Respiratory Therapist
Respiratory Therapists treat patients with breathing disorders — asthma, COPD, pneumonia, and trauma-related lung injuries — using ventilators, oxygen therapy, and aerosol medications. They work in hospitals, ICUs, pulmonary rehab centers, and home health. Becoming an RT requires an associate's or bachelor's degree and passing the TMC and clinical simulation exams.
BLS OEWS, most recent release.
Time to certify
Required exam
Exam cost
Education
Renewal
Annual openings
What it's actually like
A day-to-day reality check, grounded in current practitioner sources — not just the salary math.
Hours / week
Shift length
Weekends
Where you work
checklist A typical shift
- check_circle Receive report from the outgoing shift on patient status and any overnight events.
- check_circle Assess and manage a caseload of 2-6 mechanically ventilated patients in an ICU or up to 30 patients on a general floor for breathing treatments.
- check_circle Administer aerosol-based medications and perform chest physiotherapy to clear lung secretions.
- check_circle Monitor and document patient physiological responses to therapy, such as vital signs and arterial blood gases.
- check_circle Set up, operate, and troubleshoot respiratory equipment like mechanical ventilators, BiPAP machines, and high-flow nasal cannulas.
- check_circle Respond to "code blue" or other medical emergencies to manage patient airways and provide life support.
- check_circle Educate patients and their families on managing chronic respiratory conditions and using home equipment.
Physical demand
The role requires long periods of standing and walking, as well as lifting, turning, and moving patients and heavy equipment like ventilators.
Stress level
Stress stems from managing life-threatening emergencies, dealing with critically ill or dying patients, and handling significant patient loads due to staffing shortages.
thumb_up Best fit if
- add_circle You can emotionally compartmentalize after dealing with traumatic patient outcomes and then move to the next patient's room.
- add_circle You function well with a high degree of autonomy, making critical decisions independently during emergencies.
- add_circle You prefer a schedule with more days off per week (e.g., three 12-hour shifts) and can handle the intensity of long workdays.
- add_circle You have a strong technical aptitude for operating and troubleshooting complex medical machinery under pressure.
thumb_down Skip if
- do_not_disturb_on You are looking for a career with numerous opportunities for vertical advancement into different clinical roles.
- do_not_disturb_on You need a predictable 9-to-5, Monday-Friday schedule without weekend or holiday commitments.
- do_not_disturb_on You are squeamish about bodily fluids, particularly respiratory secretions.
- do_not_disturb_on You have difficulty managing high-stress, life-or-death situations and the emotional toll of losing patients.
Sources cited (5)
The Landscape
Alaska stands out as a unique outlier, paying a high median salary of $94,210 despite being the only state not requiring a state-specific license; here, employers typically mandate active NBRC certification, which is also a common requirement for license renewal even in states without explicit state CE. While nearly all states mandate licensure, the practical implications vary, with some like Hawaii and Colorado relying on NBRC certification to fulfill CE, effectively standardizing a national competency benchmark even without direct state CE requirements.
Beyond salary, state-to-state differences manifest significantly in continuing education (CE) requirements, ranging from minimal state-specific hours to a demanding 30 hours every two or three years in states like New York and California. Most states now require criminal background checks, and many have specific CE mandates such as child abuse identification, HIV/AIDS training, or state jurisprudence exams, underscoring a commitment to public safety and specialized professional development across the board.
Respiratory Therapist by State
Click any state for detailed requirements & ROI.
| State | License | Median | vs. National |
|---|---|---|---|
| Alabama | Yes | $64,010 | -20.4% |
| Alaska | No | $94,210 | +17.1% |
| Arizona | Yes | $79,290 | -1.4% |
| Arkansas | Yes | $67,960 | -15.5% |
| California | Yes | $102,120 | +26.9% |
| Colorado | Yes | $80,690 | +0.3% |
| Connecticut | Yes | $83,250 | +3.5% |
| Delaware | Yes | $87,380 | +8.6% |
| District of Columbia | Yes | $104,240 | +29.6% |
| Florida | Yes | $79,710 | -0.9% |
| Georgia | Yes | $81,890 | +1.8% |
| Hawaii | Yes | $94,670 | +17.7% |
| Idaho | Yes | $75,510 | -6.1% |
| Illinois | Yes | $81,310 | +1.1% |
| Indiana | Yes | $77,820 | -3.3% |
| Iowa | Yes | $68,790 | -14.5% |
| Kansas | Yes | $73,580 | -8.5% |
| Kentucky | Yes | $65,670 | -18.4% |
| Louisiana | Yes | $70,140 | -12.8% |
| Maine | Yes | $79,330 | -1.4% |
| Maryland | Yes | $85,570 | +6.4% |
| Massachusetts | Yes | $96,940 | +20.5% |
| Michigan | Yes | $77,460 | -3.7% |
| Minnesota | Yes | $88,040 | +9.4% |
| Mississippi | Yes | $61,320 | -23.8% |
| Missouri | Yes | $73,880 | -8.2% |
| Montana | Yes | $80,950 | +0.6% |
| Nebraska | Yes | $78,880 | -2.0% |
| Nevada | Yes | $79,510 | -1.2% |
| New Hampshire | Yes | $83,620 | +3.9% |
| New Jersey | Yes | $98,020 | +21.8% |
| New Mexico | Yes | $66,460 | -17.4% |
| New York | Yes | $103,820 | +29.0% |
| North Carolina | Yes | $77,050 | -4.2% |
| North Dakota | Yes | $76,660 | -4.7% |
| Ohio | Yes | $78,400 | -2.5% |
| Oklahoma | Yes | $76,080 | -5.4% |
| Oregon | Yes | $96,130 | +19.5% |
| Pennsylvania | Yes | $76,160 | -5.3% |
| Rhode Island | Yes | $83,600 | +3.9% |
| South Carolina | Yes | $75,960 | -5.6% |
| South Dakota | Yes | $64,720 | -19.6% |
| Tennessee | Yes | $65,000 | -19.2% |
| Texas | Yes | $77,550 | -3.6% |
| Utah | Yes | $78,990 | -1.8% |
| Vermont | Yes | $78,760 | -2.1% |
| Virginia | Yes | $79,600 | -1.1% |
| Washington | Yes | $97,150 | +20.8% |
| West Virginia | Yes | $66,370 | -17.5% |
| Wisconsin | Yes | $82,160 | +2.1% |
| Wyoming | Yes | $75,900 | -5.7% |