2027 Respiratory Therapist (RT) vs. Registered Nurse (RN): Explaining the Difference

Imed Bouchrika, PhD

by Imed Bouchrika, PhD

Co-Founder and Chief Data Scientist

What does a Respiratory Therapist (RT) do?

A Respiratory Therapist (RT) evaluates and treats patients who have trouble breathing because of conditions such as asthma, COPD, pneumonia, trauma, premature birth, or acute illness. RTs focus on the cardiopulmonary system, which means their work centers on lungs, oxygenation, ventilation, and airway support.

In a hospital, an RT may assess lung function, monitor oxygen saturation, draw or analyze blood gases, provide breathing treatments, manage oxygen therapy, and operate mechanical ventilators. In critical care, RTs are often called when a patient’s breathing worsens, when a ventilator needs adjustment, or when airway support becomes urgent.

RTs also educate patients. They may teach someone how to use an inhaler, maintain a nebulizer, follow a pulmonary rehabilitation plan, or manage oxygen equipment at home. Documentation is another major part of the job because respiratory treatments, ventilator settings, patient response, and physician orders must be recorded accurately.

Common RT work settings

  • Hospitals: Especially emergency departments, intensive care units, neonatal units, and pulmonary care units.
  • Long-term care and nursing homes: Supporting patients who need ongoing oxygen therapy, airway clearance, or ventilator care.
  • Rehabilitation centers: Helping patients improve breathing capacity after illness, surgery, or injury.
  • Home healthcare: Assisting patients who use respiratory devices outside the hospital.
  • Sleep laboratories: Supporting testing and treatment for sleep-related breathing disorders.

The RT role is best suited for people who want a specialized clinical career with frequent use of respiratory equipment, strong technical decision-making, and direct involvement in urgent breathing-related care.

What does a Registered Nurse (RN) do?

A Registered Nurse (RN) provides direct patient care across a broad range of medical conditions. Instead of focusing mainly on one body system, RNs assess overall patient status, monitor vital signs, administer medications, carry out physician orders, document care, and coordinate with the wider healthcare team.

RN responsibilities can vary widely by specialty. A hospital RN may care for post-surgical patients, monitor cardiac symptoms, manage IV medications, prepare patients for procedures, or respond to changes in condition. A clinic RN may focus more on triage, patient education, chronic disease management, vaccinations, and follow-up care. In long-term care, school nursing, home health, or community health, the job can look very different again.

RNs are also central communicators. They explain care plans to patients and families, report changes to physicians or advanced practice providers, coordinate with therapists and aides, and help ensure that care remains safe and timely. Many also supervise nursing assistants or licensed practical nurses depending on the setting and state rules.

Hospitals are the primary employers, with more than 60% of U.S. RNs working there as of 2025. However, one of the major advantages of nursing is flexibility: RNs can move among specialties, care settings, patient populations, and leadership tracks more easily than many narrower healthcare roles.

Ratio of coaching programs to workers available.

What skills do you need to become a Respiratory Therapist (RT) vs. a Registered Nurse (RN)?

RTs and RNs both need clinical judgment, compassion, communication skills, and the ability to stay calm when patients decline. The difference is in how those skills are used. RTs need deeper expertise in respiratory physiology and equipment. RNs need broader patient-care knowledge and strong coordination skills across many conditions and treatments.

Skills a Respiratory Therapist (RT) needs

  • Respiratory equipment expertise: RTs must understand ventilators, oxygen delivery systems, nebulizers, airway clearance devices, and monitoring tools.
  • Careful technical judgment: Small changes in oxygen delivery, ventilator settings, or airway support can matter, especially in critical care.
  • Fast problem-solving: RTs often respond to sudden drops in oxygen levels, breathing distress, or ventilator alarms.
  • Strong assessment skills: They must interpret breath sounds, oxygen saturation, blood gas results, respiratory effort, and patient response to treatment.
  • Clear patient instruction: RTs frequently teach patients how to use inhalers, breathing devices, and home respiratory equipment correctly.
  • Team communication: They work closely with physicians, nurses, emergency teams, and critical care staff.

Skills a Registered Nurse (RN) needs

  • Multitasking: RNs often manage medications, assessments, documentation, family questions, physician orders, and changing patient needs at the same time.
  • Broad clinical knowledge: Nurses need working knowledge of many body systems, diagnoses, medications, procedures, and safety protocols.
  • Critical thinking: RNs must notice early warning signs, prioritize care, and escalate concerns quickly.
  • Medication safety: Administering drugs accurately and monitoring for side effects are core nursing responsibilities.
  • Patient and family communication: Nurses often explain care plans, discharge instructions, symptoms, and next steps.
  • Emotional resilience: RNs regularly handle pain, grief, conflict, emergencies, and high patient volumes.

Key difference in day-to-day skill use

If you like specialized technical care and want to become highly skilled in one clinical area, respiratory therapy may feel like a better match. If you prefer a wider scope of care and want the option to move among many specialties, nursing may offer more flexibility.

What Professionals Say About Being a Respiratory Therapist (RT) vs. a Registered Nurse (RN)

  • Enoch: "Choosing a career as a Respiratory Therapist has been incredibly rewarding for me. The demand for RTs continues to grow steadily, offering excellent job stability and competitive salaries, which gave me peace of mind during uncertain times. I'm grateful for the variety of medical environments I get to work in daily."
  • Keanu: "Working as a Registered Nurse has exposed me to an immense range of challenges that keep my work engaging and continuously help me grow. From critical care units to community health, the diversity of nursing roles means you're always learning new skills and adapting. It's a career that demands resilience but rewards you with the opportunity to make a tangible difference."
  •  Jonah: "The professional development pathways available in respiratory therapy are impressive. Having access to specialized training and certifications has enabled me to advance my career and take on leadership roles within healthcare teams. This ongoing growth has kept me motivated and confident in my profession's future."

Other Things You Should Know About a Respiratory Therapist (RT) & a Registered Nurse (RN)

What credentialing exams are required for RTs and RNs in 2027?

Respiratory therapists typically must pass the NBRC Certified Respiratory Therapist (CRT) exam, and many states require the Registered Respiratory Therapist (RRT) exam for full licensure or advancement. Registered nurses must pass the NCLEX-RN and meet state Board of Nursing requirements for licensure.

What is the job outlook for Respiratory Therapists versus Registered Nurses in 2027?

In 2027, the job outlook for Respiratory Therapists is projected to grow by 19% according to the U.S. Bureau of Labor Statistics, while Registered Nurses are expected to see a 6% increase. This reflects demand and opportunities in their respective fields.

What are the licensure requirements for Respiratory Therapists compared to Registered Nurses in 2027?

In 2027, Respiratory Therapists must obtain the Certified Respiratory Therapist (CRT) credential and pass the National Board for Respiratory Care exam, while Registered Nurses need to pass the NCLEX-RN exam to secure their licensure. Each profession has state-specific requirements beyond these exams.

What educational qualifications differentiate Respiratory Therapists and Registered Nurses in 2027?

In 2027, Respiratory Therapists typically require an associate's degree in respiratory therapy, although some employers may prefer or require a bachelor's degree. Registered Nurses generally need at least an associate's degree in nursing, with a bachelor's degree being the preferred qualification for many employers.