Novant Health respiratory therapist Candy Yow remembers when a few months ago, she hooked a COVID-19 patient up to a breathing machine. The patient was in her early twenties and hadn’t been vaccinated. She was in the intensive care unit.
Yow said the patient’s mother was shocked as she watched the machine, called a BiPAP, help push air into her daughter’s lungs.
“She kept saying, ‘I thought I was doing the right thing by protecting her against the vaccine’ because it wasn’t FDA approved,” Yow said.
The patient was able to wean off the breathing machine, according to Yow, and was eventually discharged. But that doesn’t always happen.
Respiratory therapists like Yow play a critical role in treating COVID-19 patients. When patients struggle to breathe, respiratory therapists manage therapies like inhalers and supplemental oxygen. They also operate ventilators. These workers were in high demand before the coronavirus pandemic, and now, with a surge in cases because of the highly contagious delta variant, the need is even greater.
A Growing Shortage
“We’re seeing the need for many, many more respiratory practitioners in our state and it’s hard to fill those vacancies,” said Charley Starnes, president of the North Carolina Society for Respiratory Care, an advocacy group for the state’s roughly 4,500 licensed respiratory therapists.
Starnes said fewer people are enrolling in North Carolina’s 14 associate's degree programs for respiratory care. There are also fewer faculty members to teach those programs.
“I would love for every one of those (14 programs) to have enough persons in academia that are teaching respiratory care to be able to graduate 30-plus respiratory therapists every single year,” Starnes said.
But Starnes said the respiratory therapy program at Central Piedmont Community College, where she is the director of clinical education, currently graduates only around 20 students annually. Not all of those graduates remain in the field, according to Starnes. Some use the program as a step toward a different health care career, like as a nurse or physician assistant.
Meanwhile, the number of existing respiratory therapists is dwindling, Starnes said, as people leave for other jobs or grow older and retire.
“I think the pandemic has pushed some practitioners that can retire early to want to do so,” she said.
Leaving For ‘The Big Bucks’
Starnes said the pandemic has made the shortage feel worse because there are so many COVID-19 patients that need respiratory care. Over the past 18 months or so, respiratory therapists have seen sometimes quadruple the number of patients they saw before the coronavirus. The high demand means companies compete to hire them.
At Novant Health, Candy Yow said she and her coworkers are constantly being contacted by companies trying to recruit them to become traveling respiratory therapists and make what she called “the big bucks.” Traveling respiratory therapists may be asked to go to parts of the U.S. hit hardest by the pandemic.
“If they see you on LinkedIn, if they see you on Facebook, and they know you’re a respiratory therapist, you get messages time and time again,” Yow said. “(They say), ‘Hey, you can come work here for x amount of dollars an hour. You can work 36 hours and make this.’”
According to Yow, about half of Novant’s respiratory therapists in Charlotte have left for travel jobs in the past couple of years. Novant said it filled some of those vacancies and is working to attract more workers by offering professional development opportunities and “competitive incentives.” Atrium Health, Charlotte’s other large hospital system, is also looking for respiratory therapists and offering a $10,000 sign-on bonus.
At CaroMont Health in Gaston County, respiratory therapist Andrea Bailey said she, too, has lost coworkers to traveling positions.
“It does put us in a bind because then we have to bring in travelers and we have to get them trained and we have to get them used to our system,” Bailey said.
The U.S. Bureau of Labor Statistics estimated that the nation will need about 20% more respiratory therapists by 2029. Those numbers were calculated before the pandemic.
‘Everybody’s Trying To Brace Themselves’
Like every health care worker, respiratory therapists are burnt out. Starnes with the state’s Society for Respiratory Care said her members are exhausted even as patient volume continues to increase.
In Mecklenburg County, 456 patients were in the hospital with COVID-19 last Wednesday, according to the latest available county numbers. That’s roughly 12 times the number of patients hospitalized with the disease in the county in early July, but about 100 fewer hospitalizations than during the peak of the winter coronavirus surge.
Every area hospital does not always have a patient bed available, according to Jonathan Studnek, deputy director for Medic, the agency that provides emergency medical services in Mecklenburg County.
“These patients who … we would take to the emergency department, there would be a bed waiting and staff ready to treat them. That capacity is not there,” Studnek told WFAE on Friday.
Statewide, North Carolina on Friday reported 3,651 patients were in the hospital with COVID-19 statewide--more than three times the number of patients hospitalized at the beginning of August, but still 340 fewer than at the peak of the state’s winter surge.
Coronavirus trends will continue to worsen for the next two to four weeks, Dr. Katie Passaretti, an infectious disease physician at Atrium Health, told the hospital system’s board meeting last Tuesday.
When COVID-19 patients go from bad to worse, Yow, the respiratory therapist with Novant, said her team members will try different techniques like turning patients onto their stomachs or having them inhale nitric oxide gas.
“(We’re) trying to think of everything possible to make these patients be able to walk out of the hospital. But no matter what we do, we just aren’t saving them--we can’t save them all,” Yow said.
Andrea Bailey with CaroMont said she and her coworkers felt “victorious” after making it through the winter wave.
“For it to all be happening again, everybody’s just trying to brace themselves and go, ‘OK, I hope we can do this again,’” she said.
