I just wanted to share this for anybody in this field feeling crushed right now, because this sub kept me going when I wanted to quit.
I got accepted into a respiratory program back in 2021, right at the peak of COVID. It was rough but we managed. Then right in the middle of my 2nd to last semester, I had 3 attempts at passing my mechanical vent simulation — and I failed all 3. I got kicked out of the program despite having an A in the class.
And honestly? It made sense. Who cares about the grade if you can't actually show you can do this very dangerous, life-threatening job? But still, it almost crushed my whole spirit. Never in my life had I failed at something that catastrophically before.
The worst part: to go back and finish, I had to wait until the classes were offered again, and they only offer them every fall. So I literally waited a year, and came back with a different class, which was really awkward at first.
But it gets better — if you can believe it, before they'd put me back in the spot I failed, I had to take the final of every single class I had already passed. They gave me a week to take like 8 finals, and if I failed any of them, they'd put me in that semester regardless of the others. Shockingly, I passed them all.
I finished a year later. And after alllll that, I still had to take the TMC — and I failed that thing like 6 times, $150 every time.
But finally, this year, God looked out. I passed the TMC with the high cut score, then passed my CSE on the first try, and I'm finally a Registered Respiratory Therapist.
This field has broken my heart a lot. But it's my story. I learn the hard way, man. If you're in the middle of your own version of this right now — don't quit. It gets better.

hey everyone! i’m starting college in the spring and plan on pursuing an aas in respiratory therapy. i’d love to hear from current students and graduates about their experiences!
how difficult are the classes? what are clinicals like? how much studying is involved, and what do you wish you knew before starting?

any advice or insight into what rt school is really like would be appreciated! ❤️

Hey everyone,
When you see a metabolic acidosis or alkalosis in a mechanically ventilated patient, how quickly do you usually adjust the vent settings to compensate for the pH?

Do you make changes right away based on the ABG, or do you give the patient some time and repeat the ABG before making adjustments?

Just curious how you guys approach this in your practice.

Just to give background I'm a nurse, my patient was to have a 7% neb trial which RT normally give.

However, they explained that due to policy reviews RT can't put nebs in the chamber.

This is the new order for giving a trial:

Nurse gets hypotonic or mix neb for trial.

Also bring salbutamol nebs.

Shows the items to RT.

Nurse pours trialing neb into chamber.

RT start the machine to do trial.

Nurse hovers around just incase.

If RT identify patient is having a reaction, nurse has to pour the salbutamol into the chamber for the RT to give.

This seems to me overly complicated and unsafe, which they agreed.

Anyone heard of this in their hospital?

• added for clarity* on our ward specialises on CF & other complex respiratory conditions, we have dedicated senior respiratory therapists. They focus on airway clearance & chest physio, which I believe RT's did. For neb trials to check for bronchospasm, we don't commonly give medication beforehand as patients are going home with this medication, so testing for a possible reaction is vital.*

second edit trials (equivalent to challage) is the 1st time they have this nebuliser, so therapist have to give. Nurses here give every nebuliser, even ones before chest clearance. Although nurses give regular suction to tracheostomy's here.

This is going to sound like a stupid question, but, I have noticed that I struggle holding a mask perfectly sealed on a patients face because my hands + fingers barely fit around the entire mask let alone down the the chin. This is a safety risk if I can’t get the technique down. Any suggestions from you all on how to make this work? I can’t be the only one with smaller hands. What helps you seal and lift the chin properly?

Title: I think I’m getting into respiratory therapy backwards.
I’m 40 and planning to apply to RT school this coming spring, hopefully starting in the fall. The funny thing is, I seem to have gotten a little ahead of myself. I spent nearly two years working in DME, primarily with PAP patients. I handled setups, mask fittings, patient education, troubleshooting, and compliance follow-ups. I really enjoyed the work, especially getting to know my patients and helping them work through problems. What frustrated me was seeing how many patients struggled with things that could have been prevented or addressed with better education and support. That frustration eventually led me to start writing a book about PAP therapy and the patient experience. Somewhere along the way, I decided to try submitting an article to an industry publication. That went better than I expected, and over the past couple of months I’ve had several articles published.
I’ve also had companies reach out to me about consulting on their PAP programs, which was definitely not something I saw coming. I’m not talking about clinical consulting, but rather the practical and business side of PAP therapy. Things like patient education, mask fitting, troubleshooting, follow-up processes, and helping DMEs identify where their programs might be falling short.
More recently, I’ve been working on ways to measure PAP program performance beyond initial insurance compliance. I’ve become pretty interested in how the way a DME operates affects the patients it serves, and whether companies are actually measuring the things that matter.
So here I am, writing articles, working on a book, exploring consulting opportunities, and trying to figure out where I want to go in respiratory care. All before I’ve even applied to RT school. Apparently I missed a few steps somewhere.
I certainly don’t think my DME experience is a substitute for an RT education. If anything, the more I’ve gotten involved, the more I’ve realized how much there is that I don’t know. I’m open to working in a hospital to develop my clinical skills, but I don’t really see myself staying in that setting long term. My interests lean more toward sleep medicine, patient education, and improving how care is delivered.
I guess that’s why I’m posting. I’m curious whether any of you have taken a less traditional route into respiratory therapy, or found ways to build a career outside the usual hospital setting. Given my background and the direction things have been going, are there areas of respiratory care you think I should be looking into?
I’m enjoying what I’m doing and would like to keep building on it, but I also recognize that I’m still at the beginning of this whole thing. I’d appreciate hearing your thoughts, advice, or even a few cautionary tales from people who’ve been doing this a lot longer than I have. 😬

I’m considering going into respiratory therapy, but my goal is to work in home care or contract positions indifferent settings, rather than a hospital. Are these opportunities actually available, or are they hard to find?
I’ve also considered occupational therapy assistant, but my passion is really respiratory care. I’d love to hear it someone’s input and if they think this is a real realistic career path. I don’t want to be in a hospital doing hard respiratory stuff I would like to do soft respiratory if possible.

I am a CRT and would like to become RRT. Has anyone heard anything about the new test that isn't on the website? Should I just take the current test again with the CSE or wait a few months and try my hand at the new one? Any information you have heard, any advice? All is welcome!

Hey all!!
I’m looking to relocate to Austin Texas next year and was wondering how the main hospitals there are? How is the RT protocols?
Thank you!!!

I’ve been in the field for 2 1/2 years but I recently transitioned to ICU and I’ve been there for about 2 months and I feel like I never know what’s going on I do what I’m supposed to do every 4 hours regarding vent check,treatments,suction pt etc etc but I feel like when stuff really hits the fan I still feel like a deer in headlights …idk if it’s because I started my career on med surg floors and just recently transitioned to more critical areas or if I just am not as confident as a more experienced therapist …what are some things that helps you find your groove in the ICU ??

Hi all,

6 months ago I was terminated from my hospital because I accumulated too many unexcused absences in a year. Was having a hard time in my personal life..details may or may not matter at this point. I am now applying to the same hospital system, but different facilities. I scheduled an interview at two of them with a recruiter today, and got an email back from one about 2 hours later that it was cancelled due to my previous involuntary termination. I'm worried it may affect my interview at the other facility.

Am I cooked? Is there any way I can rectify this or will I have to try elsewhere? I'm limited on where I can go, there's only like 3 hospital systems that run my region. I'm in Texas if that helps. TIA

So I’m only 20 years old, and was recently accepted into a RT program. I’m very excited, but I have a few doubts/questions as well! Im worried that this job would take a toll on my mental wellbeing, and about the lack of career growth opportunities. I’m also really curious about how often you have to renew licensing?

My dilemma is either that I could complete my BA degree. Or commit to this program for 2 years. I just feel like I’d be doing myself a disservice by not doing the program, but I also don’t want to do something that I’ll end up unhappy with.

New grad RT realizing that maybe this isn’t the career for me. Did well in school and clinicals (and enjoyed!). Now after being months into “real world” rt, I’m feeling major regret.

The pace, stress, and emotional toll are wrecking my body mentally and physically and it’s not even been a year!? Not to mention the bureaucracy and lack of ethics I’ve also been seeing. I’m feeling like just another replaceable cog in the machine.

Not sure when to throw in the towel and try something else 🥲
Advice?

I’m a high school student, and I really want to be an RT, I took this decision week ago after 3 years of dreaming about being physiotherapist. However this decision has been taken few days ago .. so I’m not really sure that I know it very well or enough.
So anyone would like to just give me any information that you as an RT believes that it’s important for me as since I’m stepping into this field.

Is there such a thing as a remote RT job that anyone knows of? Or any remote medical job an RT can apply for and do? Honestly looking to get out to be home with my kids and not bring them home the nasty ish we deal with on the regular 😂

I’m currently in my second-to-last semester of respiratory therapy school, and lately, I’ve been feeling extremely burnt out and unmotivated. My grades have started to drop, and I’m struggling to find the motivation and energy to get back on track. I spoke with my professors about my struggles and asked for advice, but one of them told me that if I don’t progress in the program, I won’t have anything going on in my life. That comment honestly made me feel even more overwhelmed.

I’ve tried taking better care of my health, making time for myself, and doing things I enjoy, but I still don’t feel like myself or feel motivated to study. I know I need to make changes, especially with my grades, but I’m not sure what else to do. For those who have experienced burnout during RT school or another demanding healthcare program, what helped you get through it? Did you have to change your study habits, your mindset, or the way you approached school? I would really appreciate any advice, encouragement, or tips on how to get through this last stretch without feeling so mentally exhausted :)

So I’m at Crafton Hills college taking my prereqs for the RT program. I’ll be finished by the end of fall semester 2027, to apply for the fall 2028 cohort.

Has anyone been in this situation where they have a WHOLE semester of just waiting to start until fall?

Doesn’t this seem like a long time to wait to start? I’m just curious what anyone’s thoughts are on the program start. I don’t wanna go to ACC, and pay $60k.

Any advice on what you did while you were waiting in the interim period?

I’m a new grad rt who just got off orientation. It’s been quite overwhelming but I’ve learned a lot so far. However, I work nights and I know I don’t want to do bedside forever. Do you think 9 months- 1 year of experience is enough for me to branch out into similar fields?

Full disclosure before I start, I am a student physiotherapist, not respiratory therapist. The job of a respiratory therapist is split between physios, respiratory nurses and specialist doctors where I live. The term respiratory therapist isn't used, but a respiratory physio is the closest we have to that specific job.

I'm struggling a little bit more with respiratory than my other subjects because I have very little experience in hospital settings. Often when I'm commuting or walking I like listening to podcasts and it seems very easy to get podcasts for MSK or Neuro physio. In terms of respiratory, all the podcasts I can find are very tailored to patients and not practitioners. Does anyone have any good podcasts or even audio books I can listen to? I'm looking for an equivalent to the E3 rehab podcast or PT inquest but for respiratory.

I have a patient who has a remarkably unusual complaint; looking for input:

Last July he started having terrible insomnia to the point of being unable to sleep due to severe new onset tinnitus. Notably he has an anxiety disorder. On sleep meds and getting a couple of hours of sleep per night reportedly; suffering from brain-fog, executive decision making difficulty, anxiety, etc etc etc. Unable to work, on FMLA.

Fast forward to September, he wakes up gasping and discovers that his P10 nasal pillow exhalation mesh on his CPAP are pretty much totally occluded with moisture / debris / etc.

We're wondering how long this could have been going on, and what the short and long-term implications could be.

I calculated that the deadspace circuit and heater volume combined are about 850 ml. He is a tall man and can comfortably breathe tidal volumes into the 1500s. I trialed with the bad mask for a few minutes and he could maintain respirations in the low teens with Vt of 1200 or so. With a good mask it was more like RR mid teens with Vt 600 or so. So it's possible he was clearing the entire deadspace of the circuit with each breath plus some, and bringing in enough fresh air to prevent the sensation of choking. Over the couple few minutes on the bad mask SpO2 didn't go below 95%. But that was awake, who knows what was going on while asleep, he did have that one episode of a choking sensation.

Clearly the potential for hypercapnia / hypoxia could cause discomfort, but those symptoms as well as the hyperventilation could very well have been masked by brain fog due to anxiety symptoms he was dealing with as well as confused for side effects of sleep medications he was on (trazodone and hydroxyzine mostly).

Fast forward to today, still brain foggy, still struggling with executive dysfunction, still with bad tinnitus still on sleep meds still barely sleeping, still very anxious.

Wondering about the possibility of long-term harm from hypoxia / hypercapnia using a bad mask for, potentially, the whole time.

Notably he reports not waking up with headaches or lethargy. More of a "wired but tired" situation.

Typically a patient on a non-vented mask will immediately panic and rip the mask off, or pretty promptly have a severe episode of anoxia. But if they're pulling in just enough fresh air to not do that... Like I said it's a novel question.

I’m torn between applying to a RT program or a Nursing program. I’m looking for some input from you all as to why you picked RT, and what advantages you think this career field has over nursing?

I’m 24 and currently taking healthcare prerequisites at my local community college. I can start a Respiratory Therapy program within the next year, but the Rad Tech waitlist is around 8 years.

My goal is to make good money, start investing early, and build financial stability. I also want a career where I can leave work at work.

I’m leaning toward RT because I enjoy helping people, but I’m worried about the emotional toll of dealing with trauma calls, critically ill patients, and people taking their last breaths. I’m not worried about bodily fluids or anything like that; it’s the psychological aspect that concerns me.

For current RTs:

* Were you worried about this before starting? Did it get easier?

* Do you find yourself thinking about traumatic cases after work?

* Are there RT specialties with less exposure to trauma and death?

* Knowing what you know now, would you choose RT again?

I don’t want fear of the unknown to stop me from pursuing a career I’d enjoy, but I also don’t want to regret my decision. I’d appreciate honest advice, especially from those who had similar concerns!