Waco Healthcare is looking for a PRN Registered Respiratory Therapist to join their team. Respiratory Therapist - PRN Tracheostomy Care Job Summary The PRN Respiratory Therapist provides direct respiratory therapy services and clinical support for residents with tracheostomies and other complex respiratory conditions. The therapist works within the facility's established tracheostomy program, policies, physician orders, and resident-specific plans of care. This position focuses on tracheostomy management, respiratory assessment, airway clearance, oxygen therapy, emergency response, documentation, and collaboration with nursing and medical providers. The PRN Respiratory Therapist reports changes in condition and assists nursing staff with safe respiratory care practices. Program leadership, policy development, and overall management of the tracheostomy program remain the responsibility of the designated Tracheostomy Program Lead and facility leadership. Essential Duties and Responsibilities Direct Respiratory and Tracheostomy Care Perform comprehensive respiratory assessments for residents with tracheostomies or complex pulmonary conditions. Assess respiratory rate, effort, breath sounds, oxygen saturation, airway patency, secretion characteristics, and signs of respiratory distress. Evaluate the tracheostomy site, ties, flange, inner cannula, humidification system, and associated respiratory equipment. Provide routine and as-needed tracheostomy care according to physician orders, facility policy, and the resident's plan of care. Perform tracheal suctioning using appropriate infection-control and safety practices. Provide airway-clearance therapies and secretion-management interventions as ordered. Administer and monitor oxygen therapy, humidification, nebulizer treatments, and other prescribed respiratory treatments. Monitor residents using CPAP, BiPAP, or other noninvasive respiratory-support equipment according to physician orders and facility capabilities. Assist with tracheostomy tube changes when ordered, clinically appropriate, and permitted by facility policy and the therapist's scope of practice. Evaluate resident tolerance and response to respiratory treatments and interventions. Emergency Airway Management Respond promptly to respiratory distress and tracheostomy-related emergencies. Provide immediate intervention for suspected mucus plugging, airway obstruction, accidental decannulation, equipment malfunction, bleeding, or acute oxygen desaturation. Initiate emergency procedures according to facility policy, physician orders, and the resident's emergency airway plan. Assist nursing staff during respiratory emergencies and activate emergency medical services when indicated. Verify that resident-specific emergency equipment is immediately available and functional. Participate in post-event review and documentation following respiratory emergencies. Monitoring and Clinical Communication Identify and promptly report changes in respiratory status to the licensed nurse, attending provider, designated program specialist, and Director of Nursing. Communicate recommendations regarding airway clearance, oxygen delivery, humidification, suction frequency, equipment needs, and monitoring. Collaborate with nursing, physicians, speech therapy, rehabilitation services, hospice, and other interdisciplinary team members. Participate in resident care-plan meetings when requested. Assist with respiratory care coordination during hospital transfers, appointments, off-site leave, and return to the facility. Provide clear handoff communication to nursing staff at the completion of the shift or visit. Documentation Document respiratory assessments, treatments, suctioning, oxygen use, secretions, tracheostomy-site condition, resident response, and provider notifications in the medical record. Document respiratory emergencies, interventions, outcomes, and transfer information completely and promptly. Complete respiratory flow sheets, treatment records, equipment checks, and other required facility documentation. Ensure documentation is consistent with physician orders, facility policies, professional standards, and the resident's plan of care. Equipment and Supply Management Inspect respiratory and emergency airway equipment for proper function. Confirm availability of the resident's current-size replacement tracheostomy tube, one-size-smaller tube, obturator, suction equipment, oxygen equipment, and other required emergency supplies. Report missing, expired, damaged, contaminated, or malfunctioning equipment immediately. Assist with maintaining adequate bedside and emergency respiratory supplies. Follow manufacturer instructions and facility procedures for equipment use, cleaning, storage, and infection prevention. Staff Support and Education Reinforce established tracheostomy-care and respiratory-safety practices with nursing staff. Provide bedside guidance related to suctioning, oxygen therapy, humidification, secretion management, and recognition of respiratory distress. Assist the designated Tracheostomy Program Specialist with staff competency validation and emergency drills when requested. Report observed knowledge gaps, unsafe practices, or additional training needs to the program specialist and Director of Nursing. The PRN Respiratory Therapist may assist with education but is not primarily responsible for developing or leading the facility's respiratory program. Quality and Infection Prevention Follow standard precautions and all applicable infection-prevention procedures during respiratory care. Maintain clean or sterile technique as required for each procedure. Monitor for signs of respiratory infection, aspiration, tracheostomy-site infection, or equipment contamination. Report safety concerns, adverse events, equipment failures, and deviations from the resident's plan of care. Participate in respiratory-care audits, incident reviews, and quality-improvement activities when requested. PRN Scheduling and Availability Work on an as-needed basis according to resident needs and facility scheduling. Provide coverage for scheduled respiratory visits, staff absences, increased resident acuity, new tracheostomy admissions, and other identified clinical needs. Provide on-call availability only when separately scheduled and approved by facility leadership. Respond within the facility's established timeframe when scheduled for on-call coverage. Availability for weekends, holidays, or urgent clinical needs may be required. PRN employment does not automatically require continuous 24-hour availability unless specifically included in the employee's written schedule or on-call agreement. Supervisory and Program Responsibilities This is a clinical support position and does not have primary responsibility for: Leading or developing the tracheostomy program Approving facility policies Determining whether the facility is ready to accept tracheostomy residents Providing administrative supervision of nursing staff Independently changing medical treatment plans or respiratory-device settings without an authorized order Serving as the sole emergency-response resource for the facility The PRN Respiratory Therapist works under applicable physician orders, facility policies, professional standards, and the direction of the designated program specialist and facility leadership. Qualifications Education Graduate of an accredited respiratory therapy program. Associate degree in Respiratory Therapy required; bachelor's degree preferred. Licensure and Certification Current, unrestricted Texas respiratory care practitioner license. Registered Respiratory Therapist credential. Certified Respiratory Therapist credential may be considered based on experience and facility requirements. Current Basic Life Support certification required. Advanced Cardiovascular Life Support certification preferred. Experience Minimum of two years of respiratory therapy experience preferred. Experience in long-term care, skilled nursing, LTAC, ICU, subacute care, home respiratory care, or another high-acuity setting preferred.

Demonstrated competency in:

Tracheostomy assessment and care Tracheal suctioning Oxygen administration Humidification Airway-clearance therapies Emergency airway response CPAP and BiPAP monitoring Respiratory equipment operation Clinical documentation Knowledge, Skills, and Abilities Knowledge of tracheostomy care, airway management, oxygen therapy, secretion management, and respiratory assessment. Ability to recognize and respond to respiratory distress and airway emergencies. Ability to follow physician orders and resident-specific respiratory plans of care. Strong clinical judgment, communication, and documentation skills. Ability to work independently while collaborating with nursing and interdisciplinary team members. Ability to educate and support nursing staff without exceeding the therapist's assigned authority. Knowledge of infection-prevention practices related to respiratory equipment and treatments. Physical Requirements Ability to respond quickly during respiratory emergencies. Ability to stand, bend, reach, and remain physically active while providing resident care. Ability to assist with positioning or moving residents according to facility procedures. Ability to lift and operate portable oxygen, suction, and respiratory equipment. Ability to wear required personal protective equipment. Reporting Structure The PRN Respiratory Therapist reports to the designated Tracheostomy Program Specialist and/or Director of Nursing, according to the facility's organizational structure.

License/Certification:

Respiratory therapist (Required)

Work Location:

In person