Why Ask Why?

As I remember reading the document that created CRT's out of CRTT's, the rationale was that the respiratory therapy profession needed to stop the confusion surrounding credentials and elevate everyone to the therapist level. Then the goal was to get therapists to move to the Advanced RCP/RRT model.

These hoped for changes have not occurred, and caused many problems because many newly created respiratory therapists, do not want to pay the extra money to be registered as opposed to simply certified. What should have lessened confusion caused a generalized apathy towards taking the RRT exam and the numbers of eligible people taking the RRT exam fell off dramatically.

After all why spend money, study and demonstrate your knowledge to only change one letter on your credential and when you go back to work you will not make more money for your efforts. As well, when you think about it most of the public and certainly other hospital personnel do not know the difference between the CRT and RRT credential!

My opinion is, if the NBRC decision makers wanted to be logical in their creation, they should have done what other therapy professions such as physical therapy and occupational therapy have done. Those professions have a lower level worker namely the PTA and OTA that essentially have two years of education and generally do what the Registered PT and OT can do, but not to the same level. These two groups do not allow a step-ladder advancement opportunity, but respiratory therapy can and does allow for this which is a positive for our profession!

In my opinion, the CRTT simply and logically should have become the RTA or respiratory therapy assistant and legally required to work under the supervision of a RRT while they qualified for their Advanced Respiratory Care Practitioner/RRT qualification.

This model revision of the credentialing system would have motivated any RTA eligible to become a RRT to study and obtain their RRT credential and the recognition that comes with that credential. Alternatively those individuals that do not want advance themselves for whatever reasons can continue to work at the RTA level.

Ideally we would have Bachelor degrees to qualify for RRT and who knows, then we might even be able to develop some online clinical Masters degree programs much like pharmacy or physicians assistants have that could be completed while you worked and would prepare those interested to work at an advanced specialty level in Respiratory Care much on the order of a nurse practitioner or physician assistant, with licenses under our states respiratory licensing boards. This would provide for those willing and motivated to advance to their highest potential within the respiratory profession rather than leaving for professions that allow for greater advancement.

Overall this model for respiratory therapy would force the profession to advance in a unified manner, discontinue the three decade argument about credentials and allow for the multi-levels of personnel that are needed to exist within the workplace.

The NBRC has already shot the profession in the foot by not eliminating the entry level exam when they eliminated the CRT programs. Who does it really benefit??

The certificants? They are forced to take the "easier" exam before they can sit for the exam appropriate for the training and education completed. Perhaps the NBRC should decertify the programs that cannot produce grads that can pass the exam!

Their colleagues? Wage ceilings are lowered by the administrative policies of hire the same for less, CRT vs RRT.

Or pay comparable wages and slap the RRT in the face for obtaining the credential for which they are qualified.

The Patients? The ones who pay out trillions in healthcare expenses and ultimately fund the whole system. They deserve top value for each dollar spent. They can only hope and trust that their dollars are used wisely and appropriately when they come through the door.

The NBRC’s rationale does nothing to address the very real issue of manpower shortages in healthcare other than increasing costs without adding value, also known as price gouging. If other credentialing bodies follow this rational we would have mandatory LPN testing for RN’s , maybe PA requirements for all physicians, and even pre license fees before becoming licensed. If we all use this philosophy, get a little extra for nothing, our customers won’t be able to afford our services. OH!!!! That’s already happening!

I don't understand why they cannot just stop offering the CRT but allow those that have only the CRT to practice at the risk that some places may not hire them any longer.  The CRT's will slowly go away leaving only RRT's wouldn't it?

After being an "Respiratory Therapist" for 35 years, I believe Mr. Laher has hit the proverbial nail on the head.  Why would we diminish the value of those who had the initiative to go forward in their careers and take/pass their Registry Exams, while "extending" the time others have?  What does that say to ours and other professions?  Can our graduates not perform at the level of other professions?  In my humble opinion, Mr. Laher is exactly correct.

I've watched our chosen profession evolve over the last 25 years and I have worked side by side with many therapist's credentialed or otherwise.  Our history emerged from the classic on the job trainee and we find ourselves on the precipice of labeling ourselves out of our chosen fields.  Many hospitals do not have full-time respiratory care staffs, and it is my gut feeling that if we strive to improve the quality of our overall delivery of care, then we shall survive as a profession regardless of what letters follow our name.  Many therapist need only look no further than our past to see how the uncredentialed professional has influenced our field.  I dare say that many of our trusted practices came as the result of the dedicated efforts of those that preceeded us, and it is our responsibility to pass those on to the next generation.  Education is a blessing, licensure and credentialling have protected the integrity of our profession.  We should not allow the powers that be to regulate us into oblivion.

Having been a Director of Respiratory Care and a Program Director of Respiratory Therapy Education, I feel that I am very well qualified to respond to this issue.  With the "Aging of America" and the reduction of High School Graduates going into the "service industries" (health care included), there is no question that all health care professions are going to experience a significant shortage of qualified practitioners.  There is no way that our Respiratory Therapy Educational Programs can reduce the quality of their entrance level requirements, and there is no way that a 2.3 GPA can be accepted into these Programs.  Each of us have to insist on a higher quality of expertise in our field and, pay for it!  There is no way that a local Community College can have 300+ students and still assure a "quality education".  I can totally understand why the NBRC decided to extend the privilage for CRT's to become RRT's.  Many of these CRT's are exteremly well prepared but have never had the encouragement to advance to the RRT Level.  This is our Manager's Problem in that the majority of Educational Programs are aimed at the RRT credential.  WAKE UP FOLKS - WE NEED TO ADVANCE!

I am a CRTT, Paramedic, Firefighter, working on my Masters Degree and working in respiratory.

I have accomplished a lot, becomming a RRT is not that important to me.  We have such a shortage or nurses and RT's you would think soneone could come up with a solution, like pay.

J

I agree that there should be only one credential RRT.  The problem is that the differenc e in pay from CRT/CRTT to RRT is just not enough to make it worth the money you pay for Kettering, both tests and possibly travel expences.

I have worked with many outstanding CRT's and a few poor RRT's.  I have written (co-authored) 3 Respiratory Care books amd worked for some outsanding hospitlas over the past 15 years.

I don't think I will ever take the RRT exam, however I may take one or two in the focused areas.  Maybe they should just grandfater in all the CRT/CRTT to RRT and stop worring about who is going to take the test.  We don't have enought Respiratory Professionals to go around now...

Stan Bryant

US Navy Retired

I read Mr Laher comment about CRT to RRT and the delay and I felt I should put in my 2 cents. I agree 100% the delay is not called for. All the therapist were given over a year to obtain their RRT. Those that didn't comply knew their jobs were not in peril so why do it. Plus many of the old time CRT never have any intention to get their RRT. Case CLOSED! The point we all miss is never assume that a CRT is not "most qualified, most educated and most talented critical thinkers at the bedside". I know many CRT that I would trust with my life and the lives of my family. I also know or have known many RRT that were book smart but put them at the bedside or in a crisis and they fall to pieces. We need to look at the person, their experience and not the letters they have after their name. The letter could mean they are just good at taking a test. I worked with a therapist that took the Pediatric/Prenatal exam passed it and never worked in the area. Is he the best. I think not. The point is the NBRC needs to make a decision and them just stick to it. We as therapist need to decide what we want out of this profession and be the best that we can be. Should we all be RRT. YES But if the NBRC is going to change it mind and the hospitals are going to be .....well CRT are cheaper.... then we as a profession don't deserve some of the respect that some of us have earned. I for one am proud to be an RRT.