Based on employment projections, the U.S. will need 17,500 more respiratory therapists (RTs) by 2033 to replace those leaving the profession. However, the supply of new RT graduates likely won't meet the demand.

A report from the Commission on Accreditation in Respiratory Care shows a declining trend. In 2021, there were 7.6% fewer new entry-to-practice graduates than in 2020 and 26.6% fewer than 2012. With nearly 95,000 veteran respiratory care professionals expected to retire by 2030, the need will continue to grow in the next decade.

Respiratory therapists: Percent change in employment, projected 2023-33

How we got here

Myriad factors are driving the problem. Demographic shifts among the workforce and population, increased demand for services, and systemic challenges within the health care sector influence the situation.

And while COVID-19 highlighted the profound need for RTs, the pandemic also intensified existing challenges. The demands of the pandemic led many RTs to leave the profession or accept temporary contract positions.

Years after the pandemic, burnout continues to stymie efforts to retain RTs. A survey found 93% of RTs identified burnout as a major issue. The Respiratory Workforce Project has identified scheduling issues, limited career development opportunities, and salary competitiveness as barriers within the respiratory care workforce. However, the demand for care continues to increase, with more than 100 million Americans affected by respiratory disorders.

Pediatric-specific challenges

The challenge is especially impactful for children's hospitals where RTs treat the highest acuity patients in NICUs and PICUs. RTs must be able to care for low-birthweight babies as well as adult-sized adolescents. They need a mastery of disease etiology, pharmacology, diagnostic and therapeutic equipment, procedures, and pediatric anatomy and physiology.

RT education

Despite these needs, RT education programs often lack robust pediatric coursework, leaving new grads without the experience to confidently step into roles at children's hospitals. A survey of managers and clinical educators found respiratory therapy students were largely unprepared to work in neonatal and pediatric settings. Of respondents, 63% said associate's degree programs did not adequately prepare students for pediatric settings; 42% said bachelor's programs did not prepare students.