Position Statement on Respiratory Staffing and Patient Safety
Elevate Respiratory Care Position Statement
Position Statement on Respiratory Staffing and Patient Safety
Elevate Respiratory Care (ERC) supports collaborative, interdisciplinary healthcare teams and recognizes the valuable contributions of nurses, licensed practical nurses (LPNs), respiratory therapists (RTs), physicians, and all healthcare professionals involved in patient care. Every member of the healthcare team plays an essential role in improving patient outcomes.
ERC also recognizes the ongoing workforce challenges facing healthcare organizations across the country. Innovative staffing solutions may help address shortages; however, such solutions must never compromise patient safety or diminish access to licensed respiratory care professionals when respiratory assessment and intervention are required.
Respiratory therapy extends far beyond the administration of aerosolized medications and oxygen. Every patient encounter represents an opportunity for a comprehensive respiratory assessment. Respiratory therapists evaluate breathing patterns, work of breathing, breath sounds, oxygenation, airway clearance, response to therapy, and subtle changes that may indicate early respiratory deterioration.
While routine respiratory treatments are often perceived as low-acuity tasks, ERC believes these patient encounters may be among the most clinically significant. Many medical-surgical patients are not continuously monitored with cardiac telemetry, pulse oximetry, or direct observation. In these settings, respiratory therapists frequently serve as the first clinicians to recognize declining respiratory status before a medical emergency occurs.
Healthcare has invested heavily in Rapid Response Teams because early recognition of patient deterioration improves outcomes, decreases unplanned ICU admissions, and reduces in-hospital cardiac arrests. Respiratory therapists are integral members of these teams and contribute unique expertise in identifying respiratory compromise before it progresses to respiratory failure.
Reducing the number of respiratory therapists responsible for direct patient assessment—even when portions of respiratory-related care are delegated to other qualified healthcare professionals—may unintentionally decrease the number of specialized respiratory assessments being performed throughout the hospital. ERC believes this reduction in dedicated respiratory surveillance has the potential to delay recognition of patient deterioration, increase adverse events, and negatively affect patient outcomes if not carefully evaluated.
ERC supports the appropriate use of licensed practical nurses and other healthcare professionals within their respective scopes of practice. We do not oppose interdisciplinary collaboration or cross-functional support. Rather, we advocate that respiratory care staffing models preserve the critical assessment role of the licensed respiratory therapist and ensure that delegation of tasks does not replace the specialized clinical judgment that respiratory therapists provide.
ERC encourages healthcare organizations implementing alternative respiratory staffing models to monitor objective quality indicators, including:
Rapid response activations
In-hospital cardiac arrest rates
Unplanned ICU transfers
Mechanical ventilation rates
Respiratory-related adverse events
Hospital mortality
Respiratory therapist staffing ratios
Patient satisfaction
Employee retention and turnover
Staffing decisions should be guided by patient outcomes, evidence-based practice, regulatory standards, and the demonstrated value of specialized respiratory assessment—not solely by workforce shortages or financial considerations.
Elevate Respiratory Care remains committed to advancing policies that promote safe, evidence-based respiratory care and ensure every patient receives timely assessment by appropriately licensed respiratory professionals whenever respiratory compromise is present or suspected.
About Elevate Respiratory Care
Elevate Respiratory Care is a nonprofit organization dedicated to advancing the respiratory therapy profession through education, advocacy, professional recognition, and the promotion of excellence in patient care. Our mission is simple: We Breathe Hope.