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How to hire a respiratory therapist

Hiring a respiratory therapist takes two to eight weeks for a contract placement, and longer if the clinician needs a new state license. RTs are licensed in 49 states with no interstate compact, so an out-of-state candidate cannot simply transfer in. Expect facility bill rates of roughly $85–$115 per hour on contract, more for ECMO, neonatal or adult critical care credentials. The most common hiring mistake is treating an RRT and an RRT-ACCS as interchangeable.

What does a respiratory therapist actually do on your unit?

Far more than most hiring managers outside the department realize. Ventilator management, airway maintenance, arterial blood gas sampling and interpretation, intubation assistance, bronchial hygiene, aerosol therapy, code and rapid response participation, and transport. In many facilities the RT is the person who decides whether a patient is ready to be extubated.

The practical consequence: a vacancy does not degrade service evenly. It concentrates on the sickest patients you have.

What credentials should you actually require?

Start with the baseline, then be specific about the population.

  • CRT — Certified Respiratory Therapist, entry-level NBRC credential
  • RRT — Registered Respiratory Therapist, the standard for acute care
  • RRT-ACCS — Adult Critical Care Specialty, for ICU-heavy assignments
  • RRT-NPS — Neonatal/Pediatric Specialty, required in most NICU and PICU settings
  • State license — separate from the NBRC credential, and required in 49 states

Writing "RRT preferred" on a NICU req and then rejecting candidates for lacking NPS wastes three weeks. Specify it at intake.

How long does it take to fill?

A credentialed RT who already holds a license in your state can often start within two to three weeks, limited mainly by your onboarding. A candidate who needs a new state license adds anywhere from a few weeks to several months depending on the board, and no compact exists to shortcut it.

This is why fill timelines for respiratory vary so much more than for nursing, and why an agency that quotes you the same window regardless of state has not checked.

What does it cost?

Travel RTs currently see gross weekly packages of roughly $2,300–$3,600, landing around $60–$70 per hour in total clinician compensation. Facility bill rates typically fall in the $85–$115 per hour range. Specialty credentials, night and weekend coverage, and short-notice starts all move it upward.

Full breakdown of what sits inside that number is on our staffing cost page.

Should you hire contract or permanent?

Contract if the need is seasonal, covering leave, or bridging to an approved FTE. Respiratory demand is genuinely seasonal — winter respiratory illness volume is predictable and a contract RT from November to March is often the correct answer rather than a failed permanent search.

Permanent if the role is structural. Employment for respiratory therapists is projected to grow about 12% between 2024 and 2034, roughly 8,800 openings a year, and the training pipeline has not kept pace. If you need the seat filled for the long term, the market is not going to get easier.

What goes wrong most often?

  • Credential mismatch discovered at interview. Specify ACCS or NPS at intake if the unit requires it.
  • Licensure discovered after the offer. Confirm state license status before the first submittal, not after.
  • Vent population not described. An RT who has managed adult vents is not automatically comfortable on a neonatal unit.
  • Ratio not disclosed. RTs leave assignments over patient load faster than over pay.

Need a respiratory therapist?

Tell us the credential, the unit and the start date. We will come back with a realistic fill window and the current market rate.