The incumbent demonstrates the knowledge and ability to successfully perform the following duties within the scope of Respiratory Care. A Respiratory Therapist may perform other duties, both major and minor, that are not mentioned below. Essential functions may change from time to time to reflect the current trends within the field of respiratory therapy, and to meet the cardio-pulmonary needs of the patients served.
BASIC REQUIREMENTS. To qualify for appointment as an RRT, all applicants must possess the following: 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. Education. Individuals must have successfully completed a respiratory care program accredited by the CoARC or its successor. Licensure. Persons appointed or reassigned to RRT positions in the GS-0601series must possess and maintain for the duration of employment a full, current and unrestricted license from a state to practice as an RRT. Credential. Persons appointed or reassigned to RRT positions in the GS-0601series 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. 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. Physical Standards. See VA Directive and Handbook 5019, Employee Occupational Health Service for requirements. English Language Proficiency. RTs/RRTs appointed to direct patient-care positions must be proficient in spoken and written English as required by 38U.S.C. § 7403(f). GRADE REQUIREMENTS. 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. Working titles, such as program coordinator, assistant chief, national program manager, etc., may be used at the organizational level to designate the work of the position. GRADE DETERMINATIONS. Grade Determinations. In addition to the basic requirements for employment in paragraph 3 above, all individuals referred and assigned to this occupation must meet all the qualification requirements and KSAs defined in the specific assignment as follows: Registered Respiratory Therapist, GS-07. Experience, Education, Licensure and Registration. In addition to the basic requirements, candidates must possess their RRT credential. Demonstrated Knowledge, Skills and Abilities. In addition to the requirements above, candidates must demonstrate all the following KSAs: i. Ability to perform therapeutic modalities related to respiratory care. ii. Skill in analyzing physiological specimens obtained to include arterial blood gases, pulse oximetry, End tidal Co2 (ETCo2) monitoring, basic spirometry and other basic diagnostic procedures. iii. Ability to collaboratively consult with physicians and other healthcare professionals for respiratory care to help provide favorable patient outcomes. iv. Skill in assessing oxygenation and ventilation. v. Ability to perform basic airway management to include artificial airways and mechanical ventilation. Assignment. This is a developmental position. RRTs at this grade level will be responsible for the following assignments with minimal clinical supervision from an RRT at the full performance level in both inpatient and/or outpatient settings. RRTs complete patient assessment through direct contact, chart review and other means as appropriate and share the information with health care team members. They use accepted measuring/monitoring tools for determining plan of care. They place nasal and oropharyngeal airway and perform nasal and tracheal suctioning. RRTs obtain, analyze and report arterial and venous blood gas samples. They perform duties in the critical area with close supervision to include in- line suctioning, re-positioning and securing Endo Tracheal tube, bag valve mask ventilation, assisting in patient transport and performing patient ventilator assessment. RRTs provide outpatient services, such as positive airway pressure (PAP) therapy, oxygen therapy and COPD care. Registered Respiratory Therapist, GS-09. Experience or Education, Licensure and Credential. Candidates must have: i. One year of creditable experience equivalent to the GS-07 grade level demonstrating the clinical competencies described at that level; OR ii. A Master of Science degree in respiratory care AND a license AND an RRT credential. Demonstrated Knowledge, Skills and Abilities. In addition to the requirements above, candidates must demonstrate all the following KSAs: i. Skill in performing therapeutic modalities related to respiratory care. ii. Ability to collaboratively consult with physicians and other healthcare professionals to help provide favorable patient outcomes. iii. Skill in assessing oxygenation and ventilation. iv. Ability to perform airway management to include artificial airways and mechanical ventilation. Assignments. This is a developmental position. RRTs at this grade level are responsible for the following under general guidance in both inpatient and/or outpatient settings. RRTs obtain, interpret and analyze physiological specimens and data. 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 through the use of appropriate mechanical means. RRTs assess and evaluate patients to determine and recommend intervention to develop and implement a plan of care, such as, implementing protocols, intubation, monitoring critical systems and uses advanced modes of ventilation. Registered Respiratory Therapist, GS-11. 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.
Area I: Collection of Diagnostic Information A. Pulmonary Function Technology 1. Perform basic spirometry, including adequate coaching, recognition of improperly performed maneuvers, corrective actions, and interpretation of test results. B. Invasive Diagnostic Procedures 1. Identify and distinguish the indications, contraindications, and general hazards, complications in preparation, performance, and post care of bronchoscopic procedures. 2. Describe the role of a respiratory therapist in diagnostic bronchoscopy procedures. 3. Monitor and evaluate the patient's clinical condition with pulse oximetry, electrocardiogram, exhaled gas analysis, and other related diagnostic devices. 4. Perform arterial sampling for blood analysis. 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. Assist in developing, administering, and re-evaluation of patient care plans. B. Management of Acute Diseases 1. 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. Area III: Evidence-Based Medicine and Respiratory Care Protocols A. Evidence-Based Medicine 1. Retrieve credible sources of evidence. 2. 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 1. 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 1. Review and interpret pulmonary function studies (spirometry) and pulse oximetry. 2. 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 deformation, cyanosis, edema, clubbing, and other anomalies. 2. Measure vital signs (blood pressure, heart rate, respiratory rate). 3. Evaluate patient breathing effort, ventilatory pattern, and use of accessory muscles. 4. Measure and document oxygen saturation with oximetry under all appropriate conditions (with or without oxygen at rest and during sleep, ambulation, or exercise). Area V: Leadership A. Knowledge of advanced practice skills in all aspects of respiratory care B. Ability to communicate orally and in writing at varying levels, both internal and external to the organization C. Skill in communicating data, policies, and regulations D. Ability to develop resource material E. Skill in the development of and implementation of appropriate standards of care for Respiratory Care F. Serves as liaison between the department and its clinical consumers (i.e., nursing service, administration and other support services). G. Advise leadership on policy implications, key issues, relationships to both internal and external interest groups and recommended course of action. H. Maintain interdepartmental relations with other services to accomplish medical center goals. I. Coordinate and negotiate resolutions to complex problems and report progress and resolution of problems in achieving goals and objectives to higher levels of management. 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. Maintain knowledge and skills necessary to retain certification as per associated guidelines as stated above. 3. Perform endotracheal intubation. 4. Perform as a member of the rapid response team (medical emergency team). 5. Perform as a member of the Code Blue team to provide airway management, manual and mechanical ventilatory life support, medical gas administration, aerosol delivery of bronchodilators and other agents in the resuscitation of respiratory and cardiovascular failure. 6. Manage monitoring systems 7. Manage airway devices. 8. Make treatment recommendations based on waveform graphics, pulmonary mechanics, and imaging studies. 9. Apply knowledge, and analysis of use of therapeutic medical gases. Work Schedule: 1930-0800 Compressed