Career Outlook

Vol. 19 • Issue 5 • Page 20

Ask Diane Kohnen about the most important things she discovered as a respiratory student at the University of Missouri’s School of Health Professions in Columbia. She could recite the alveolar gas equation or demonstrate how to perform a vent check, but she also received a crash course in economics.

“One thing that I learned from this recession that we are going through is that health care is not recession proof,” said Kohnen, the school respiratory care association’s president and a regular volunteer at asthma clinics and cystic fibrosis walks. She fears that she will not find a job when she graduates in May with a bachelor’s degree.

Many 2010 RT graduates share her anxiety. Landing that first respiratory therapy job could be harder today than any time in recent memory. While the U.S. Bureau of Labor Statistics predicts a 21 percent job growth in respiratory therapy from 2008 to 2018, the reality is that these projections do not reflect the true economic situation.3Up until a year ago, employers were knocking on the doors of new respiratory care program grads from the University of Medicine and Dentistry, New Jersey – School of Health Related Professions. Then, four hospitals closed in Northern New Jersey alone. Veteran therapists from these facilities filled open positions at hospitals and took health care staffing agency work.

“We have gone from two to three offers upon graduation to anywhere from zero to six months to find either a full-time job or a substantial per diem or part-time employment,” said Al Heuer, PhD, MBA, RRT, RPFT, associate professor at UMDNJ.

When there is a job at a hospital, respiratory care directors are being inundated with applications. The number of 2010 RT grads is estimated between 6,000 and 7,600, based on numbers respiratory care programs voluntarily reported to the Commission on Accreditation in Respiratory Care in recent years. So it will take some pounding of hospital corridors for respiratory care grads to find these golden opportunities in an uncertain economic recovery. Persistence is key, according to respiratory care program directors and recent grads across the country, along with networking skills, openness to part-time work, and a good attitude.

“We may not get exactly what we are looking for off the bat, but we need to keep looking and not give up until we find it,” Kohnen said.

Make it personal

Jamie Margolis, RRT, knew she wanted her first job at a “name-brand” hospital that used the latest technologies, offered continuing education and professional growth, and paid a good salary with benefits. So how did she land a job at one of the nation’s top-rated children’s hospital for respiratory disorders?

Margolis called the hospital’s respiratory care department business manager daily to find out when job openings would be posted. When she applied, she emailed the respiratory care department head to introduce herself and ask for a facility tour.

“You’ve got to get personal interaction because you’re not going to get the job without it,” said Margolis, a ’09 graduate of Jefferson College of Health Sciences in Roanoke, Va. “Let people know what you want, and it will happen.”

Margolis is certain her diligence is what got her the job. When she signed on as a staff therapist at Children’s National Medical Center in Washington, D.C., the only other new hire for that fall had more than 30 years experience in the neonatal intensive care unit.

New grads can network at professional meetings and with local hospital departments to learn of job openings early. “Respiratory therapy is a very small profession,” said Shawna Strickland, MEd, RRT-NPS, AE-C, clinical associate professor and program director of the respiratory therapy program at University of Missouri Health Systems’ School of Health Professions. “The interaction (students) have with the other respiratory therapists at these professional events could impact future job placement.”

Sometimes there is lag between when a department identifies the need for a therapist and the hospital management approves the official job posting. In that time, a new grad could meet and impress a supervisor and get in for an interview,

Dr. Heuer said.

He advises his students to keep a log of when and to whom they spoke with, addresses for where they sent resumes, and all follow-up communication. Using a project management approach can help grads stay organized when pursuing job ?opportunities for several months at multiple hospitals.

“That may seem like a very low dividend activity,” Dr. Heuer said. “But in respiratory, it might seem like you’re being proactive.”

Alternative opportunities

Even after the most Herculean job search, some new RTs find themselves without a full-time position. In the Northeast, where the job market soured last year, some graduates have accepted multiple per-diem and part-time positions to get their start.

“Working per diem is a very good inroad to full-time employment,” Dr. Heuer said. “As long as it is significant and health benefits are not a major issue, consider doing it.”

David Agar, RRT, took a PRN position with Sioux Falls, S.D.-based Avera McKennan. “I wasn’t guaranteed any hours, but I got hired,” he said. From the beginning, Agar told the department manager that he wanted full-time employment. “The manager was very understanding and very receptive.”

As Agar learned the ropes at Avera McKennan, he applied to home care companies, hospitals, and long-term acute care facilities. Within the space of a month, he was offered a full-time position at his former employer, Sanford Health, where he had worked as a registrar while attending Dakota State University. As fate would have it, a

full-time positioned opened up at Avera McKennan at the same time.

“It was exciting but frustrating,” Agar said. Avera McKennan offered quicker orientation to the intensive care unit and flight team. Sanford Health offered seniority, higher pay, and more continuing education. Ultimately, Agar decided to take the full-time position at Sanford and keep working PRN at Avera McKennan. “Things are very good (now), but it was a long process to get where I am,” he said.

Part-time employment also can create opportunities for graduates to work in specialized units such as critical or neonatal care. “The chance that you are going to walk into a job in the NICU is slim to none,” said Maria Jacoby, MSA, RRT, director of the respiratory care program at Reading Area Community College in Reading, Pa. However, taking a part-time position in a hospital that has a NICU can get your foot in the door.

“You’d be surprised how being there two days a week, one day a month, gets people to look at you,” Jacoby said.

Taking initiative

From the time Timothy Carroll, RRT, a student at Jefferson College of Health Sciences started clinical rotations at Carilion Roanoke Hospital in Virginia, he knew he wanted to work in the medical intensive care unit. “It seemed very

progressive,” he said.

The physicians there use ventilator management protocols, and RTs have the autonomy to wean patients. The unit also implements novel and experimental treatments such as nitric oxide on adults and oscillator ventilators on difficult cases.

Once he was hired as a respiratory care assistant, Carroll did everything he could to make a good impression on the MICU’s team lead.

“If all the vents were clean and I didn’t have much to do, I went up to one of the busier units and asked if I could follow them or go through the modes with them,” Carroll said. “I treated downtime like clinical time as a student.” He earned the nod to apply to the unit and got the job.

For hospitals, a new graduate’s attitude sometimes can outweigh the skills offered by more seasoned professionals, noted Julie Brooks, CHCR, immediate past president of the National Association of Health Care Recruitment and employment coordinator at Manatee Memorial Hospital in Bradenton, Fla. “They bring a level of excitement and enthusiasm that is oftentimes refreshing to staff,” Brooks said.

Contact Kristen Ziegler at [email protected].

Salaries Suffering

Salaries stalled for respiratory therapists in recent years, as hospital administrators remained skittish about the economy and effects of health care reform.

New graduates from the University of Medicine and Dentistry, New Jersey – School of Health Related Professions reported earnings comparable to 2008 grads: $25 an hour plus shift differential in their first year, according to Al Heuer, PhD, MBA, RRT, RPFT, associate professor at UMDNJ.

Data just released by the U.S Bureau of Labor show the nation’s mean annual wage for RTs hovering around $53,000 in 2008.1Those whose earnings were in the 10th percentile reported a salary lower than $37,920.

Wages vary from state to state. RTs in the five top paying states earn nearly $10,000 more than the national mean:

California $65,440

New Jersey $63,910

Nevada $63,800

Maryland $62,210

New York $61,390

However, top paying states for RTs in the 10th percentile of wages differ:

New Jersey $52,710

California $48,620

Maryland $47,660

Connecticut $46,900

Massachusetts $46,240

Compensation does not always reflect demand for RTs. Most of the five lowest paying states are in the Southeast, where educators report that students receive signing bonuses and relocation packages:

Alabama $45,340

Iowa $44,860

Kentucky $44,170

West Virginia $43,700

North Dakota $43,280

A snapshot of the lowest paying states for those in the 10th percentile of wages shows a smattering of locations across the country:

Kentucky $33,610

North Dakota $33,580

Alabama $33,480

Arizona $32,340

Idaho $30,720

RTs in Puerto Rico earn the least of all U.S. locations, with a mean salary of $18,960 overall and salaries under $13,190 for those in the 10th percentile of earnings.

Of course, compensation includes more than just wages. Benefits, continuing education, shift differential, and more, which are not followed by profession by the BLS, make up RTs’ total package. For many new grads, job security is a priority. One in four Americans age 22 to 33 plans to stay with their employer until retirement, forgoing the financial and professional advancements that historically came from early job hopping. Sixty-two percent are looking for jobs that offer greater security and benefits.2


1. Bureau of Labor Statistics, U.S. Department of Labor. Respiratory therapists (SOC code 291126). Occupation employment statistics (OES). Available from:

2. Fidelity investments study finds shift in generation Y attitudes toward finances, employment and benefits,; Available from:,,7801,00.html. Dec. 8, 2009.

-Kristen Ziegler