Registered Respiratory Therapist

Full Job Description

The Respiratory Therapist is under the technical and administrative supervision of the Chief Respiratory Therapist in the Respiratory Care Services, the Medical Direction of the Chief of Medicine Service.

They review completed work for results achieved and for conformance to department policies and requirements.

At this level the supervisor places considerable reliance on the Respiratory Therapists knowledge of complex procedures, and completed work is evaluated.

Applicants pending the completion of educational or certification/licensure requirements may be referred and tentatively selected but may not be hired until all requirements are met.

BASIC REQUIREMENTS To qualify for appointment as an RRT at the GS 11 Level, all applicants must possess the following: a.

One year of creditable experience equivalent to the GS-09 grade level demonstrating the clinical competencies described at that level. b. Citizenship. Citizen of the United States (U.S.).

Non-citizens may be appointed when it is not possible to recruit qualified citizens in accordance with chapter 3, section A, paragraph 3g, of this part. See 38 U.S.C. § 7407(a) for more information. c.

Education. Individuals must have successfully completed an associates degree in a respiratory care program accredited by the CoARC or its successor. d. Licensure.

Persons appointed or reassigned to RRT positions in the GS-0601 series must possess and maintain for the duration of employment a full, current and unrestricted license from a state to practice as an RRT.

e. Credential. Persons appointed or reassigned to RRT positions in the GS-0601 series must possess and maintain for the duration of employment a valid, current, unrestricted credential of RRT.

Exception. RT positions will be designated only to individuals who are in the process of obtaining credentials to become an RRT.

These individuals will only be hired on a temporary appointment as provided below.

(a) VHA may waive the RRT credential requirement for persons who are otherwise qualified and pending completion of prerequisites for RRT credential.

Individuals who have successfully completed a respiratory care program accredited by the CoARC or its successor, acquired the CRT credential, are fully licensed by their state and are working toward completion of their RRT credential may be given a temporary appointment as an RT.

The temporary appointment is made under the authority of 38 U.S.C. § 7401(a)(1)(B) for a period not to exceed one year from date of employment.

Candidates must hold an active, current, full and unrestricted RRT credential and be licensed to hold a position at or above the GS-07 level.

(b) RTs may only be temporarily appointed at the GS-05 level and may not be promoted/converted to a higher-level position as an RRT until the RRT credential is received.

(c) RTs must provide care only under the close supervision of an RRT. (d) Temporary RT appointments may not be extended beyond one year or converted to a new temporary appointment.

(e) Failure to Obtain Credential. In all cases, RTs must actively pursue meeting national prerequisites for the RRT credential from the first day of their appointment.

Failure to become credentialed within one year from date of appointment will result in removal from the GS-0601 RT series and may result in termination of employment.

The Human Resources (HR) Office staff will provide RTs, in writing, the requirement to 1) obtain their RRT credential; 2) the date by which the RRT credential must be acquired; and 3) the consequences for not becoming RRT credentialed by the deadline.

The HR Office staff must provide the written notice to selectees prior to entrance on duty date and maintain a copy in the electronic Official Personnel Folder.

(2) Loss of Licensure, Certification or Credentials.

An employee in this occupation, who fails to maintain the required certifications, RRT credential or license must be removed from the occupation, which may also result in the termination of employment.

Once credentialed, licensed or certified, RTs/RRTs must maintain a full, valid and unrestricted license, credential and certification to practice respiratory care. f. Physical Standards.

See VA Directive and Handbook 5019, Employee Occupational Health Service for requirements. g. English Language Proficiency.

RRTs appointed to direct patient-care positions must be proficient in spoken and written English as required by 38 U.S.C. 7403(-f).

May qualify based on being covered by the Grandfathering Provision as described in the VA Qualification Standard for this occupation (only applicable to current VHA employees who are in this occupation and meet the criteria).

GRADE DETERMINATIONS.

Grade Determinations: All individuals assigned to this occupation must meet all the basic qualification requirements above in paragraph 4 a-g and all basic qualification requirements defined in the specific assignment.

All positions must be designated in one of the approved title or parenthetical title, as described below and duties must meet the definition of the assignment: Registered Respiratory Therapist, GS-11.

(a) Experience, Licensure and Credential. Candidates must have: i. One year of creditable experience equivalent to the GS-09 grade level demonstrating the clinical competencies described at that level.

ii. Hold an active license and RRT credential. Demonstrated Knowledge, Skills and Abilities. In addition to the requirements above, candidates must demonstrate all the following KSAs: i.

Ability to collaboratively consult with physicians and other healthcare professionals for complex respiratory care to develop care plans to provide favorable patient outcomes. ii.

Skill in evaluating the efficacies of therapeutic modalities. iii. Skill in performing advanced airway and ventilation management. Assignments. This assignment is the full performance level.

RRTs at this grade level work independently providing respiratory care in both inpatient and/or outpatient settings. The specific assignments are dependent on facility structure and complexity levels.

They use data and patient assessment to establish appropriate plan of care and determine if outcomes are being met.

They consult with physicians and other healthcare professionals to ensure quality of patient care within area of specialty.

They manage and maintain the airway and ventilation of the patient using appropriate mechanical means.

RRTs determine and implement complex respiratory care such as protocols, respiratory modalities, bronchoscopy, medications or supplemental oxygen and intubation. They monitor critical systems.

They use advanced modes of ventilation and outpatient services, such as home ventilators and COPD case management.

RRTs suggest alternate modes of treatment where indicated based on assessment and analysis of patient response to treatment.

RRTs at this grade level may perform invasive procedures such as arterial line placement. They serve as a preceptor to lower graded staff.

They may lead projects developing new 10 policies, procedures or protocols. Reference: VA Handbook 5055/141 Part II APPENDIX GI I The full performance level of this vacancy is GS-11.

Physical Requirements: See VA Directive and Handbook 5019, Employee Occupational Health Service for requirements. Major Duties:

The duties include but are not limited too: Area I: Collection of Diagnostic Information A. Pulmonary Function Technology I.

Perform basic spirometry, including adequate coaching, recognition of improperly performed maneuvers, corrective actions, and interpretation of test results. 2.

Compare and evaluate indications and contraindications for advanced pulmonary function tests (plethysmography, diffusion capacity, esophageal pressure, metabolic testing, and diaphragm stimulation) and be able to recognize normal/abnormal results.

B. Sleep I. Compare and evaluate the indications and contraindications for sleep studies. 2. Explain results in relation to types of respiratory sleep disorders. C. Invasive Diagnostic Procedures I.

Identify and distinguish the indications, contraindications, and general hazards, complications in preparation, performance, and post care of bronchoscopic procedures. Area II: Disease Management A.

Management of Chronic Diseases 1.

Understand the etiology, anatomy, pathophysiology, diagnosis, and treatment of cardiopulmonary diseases (e.g., asthma, chronic obstructive pulmonary disease) and comorbidities. 2.

Communicate and educate to empower and engage patients. 3. Develop, administer, and re-evaluate patient care plans to B. Management of Acute Diseases I.

Develop, administer, evaluate, and modify respiratory care plans in the acute-care setting, using evidence-based medicine, protocols, and clinical practice guidelines. 2.

Communicate and educate to empower and engage patients. 3. Develop, administer, and re-evaluate patient care plans to Area III: Evidence-Based Medicine and Respiratory Care Protocols A.

Evidence-Based Medicine I. Retrieve credible sources of evidence. 2. Critique published research 3. Explain the meaning of general statistical tests. 4.

Apply evidence-based medicine to clinical practice. B. Respiratory Care Protocols 1.

Explain the use of evidence-based medicine in the development and application of hospital- based respiratory care protocols. 2.

Evaluate and treat patients in a variety of settings, using the appropriate respiratory care protocols. Area IV: Patient Assessment A. Patient Assessment l.

Complete the assessment through direct contact, chart review, and other means as appropriate and share the information with healthcare team members. 2. Obtain medical, surgical, and family history. 3.

Obtain social, behavioral, and occupational history, and other historical information incident to the purpose of the current complaint. B. Diagnostic Data I.

Review and interpret pulmonary function studies (spirometry) and pulse oximetry. 2. Review and interpret lung volumes and diffusion studies. 3.

Review and interpret arterial blood gases, electrolytes, complete blood cell count, and related laboratory tests. C. Physical Examination 1.

Inspect the chest and extremities to detect defonnation, cyanosis, edema, clubbing, and other anomalies. 2. Measure vital signs (blood pressure, heart rate, respiratory rate). Area V: Leadership A.

Incumbent must be able to plan and assist in the establishment of a completely integrated respiratory care program and recommend improvements based on evaluation of facility operations B.

Knowledge of advanced practice skills in all aspects of respiratory care C. Ability to communicate orally and in writing at varying levels, both internal and external to the organization D.

Skill in communicating data, policies and regulations E. Ability to develop resource material Area VI: Emergency and Critical Care A. Emergency Care 1.

Perform basic life support (BLS), advanced cardiovascular life support (ACLS) according to American Heart Association (AHA) guidelines. 2.

Perform pediatric advanced life support (PALS) according to American Heart Association (AHA) guidelines and neonatal resuscitation program (NRP) according to the American Academy of Pediatrics. 3.

Maintain knowledge and skills necessary to retain certification as per associated guidelines as stated above. 4. Perform endotracheal intubation. 5. Perform arterial line placement and management 6.

Perform IV and/or midline placement and management Area VII: Assessment of Therapeutics A. Assessment of Need for Therapy - Assesses the need for therapies in all patient settings. 1.

Medical gas therapy 2. Humidity therapy 3. Aerosol therapy 4. Lung expansion therapy 5. Airway clearance therapy 6. Airway management 7.

Mechanical ventilation Area VIII: Application of Therapeutics to Respiratory Care Practice A.

Medical Gas Therapy -Apply knowledge, understanding, and troubleshooting skills to gas delivery systems in all patient settings 1. Evaluate compressed gas cylinders. 2.

Evaluate regulators and flow meters. 3. Evaluate liquid-oxygen systems (stationary and portable). 4. Evaluate oxygen concentrators (stationary and portable). 5. Evaluate oxygen conserving devices.

Work Schedule: Tuesday-Friday 7:00am-5:30pm Telework: Not Available Functional Statement #:0000