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Friday, August 8, 2008

Choosing a career: RN versus RT

I am aware that a large portion of my readers are individuals who are surfing back and forth between RN and RT blogs trying to decide: Do I want to be an RT or an RN?

Respiratory Therapy Driven touched on this topic once. He wrote a nice post called RT -vs- RN. I wrote a humorous take on his post, What RTs can do that RNs can't.

I can rattle off the advantages and disadvantages of being an RT, and why I prefer being an RT over an RN. However, this would be skewed from an RT persective.

I can honestly say I enjoy sputum, while many nurses I talk to say they wouldn't want to be an RT because "sputum is gross."

"Well," I say, "I think handing someone a tissue is far better than wiping his butt."

But, like I just wrote, it depends on who you are. Some people might actually enjoy helping someone wipe. Besides, you are helping someone. You have a skill at taking care of sick people, and one of your responsibilities is wiping.

That, however, is a minor task as far as an RN is concerned. They also get to help the patient feel better by giving a bath. Or, perhaps, they delegate that responsibility to a nurses aide, while the RN helps the patient bandage an oozing wound.

Personally, I don't care to do that. My responsibility as an RT is with the airway, and any other holes in the body are left for the RN to take care of. Sputum is the least of my worries.

"But sputum stinks," a nurse said to me once.

"Not as much as that other stuff stinks," I said. "Besides, sputum doesn't stink very often. Poop stinks every time. And if it's of the GI bleed variety, we RTs don't have to stick around once our breathing duties are finished."

So, I've had this debate many times. Nobody ever wins.

Anyway, you don't decide RT over RN because you like sputum. And you don't become an RN because you like to wipe. It's not that simple. There is far more to the decision.

It is true that RNs get paid more than RTs, and actually get more respect nationwide because it has been a well established profession since the Civil War. RTs get paid less, but that doesn't mean we have less responsibility.

You, as an RN, have care to for the general welfare of 1-7 patients. You have to stay in one area of the hospital. You basically cannot leave your patients. We, as an RT, get a variety of patients all over the hospital. While you have to stay by your patients, we get the freedom of roaming the hospital.

That's not to say we don't occasionally have patients that need our one on one care.

RNs give the medicines, and insert the IVs, and we RTs are called when the patient cannot breath. We are the experts at knowing when to call the doctor because a patient can't breath, or simply giving a breathing treatment.

While RNs know a little about a lot of diseases, we RTs know everything about the lungs and heart, and we even know enough about the other organs as everything in one way or another is connected to the lungs: they all need oxygen.

When someone stops breathing, the page is heard loud and clear: "RESPIRATORY STAT TO ROOM 214!"

While the RNs are busy inserting IVs and inserting syringes, and taking care of any wounds on the body, we RTs are continuously managing the airway. We monitor breathing. We insert artificial airways, and run blood gases, and do EKGs and, best of all, we set up and manage ventilators.

We RTs are the team mates of the RN. We all work together. Whether or not you decide to be one or the other is basically a personal preference.

There are other advantages to being an RN beyond the job. We RTs are stuck working in the hospital setting. In Shoreline, there is only one hospital, and only one RT department. RNs can work in the hospital, and can choose between many departments of which to work.

If an RN gets tired of working on the med-surge floors, she can transfer to OB. When she gets tired of working there, she can transfer to surgery, or ER, or back to the patient floors, or the critical care.

She can also get a new job working in Grand Rapids, and can get a job doing any of the above in a busier hospital, perhaps one with a trauma center or burn unit. While working in GR, she may choose to work only with neonates and pediatrics.

An RT can work with neo and peds too, but the options of transferring are far less. An RN can also provide independent services by helping a patient one-on-one in his home. She can do home health care if she wants. She can work in a doctors office for a slight deduction in pay. She can work in a nursing home.

There are far more options for nurses than RTs. That is a simple fact. And, even while RTs and RNs can both rent their services for far more than they'd ever make in the hospital, RNs still will make more than RTs -- that's a simple fact.

Still, knowing all that, I love being an RT. I wouldn't want to do what RNs do. Another thing is, RNs are responsible for keeping all those meds straight. I certainly wouldn't want that responsibility. I'm responsible for only a few respiratory medicines.

Yes, it is true that my breathing machines keep people alive, and things I do could end a life if I made an error, RNs are inserting medicines into the IV that, if given in incorrect doses, could kill or save a life.

The challenges of being an RN or RT are phenomenal. It's the challenges, the working with each other and the doctor to find out what a patient needs. That is the most rewarding part of being in the medical field. It's the teamwork.

Personally, I would never be an RN. That's just not my thing. However, would I ever recommend anyone become an RT? Well, that depends on what your goal is in life.

Are you 28 years old, have already failed at another career, and simply need a job. That's how I became an RT. It was the fail safe for me. Despite popular belief, I did not choose this career because of my asthma. However, it was my asthma that made me aware the job of RT existed.

A lot of people become an RT for reasons similar to mine. Some go into this field because they love to work with people, but don't want the stress of being an RN, or they don't want to wait three years to get into RN school.

There is a greater chance that an RN can move up the ladder. There are simply more opportunities. RNs can get a bachelor's degree. RTs can too, but the benefits from doing so are hardly worth it (at least in my neck of the woods. It's not even offered around here.)

How hard do you want to work? How hard do you want to stress your mind. Are you good at prioritizing? These decisions come to play in both these careers. RTs can be paged three places STAT all at the same time. Which one do you go to first. This is especially important if you are working alone?

There are definite advantages and disadvantages to being an RT or an RN. For one thing, there will always be sick people, and there will always be people in need. Likewise, there will always be people who need help with their breathing.

And, on occasion, there will be people who stop breathing and need the services of both an RT and an RN.

Personally, I'm satisfied with my decision to be an RT. You can read my list of why I love being an RT if you want. Still, would I chose this career again if I had to do all over again. The answer would depend on what day you ask.

Would I recommend you be an RT? Again, it would depend on what your goals are in your life. If you want to be the sole income for your family, you better find some other career. This is not the most financially rewarding job in the world. Still, you could do far worse.

Personally, if I were advising my child, and he were vying RN or RT, I would tell him to be an RN. Why? Because RNs get paid better, and there are far more opportunities available for RNs than RTs.

Still, he might be like me, and simply prefer the RT rought.

Both of these careers can be rewarding. Both can be frustrating as any job.

And both have their advantages and disadvantages. Which one you choose depends on your preferences, your personality, your location, and your goals in life.


Anonymous said...

Curious,what is the starting pay for RN / RT's where you are?

I start RT school at Macomb CC this fall - sunrise side of state!

Just spent a week on the sunset side of the state - Holland, Grand Haven, etc


Love the blog!

Rick Frea said...

send me your email. Mine is

Kolla said...

Fantastic post... now need to look more into this RT stuff! Before tripping across your blog (and now a daily reader!) I had no idea the profession even existed.

Thanks for sharing!

Anonymous said...

So as an Rn in an Er and with previous experience in a post cardio thoracic unit. I can say I do more than tend to wounds and bathe patients. I have respect fo the RT however I can also say that I have vast knowlege of cardiopulmonary care. As per my ACLS certification which is required for critical care RNs I also can perform intubation if need be however I can say that the MD is the one that intubates 99.5% of the time with Rt and RNs also assisting. Although I know that they can I have never seen an RT intubate. My experience is that RT's usually bag the pt and set up the vent. Occasionally they secure the ET tube or suctioning (although many times I have done that myself). Rns are ususally busy administering life sustaining meds and fluids, doing chest compressions, monitering the heart rhythm and vitals, Inserting nsogastric tubes and foleys. We are usually the ones defibrilating or cardioverting. We assisting with chest tube placement or performing trach care. All the time trying to support grieving family members, code charting, and overseeing an transfer organized by the MD. Rt comes to check on vents at times but we most certainly manage our ventilators. We often do EKGs and give critically ill patients ordered respiratory treatment when time does not allow us to wait for EKG tech or RT as they are often busy themselves. The point is that we all part of a team and the good RNs, MDs and RT work as a team as respect each other as part of that team for the betterment of our patients.

Rick Frea said...

well said.

MrsTygalee said...

Thanx so much for taking to the time out to do that blog. You just validated my reasons for choosing RT over RN. No offense. I'm just not cut out for it. kudos, Ty

Emily I said...

As a first year student, I'm absolutely loving this blog.

I'm lucky enough to be in the MD/VA/DC area, so the number of hospitals is astronomical. I *almost* moved to the RN program, but it just never felt right and something kept pulling me back to the RT. So despite everyone in my life trying to nudge me towards the nursing, I went RT. And now, as I learn the roles of my future career, everyone I know is learning more about the apparently mysterious field. RT bound and proud, and I'm starting to enjoy responding when people see me in scrubs and assume that I'm a nursing student.

One thing that I can say is a great way for someone to try out nursing at a fraction of the price/hassle of going for LPN/RN/etc is to look into CNA (certified nurse assistant) programs in their area. Should you hate it, it's a fast course (4-6 weeks) and you learn a lot in the realm of patient positioning and the art of caregiving (mental status, emotional needs, family interaction) and it fills in the gaps that my RT program doesn't touch on because of focusing more on the science of care. Or, you'll learn that Nursing is the way that you want to go. I personally didn't hate it, but I didn't love it either. Something about RT work just makes it completely engaging and fascinating, even if we're just talking about sputum. Plus, its one more cert to have on your resume and a possible PT/FT job to hold while in school that keeps you in a clinical environment.

Anonymous said...

There are also no jobs in the RT industry. It is way easier to find a full-time job as an RN whereas for an RT, most of the people that graduate from an RT program end up jobless or casual

Anonymous said...

Not sure what anonymous is talking about with their being no jobs. I live in Charlotte and their are TONS of RT jobs from full time to part time to prn. Maybe if you live in some rinky dink town it may be a bit harder to to get a job but that is true with all professions. Sounds like someone has some sour grapes. Also, around here RT's make as much as RN's.

Anonymous said...

As a 18 year RT, I make as much as RN's and working together as a team is vital and mutual respect is exchanged. We participate in Clinical Ladder, Intubate and do arterial line insertions as well as manage vents and ABG's. Nurses at our hospital do not perform these tasks. I am sure all facilities are different. There are more opportunities for advancement for RNs however.

latoya said...

I'm a newbie to your post. Thanks for every single last one of them. Though people don't comment much there are THOUSANDS that are very grateful for them.

Anonymous said...

I live in Portland OR. I have been looking at RN school, but in Portland there are so many nursing schools that over 500 new graduates come out each year, and it's basically impossible to find work. From what I'm reading, RT looks like a possible fit for me, but I don't see many job ads for it, either.

Are RT jobs really plentiful for new graduates?

You wrote in 2008 that RT students can work in a hospital during training. Is that right?

Thanks so much!

Rick Frea said...

This might be a great question for a career guidance counselor. It does seem the field is pretty saturated in Michigan too, although if you're willing to move there's always 2-3 jobs scattered about.

If you are interested in working in a hospital, I would highly recommend getting a job in one when you graduate. You can even get a summer job as a nurses aide just to see how you like it in a hospital

You can work in an RT department doing random jobs without a degree, although I'm not sure how easy they are to get. If you have further questions feel free to email my by clicking the contact me icon in the right margin.