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Scott Sapp was looking for a career in healthcare that was interesting and well paid — and that would give him mobility and the possibility to use his skills in a wide variety of settings. Respiratory care seemed like a good bet. Thirty years later, he has no regrets.

"It was a wonderful choice," says Sapp, director of respiratory care at Bethesda Hospital, a member of the HealthEast Care system.

An Evolving Field

Respiratory care began in the 1940s when physicians started prescribing oxygen therapy. Then therapists began to administer aerosol medications as well as oxygen. By the 1970s, respiratory therapists were managing patients on ventilators and functioning as important members of the critical care team.

Today physicians rely on respiratory therapists to assist with the diagnosis and treatment of patients who have asthma, emphysema, spinal cord injuries, heart-lung transplants, major trauma and other serious conditions.

High-Level Skills

At Bethesda, Sapp and his staff of 50 respiratory therapists work with patients who have severe respiratory failure or chronic respiratory disability. Others come directly from an intensive care unit to be weaned from a ventilator. In addition to their acute illness, most patients at Bethesda also have an underlying chronic condition such as diabetes, high blood pressure or traumatic injury.

"Our work requires high-level clinical and assessment skills," Sapp says.

Sapp and his staff also need good communication skills, as well as the ability to work as part of a care team that includes physical therapists, occupational therapists, nurses, physicians, spiritual care providers and psychologists.

Variety And Mobility

"Respiratory therapists can find a job almost anywhere and in a wide variety of settings," Sapp says. "These include acute care, nursing homes that care for ventilator patients, sleep labs and home care."

Therapists also play a big role in patient education.

And in some parts of the country, respiratory therapists are serving as case managers for patients living in the community with chronic respiratory conditions. Respiratory therapists also work in research, management and medical device companies.

Changing Educational Preparation

"About 90 percent of the therapists working at Bethesda have a two-year associate degree," Sapp says. "But the demand for respiratory therapists with a four-year degree will grow."

That's because therapy is becoming more complex.

"For example, we can now manipulate the breath of a patient on a ventilator by controlling the length of the inhalation so the patient can exhale more easily. And we can also control air pressure to prevent damage to the lungs," Sapp explains.

Seven years ago, the Mayo School of Health Sciences asked respiratory care managers in the five-state region what the practitioners of the future would need to know. Managers said they were looking for professionals with strong clinical skills and higher-level skills in communications, management and research. As a result, Mayo moved from a two-year to a four-year degree. Recently, the College of St. Catherine did likewise.