatal respiratory therapist. Meticulously placing and securing a tube in the infant’s trachea, setting up and managing the ventilator machine, monitoring blood gas results and chest X-rays, and instilling surfactant, a special substance given to each lung to improve respiratory function — these are just some of the many crucial tasks of a job so important that it can sustain another life.
Meet Denise M. Rees, RCP, RRTNPS and DeeAnna Serna, RCP, RRT, RRT-NPS. They are respiratory therapists in the Neonatal Intensive CareUnit (NICU) at Santa Monica-UCLA Medical Center and Orthopedic Hospital. They have worked together for over two years, and combined have 35 years of experience in the field. They even published a respiratory therapy article together.
Choosing Their Profession
Although Rees and Serna chose to work with infants, respiratory therapists can work with patients of all ages treating a variety of conditions, such as asthma, lung cancer and emphysema. “It’s kind of fun doing babies,” said Rees, who also teaches at East Los Angeles College and Santa Monica College. “They respond so well. If we do the right thing in the first two to three minutes, you would never know they had a problem.”
Infants born this early have an immature lung system and depend on the respiratory therapist to help them breathe effectively. Just the right amount of treatment must be given as their lung pressures are closely monitored. Their greatest moments on the job are the celebrations when a premature infant — after enduring months of progress — becomes healthy enough to be home with their family.
“There is a really fragile baby, and you see the baby go home,” Serna said. “You are filled with so much happiness and gratitude. We all sit there and cry and take pictures. It’s indescribable.”
Serna didn’t know she wanted to be a respiratory therapist until she was 28 years old. “I was working in retail and was miserable,” she said. “My dad told me, ‘you should really look at this. You get to use your smarts, and this would really fascinate you.’ ”
Before getting hired in California, respiratory therapists must be licensed as a respiratory care practitioner (RCP) to practice in the state. They also have to complete a two-year associate’s degree respiratory therapy program and earn national credentials as a registered respiratory therapist (RRT).
A Day in the Life
A typical day can vary from providing neonatal life support to treating patients after surgery and educating families. However, the duties of a respiratory therapist can vary day to day. “You never know what is going to go through the door,” Serna said. “You don’t know what to expect.”
Serna coordinates with a medical team, such as a physician, nurse and physical therapist. In addition to managing ventilators, giving breathing treatments using nebulizers, and monitoring the patient’s pulmonary status, her role also includes intubating the trachea – which is the insertion of a tube into the patient’s windpipe to open and stabilize their airway.
“I love intubating,” she said laughing. “I know it’s an odd thing to say. I like to intubate because of the skill and reward involved. Once I establish the airway I feel that we as a team are in a much better position to manage other systems. It is a learned talent and some are better than others; this is my forte. As one of my medical directors once said of me, ‘DeeAnna can intubate a rock.’ ”
Does This Sound Like You?
A good candidate for a respiratory therapist is someone who is passionate about the medical profession and would like to practice hands-on with patients in a detail-oriented specialty area. They must have compassion, excellent interpersonal skills and ability to multitask, yet focus during an emergency. They also should enjoy learning as the profession can change even by the year.
“One of the biggest challenges is making sure we understand new technologies,” Rees said. “Evidenced-based medicine is so important. Your education really doesn’t stop. You have to stay on top of it.”
Where They Work
Most respiratory therapists work in hospitals, such as emergency or intensive care, but some work in special air transport teams, hyperbaric medicine, pulmonary rehabilitation, or in home health providing respiratory therapy in patients’ homes. According to the Bureau of Labor Statistics, in 2008, most respiratory therapists earned between $37,920 and $69,800.
Movin’ On Up
Respiratory therapists can specialize by earning additional credentials through the National Board for Respiratory Care in a specific area, such as neonatal pediatrics specialty (NPS), adult critical care specialist (ACCS), or sleep disorders specialist (SDS). They can also pursue a bachelor’s or master’s degree, which may help them advance to management or teaching; they can also transition to sales of medical products, such as respiratory care supplies.
In a special moment, Denise Rees was at Disneyland and ran into one of the patients she cared for who had a heart transplant as a toddler. It had been about nine years, but the mother recognized her right away and excitedly called out to her. “I was amazed at how the boy looked so normal, seemed so happy and like every other kid in line,” she said. “I did tear up. I felt excited and sort of awed that what we do continues after they aren't our patients and lets them become people with a future.”