Lung Language – A Journey into Respiratory Care

James Sherpa: Coming up on BroncoTales. 

Megan Koster: The Boise State Department of Respiratory Care is the largest respiratory care department in the world. And really, the projected growth for respiratory care is 14 to 20% over the next 10 years.

Camille Stover: Unbelievable resources to build one of the best ventilator labs in the country. 

Daniel Lemus: All right, everybody, welcome to another edition of BroncoTales with the College of Health Sciences. Today, we are focusing on respiratory care.

My name is Daniel Lemus. I’m the Business Operations Manager for the Department of Respiratory Care. And it brings me great pleasure to be with Megan Koster, our department chair. 

Megan Koster: Hi, my name is Megan Koster, and as Daniel mentioned, I am the chair here in Respiratory Care. I am also the director of our online master’s degree program, and I’m super excited to be here. 

Daniel Lemus: And Camille Stover, our on-campus program director. 

Camille Stover: I’m Camille Stover, our on-campus or our entry to practice program director here at Boise State campus in Boise, Idaho. 

Daniel Lemus: What is a respiratory therapist? 

Megan Koster: Oh boy, we get that a lot. Yeah, that’s probably our number one question: What do you do? 

Camille Stover: And I wish, after all of these years, I had a better elevator speech about what it is that a respiratory care practitioner is. And I think it’s so broad and diverse that you can’t cover everything that we do. And the expansion of our role over the last few years in, you know, 20, 30 seconds…blurb.

Megan Koster: One of the things that I like to do with people who really have never heard about what we do is, I say we’re a specialty. So we specialize in the cardiopulmonary respiratory system. In addition to dealing with the kidneys, anything having to do with the breathing or the cardiac function that a person does, and because those are so closely related to the kidneys, those are the three primary body systems that we deal with most.

And I also like to say we’re like a specialized lung practitioner, right? And I like to say we’re one of the most important because if you’re not breathing, you’re really not doing much else. You know what I mean? 

Camille Stover: Yep, I couldn’t agree more and, you know, respiratory care practitioners can really work anywhere. In the last couple of years we’ve worked to expand our role in where we really do work. You know we can see patients anywhere throughout the hospital, we’re there when a patient arrives in the ER via ambulance or personal car.

You can find us in ORs, and you know, critical care units are a really large place that you’ll see respiratory therapists. We work with newborn babies; we’re in delivery rooms. We also work in the outpatient setting and with DMEs, so companies that provide patients with resources to be at home when they’re critically ill or even need that CPAP or BiPAP machine for their home or for their sleep apnea. 

Megan Koster: Absolutely. I think that’s a really good overview of what we do. And like Camille mentioned, it’s really hard to say we do this one thing, because like, again, we are everywhere in the hospital. And a lot of times we don’t get the glaring spotlight on us because we are so busy solving problems.

So my background is in neonatal and pediatrics. And I knew while I was still in school that that’s the avenue that I wanted to go down. I can get into the reasons why, but I really, really enjoyed the autonomy that came with learning about etiology of newborn diseases. And then that led me into pediatrics as well. There are specialty credentials that you can get, depending on what avenue that you like to go in.

One of the other areas that is infrequently mentioned is patient education. There are a lot of really chronic diseases. Lots of people probably have heard of COPD, pulmonary fibrosis, a lot of those chronic diseases that respiratory care providers are integral in doing the education for and the outpatient, like Camille mentioned.

And so even if you don’t want to be in the hospital for your entire career, there are so many different avenues that you really can go into. Camille and I also found ourselves in higher ed. I couldn’t have planned that. And if you had asked the younger me, would you ever be an instructor? I just said, absolutely not. Here I am. You know what I mean? So you can never say never.

And what I tell people who are considering going what we call degree advancement and respiratory care moving from one degree to the next is why would I do that? I’m happy to talk about that. But one of the reasons I always say is education will never close the door to you and you don’t want to wait until that opportunity is in front of you to say, oh, I wish I had done this degree or I wish I had gotten this extra credential. That’s not the time to be thinking about that. 

Daniel Lemus: Well, that’s awesome. It sounds like there are a lot of opportunities, as a respiratory therapist, to work in hospitals, to work in private care, to work with all sorts of different age groups. So, there’s something out there for everybody. 

Megan Koster: Absolutely. That’s a great way to put it, Daniel. There’s something out there for everybody. 

Daniel Lemus: Cool. Well, you know, I think…if someone does decide to move into the respiratory therapy field, they probably do have some questions like, what career trajectories exist for me. It sounds like there really is no limit.

It could go towards education. They might also be curious about, you know, pay. That seems to be a very important topic. So maybe you guys could address some of those things when it comes to respiratory care. 

Megan Koster: Absolutely. That’s another really broad range. And really, the projected growth for respiratory care is expected. Is it 14 to 20% over the next 10 years? 

Camille Stover: I think so.

Megan Koster: You know, and pay really is going to differ not only depending on the state that you’re in, but also the role that you’re fulfilling. Entry level, it’s really, really hard. You can expect at least 60 to $70,000 as an entry-level practice respiratory therapist with your, you know, brand spanking new credential. And then, depending on what institution you’re in, whether or not they have a ladder or other incentives, you can expect to go up from there. 

Again, it’ll also depend on the avenue that you’re in. There are opportunities. If you’re not sure what you want to do, you don’t have roots, and you just want to get a lot of experience. There are opportunities to travel with travel companies. Usually, you get a 13-week assignment. They pay for housing and other stuff and you get to learn from some of the best places. They usually paid very, very well in order to do that. So again, that’s just another avenue, but it really is dependent on the institution that you’re going to work in, the path that you’re going to take, but it’s definitely, what would you say Camille? It’s pretty much a secure living. 

Camille Stover: Yeah, I think so. You know, I also think you have to think about where you’re going to be living. You know, a student who starts as a new grad here in Boise is not going to make as much as a student who starts in San Francisco or in Seattle.

Interestingly enough, the AARC, the American Association for Respiratory Care, there are national organization for respiratory care practitioners. They did a HR study in 2020. Obviously salaries have gone up quite a bit since 2020 because of how the environment of health care has changed in the last three years. But their median salary in 2020 was $60,000 with a max of 170. 

So there are opportunities to grow. 

Megan Koster: It’s quite the range. 

Camille Stover: Exactly. You know, and God, it just always depends. You know, in health care, we also have to think about differentials. There’s the opportunity to work night shift, which generally comes with an increased salary. There is, you know, weekends and holidays. Those also make more. So, you know, we can talk about, our students here in the valley started about 30 bucks an hour as a new grad. But that’s not taking into account the extra shifts, the holiday differentials. So I think it’s a comfortable salary. 

Megan Koster: Well, not to mention that, but some of the other places that you want to look into, in addition to salary, what other fringe benefits do they have, right?

So a lot of institutions, especially if you’re lucky enough to hook up with a really large hospital system, we’ll have things like tuition reimbursement or maybe tuition forgiveness, excellent healthcare packages. Like I mentioned, some of those ladders where the more you do, the more you’re incentivized in terms of pay. So again, that is one thing I would tell anybody interested in respiratory care is look around you, where do you want to be, and what opportunities exist within those institutions to help support your goals, whether they be financial or otherwise, to help get you where you want to be. 

Daniel Lemus: Well, that’s awesome. So sounds like again, there’s just a lot to take in there. I heard from 60,000 all the way to 170,000. 

Megan Koster: What are the 170,000 people doing? 

Camille Stover: I don’t know, but I’d like to. 

Megan Koster: I didn’t church up my resume a little bit. 

Daniel Lemus: Cool. Well, let’s say that someone here is at 170,000, and they’re like, all right, I’m going to be a respiratory therapist today.

How does Boise State help people become respiratory therapists or how does Boise State engage in the profession and the associations that exist within? 

Megan Koster: But this is one of our favorite topics. 

Camille Stover: Yeah. So, in our on-campus program, which I’m the program director for, we prepare students to sit and take their licensure board exams. Our program is two and a half years, or five semesters, and during those five semesters, students learn what it takes to be a respiratory therapist. Students engage in clinical rotations for the entire time that they’re in the program. They get about 700 clinical hours over those five semesters. 

Megan Koster: And I want to interject that those clinical hours per our accrediting body are actually in the hospital clinical hours. They’re not simulation. They’re not lab hours. They are direct patient contact hours, which is pretty impressive. 

Camille Stover: Yeah, especially given the size of our valley and the clinical opportunities that our students have. A major shout out to our director of clinical education, Alyssa, who figures out where all those students are going to go. 

Megan Koster: And our clinical partners, who are amazing with our students. 

Camille Stover: Yes, who supports the education of our students. 

Daniel Lemus: And for a non-healthcare person, is clinical rotation, is that like an internship or…? 

Megan Koster: That’s a great point. So yeah, sometimes we use the lingo.

When we say clinical environment, that’s where students are not in the classroom or the laboratory here at Boise State. They’re actually learning in a hospital environment. And again, Camille can explain more about this than I can. Go ahead. 

Camille Stover: Yeah, so our students go, during clinical rotations, our students are either paired up one-on-one with a staff therapist. So a respiratory care practitioner who’s out in the hospital taking care of patients. It’s an opportunity for students to see how these practitioners take care of patients, how we provide our therapies, and how we interact with patients and families.

Or sometimes they’re paired up with faculty or paid instructors. So during those rotations, they have a few more students per staff therapist, or I guess they’re our clinical instructors. And students get a little more hands-on time. They’re a little less rushed because they don’t have that full patient load. And we can take the time to talk about what it is that we’re doing and the reasons behind it. 

Megan Koster: One of the things I love about the way Camille structured her program for entry to practice students is that our students hit the clinical environment 10 weeks into their first semester. So what she’s really tried to do in the entire on-campus program, faculty and staff, have really tried to integrate those theoretical and laboratory experiences with actual world hands on.

So our students are able to apply what they’re learning in the classroom or laboratory directly in the clinical environment and vice versa. We have students come into the classroom all the time that’s like, oh, you won’t believe what I saw in clinical the other day. And they’ll tell us about it. And we’re like, you know what? That’s a great segue into what we’re going to learn. Let’s go a little bit deeper into that. And so we find that that ability to have students in clinical so early in their programming really does enrich their experience. 

Daniel Lemus: Awesome, so I heard two and a half years to get to the program, some clinical experience that happens almost immediately, and 700 hours to really feel comfortable in the field. What else happens in that on-campus program to help support respiratory therapists? 

Camille Stover: So we teach students to be part of the interprofessional team. And with that go patient assessment skills.

How do I listen to what a patient’s lungs sound like? How do I figure out what is going on and how to differentiate out the pieces to see through the noise? Students do labs for the five semesters where they get to come into our labs, which I’m going to brag and say we have an incredible lab. We have had unbelievable resources to build one of the, in my opinion, best ventilator labs in the country. We have, and that’s in part to our clinical partners and our wonderful donors. And so students get to learn on equipment that they may not necessarily have here in the valley. If they were to go out across the country, they could see a variety of different therapeutic options and really get that hands-on opportunity to learn what it is that they’re going to do out there. 

Megan Koster: And I love the fact that you mentioned that our students do go everywhere. So I think, and correct me if I’m wrong Camille, over the past at least 10 years, every student who has wanted a job in respiratory care has been able to find a job in respiratory care.

And a lot of that has to do with our reputation as a program. So we are a nationally sought after program. We’re one of the best in the nation. And so we’ve actually had people and institutional partners or clinical partners from outside of the Valley come to us and say, hey, we’d love for you to send students here. So one of the other unique things that students may take advantage of while in our program are remote clinicals.

In addition to our amazing Treasure Valley supporters; we have relationships with institutions across the United States. And so that has really, really helped students say, wow, it’s great to learn here and I can learn over here. And I can take all of that with me, as a toolkit to be the most amazing provider after graduation that I can be. 

Camille Stover: Yeah, in our last graduating class, we had students go to Boston Children’s, to Duke, to Vanderbilt, to Seattle Children’s, UC Davis, to MassGen. It’s wonderful to see our students go out there, and sometimes they come back too, which is… 

Megan Koster: We love that. 

Camille Stover: Yeah, it’s great. 

Megan Koster: We absolutely love that. We joke, actually. So within our department here, all of the entry-to-practice faculty are actually alumni of the entry-to-practice program. So we do really invest in those people who come back, and we love to have our alumni teaching with us. And lots of our adjuncts are also alumni. Then we just find our little go-bright bronchi family, and we like to keep it close, and you know, once you’re here, you’re family. 

Camille Stover: Yeah, and we know what it’s like to be a student in the program. 

Megan Koster: Yes. We have not forgotten. 

Camille Stover: Yes. 

Daniel Lemus: Like how much you love it? 

Megan Koster: We did love it. Yes. 

Camille Stover: I mean, I came back for a reason. 

Megan Koster: Oh, 100%. And I think that is again not to continue to pontificate about how amazing our program is, but guess what it totally is. One of the reasons I think that our students are so successful is the culture that we have here at Boise State.

Like I mentioned, and I joked a little bit, that once you’re here, your family, that is absolutely true. Camille and her team, and regardless of what program, you’re here–in here at Boise State in respiratory care, once you’re here, you really are family. The faculty and staff care so deeply about the development of the students; you’re not just a number, right?

So you’re having a hard day in clinical, you saw something awful which throughout COVID our students saw some incredibly traumatic experiences in order to help students deal with that, Camille and her team brought in counseling. You know what I mean, so we have a very close relationship with our students to make sure that we are preparing them in the best way possible and that means in a holistic way. So yes you will absolutely, after completing Camille’s program, be able to pass your clinical board examinations not even a question right. You will also be very prepared to tackle anything that the workplace has to throw at you, so I think again that’s one thing that sets our program apart. 

Camille Stover: And we have small class sizes. It’s much less intimidating to know 26 students’ names in a classroom than 300 or 80 or whatever it is.

And I think that the small class sizes also lead to a positive experience for the students as a peer group. They can really collaborate and get to know each other. And I think many of us who graduated from this program are still very close to many of our classmates. Because you do–hard times bring people together. 

Megan Koster: Misery loves company, and I’m just kidding. 

Camille Stover: Not that the program’s mis- you know. 

Megan Koster: No, but those are trench times where you’re like, oh my gosh, I’m taking four classes, trying to work a job, or my kiddo is sick, or I’m taking care of all of this, and we really do try to understand that.

And because you move through this program in a cohort, and that means that you’re taking the same classes on the same semesters as the people you started with, everything builds on itself. So the nice thing about that is you can circle back with your instructor because I might have taught you the first semester, and Alyssa or someone’s going to teach you the second semester, but I’m still around, right?

And so if you come back to me and say, hey Megan, remember that thing that you told me in class? And I’d be like, oh yes, this is what I meant, and this is how you can connect the dots. So I think that’s really, really amazing. The other thing that we really strive to do, because there are different entry points in respiratory care, so you can go to an associate level program, or a baccalaureate program, or even a master’s to entry program, and sit for the same NBRC examinations. 

One of the things we do as a baccalaureate program is really try to build on just having those clinical skills, right? So like I mentioned, yes, you can absolutely pass those clinical board examinations, and you will have all of the bedside knowledge that you need to be an effective clinician, but you also have some of those advanced skills that a baccalaureate graduate will require. So those oral communications, written communications, and those really deep critical thinking skills really do set our students apart as baccalaureate level respiratory therapists. 

Daniel Lemus: Well, that’s awesome, and I know that we could talk probably for a few more hours on how great the entry-to-practice on-campus program is, but I am aware that there are a few other programs in the department as well. So maybe we could do like a two-minute plug on those?

Megan Koster: Oh my gosh. Only two minutes. I think I can do that. Absolutely.

Well, one thing that a lot of people might know is actually the Boise State Department of Respiratory Care is the largest respiratory care department in the world. And part of the reason that is, is you have three distinct programs. We’ve talked a lot about Camille’s entry-to-practice program that leads to licensure. As I also mentioned, there are a lot of associate level programs out there. 

So in order for clinicians who are actively working, who already hold that RRT credential to advance to a baccalaureate degree, we have a really large online, what we call our RRT to BSRC program, or affectionately our degree advancement program, that is very, very large. And our director, Dr. TJ Wing, and some faculty and staff there, really work hard to bring that culture of the on-campus program to the online setting. And so we’re incredibly fortunate to have students from all over the United States and even other countries come to Boise State to finish their degree.

In 2018, we looked at each other and said, man, what’s the next step for Boise State in education? People looked at us to be trailblazers in the education world for respiratory care. So we said, what do we do next? So we started a master’s program. And one of the things that we did, we wanted to make sure that we were catering to respiratory therapists who were working, right? So we know that people in this program are going to be working professionals, working 40-plus hours. They might have familial obligations or other obligations. We need to make this a doable program in order to push the profession forward.

So Dr. Joe Coyle and I developed the master’s program specifically for working respiratory therapists to give them that, again, advanced knowledge they need to go to a different level of respiratory care. And so the cool thing about our master’s, again, a little plug here, is that 40% of our classes are advanced bedside management classes. The other 60% are split between both education and leadership. We really tried to do this holistic umbrella of degree advancement because in respiratory care, you may not know what you’re gonna do with the degree. 

We want people to be able to use this degree no matter what opportunity presents itself. So here at Boise State, we have created a total trajectory for students in respiratory care to continue or advance their degree to be the best clinician they can be and propel the profession forward. 

Daniel Lemus: Well, I think…

Megan Koster: Did I nail it in two minutes? 

Daniel Lemus: Yeah, I think you did.

Megan Koster: I saw him eyeing the time, and I was like, whoa, it’s on. 

Daniel Lemus: Cool, well thank you so much for spending this time with me today to talk more about respiratory therapy and then care. What I’m hearing is that it’s the most important part of healthcare and that people who are wanting to go into this field, really, Boise State is the number one leader in the nation to help fulfill that.

So, I think, 30-second wrap-up, if you guys had any advice that you would give a student who’s looking to go into the respiratory care field. And we’ll start with Camille. 

Camille Stover: Oh, me? Okay. What advice would I give? I think…ask for help is one of the best things that a student can do.

I guess that’s once they’re in the field and in the program. But research it, look into it. There are our national organization, along with our credentialing body has worked really hard to share what it is that a respiratory care practitioners do. And there are wonderful websites out there where you can explore the different roles that real people have taken out in the world. And so I think those are really wonderful resources for interested students to explore what their options are. 

Shout out to our team for our awesome Instagram page. Because I think social media is a great way to connect with people. So follow us on social media, we share what it is that respiratory care practitioners do both here in the Valley and out and about. So I guess research would be my advice. 

Daniel Lemus: And how would they follow us on social media? 

Camille Stover: Umm…what is it? It’s at Boise State Respiratory Care. And we’re also on Facebook, but I understand that’s a little outdated. 

Megan Koster: Depending on the demographic. I’d say I would plug what Camille mentioned is just like any career that you’re gonna think about research it She mentioned the AARC has put out bnrt.com and that’s a great place to start but come see us. You can call our office. You can call Robin Hood and schedule a time to sit down with one of the faculty, get in touch with us.

The advising office here in the College of Health Sciences is also amazing so huge shout out to Olga and her team for all the work that they do. Still, they are wonderful and asking–or answering all the questions students have to ask and providing different parallel pathways so you can think holistically about what’s the best way for you to pivot as a student given your interests.

Camille Stover: And reach out to us. 

Megan Koster: Yeah, we’re good at email, texting…don’t call me though, I’m just kidding. I’m a millennial, and I will not answer the phone unless you leave a message. 

Camille Stover: You can leave me a voicemail, and I’ll email you back. 

Megan Koster: But no, in all seriousness, please get a hold of us. As you can tell, we love to talk about what we do, and we love to talk to potential students. So get a hold of us. 

Daniel Lemus: All right. Sounds good. Thank you, guys. 

Megan Koster and Camille Stover: Thank you!

James Sherpa: Thank you for listening to BroncoTales. Join us next month as we discuss body positivity and Boise State’s Body Acceptance Week. 

Laci Whipple: So, my hot take, I think, is that body positivity is like such a great place to be, such a great place to like direct people, but it’s still about bodies. And I’m a big proponent of like, we’re so much more than what our bodies look like. It’s so much more than our bodies.