As an undergraduate student at Indiana University Indianapolis, Desiree Cariaso was searching for a new major when she realized respiratory therapy was not only a potential profession but a field she had been interacting with throughout her life.

“I had childhood asthma — I had breathing treatments, I have been in the ICU with an asthma attack, I got pulmonary functioning tests — but I always thought they were nurses,” said Cariaso, who will soon graduate from the Respiratory Therapy program at the Indiana University School of Medicine.

Respiratory therapists are the first responders in hospitals across the nation when a patient is struggling to breath. It could be a premature baby’s first breath, someone in cardiac arrest or a person taking their final breaths. Never were respiratory therapists more visible than during the COVID pandemic as they administered mechanical ventilation to thousands of people in acute respiratory failure.

“Respiratory therapists are unsung heroes with hidden capes,” Cariaso said.

A consortium led by IU Health has been training respiratory therapists since the 1990s in partnership with the IU School of Medicine. The program includes students from IU, Ball State University and the University of Indianapolis who complete two years of coursework on their home campuses before doing clinical training at central Indiana hospitals.

“We have a very large shortage of respiratory therapists,” said Christopher Porter, MPH, RRT-NPS, director of the Indiana Respiratory Therapy Education Consortium (IRTEC) and an IU adjunct clinical assistant professor of medicine. “All of our current senior students already have positions lined up. We’ve had 100% job placement for the last 15 years.”

After graduation, Cariaso will be staying at Riley Hospital for Children, where she completed a summer internship and currently works as a respiratory therapy assistant. She treats children with asthma, cystic fibrosis and other conditions affecting their breathing.

According to the U.S. Bureau of Labor Statistics, jobs in respiratory therapy are expected to grow by 12% between 2024-34. However, enrollment in respiratory therapy and other health professions programs across the nation has been declining over the last decade.

In 2022, IU Health launched a recruitment and retention initiative that was recognized by the Children’s Hospital Association for its success. Working closely with IU School of Medicine, the health system created more touch points between students and working RT professionals, along with easier access to mentorship and job opportunities. IU Health also instituted a hiring bonus as in incentive to keep the best respiratory therapy students in Indiana. More than 60% of this year’s IRTEC graduates will work at IU Health hospitals as they launch their careers this spring.

The consortium’s respiratory therapy program has gained national recognition for its 100% pass rate on the board certification exam — more than 90% of students pass on the first attempt. Porter is himself a graduate of the program and a proud IU alum who is passionate about training the next generation of respiratory therapists.

“A lot of people don’t realize respiratory therapists are the first responders in the hospitals,” he said. “If a patient isn’t breathing well, the nurse calls the respiratory therapist first, then it would be the physician.”

Respiratory therapists are on every floor — in the operating room, the intensive care unit, the emergency department — and they are required to be part of the neonatal assessment team for all high-risk births. “If there’s an issue with a baby at birth, it’s typically respiratory in nature because the lungs are the last to develop,” noted Porter.

Outside the hospital, respiratory therapists can be found in sleep labs and outpatient pulmonary care clinics.

While some respiratory therapy programs are two-year degrees, IU’s baccalaureate program offers a wider breadth of experiences including the opportunity to do pulmonary research with Michael D. Davis, PhD, RRT. Cariaso also enjoyed rotating on the IU Health LifeLine helicopter for emergency medical transport and participating in a chaplaincy rotation that helped students debrief from traumatic experiences like removing breathing support from a patient at the end of life.

In April, she’s looking forward to taking on the role of educator: she and her senior classmates will teach IU medical students how to intubate a patient. Her extensive training has given her confidence as she begins her career.

Now, when a patient refers to her as “the nurse,” she gently corrects them. Perhaps one day, a child she’s treating for asthma will become a respiratory therapist, too.

What’s it like to be a respiratory therapist in Indiana?

Meet 2025 graduate Aquoia Johnson, respiratory therapist at IU Health Methodist Hospital

Aquoia Johnson graduated from IU’s Respiratory Therapy program in 2025 and is now working at IU Health Methodist Hospital on the special weekend night shift.

“While in school, I was an RTA (respiratory therapy assistant) at Methodist on nights and loved the fast-paced working environment and hands-on trauma experience,” she said.

Question: When did you decide respiratory therapy was the right career for you, and what influenced that decision?

Aquoia Johnson: Both me and my sister are Riley kids. My sister has multiple physical disabilities and has had a trach my whole life. I am a severe asthmatic who has spent an extensive amount of time in Riley's PICU. I've spent most of my adolescence educating people about our health issues, and once I found the respiratory career, I knew it was the right choice for me.

Q: What do you do in a typical workday?

Johnson: I primarily work in the ICU. I start my rounds based off patient acuity. I always try to start with my patients on life support (ventilators) and assure that my vent orders are accurate, the patient is comfortable and well sedated, that their endotracheal tube is where it's supposed to be and general safety checks. I then check on my patients that are on BIPAPs and High Flow, interpret any ABG's/VBG's (tests for oxygenation) and assess if support could be weaned. I then follow my patients that are on lower oxygen needs and may require simple breathing treatments though a nebulizer. Our jobs are often met with interruptions, and we are often being called to rapidly assess other patients, which could lead to initiating sudden therapies, intubations, new medications, new admissions from our ER, OR, or from our LifeLine team that require ventilator support — and so much more.

Q: What do you most enjoy about your work?

Johnson: I most enjoy seeing the impact our therapies have on our patients! Being able to take care of a patient pre-lung transplant that is having a severe exacerbation for weeks, to having them intubated post-transplant, and then see them again weeks later looking healthier and happier; or watching a severe trauma patient admitted from our ER that is critically unstable become stable and able to sit up and talk to you is truly a pleasure. To be able to see our interventions change a life continuously motivates me to come to work.

Meet 2024 graduate Elsie Walters, advanced respiratory therapist at Riley Maternity Tower

Elsie Walters, RRT, graduated in 2024 and now works in the Riley Maternity Tower at Riley Children’s Health. As an advanced respiratory therapist, she treats newborns in the neonatal intensive care unit and is a member of the STORK team for high-risk labor and deliveries.

“I attend high-risk deliveries including those of premature infants, twins, triplets and infants with various congenital anomalies,” she said. “I also care for and treat high-risk mothers before and after giving birth.”

Question: What do you most enjoy about your work?

Elsie Walters: We care for patients from the time they take their first couple breaths when they are born, all the way up until they get to go home — sometimes weeks or months later. It is fulfilling to watch them grow and care for them through every step of this process.

Q: What advice do you have for someone considering a career in respiratory therapy?

Walters: I recommend shadowing a respiratory therapist and talking to them if you are interested in this career. RTs work in many areas of the hospital, and there are a lot more job opportunities that come with being an RT than people realize — ICU, pulmonary rehab, pulmonary function tests, sleep lab and more.

Q: How well do you think the program prepared you for your career?

Walters: I felt extremely prepared. Most of my clinicals were at the downtown IU Health hospitals, so it was an easy transition starting my career at Riley, as I was already somewhat familiar with the hospital from my time here during school.

Discover more: Health Professions Programs at IU

Explore the Health Professions Programs at the IU School of Medicine and learn more about how IU is preparing students to enter these critical healthcare fields, including radiation therapy and the competitive field of medical laboratory science.