Registered Respiratory Therapist

About the role

The Registered Respiratory Therapist (RRT) at Sheridan VA Medical Center serves as a clinical educator — responsible for developing and implementing policies and guidelines, recommending new and emerging modalities, performing complex analytical analysis, and managing day-to-day respiratory care operations and related fiscal activities. The incumbent builds clinics and clinical grids, conducts competency checks, and mentors both inpatient and outpatient RRT staff.

Qualifications

Basic Requirements

• Citizenship: United States citizenship required. Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy.
• 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).
• Education: Successful completion of a respiratory care program accredited by the CoARC or its successor.
• Licensure: Full, current, and unrestricted license from a state to practice as an RRT, maintained for the duration of employment.
• Credential: Valid, current, unrestricted RRT credential from the National Board for Respiratory Care (NBRC), maintained for the duration of employment.

Grade Determinations (GS-12)

• One (1) year of creditable experience equivalent to the GS-11 grade level demonstrating the clinical competencies described at that level.
• GS-11 level assignments include:
  • Working independently providing respiratory care in inpatient and/or outpatient settings
  • Using data and patient assessment to establish appropriate plan of care and determine if outcomes are being met
  • Consulting with physicians and other healthcare professionals to ensure quality of patient care within area of specialty
  • Managing and maintaining the airway and ventilation of the patient using appropriate mechanical means
  • Determining and implementing complex respiratory care such as protocols, respiratory modalities, bronchoscopy, medications or supplemental oxygen, and intubation
  • Monitoring critical systems
  • Using advanced modes of ventilation and outpatient services (e.g., home ventilators, COPD case management)
  • Suggesting alternate modes of treatment based on assessment and analysis of patient response
  • Performing invasive procedures such as arterial line placement
  • Serving as a preceptor to lower graded staff
  • Leading projects developing new policies, procedures, or protocols
  • Holding an active license and RRT credential
• Desirable certifications (not required): Certified Pulmonary Function Technologist (CPFT), Registered Pulmonary Function Technologist (RPFT), or Registered Polysomnographic Technologist (RPSGT).

Required Knowledge, Skills, and Abilities (KSAs)

• Knowledge of complex pulmonary function testing and stress/exercise testing
• Ability to maintain a quality control program related to pulmonary function testing
• Ability to treat acute complications for all pulmonary function testing
• Skill in performing polysomnographic studies to include obtaining both physiologic and diagnostic data
• Skill in calibrating and troubleshooting polysomnographic equipment and physiologic and diagnostic monitoring

Preferred Experience

• Previous experience in leadership, preceptor, educator, or supervisory role
• Minimum of 3–5 years of progressively responsible RRT experience, preferably in an acute care setting
• Credentialed by the NBRC as RRT; additional specialty credentials such as Registered Pulmonary Function Technologist (RPFT) or Chronic Obstructive Pulmonary Disease (COPD) Educator highly desirable
• Experience with complex patients/populations such as veterans with COPD, ALS, spinal cord injury, or other complex comorbidities
• Proficiency in department improvement, protocol development, and/or policy writing
• Demonstrated ability to participate in interdisciplinary collaboration, serve as a subject-matter expert, and/or lead quality or safety initiatives
• 5 years of progressively responsible clinical experience as an RRT in a hospital setting, with at least 1 year in a supervisory or education role
• Experience in the VA Healthcare System and with the care of complex cardiopulmonary patients preferred
• Advanced credentials such as Adult Critical Care Specialist (ACCS) highly desirable

Reference: For more information on this qualification standard, visit https://www.va.gov/ohrm/QualificationStandards/. The full performance level of this vacancy is GS-12.

Responsibilities

Oxygen Program Coordination

• Monitor and troubleshoot all modalities of home ventilators and oxygen delivery systems
• Ensure annual oxygen qualification standards for patients are maintained
• Train RRTs, other staff, and/or patients/caregivers on existing and newly acquired equipment, therapies, and medications
• Determine continuing education needs of staff and identify appropriate resources to meet those needs
• Develop clinical policy, procedures, protocols, competencies, and simulations relative to respiratory care
• Set up and change oxygen delivery devices; assure proper delivery of ordered liter flow or concentration
• Maintain knowledge of respiratory drugs, appropriateness of therapy, patient response to therapy, adverse drug effects, and proper drug dosage
• Follow the National Directive for the Home Oxygen Program and participate in associated committees
• Conduct site visits, home visits, and oxygen prescription renewals to ensure compliance with expired prescriptions
• Coordinate with Prosthetic Services to ensure patients receive appropriate equipment services
• Perform oximetry testing (exercise and resting), titrate oxygen liter flow for appropriate saturations, and report in main computer system
• Provide oversight and support for a home oxygen program including ordering home oxygen evaluations, expert-level knowledge of VA oxygen qualification standards, and high-level familiarity with home oxygen modalities
• Partner/coordinate with VA Contracting Officers, external vendors, and suppliers of VA services including home oxygen services
• Assist physician staff in the management of patients on home ventilation modalities

Pulmonary Function Testing

• Complete complex pulmonary function testing and stress/exercise testing
• Treat acute complications during pulmonary function testing
• Calibrate and troubleshoot pulmonary function testing equipment
• Maintain and perform quality controls, biologic testing, and machine maintenance logs according to ATS standards
• Develop and implement policies and guidelines following ATS standards; make recommendations about new and emerging modalities
• Maintain understanding of the PACT Act and Burn Pit Registry requirements

Diagnostic Testing

• Oversee the Electrocardiogram (EKG) and Cardiac Event Monitor program, including staff in CBOCs, Specialty RNs, and RRT staff enrolling and placing monitors
• Set up and assist physicians in the performance of exercise tolerance tests, treadmills (Cardiac Stress Tests), according to policy and procedure
• Perform pulmonary function testing including routine spirometry, flow volume loop, pre- and post-bronchodilator, and diffusion studies
• Manage the MUSE system to collect, store, review, and manage EKG data
• Provide input to clinicians to review, compare, and interpret EKGs
• Facilitate ordering, confirming, and finalizing EKGs requiring follow-up

Home Sleep Testing

• Perform basic Home Sleep Testing (HST) and communicate tests to Pulmonary Physician
• Upload tests and oversee RRT staff to ensure competencies and procedures are followed
• Troubleshoot sleep equipment and diagnostic monitoring data
• Perform instruction for hook-up of overnight oximetry testing for patient and/or caregiver
• Download data from oximetry, clean equipment, interpret oximetry test, and report findings in main computer system
• Set up PAP therapy on patients, complete orders in computer system, place supply orders, and perform downloads relaying findings
• Set up home oxygen for patients as ordered by physician; notify vendor and complete order in computer system
• Troubleshoot Somnoware and consult issues ensuring compliance with tele