Respiratory Nurse Career Overview

What Is a Respiratory Nurse?

Respiratory nurses care for patients with acute and chronic respiratory illnesses, injuries, and disorders. Nurses in this specialty can see patients of any age and often treat a large range of diagnoses. Also called pulmonary care nurses, respiratory nurses frequently work in hospitals, but can also work in clinics and private practices.

Early on in their education, nurses learn about the importance of the respiratory system. The entire body needs oxygen to function, and the respiratory system provides that oxygen to the heart, which then delivers it to all areas of the body through the bloodstream. In this way, respiratory nurses treat the entire body. For example, the novel virus COVID-19 hit the respiratory system hard, and in turn, many other body systems were affected. Respiratory nurses were on the front lines of treatment. Many of them helped discover prone positioning and other simple techniques that saved lives.

Where Do Respiratory Nurses Work?

Respiratory nurses can work in many different medical settings:

• Hospitals
• Outpatient clinics
• Private provider practices
• Home care agencies
• Military or government facilities
• Assisted living apartments
• Long-term care units
• Skilled nursing facilities
• Sleep disorder centers

In the hospital, respiratory nurses can work in an intensive care unit (ICU) or on a respiratory unit. Patients in the ICU are sicker than those on a respiratory unit, and ICU nurses will typically have two patients at a time, although many took on heavier patient loads during the height of the COVID pandemic. Once patients stabilize enough to move out to the respiratory unit, they will be one of four or five patients on their nurse’s assignment.

In outpatient settings, respiratory nurses may administer treatments like inhalers and nebulizers. They also provide education to patients and family members on their diagnosis and treatment. Respiratory nurses work closely with respiratory therapists, who often administer all respiratory medications in the hospital.

What Does a Respiratory Nurse Do?

Respiratory nurses treat respiratory illness and injury. They administer treatment, provide education, and stabilize patients in respiratory distress. Some common respiratory nursing tasks include:

• Assisting respiratory therapists with treatments
• Documenting patient history
• Collecting blood and other bodily fluids for laboratory testing
• Central line management (like ports and PICCs)
• Chest tube management
• Collaboration with other health team members
• Coordination of care with other departments
• Dressing changes
• Educating patients and families
• Emergency resuscitation
• Head-to-toe assessment
• Insertion and management of foley catheters
• IV insertion and maintenance
• Medication administration
• Patient hygiene and comfort
• Tracheostomy management
• Transporting patients
• Vital signs monitoring
• Oxygen administration
• Performing diagnostic tests using specialized equipment
• Monitoring and troubleshooting breathing tubes and ventilators

Respiratory nurses in the hospital see a lot of tracheostomies and chest tubes, and in the ICU, nurses get very familiar with ventilators and intubation. Some patients go home with long-term ventilators, and home health nurses perform on-site check-ups to ensure their equipment is functioning correctly.

The respiratory system can malfunction in many ways, and respiratory nurses may treat the following conditions:

• Acute respiratory distress syndrome (ARDS)
• Acute chest syndrome
• Asbestosis
• Asthma
• Acute or chronic bronchitis
• Black lung disease
• Chronic obstructive pulmonary disease (COPD)
• COVID-19
• Cystic fibrosis (CF)
• Emphysema
• E-cigarette or vaping use-associated lung injury (EVALI)
• Influenza
• Interstitial lung disease (ILD)
• Lung cancer
• Pneumonia
• Pneumothorax
• Pulmonary arterial hypertension (PAH)
• Pulmonary embolism
• Pulmonary fibrosis

How Do I Become a Respiratory Nurse?

The first step for any aspiring respiratory nurse is to graduate from an accredited nursing program. Respiratory nurses can graduate with an Associate Degree in Nursing (ADN) or a Bachelor of Science in Nursing (BSN). While both degrees earn the designation of a registered nurse (RN), many respiratory units prefer to hire nurses with a BSN due to the high acuity of their patient population.

After graduating with their degree, nurses can apply for respiratory jobs as graduate nurses (GNs). Many respiratory offices and units hire GNs and begin to train them while they prepare to take their state licensing exam, the NCLEX-RN. After GNs pass this standardized test, they become RNs. Once they complete their facility’s orientation period under a nurse preceptor, they can work independently.

Respiratory nurses can pursue a specialty certification after they have some experience under their belt. They can also return to school to earn an advanced practice degree. After graduating with a Master of Science in Nursing (MSN), nurses can practice as nurse practitioners (NPs). Nurses can earn their MSN in two years, but some prefer to go at a slower pace so they can work full-time while they study.

While respiratory nurses have no specific certification, many choose to pursue the Critical Care Nurse Certification offered by the American Association of Critical Care Nurses. To be eligible for this certification, nurses must have:

• A current RN or APRN license
• 1,750 hours of direct care experience with acutely/critically ill patients during the last 2 years, with at least half of those hours earned in the past year OR
• 2,000 hours of direct care experience with acutely/critically ill patients, with 144 of those hours accrued in the past year

How Much Does a Respiratory Nurse Make Per Year?

Respiratory nurses make $94,480 per year on average, according to the U.S. Bureau of Labor Statistics (BLS). The BLS does not measure RN salaries based on specialty, but respiratory nurses can expect to make what any other RN would in similar settings. Salaries can change with location and experience, with a low-end average of $63,720, and a high-end of $132,680. Depending on the workplace type, employers may be able to offer higher or lower compensation:

• General Medical and Surgical Hospitals: $96,830
• Home Health Care Services: $87,430
• Nursing Care Facilities (Skilled Nursing Facilities): $79,280
• Offices of Physicians: $83,110
• Outpatient Care Centers: $102,640

The West Coast, New England states, and Alaska may offer the best nursing pay, but the cost of living in these areas can also be high. The lowest-paying states are in the Midwest and some Southeastern states.

The top-paying cities for respiratory nurses include:

• San Francisco-Oakland-Hayward, CA: $174,370
• Vallejo-Fairfield, CA: $171,620
• San Jose-Sunnyvale-Santa Clara, CA: $170,780
• Napa, CA: $166,180
• Sacramento–Roseville–Arden-Arcade, CA: $154,510
• Santa Rosa, CA: $152,930
• Modesto, CA: $145,190
• Santa Cruz-Watsonville, CA: $140,880
• San Luis Obispo–Paso Robles–Arroyo Grande, CA: $140,560
• Stockton-Lodi, CA: $138,420

Are Respiratory Nurses in High Demand?

The United States is experiencing a shortage of nurses across all specialties. According to the U.S. Department of Health and Human Services, 24% of U.S. hospitals have reported critical staffing shortages, and at least eight states have had to call in help from the military for staffing. Though the World Health Organization has declared the COVID-19 pandemic is no longer a public health emergency, this viral illness continues to spread, and these patients will continue to require respiratory nursing care.

Additional Resources for Respiratory Nurses

To learn more about becoming a respiratory nurse, these additional resources may help:

• American Association for Respiratory Care (AARC)
• Association of Respiratory Nurses
• Respiratory Care Journal
• Respiratory Health Association
• Respiratory Nursing Society