How to Become a Respiratory Therapist in 2025

As a respiratory therapist, you’ll specialize in helping people breathe—whether they’re premature infants fighting to survive, adults recovering from heart attacks, or elderly patients managing chronic lung diseases. Your primary role involves assessing, treating, and monitoring patients with breathing challenges under physician supervision. You’ll operate medical devices like ventilators for critical care patients, administer aerosol medications through nebulizers, and analyze blood samples using arterial blood gas (ABG) machines to measure oxygen levels. Every shift brings direct interaction: you might stabilize a COVID-19 patient in the ICU, perform chest physiotherapy to clear mucus from a cystic fibrosis patient’s airways, or teach an asthma patient how to use an inhaler correctly.

Your responsibilities go beyond crisis management. Routine tasks include conducting pulmonary function tests to diagnose conditions like COPD, adjusting ventilator settings based on real-time data, and collaborating with nurses to create care plans. In emergencies, you’ll perform intubations or manage life support systems. Precision matters—a minor error in oxygen calibration or medication dosage can have serious consequences. Strong analytical skills help you interpret lab results and lung imaging, while communication skills let you explain complex treatments to anxious families. Physical stamina is essential, since you’ll spend hours on your feet lifting patients or maneuvering equipment.

Most respiratory therapists work in hospitals—about 75% according to Mayo Clinic College data—but you could also work in home care settings adjusting oxygen tanks for hospice patients, in sleep clinics diagnosing apnea, or in rehab centers guiding stroke survivors through breathing exercises. Shifts often include nights, weekends, and holidays, particularly in critical care units. The job’s intensity is balanced by its impact: you’ll watch premature babies take their first unassisted breaths and help COPD patients regain independence.

The demand for respiratory therapists is rising sharply, driven by aging populations and increased awareness of lung health. If you thrive in fast-paced environments, want hands-on patient care without a medical school timeline, and can handle both the emotional weight of critical cases and the routine of long-term care, this field offers stability and purpose. You’ll need adaptability—no two patients or shifts are identical—but the ability to directly improve someone’s ability to breathe creates tangible, immediate rewards.

As a respiratory therapist, you can expect to earn between $59,180 and $104,480 annually, with the national average at $77,960 according to Nurse.org. Entry-level positions typically start around $53,700 per year ($25.82/hour), while mid-career professionals with 5-9 years of experience average $63,300 ($30.42/hour). Those with 20+ years reach approximately $73,000 ($35.09/hour), though top earners in high-demand areas or specialized roles exceed $104,000.

Geographic location significantly impacts earnings. For example, respiratory therapists in Washington state average $123,425 annually, while those in California and New York earn $105,248 and $110,140 respectively. Southern states like Florida ($74,431) and Arkansas ($76,376) often pay below the national average, reflecting regional cost-of-living differences. Hospitals generally offer higher wages ($78,300) compared to nursing facilities ($73,390) or physician offices ($77,580).

Certifications directly boost earning potential. Becoming a Registered Respiratory Therapist (RRT) or specializing in neonatal/pediatric care can increase salaries by 8-12%. Additional skills like ventilator management or pulmonary function testing also command premium pay. Many employers offer shift differentials for nights or weekends, adding $2-5/hour, while overtime typically pays 1.5x your base rate.

Benefits packages usually include health insurance, retirement contributions, and tuition reimbursement. Per diem roles offer higher hourly wages (often $45-60/hour) but lack guaranteed hours or benefits. The field is projected to grow 13-14% through 2030 due to aging populations and increased respiratory conditions, likely pushing salaries upward. By 2025, average earnings could reach $83,000-$87,000 in high-demand states if current trends continue.

To maximize income, consider relocating to states with stronger compensation or pursuing roles in ICU/ER settings where advanced skills are prioritized. Contract positions through staffing agencies may offer $50-65/hour for short-term assignments, though these roles lack job security. With strategic career moves and ongoing certifications, you could reach the top 10% of earners within 10-15 years.

To become a respiratory therapist, you’ll need at minimum an associate degree in respiratory therapy from a program accredited by the Commission on Accreditation for Respiratory Care (CoARC). Many employers prefer candidates with a bachelor’s degree, which provides broader career opportunities and aligns with industry trends favoring advanced education. Both programs include clinical rotations to build hands-on skills, but a bachelor’s degree adds coursework in leadership, research, and advanced clinical practices. If you start with an associate degree, you can work while completing a bachelor’s program online—many schools offer flexible options for working professionals.

Your coursework will focus heavily on anatomy, physiology, pharmacology, and cardiopulmonary diagnostics. Classes like respiratory care protocols, mechanical ventilation management, and neonatal/pediatric care prepare you for real-world scenarios. Math and science fundamentals are critical for calculating medication dosages and interpreting blood gas analyses. Technical skills—such as operating ventilators, performing CPR, and analyzing lung function tests—are developed through lab work and clinical hours. Soft skills like clear communication, empathy, and problem-solving are equally vital, as you’ll explain treatments to patients and collaborate with healthcare teams.

Certification starts with passing the Certified Respiratory Therapist (CRT) exam, required for licensure in all states. Most employers and states also expect you to earn the Registered Respiratory Therapist (RRT) credential, which the National Board for Respiratory Care considers the profession’s highest standard. Specialty certifications in areas like sleep disorders or adult critical care can further boost your qualifications. Entry-level roles typically require 600+ clinical hours completed during your program, often through hospital rotations or internships. These placements let you apply classroom knowledge under supervision while building professional connections.

Plan for two years to complete an associate degree or four years for a bachelor’s, plus exam preparation time. Accelerated programs may shorten this timeline, but balancing coursework with clinical hours demands focused effort. Staying current with certifications and pursuing advanced degrees can open paths to roles in management, education, or specialized care. Employers prioritize candidates who combine technical expertise with adaptability—skills honed through consistent practice and real-world experience.

As a respiratory therapist, you’ll enter a field with strong growth projected through 2030. The Bureau of Labor Statistics initially estimated 23% job growth between 2020-2030, driven by aging populations needing care for chronic respiratory diseases like COPD and pneumonia. More recent data suggests a slightly slower but still robust 13% growth rate from 2023-2033, with about 8,200 openings annually. Over 16 million Americans currently live with COPD according to CDC data, and this number will rise as baby boomers age, ensuring steady demand for your skills.

Hospitals employ most respiratory therapists—organizations like Mayo Clinic, HCA Healthcare, and Kaiser Permanente regularly hire for these roles. However, home healthcare services and outpatient centers are growing employers as care shifts toward reducing hospital readmissions. Geographically, states with large elderly populations like Florida, Texas, and California have the strongest job markets, particularly in urban areas. Rural regions also need respiratory care but may require you to handle broader responsibilities.

Specializing can make you more competitive. Neonatal/pediatric care, sleep medicine, and ECMO (extracorporeal membrane oxygenation) therapy are emerging niches. Telehealth is creating opportunities to monitor patients remotely, while advancements in portable oxygen systems and smart ventilators are changing how care gets delivered. You’ll need to adapt to technologies like AI-driven diagnostic tools and virtual reality training platforms, which enhance precision but won’t replace hands-on expertise.

Career advancement often starts with certifications like Adult Critical Care Specialist (ACCS) or Registered Pulmonary Function Technologist (RPFT). With experience, you could move into leadership roles, clinical education, or medical equipment sales. Travel respiratory therapy offers higher pay and flexibility, with agencies like Barton Healthcare Staffing reporting increased demand for short-term assignments. Some therapists transition into related roles such as pulmonary function technologists or healthcare administrators.

While opportunities are plentiful, competition can be stiff in major cities. Employers increasingly prefer candidates with bachelor’s degrees over associate degrees, and certifications often determine who gets hired first. Balancing technical skills with adaptability to new care models—like home-based treatments post-COVID—will help you stay relevant. Job security remains strong, but staying current with industry shifts is key to maximizing your opportunities.

Your day starts with reviewing patient charts and ventilator settings during morning rounds in a hospital’s intensive care unit. You adjust oxygen levels for a COPD patient, perform chest physiotherapy on someone with cystic fibrosis, then rush to the emergency department to assist with intubating a trauma victim. Between treatments, you educate a new asthma patient on inhaler techniques and troubleshoot a BiPAP machine malfunction. Every hour brings a mix of scheduled therapies and urgent interventions—you might spend 20 minutes analyzing blood gas results for a premature baby in the NICU, then pivot to performing an emergency airway clearance for a pneumonia patient.

You’ll typically work 12-hour shifts, often including nights and weekends, with 65% of hospital-based therapists rotating between day and night schedules. The physical demands are relentless—you’ll walk 5-7 miles daily between patient rooms, lift equipment weighing up to 50 pounds, and stand for hours during complex procedures. Emotionally, you’ll balance the joy of helping a COVID-19 survivor breathe independently again with the weight of comforting families withdrawing life support.

Your toolkit includes advanced ventilators, arterial blood gas analyzers, and electronic health records systems. Collaboration is constant: you’ll consult with pulmonologists about ventilator weaning plans, coach nurses on suctioning techniques, and brief social workers on home oxygen needs. In outpatient roles, you might lead pulmonary rehab classes or conduct sleep studies, working regular weekday hours with fewer emergencies.

The job’s flexibility allows some control—you could work three hospital shifts weekly or choose predictable clinic hours. However, 24/7 patient needs mean holiday shifts and last-minute schedule changes. Burnout affects 1 in 3 respiratory therapists due to high-stakes decisions and prolonged exposure to suffering. You’ll counter this by focusing on victories like discharging a long-term ventilator patient or teaching a child with asthma to use a peak flow meter.

Most days end with charting treatments and restocking crash carts, knowing your expertise directly impacts survival rates during respiratory crises. The work exhausts you physically and emotionally, but few careers offer this immediate, visceral connection between your skills and someone’s ability to take their next breath.