In these times of rising health care expenses, many hospital administrators and private doctors have come to recognize that nursing professionals are able to provide a high quality of patient care in a cost savings manner.

While a Registered Nurse (RN) may be employed in a variety of health care settings, specific duties depend on experience and education.

Common Responsibilities include:

• Update and maintain patient charts, reports, and medical records
• Monitor and record any symptoms or changes in the patient’s condition
• Record patient vital signs, such as heart rate, blood pressure and body temperature
• Record patient’s medical history
• Collaborate with other health care providers to assess and implement patient care plans
• Notify doctor of physician assistant of any major changes to patient’s condition and change treatment plan as directed.
• Order and interpret various medical tests to identify underlying causes of medical conditions
• Educate patients with regard to preventative care and the importance of nutrition and exercise to foster health and wellness
• Oversee and coordinate all aspects of the patient’s care including nutrition and exercise
• Supervise licensed practical nurses (LPNs), certified nursing assistants (CNAs) and nurses aids.
• Perform basic physical exams and triage emergency room patients..
• Dispense medication as prescribed by physician or physician assistant.

A Master’s Degree can also help nurses specialize in such areas as pediatrics, oncology, obstetrics, critical care and gerontology, and home care.

Career Outlook

According to the U.S. Bureau of Labor Statistics (BLS), the employment of RNs is expected to grow at a rate of about 22 percent annually through 2018, which represents a much faster rate of growth than the average of most other occupations.

According to the BLS, the areas where the greatest growth will be seen are:

• Private Physician offices: 48%
• Home Health Care:  33%
• Nursing Care Facilities:  25%
• Employment Services:  24%

Education/Training

As per the California Board of Registered Nurses (CBRN) all candidates interested in becoming RNs in the state must possess a minimum of a high school diploma or general equivalency diploma and graduate from a program of study accredited by the California State Board and the National League of Nursing Accreditation Commission (NLNAC).  The NLNAC is the agency recognized by the U.S. Department of Education as the official accreditation agency of RN training programs. Accreditation provides verification that the school has met strict standards set by the NLNAC and the CBRN with regard to curriculum, faculty background, practicum experiences, support services and job placement.

There are 3 educational pathways to become an RN in California. From the Web site of the CBRN these pathways include:

• Associate Degree in Nursing (ADN) - Takes 2-3 years. Offered at many community colleges. Prepares you to provide registered nursing care in numerous settings.
• Bachelor of Science in Nursing (BSN) - Takes 4 years. Also referred to as Baccalaureate degree. Offered at many California State Universities and some private colleges. Prepares you to provide registered nursing care in numerous settings and to move to administrative and leadership positions.
• Masters Entry Level Program in Nursing - Designed for adults who have a baccalaureate degree in another field and wish to become registered nurses. Takes 1-2 years depending on how many nursing course prerequisites you have already completed. Graduate receives a master’s degree.
• LVN 30 Unit Option - Designed as a career ladder for California Licensed Vocational Nurses wishing to become registered nurses. Takes approximately 18-24 months. No degree is granted upon completion. Most other states do not recognize California’s LVN 30 Unit Option and will not issue RN licenses to these LVNs. Some LVNs prefer to complete an ADN program in order to obtain a degree and to have the flexibility to get an RN license in other states. Most ADN programs will give LVNs credit for some of the coursework they completed to become an LVN.

Licensure

To work as an RN in California, candidates must obtain a license from the CBRN. To be licensed, candidates must meet the educational requirements as stated above, pass a national licensing examination, as well as a criminal background check.

NCLEX-RN Exam

Candidates for RN licensure are required to pass the National Council Licensure Examination for RNs (NCLEX-RN).

The NLEX is a national, standard multiple-choice type examination for entry-level RN candidates. The test was developed by the National Council of State Boards of Nursing (NCSBN) and places greater emphasis on nursing practice than theoretical knowledge. Specifically, the test focuses on those duties that are expected to be carried out entry-level staff nurses and assesses competency in terms of patient care and medical knowledge.

Salary of RNs

The following present the median earnings of entry-level nurses in select regions of California. Figures as per Salary.com January 2012.

Accounting Clerk Job Description

Accounting and auditing clerks update and maintain financial records and accounts payable and receivable, keeping track of expenditures and revenue. Accounting clerks possess a wide range of skills from bookkeeping through managing the general ledger to tracking accounts payable and reconciling accounts receivable with invoices.

In smaller-size firms, accounting clerks may have responsibility for maintaining the general ledger which records all daily transactions. They post debits (expenditures) and credit (revenue). They may also prepare financial statements and reports for financial managers. Accounting clerks may also prepare bank deposits and handle payroll, prepare invoices, send cash and checks to the company’s bank, and monitor overdue accounts. Some accounting clerks also perform collections of unpaid bills.

In larger size companies, accounting clerks routinely handle more specialized tasks such as accounts payable or accounts receivable. Their duties may also vary by level of experience. Entry-level accounting clerks may post daily transactions, total accounts receivable or accounts payable, and monitor accounts to ensure that payments are current and calculate interest charges on those overdue. Experienced accounting clerks may total and reconcile billing vouchers with cost estimates, ensure the accuracy of financial records, and code financial documents according to company policy.

Auditing clerks (a specialized type of accounting clerk) verify transactions posted by other clerks. They examine all financial records to ensure they are accurate and properly coded. They also make note of any mistakes for accountants to correct.

Accounting clerks must be comfortable using computers as most accounting is performed using specialized financial software such as QuickBooks, as well as spreadsheets and databases. Most accounting clerks now input financial information into computers where it is stored electronically. The use of computers has enabled accounting clerks to take on more responsibilities such as payroll, purchasing, and billing.

Career Outlook

As per the Bureau of Labor Statistics, the growth of jobs in the field is expected to be about 10 percent through the year 2018. It is estimated that there will be about 215,000 new jobs over the next decade. The large need for these workers in all industries ensures a good supply of job openings, as many accounting clerks are expected to retire or move to other occupations. Many accounting clerks continue their education to become accountants.

An increased need for financial oversight and reporting regulations, such as the International Financial Reporting Standards, will spur demand for these workers. In addition, an increased emphasis on transparency and accuracy of the financial records of large public firms will also increase demand.

Education and Training

Most accounting clerks must have a minimum of a high school diploma. However, to be most competitive, most entrants to the field are enrolling in formal coursework to obtain an associate’s degree in business or accounting studies. A bachelor’s degree is rarely required for this level of worker but a necessity for those who wish to become accountants. Once hired, accounting clerks receive on-the-job training under the guidance of a senior accounting clerk.

Coursework will include basic accounting, management accounting, introduction to finance, introduction to business law, business management, statistics, payroll systems and such bookkeeping software as QuickBooks.

Working as an accounting clerk is a great way to begin a career in accounting. In some cases, you may transfer the credits you earn as part of your associate’s degree into a four year program. Upon graduation you will be eligible to work as a full-fledged accountant with many career options.  Another advantage is that you can earn a salary while pursuing your bachelor’s and even have part of your tuition paid for by your employer via tuition reimbursement programs.

View a list of accounting programs in California >

Certification

There are no mandatory certification requirements to work as an accounting clerk in any state,  including California. However, many accounting clerks, especially those who oversee all recordkeeping for their firm, may find it valuable to become certified. The Certified Bookkeeper (B) credential, awarded by the American Institute of Professional Bookkeepers, provides evidence that you have the knowledge and skills needed to perform a wide variety of accounting and bookkeeping functions, including payroll and reconciling accounts according to accepted accounting standards.

To become certified, candidates must have a minimum of two years experience as an accounting clerk, pass a four-part examination administered by a Prometric Test Center, and abide by a strict professional code of ethics. Certified accounting clerks and bookkeepers are also required to participate in continuing education every three years to maintain their certification.

For more information on certification procedures, visit http://www.aipb.org/certification_program.htm

An article in the International Auditing Report states that many employers value this certification since it professionalizes the field and ensures a higher standard of financial reporting—important in today’s world of increased financial scrutiny. To read the full article visit http://www.aipb.org/pdf/AIPB_IAR.pdf

Accounting Clerk Salary

The following are median earnings of accounting clerks at the entry level and with 5 years experience in select California cities.

CityEntry Level5 Years

View a list of accounting programs in California >

Pastry chef training will enable you to perform a diverse array of tasks from preparing baked goods for a grocery store chain, restaurant, or neighborhood bakery through cake decoration and the creation of mouth-watering desserts for expensive restaurants and catering companies. No matter your specialty, a career of a pastry chef is a sweet choice!

Pastry chefs direct and oversee pastry cooks, keep their area of the kitchen well organized, track inventory and order supplies. Pastry chefs are highly skilled workers who blend the technical aspects of cooking with the creativity of an artist in developing new recipes. They are also responsible for maintaining health and safety standards by ensuring that all fresh food is stored properly, and that work surfaces, dishes and utensils are clean and sanitized. Many pastry chefs earn a highly regarded reputation because of the quality and creativeness of the pastries they serve.

Career Outlook

Job prospects for pastry chefs are expected to be good through 2018; however there will be strong competition for these jobs at upscale restaurants that generally pay a higher salary. Although job growth will account for a good number of job openings, the majority of vacancies will arise from the need to replace pastry chefs who leave the profession due to retirement or career change. The fast pace, long hours, irregular schedule are the primary reasons for high turnover in the industry.

Advancement opportunities into senior and supervisory roles are dependent on work experience and gaining advanced certification through the American Culinary Federation (ACF).  Pastry chefs may start their own business as caterers, personal chefs, or open their own bakery. Others become instructors in culinary training programs, consultants, or even sales representatives for major manufacturers.

Education

Most pastry chefs have prior experience in the food service or hospitality industry. Many have attended culinary training school and participated in internships or apprenticeship programs to acquire the skills necessary to obtain employment in a variety of establishments.

While very experienced chefs may become pastry chefs with only a high school diploma, entry level pastry chefs will need to obtain formal training to be competitive in obtaining entry-level employment. Training to become a pastry chef may be obtained in two and four year colleges, vocational programs, or culinary arts schools. A growing number of would-be pastry chefs are enrolling in professional culinary institutes, as well as 2 or 4-year colleges with majors in hospitality or culinary arts. Some of the larger hotel and restaurants also offer their own in-house training and job placement programs for pastry chefs. Pastry chefs who wish to work in high-end dining establishments will need to acquire many years of training and experience.

Students enrolled in culinary training programs will spend much time in the kitchen learning to prepare different pasties and desserts. They will learn the proper use of various cooking utensils, how to prepare different types of desserts and pastries, as well as the care and maintenance of kitchen equipment. Training programs will also include coursework in nutrition, menu planning, portion control, proper food storage, sanitation and public health regulations, as well as purchasing and inventory methods. Additional courses may be offered in food service management, computerized bookkeeping and inventory software. Most formal training schools also require students to participate in an internship or apprenticeship in a commercial kitchen.

The American Culinary Federation (ACF) accredits programs in culinary education. Accreditation by the ACF Accreditation Commission attests that the program has met minimum standards and competencies with read to faculty, curriculum, placement, and student support services.

View a list of culinary arts schools in California >>

Certification

Certification of pastry chefs is granted by the ACF. Certification standards are based on a combination of work experience and education, along with passing both a written and practical exam. The purpose of the certification exams is to objectively evaluate a candidate’s knowledge and skills to determine if they meet standards of the ACF.

Although certification is not required in any state, including California, it can attest to your accomplishments, as well as lead to career advancement and higher salaries. From the Web site of the ACF:

What certification means to an employer:

• Your skills and culinary expertise have reached a set benchmark
• You are well versed in culinary nutrition and food safety and sanitation
• You understand the responsibilities of culinary supervisory management
• You recognize the importance of high standards for food preparation
• You take charge of your professional development and career

Those who meet all certification requirements of the ACF will be awarded the credential Certified Pastry Culinairan (CPC) an entry level designation.  There are also come additional advanced certifications that you can earn from ACF.

Continuing Education

As per the ACF:

To maintain your ACF certification, you are required to earn a minimum of 80 continuing education hours (CEHs) during the five-year certification period. CEHs are experiences that assist in the development or enhancement of the knowledge and skills directly related to the individual’s professional occupation.

It is important to join your local chapter as membership can offer significant opportunities to network with colleagues and industry professionals, as well as obtain valuable leads on new employment.

Salary of a Pastry Chef

The salaries of pastry chefs vary widely depending on geographic location and type of employer. Earnings are generally the highest within upscale restaurants and hotels, and in large urban cities and resort areas.

As per Salary.com the median annual salary of an Assistant Pastry Chef in Los Angeles, CA as of November 2011 is $42.527 with the highest 10 percent earning $71,096 and the lowest 10 percent earning $27,525. In the smaller town of San Mateo, CA, the median earnings of Assistant Pastry Chefs is $41.190, with the highest 10 percent earning $59,306 and the lowest 10 percent earning $26.722.

View a list of culinary arts schools in California >>

Film editing is one of the most creative aspects of movie making, and also one of the most challenging and demanding. The process of cutting film can be a laborious process and is largely overlooked in the exciting film industry.  Film editors work long hours in dark rooms trying to piece to together footage to make a great movie only to see directors get all the credit!

If the pay of an editor is relatively low compared with other professions within the film industry and others get all the credit, why would anyone choose this career? Most film editors will tell you that they do this work for the pure enjoyment and satisfaction of knowing that they are the ones who are actually making the movie—not the director, not the actors, but the editors who slice and dice to create footage to create an entertaining movie.

Editors create the movie out of the raw footage, piecing each scene together in such a way that it moves the narrative forward in a logical yet entertaining way. Film Editors often delete segments of film, transpose dialogue from one scene into another, and change the order of events to build tension or create a dramatic ending.  They also select the music to play in the background and reinvent entire scenes to mask mistakes in continuity and flow. Once the editor has created the first cut of the entire film, the director then collaborates on creating a final cut – a process that can take weeks or months.

An editor’s job provides a unique blend of solitary work with collaboration and a good relationship with the director is essential in creating a successful film. This is why directors often remain with one editor for their entire careers.

Summary of tasks:

• Evaluate and select scenes for dramatic presentation and entertainment value
• Cut film segments to specified lengths and rearrange sequence of segments to foster story continuity
• Use editing equipment to insert music, dialogues, and sound effects
• Review edited film on screen to make any needed corrections
• Work collaboratively with Directors, Sound Effects Editors, and Music Editors.

Union Membership

Most Film and Video Editors belong to the Motion Picture and Videotape Editors Guild of the International Alliance of Theatrical Stage Employees (IATSE). The IATSE has over 110,00members and is the largest union within the entertainment industry.  For a list of local offices in California visit http://www.iatse-intl.org/directory/search.asp.

Career Outlook

As per the California Occupational Guide:

The projected growth rate of 27.3 percent indicates that Film and Video Editor occupations are growing faster than average compared with all occupations.

Film and video editing has changed radically over the last few years and should change even more radically in the years to come. Already, DVD, streaming media, interactive television, and the constantly changing film and video editing software involved have transformed the occupation (and contribute to the steady demand for workers in this field).

Education and Training

Film editing is a highly technical profession and there are two main software programs you will need to learn in order to obtain an entry-level job as an assistant editor. These are Avid and Final Cut Pro (FCP). FCP is the less expensive of the two and used more frequently by editors. Both programs are digitally-based; very few editors make physical cuts to film any longer.

The best preparation to begin a career as a film editor is by obtaining a degree in film studies from a four year college or university. The curriculum will be based on theory and history, as well as the technical aspects of filmmaking. Specific coursework could include the History of Film and Television, Screenwriting, Introduction to Film Editing software (such as AVID and FCP), Video Production, Foreign Cinema, and Film Theory. Aside from attending a specialized film school, many community college and four year colleges also offer majors and classes in film studies.

Film and video editors need to be creative, able to communicate effectively and work collaboratively, and possess good judgment and decision-making skills.

Film editors may find it necessary to enroll in formal continuing education coursework to keep current with regard to technological changes in the professional, especially since her is little on-the-job training.

View a list a schools in California that offer programs in film >

Licensing and Certification

As per the California Occupational Guide, there are no state licenses or certifications required to work as a Film and Video Editor in California.

Internships and Apprenticeships

If you want to get a foot-in-the-door and learn the craft of film editing, the best way is to apply for an internship or apprenticeship with an experienced editor. As an intern or apprentice you won’t do much aside from running errands and other clerical tasks but you will have the opportunity to see the inner working of an editing room and how the editor performs his or her work.

Each year American Cinema Editors (A.C.E.) accepts applications for its annual A.C.E. Internship program. Two American applicants and one international applicant are chosen to participate in its 6 week program which starts in July and ends in August.

Work as an Assistant Editor

The next step in becoming an editor is to first work as an assistant editor. As an assistant editor you will digitize hours of footage, as well as search for specific scenes, sound effects, and music.  If you are good, you will begin to develop a nice working relationship with the editors who may over time ask for your opinions and suggestions with regard to the editing process. Once you have gained the trust of the editor you may be asked to cut a scene on your own. Over time these editors may hire you as part of their own staff or recommend you for openings with colleagues. Keep in mind that it takes years to advance from assistant film editor to editor so patience and persistence are important attributes for anyone interested in this career.

Assistant film editors usually find employment through registration with the union, but direct application to employers remains one of the most effective methods of obtaining a first job. Job postings for film editors are advertised on the Web site of the Motion Picture Editors Guild.

Networking for jobs

Once you have gained some experience, many film editing opportunities will come to your attention via word-of-mouth and networking. For example, if one editor is busy with a television movie, he or she will gladly recommend a talented colleague for an available opening. If you are an assistant editor looking to rise up to editor, be sure to remain in contact with any editors you have worked for, join social media groups, and attend screenings, conferences, seminars, workshops and mixers. Stay apprised of networking events through American Cinema Editors, some of which are open to non-members. Make sure you let everyone you meet know of your work experience and what type of job you are looking for.

Salary of Film Editors

As per the California Occupation Guide:

Pay rates in the motion picture industry tend to be somewhat higher than rates in television because of the type of editing and the degree of skill involved. The pay scales are contractual and subject to a percentage increase each year. Contract negotiations occur every three years.

Since motion picture work has seasonal fluctuations, Film Editors may work only a few weeks a year. Much of the work in the industry is freelance, which often pays a high salary because of the short-term nature of employment.

As per Salary.com the median salary of entry level assistant editors in Los Angeles, California (where the large majority of film editing work is based) as of November 2011 is $35,488 with the lowest 10 percent earning $30.649 and the highest 10 percent earning $40,328.

Given high unemployment rates over the past few years, you may be thinking of returning to school to enter a new career offering higher job security or pay. As you begin to research different programs, take advantage of the new Gainful Employment law which requires private career schools to supply students with some key facts about cost, loan debt, potential salary, and job placement.  By comparing these facts between schools, you’ll be able to make a better decision on which program to attend.

Most career programs advertise that graduates of their schools will be able to to find competitive-wage jobs easier than those who did not receive such training. The gainful employment legislation basically requires schools to verify that this claim is true and to make the data publicly available on their websites for prospective students.  If they don’t, they can lose the option to offer government-backed financial aid.

The Gainful Employment legislation applies a special formula to career-oriented programs to determine which programs lead to gainful employment upon graduation. The term “gainful employment” refers to entry-level jobs that are expected to show enough of a salary growth rate that graduates will be able pay for living expenses, pay off their loans, and build savings.  Important to note is that the gainful employment legislation applies only to for-profit career colleges and to students enrolled in non-degree career-oriented programs within public and private schools.  Many such non-degree programs award certificates upon completion.

Gainful employment is affected by student loan obligations. Most students who attend career programs take out government-based student loans to meet tuition and related expenses. These loans will then need to be repaid after graduation and this debt can substantially influence whether graduates have indeed obtained gainful employment.  If students must spend a large part of their salaries to pay back the loan, can this job then be accurately defined as gainful employment, with the word gainful implying that the student earns over and above the amount needed to meet expenses? For example, if a student earns $1300 per month but must make a loan payment of $350 how much is then left over for rent, living expenses, and savings? More precisely, what has been gained? Students must earn a salary that will be sufficient to help them meet all expenses with enough left over to live comfortably and build savings.

Here are some important metrics with regard to student loans are the repayment rate and debt-to-student ration:

• Repayment rate requirement: This requirement stipulates that 35 percent of graduates must be repaying their loan on time, as demonstrated by a loan balance that goes down by at least $1.00 over the year (as determined by loan size).
• Debt-to-discretionary income ratio: The regulation holds that the annual loan payment does not exceed 30 percent of a graduate’s discretionary income (income earned after paying taxes). For example, if a student earns $32,000 per year in discretionary income, the annual loan payment cannot exceed 30 percent of this figure or $9,600 ($32,000 x .30).
• Debt-to-total earnings:  This means that the annual loan payment cannot exceed 12 percent of the graduate’s total annual earnings (before taxes). For example, if the student earns $35,000 in total earnings, the annual loan payment cannot exceed $4,200 or 12 percent of this figure ($4,200 x .12).

Criteria for successful loan payments include:

• Loan balance reduced by at least $1.00 per year; or
• Loan is paid-off in full or;
• Loan is forgiven due to public-service employment (e.g. teachers or nurses working with underserved populations) or;
• The student is making payments on an interest-only basis or income-based repayment plan.

As per the Gainful Employment legislation, career programs are now required to provide this data to all prospective students. Information on each of the above metrics and other aspects of the gainful employment legislation, along with tuition costs, placement rates, and courses of study may be found on school web sites. Most schools have provided a link to the gainful employment regulations. These links may be titled “Gainful employment disclosures”; “Student Consumer Information; “Consumer Disclosure”. You might also type “Gainful employment into the search bar of the school Web site or Google “{School name} Gainful Employment.”

When considering costs be sure to consider actual tuition as well as associated fees such as books and supplies. From this figure determine how much you will need to borrow and then peruse the salary data for your program which may be found in the career/placement office of the school. If the results do not satisfy the above requirements in terms of debt-to-earnings ratios, you may want to consider another program where the numbers may work better for you.

When you research salaries, keep in mind that the figures will likely be provided as a median or average and that graduates earn both below and above the stated numbers. Verify the school’s figures by researching current salaries for your field on such sites as salary.com or payscale.com. These sites allow you to narrow your search to location and year’s of experience.  You want to know the lowest salary you might earn so you can plan appropriately in terms of future loan obligations.

We interviewed Corrie Alvaraz, who has been in the medical coding field for 30 years, to learn more about this career.

Q:  What is your current job title?

Educator/Auditor/Revenue Operations Manager.

Q: Tell us about your job and the most challenging aspects of the work?

I perform random chart audits; conduct workshops on coding; train new coders; participate in process improvements: evaluate a process to determine if it can be improved upon.  We would look at the time a task took to complete, the steps needed to complete each task and to make sure each task value-adds to the process.

In improving processes, the goal is to save time, money and resources.

A coder takes a source document (which can be written, typed, paper or electronic) and converts the written documentation (x-ray, operative report, pathology report, office visit, etc) into a series of codes.  For example, a patient may come into a clinic with a chief complaint of cough  The cough is converted to 786.2 (diagnosis code).  The physician may then decide to order a 2 view chest x-ray in order to rule out pneumonia. The chest x-ray is converted to 71020 (procedure code).  There are also codes and rules on how to code office visits based on the documentation in the chart.   These codes are submitted to an insurance carrier (usually electronically) so that they know exactly what was performed (procedure) for a patient and why (diagnosis).  This allows a physician to be paid accurately.

Coding can be difficult because in a written chart, the physician’s handwriting may be a bit challenging to read or the type of service (or the case/situation) may be complicated.  For example, many coders find coding for a cardiovascular surgeon challenging.

It’s difficult to be an “expert” in every type of coding.  However, that doesn’t mean that someone who has been an OB/GYN coder couldn’t work in Orthopedics, it would just take some research and finding someone that could help mentor you through the difficult cases.  Many of the surgical aspects of coding will be similar, the anatomy, obviously would not be.

Another challenge, is with the payers.   Not all payers have the same coding rules.  So, a coder not only has to know the general coding guidelines, they need to know when the payer has specific coding rules that differ from the general guidelines. Not knowing/applying these specific rules when necessary, may cause payment denials, delays or less reimbursement for the physician.

So, some coders choose to become specialized in a certain disciplines.  For example, I have a specialty credential in emergency room coding ( CEDC).  To be specialized, you need to take another exam that is specific to that discipline (cardiovascular, orthopedics, OB/GYN, Dermatology, ENT, etc).

Q:How long have you been in this current career?

I’ve been in the Medical billing and Coding field for 30 years.

Q:Where do you work?

I work for a national company.  Without corporate approval, I cannot give the name. However, I can tell you I conduct workshops and seminars for the AAPC.

Q:What other types of work places could you work?

Other employment opportunities would include medical groups and insurance carriers.

Q:What is a typical day like for you?

Prepared material for training, researched complex coding questions and attended a conference call on documentation improvement strategies.

Q:Is this typical of most days?

Every day is a new adventure in that you never know what change has taken place; e.g. insurance carriers may change their regulations; problems may surface that need immediate attention, or someone will need assistance with an insurance claim.

Q:What parts of your job do you really enjoy?

Mentoring new coders, educating providers and knowing that you were responsible for improving a process that saved time, money and resources.

Q:What parts of your job do you really dislike?

As a manager, there are department goals and standards that need to be met.  It can be a bit stressful, especially with a group of employees.  I try to get everyone to understand the big picture and to embrace team work and to not create silos.

Q:What qualities would someone need to have to do your job well?

Embracing change, enjoy networking and be willing to continue to improve what you know.

Q:What is a typical entry-level salary for your field?

$18-$35 per hour, more for management positions and consultants. A consultant would make anywhere between $100-$250. an hour.  If a coder works from home, they make less than an in-house coder.  A traveling coder would be paid on the higher end of the scale.  Also, some specialties are more difficult, like interventional radiology or cardiovascular surgery.  These coders tend to be on the higher end of the scale as well.

Q:What is the most you can typically earn within your field?

An experienced coder can earn  $40 per hour, while a manager/director employed in a large medical large group may earn up to $100k, with a consultant earning up to $200k.

Q:What is the typical next career step for people in your field?

It’s a wide-open field. Many coders seek to start a home-based business-in medical billing, become a consultant, or work as an auditor of medical claims.

Q:Will this be your next step or will you do something different? Why?

I am in the final third of my career and seek to work less hours.   My colleagues laugh at me but at least it’s a goal.

Q:Were there any special licenses or certifications that you need to receive before getting a job?

In California the core credential is the CPC (Certified Professional Coder).  After that you can sit for specialty exams. I took the AAPC exam for a simple reason: this association has a community based networking system for coders with state chapters created by coders. Most chapters meet monthly to hear lectures on coding and to network. This is a very important component to the career.

Q:What type of education or training did you receive to enter into this career?

I have a BA. I wanted to be an elementary teacher.  I was working my way through college by working in the medical field. By the time I was ready to graduate, I was making more money in the medical field than a first year teacher.  So, I stayed in medical field.

Q:What school did you attend and where was it located?

Cal State Northridge.

I took a class in Medical Terminology and Anatomy at a local community college.   I then attended workshops to fine tune my coding skills.  This included reading and studying for the CPC exam.   I completed this training in about one year.

Q:How long ago did you attend this school?

Since I was a part-time student (evenings) it took me almost 10 years (proves I have endurance and patience).

Q:How would things be different for you if you hadn’t received this training?

Training provided the opportunity for me to constantly learn and meet new people.  And since I had been working with nurses and physicians since I was young (age 13), I was comfortable with the content of all classes.

Q:Do you think you progressed farther in your career because you received specific training?

I think I progressed because I never stopped wanting to learn and network and the training I received helped in both regards. In addition, being engaged with the local chapter helped not only my career, but, boosted my confidence and opened a lot of doors.

Q:Were you satisfied with the training that you received?

Yes, the classes in medical terminology and anatomy and the workshops in coding were both great experiences and help me prepare to sit for the AAPC exam.  It was a great experience.

Q:What were your favorite classes and why were they your favorite?

Since I only took Medical Terminology and Anatomy, they both were good classes and both were instrumental in helping me prepare and pass the certification exam.

Q:What specific skills did you take from the program that you use in your everyday job tasks?

I had been working in the medical field since I was 14.  I loved learning and I was lucky that I had some great mentors that allowed me to observe everything and ask a lot of questions. In this field, it is important to have a mentor.  A person who helps you develop a passion for your work and to give you a reason to show up to work every day, even when you don’t feel like it.   I was fortunate to have two.  One was my mother, who at 82 is still a full-time coder.  The other was a physician, who taught me that work could be a salvation from a bad relationship, family problems, or other challenging life issues.  He taught me to work hard, do my best, maintain a good work ethic and give back to others.

Q:What was the most important class/lesson from the program?

That there are many gray areas and it takes sound judgment, combined with experience, to properly code some cases.

Q:Was there a certain book that you still reference for your job that you could recommend to others?

Ingenix’s Coder’s Desk Reference.  It helps me through some really tough cases!

Q:If you could do it all over again, would you?

Yes

Q:What was the most difficult part of the program for you?

Staying focused and on track.

Q:About how many other students were in your classes?

They were large classes with about 40 students in both the anatomy and medical terminology classes.

Q:Were any of your classes online?

I’ve never enjoyed on-line classes.  I love the interaction of a classroom.

Q:Did you consider other schools or programs?

No

Q:Why did you choose the one you did?

Classes were held at a local community college near my home.

Q:Would you recommend this school to someone else?

Yes.  They have great classes, taught by experts and at a great cost.  Some of the private schools out there are not worth the expense.  I’ve heard of some billing/coding courses that cost $12-15k.  I always advise students to stay away from them.

Q:For your  career, is there ongoing education that is required?

Yes, we are required to obtain 18 CEUs (18 hours) of continuing education hours per year.

Q:For your  career, are there any organizations that are beneficial to join?

I am a proud member of the AAPC.  I joined their organization because of the local community chapter networking opportunities. If you take their exam, you are a member and you keep your certification by staying current with your CEU’s ,which are 18 credits per year-which equals 18 hours (one hour per CEU).  Our local chapters host monthly meetings where members can obtain a low cost education to fulfill the continuing education requirement.

Q:If so, what are they called and what do they provide?

“Members” can host events and facilitate workshops.

Q:How much do they cost to join and renew each year?  Student member is $75.00 per year.

Regular membership is $125.00 per year.

View a list of schools in California offering programs in Medical Coding or Billing >>

Massage therapy involves the use of touch to reduce tension in muscles and soft tissue. Massage therapy is an alternative health career with a primary emphasis on health and wellness. It is a great career choice for those who may one day wish to start their own business.

Job Description

While most massage therapists focus on one or two treatment modalities, there are over 80 treatment methods that make the practice of massage therapy. The most widely known are Swedish massage, deep tissue massage, sports massage, and reflexology. A massage therapy session may be as short as 15 minutes or last up to 2 hours depending on the extent of injury and procedure used.   For example, a massage therapist would utilize different techniques for a patient with a sports injury than with a patient suffering from migraine headaches.

For new patients, the massage therapist will record medical history and reason for seeking massage treatment. This initial consultation will enable the massage therapist to discuss client expectations with regard to outcomes and review those techniques that may prove most effective in light of their presenting condition. Because massage therapists focus on only one or two areas, they may refer clients to colleagues who offer the type of treatment recommended.

In many cases, treatment involves massaging oils, lotions and creams into the affected tissue or muscles. Massage therapists may work in a variety of setting including health spas, chiropractic offices, massage clinics, as well as private practice. Massage therapists who wish to set-up their own office will need to purchase such supplies as a massage table, pillows, oils, lotions, linens, towels, and loose-fitting clothing.

Massage therapists should have good relationship-building skills to develop client rapport and a consistent following, which is especially important for those who wish to start and grow their own massage therapy practice.

Education and Training

Most massage therapy training programs include about 500 hours of classroom study and are offered at community colleges, as well as private vocational schools.

View a list of schools in California offering massage therapy training >>

A high school diploma or general equivalency diploma is typically a requirement for admission to all programs.  Classroom study includes anatomy and physiology, study of musculoskeletal structures, organ systems, organs, and tissues. Students will also study kinesiology (body movement) and kinesthetics (body mechanics), healthcare ethics, and office procedures.

Most programs will also offer hands-on training that provides students with experience using various massage modalities.  Most training programs focus on one or two treatment methods and offer job placement assistant. You may elect to attend these programs on either a full or part time basis.

In most cases, massage therapy training programs are accredited by a State board, as well as an independent accrediting agency.  The Commission on Massage Therapy Accreditation (COMTA) is a non-profit independent accreditation agency recognized by the U.S. Department of Education. As per the Web site of the agency, “The mission of COMTA is to advance the quality of education in the field of massage therapy through an accreditation process that recognizes the evolving professional standards of practice.”

As per COMPTA, 38 states (including California) now regulate the training of massage therapists. Visit the California Council of Massage Therapists (CAMTC) for details regarding specific educational requirements for massage therapists in California and a list of accredited schools.   As per the CAMTC, “massage therapy schools must either be nationally accredited, state approved by the California Bureau for Private Postsecondary Education (BPPE), or a California community college.”

Licensing Requirements in California

Visit the Overview of Pathways to Certification of Massage Therapists on the CAMTC Web site for full details regarding the different ways in which you may become a massage therapist.

In California, prospective massage therapists must obtain licensure after graduating from an accredited training program and before beginning to work as a massage therapist.  There are two agencies that provide licensure:  1) National Certification Board for Therapeutic Massage (NCMTMB) and 2) Federation of State Boards of Massage Therapy (FSBMT).  In both cases, you’ll need to apply to take their exam, pay their fee (costing between $195 – $225), and pass the exam before gaining licensure.

Earnings for Massage Therapists

Median earnings of Massage Therapists in select California cities. Figures as per Salary.com August 2011.

Career Outlook

According to the U.S. Bureau of Labor Statistics, the growth rate of massage therapists is anticipated to be 19 percent through 2018 which represents a faster than average rate than for most other occupations.  This growth rate may be due to the fact that more people believe that massage therapy helps improve overall health. Demand also arises from the growing number of new health spas that have opened in recent years, along with the quick rise in the number of massage therapy franchises that typically offer services at lower cost than most spas and massage clinics. The field is also gaining greater respect due to the many states that have now implemented more stringent regulatory requirements for the practice of massage therapy.

Residents of nursing homes and assisted living faculties are also finding that massage therapy increases their energy level and reduces unpleasant side effects of various chronic conditions, such as arthritis. The Baby Boomer demographic, who are leading active lives well into their 60s, will also find massage therapy useful to relive sore muscles and tissues.

View a list of schools in California offering massage therapy training >>

The GED test provides an opportunity for adults who did not graduate from high school to show that they have the same level of knowledge and skills as 60 percent of graduating high school seniors.  If you pass the General Educational Development (GED) exam, you will receive a high school equivalency diploma that can be used to apply for post-secondary study or entry-level employment a variety of fields. Over 98 percent of colleges and universities accept the GED for admission and 96 percent of employers accept it for those positions requiring a high school-level education. A GED diploma can also be used to gain entry into the military. (American Council of Education (ACE))

The GED testing service is a program of the American Council of Education (ACE) a national organization that oversees GED testing and works to spread appreciation of GED credentials among educational institutions and employers.

Since its inception in 1942, more than 17 million people have earned their GED.  You can too by following some simple steps as outlined below!

Content of GED Exam

The GED exam is composed of five subject tests:

• Mathematics
• Language arts-reading
• Language arts-writing
• Science
• Social Studies

GED Scoring

The GED test score provides an indication of a test-takers academic knowledge in each of the above-noted subject areas as compared to that of recent high school graduates. Starting with the 2002 test administration, performance on each of the five subject area tests is scored in two ways: as a “standard” score” ranging from 200 to 800 on each subject area test and as a “percentile rank” in the range of 1 to 99.

The standard score is based on the number of questions you answered correctly. Every question on the GED is worth one point if answered correctly and zero points if answered incorrectly. The Language Arts-Writing test is based on a combination of scores from Part 1 (multiple choice) and Part 2 (essay component).

The percentile rank indicates the percentage of graduating seniors who earned scores below yours. For example, if your GED test- score is 600 on the Social Studies subject test with a percentile rank of 50, this means that 50 percent of graduating high school seniors earned a score below 600.

Passing scores on the GED

According to ACE, a minimum passing score set by the GED Testing Service is a standard score of 410 on each of the five subject area tests and a minimum total standard score of 2250. These scores are accepted by California as acceptable pass rates.

These pass rates allow test-takers to make up for one area of weakness by strong performance in another; e.g. a lower score in science may be made up for by a high score in social studies and result in an overall passing score on the GED!

Preparing for the GED

You can prepare for the GED through in-home study, class-based instruction, or via distance learning courses.

At-home preparation

The GED Testing Service offered by ACE partners with several resources to help you prepare for the GED test at home:

• GED connection: PBS LiteracyLink and KET, offer television programs via many PBS stations. For your local TV schedule, visit the PBS LiteracyLink web site, and enter your zip code in the top right corner of the first page, check with your local public television station or call KET at (800) 354-9067.
• Official GED Practice tests: Contact a local testing center for  information regarding the short and long version of the official practice tests (OPT). This is a great way to become familiar with test content and measure how long it will take you to complete each section.
• Keys to GED Success®. The 5 series Keys to Success books focus on those areas that past test-takers have reported as the most difficult in passing the exam. Each of the five books includes a practice test that will allow you to evaluate your skills and identify those areas where you need additional practice. Answers include complete explanations so you can learn test-taking strategies. The Keys to GED_® Success books may be ordered directly from Steck-Vaughn or you may contact your local GED testing center.

Test Preparation Courses

GED preparation courses are offered as part of continuing education departments in locations across the country.  There are four methods of identifying GED preparation classes:

1. Call, write or email the contact in your state that can help you find preparation programs near you. For California this contact is :

California Department of Education
Adult Education Office
1430 N Street
Sacramento, CA 95814
Phone: (916) 322-2175
www.otan.us/caaeproviders/index.cfm

2. Search by your zip code for the GED Testing Center nearest you and ask for assistance with enrolling in a preparation class. Many GED testing centers maintain affiliations with test preparation providers.

3.  Visit America’s Literacy Directory at the National Institute for Literacy (NIFL) web site. Enter your zip code to obtain a listing of classes in your area. The U.S. government also maintains a toll-free information number through NIFL where you may obtain information regarding classes in your area. Call (800) 828-8133.

4. Look in the local yellow pages under “schools.” Programs offered in community colleges may be listed under “adult education” or “continuing education.” Other options include performing a library search for literacy programs, high schools, and community colleges in your area.

Online Preparation

The GED exam may NOT be taken online. You will need to locate a GED testing center in your area to sit for the exam.  Online materials to prepare for the exam may be found on the ACE Web site.

GED Resource Materials

Use the links below to access sample questions for each subject area in the GED test battery. When you click on an answer, a pop-up answer will notify you whether your choice is correct.

Content areas:

• Language Arts, Reading
• Language Arts, Writing, Part I
• Language Arts, Writing, Part II (Essay)
• Mathematics
• Science
• Social Studies

If your browser does not support pop-ups or you have them blocked, you can access the correct answers and explanation from the Answers Page.

Specific California requirements for the GED

1. GED examinees who wish to take the exam in California must be residents of the state.
2. Fee for the full battery of 5 tests is $150.
3. Test-takers must be within 60 days of reaching age 18.
4. There is no wait period to retake the test should you fail.
5. Those who pass the exam will be award a California High School Equivalency Certificate. Those who are under 18 years of age will have their certificate mailed to them on their 18^th birthday. To locate an official GED testing center in California, visit http://www2.acenet.edu/resources/ged/center_locator.cfm
6. Minimum score requirements are 410 on each subject test and 2250 on the full GED test battery.
7. Test-takers must complete the exam within the time frame provided for each section of the exam battery.
8. Retest fee are set by individual testing centers. Currently the fee is about $25. per subject area test retaken. Candidates may retake the test in the failed subject area before completing the entire exam battery.
9. The GED exam is offered in English, Spanish and French.
10. When you are ready to sit for the exam visit, www.GEDtest.org/prep

Register and Take GED Exam

Once you have gained some practice with the GED exams, the next step is to register and pass the GED testing battery.  To locate a testing center near you, visit http://www2.acenet.edu/resources/ged/center_locator.cfm.  Fees vary by testing site and you will need to provide a government-issued photo ID (driver’s license or passport) along with social security card or student ID.

• According to ACE the GED testing battery will take about seven hours to complete. It is recommended that you try and get good rest the evening before and eat a good breakfast so you are able to focus during the examination. Many testing centers will allow you to bring snacks to eat during breaks.
• GED tests are offered in English, Spanish and French for California test-takers. Special accommodations can also be made for those with vision or auditory impairments. Contact your specific testing center for details. For further details regarding testing accommodations, visit Request Testing Accommodations.

After the test

If you didn’t pass one of the GED tests, don’t worry. California allows you to retake part or all of the tests with no waiting period!

For those of you who did pass: Congratulations! You now have the same educational and career opportunities as traditional high school graduates. You may request your GED transcript in-person or by phone from the testing center where you sat for the examinations.  If you are in the military or in a correctional facility, you may request your transcript by visiting http://www.acenet.edu/Content/NavigationMenu/ged/test/after/transcript_request.htm.

Trying to decide if you should pursue a career as a dental assistant or a dental hygienist?  Both dental assistant and dental hygienists are members of the support team within a dental office. Although their jobs may seem interchangeable to those outside the industry, the responsibilities of each role and the training required are different.

Key Points:

• Dental hygiene involves a greater degree of patient education and preventative dental care than does the work of dental assistants who largely provide support and general office management.
• While dental assistants may complete a training program lasting about one year to become registered, there is no requirement in California to do so and you can begin a career in this field right after high school. Indeed, many dental assistants are trained on-the-job. In contrast, dental hygienists need a minimum of an associate’s degree to work in a private dental office and must become registered by passing written and clinical examinations.
• The entry-level salaries of dental hygienists are nearly double that of dental assistants due to their advanced education and skill set.

Below we will provide an overview of each career so that you may plan accordingly.

Career Overview Dental Assistants

The work of a dental assistant is varied as they perform direct patient care, routine office duties, as well as laboratory work.

Select duties of a non-registered dental assistant (under the direct supervision of a licensed dentist) include:

• Prepare patients for examination.
• Provide assistance during treatment (i.e. using suction to keep patient mouths dry, hand tools to dentists, etc.)
• Sterilize dental instruments and equipment
• Lay out needed dental instruments
• Update and maintain patient records
• Take X-rays for analysis by dentist
• Perform intraoral and extraoral photography
• Perform measurements of instruments in preparation for dental procedures
• Prepare materials for dental impression, remove sutures and dressings, and apply topical anesthetics to gums.
• Provide education to patients with regard to oral health care
• Make appointments and perform office management
• For a full description of all duties visit the Web site of the California Dental Assistant Association

Select Duties of Registered Dental Assistant (under the supervision of a licensed dentist) include:

• All duties that a non-registered dental assistant is allowed to perform.
• Mouth-mirror inspections of the oral cavity, to include charting of obvious lesions, existing restorations and missing teeth.
• Apply and activate bleaching agents using a non-laser light-curing device.
• Obtain intraoral images for computer-aided design (CAD), milled restorations.
• Pulp vitality testing and recording of findings.
• Place bases, liners, and bonding agents.
• Chemically prepare teeth for bonding.
• Place, adjust, and finish direct provisional restorations.
• Fabricate, adjust, cement, and remove indirect provisional restorations, including placement of stainless steel crowns when used as a provisional restoration.
• Place post-extraction dressings after inspection of the surgical site by the supervising licensed dentist.
• Place periodontal dressings.
• All other duties as specified by the California Dental Association (see link below)

Source: California Dental Assistant Association

Projected Growth

Employment prospects for dental assistants are expected to be excellent with an expected growth rate of 36 percent through 2018, far surpassing the rate of most other occupations. Preference for entry-level jobs will be given to those who have graduated from an accredited dental assisting program.

Education Requirements for Dental Assistants

California has no formal education requirements to become an entry-level dental assistant. High School students interested in pursuing this career should take courses in biology, chemistry, and office management. For those wishing to pursue further education, the California Dental Assistant Association offers a training program in the field which has been approved by the Commission on Dental Accreditation. The program includes classroom instruction, laboratory work, and instruction in dental assisting skills and theory. The program takes approximately one year to complete and graduates will be awarded a diploma. Entry to the program requires a H.S. Diploma or equivalent.

View a list of schools in California offering programs in dental assisting.

Many dental assistants are trained on-the-job.  In these situations, the supervising dentist or senior dental assistant teach needed skills, terminology, patient care, and how to perform daily office tasks.

Licensure and Certification of Dental Assistants

Dental Assistants may become registered through the California Dental Assistant Association. For further information regarding registration requirements an application instructions visit, http://www.dbc.ca.gov/applicants/rda/becomelicensed_rda.shtml.

Promotional Opportunities

While not required, registration allows dental assistants to pursue career advancement opportunities as an office manager, dental assisting instructor, dental products sales representative, or claims adjuster with insurance companies. Other dental assistants return to school to become dental hygienists.

Career Overview Dental Hygienists

Dental hygienists must be registered to work in California. They provide a diverse range of responsibilities, primarily becoming involved in preventative oral healthcare. They share some of the job duties as dental assistants, such as creating molds and taking X-rays but also perform the following tasks:

• Gathers information regarding patients’ oral and medical history.
• Uses hand tools and rotating instruments to remove calcifications, tartar stains and plaque (hard and soft deposits) from surface of patient teeth.
• Counsels patients with regard to good nutrition and its affect on oral health
• Records patient current dental condition in chart for review by dentist.
• Applies fluorides and decay preventatives.
• California permits registered dental hygienists to administer local anesthetics, oxygen, and nitrous oxide.
• Removes sutures and dressings
• Performs such periodontal therapy as root planning (deep cleaning to remove infected root structures)
• All other duties as defined the California Association of Dental Hygienists. Visit, http://www.leginfo.ca.gov/cgi-bin/displaycode?section=bpc&group=01001-02000&file=1900-1966.6 for a comprehensive list of job duties permitted to be performed by registered dental hygienists in California.

Projected Growth

Employment prospects for dental hygienists are bright with a growth rate anticipated to be about 36 percent through 2018 which represents a much faster rate than is the case with most other occupations. This demand will arise from the increased need for dental services due to population growth, aging of the population, and a growing awareness of the importance of preventative dental care.

Education Requirements for Dental Hygienists

Graduation from an accredited dental hygiene program is required for entry level employment in California. High school students should take courses in biology, mathematics, and chemistry. Specific entry requirements differ from one school to another.  Coursework will include a combination of laboratory, clinical and classroom instruction in such subjects as anatomy and physiology, microbiology, pharmacology, nutrition, radiology, periodontology (study of gum disease), dental equipment, as well as behavioral science.

Most programs award an associate’s degree, although some also offer a certificate, diploma, or bachelor’s degree. As per the Dental Hygiene Committee of California, a minimum of an associate’s degree is typically required for practice in a private dental office in California. A bachelor or master’s degree will be required for teaching and advanced clinical practice in public health programs.

View a list of schools in California offering programs in dental hygiene.

Licensure of Dental Hygienists

Dental hygienists must be licensed in the State in which they work. California requires all applicants to have graduated from an accredited program and pass a written and clinical examination. The American Dental Association’s (ADA) Joint Commission on National Dental Examinations administers the written examination, which is accepted by all States and the District of Columbia. For additional information regarding application procedures and test construction visit http://www.ada.org/2662.aspx

State or regionally-based testing agencies administer the clinical examination. There are different requirements to become a licensed Dental Hygienist in California  depending on whether applicants have graduated from a dental hygiene program in-state or out-of-state.

For graduates of in-state programs visit http://www.dhcc.ca.gov/applicants/becomelicensed_rdh_calgrad.shtml to obtain licensure details: application instructions, examination details, etc.

Out-of-state applicants may visit http://www.dhcc.ca.gov/applicants/becomelicensed_rdh_outofstate.shtml to obtain licensure information.

Promotional Opportunities

Most advancement opportunities are available outside the dental office, and typically require a bachelor’s or master’s degree in dental hygiene or related field. Some dental hygienists may choose to pursue programs in teaching, careers in public health, or work in a corporate health setting.

Salary Difference between Dental Assistant and Dental Hygienists

Median Entry-level Salaries of Dental Hygienists and Dental Assistants in select cities (figures as per Salary.com May 2011).

If you are interested in becoming a respiratory therapist in California, this article will guide you through the various steps, starting with enrolling in a training program, obtaining certification, and obtaining licensure from the state of California.  You will also learn about the duties of a respiratory therapist as well as salary and employment outlook.

Job Description

The main responsibilities of respiratory therapists are to evaluate, treat, and care for patients who are experiencing breathing difficulty or those with cardiopulmonary disease. Respiratory therapists work under the supervision of a physician yet maintain complete responsibility for respiratory procedures and treatments.  They are able to make independent judgment on behalf of patients on life support, as well as work collaboratively with physicians and other health care providers in developing patient care plans.

Patients are found in all age groups, from infants with under-developed lungs to the elderly with heart disease. Respiratory therapists also work with those who have suffered a stroke, or who have chronic asthma or emphysema.

Specific responsibilities of respiratory therapists include:

• Taking case histories by interviewing patients and their families.

• Performing diagnostic tests, such as evaluating a patient lung capacity or measuring pH level.

• Treating patients by providing oxygen or oxygen mixtures, performing chest physiotherapy, positioning patients to assist them in discharging mucus from their lungs, as well as administering aerosol-based medications.

• Periodic monitoring of respiratory equipment to ensure proper functioning.

• Respiratory therapists who provide in-home care educate patients and their families in how to use ventilators, oxygen tanks, nebulizers, and other equipment. They also visit the home to inspect and maintain all equipment, assess the home environment in terms of any needed modifications, and ensure that sufficient quantities of needed medications are on hand. They may also make emergency home visits as the need arises.

Working Conditions

According the Occupational Outlook Handbook 2010-2011 edition, respiratory therapists held about 106,000 jobs in 2008. Approximately 81 percent of jobs are within hospital settings such as respiratory departments, anesthesiology, and pulmonary care. Most of the remaining employment opportunities can be found within private physician offices, medical equipment companies that supply respiratory equipment for in-home use, nursing homes, and home health agencies.

Respiratory therapists traditionally work a 35-40 hour work week, including evenings and weekends since most hospitals are in open around-the-clock.  Physical stamina is important as respiratory therapists spend long hours on their feet evaluating and treating patients, as well as making hospital rounds to visit patients in their rooms.

Because they work with gases that have been stored under pressure, respiratory therapists must abide by safety precautions and perform regular monitoring and maintenance of all equipment. As with most other health profession, respiratory therapists are exposed to infectious agents but by careful adherence to proper procedures, they are able to reduce their risk of infection.

Education Requirements

The minimum educational requirement to become a respiratory therapist is an associate’s degree, although a bachelor’s degree is preferred. A master’s degree could be important in order to be eligible for promotional opportunities.  Coursework will include human anatomy and physiology, chemistry, pharmacology, and mathematics.  Most training programs offer a clinical component in which students will have the opportunity to work in hospital or physician office settings to obtain real-world experience.

According to Rae Woods, Management Services Technician with the Licensing division of the California Board of Respiratory Therapists, the specific number of clinical hours will vary depending upon the program in which you enroll. Ms. Woods also stated that most associate’s degree programs can be completed within 18 months to two years.

View a list of schools in California offering respiratory therapist programs.

Certification and Licensing Requirements

As per the Respiratory Board of California, in order to practice as a respiratory therapist in California, graduates must be certified as either a Certified Respiratory Therapist (CRT) or Registered Respiratory Therapist (RRT) with the National Board of Respiratory Care (NBRC).

To obtain certification from the NBRC, candidates must meet the following criteria:

• Posses an associate’s or bachelor’s degree or certificate from a program that is accredited by the Commission on Accreditation for Respiratory Care (CoARC) or the Commission on Accreditation of Allied Health Education Programs (CAAHEP).

• Pass either the Certified Respiratory Therapist (CRT) or Registered Respiratory Therapist (RTT) exam, both administered by the NBRC.

To obtain licensure from the Respiratory Care Board of California, respiratory therapists must comply with the following requirements:

• Successfully complete a degree program or certificate program accredited by CoARC or CAAHEP. Those applicants who do not fully meet the education requirements may apply to have them waived by the Board if they possess the requisite professional experience and are in good standing with the state in which they first obtained licensure, as well as with the California state board.

• Possess current CRT or RRT certification from the NBRC and submit proof of this certification to the California State Board.

• Successfully complete one state-approved course in the area of Law and Professional Ethics. This may be completed via a distance learning course but must be done before licensure.

• Submit a completed application for licensure with all appropriate supporting documentation, along with a $200.bank check or money order to cover the application fee. Also required will be fingerprinting by a background investigation firm or law enforcement agency, and transcripts from the institution where you obtained your degree.

Career Outlook

According to the Bureau of Labor Statistics, the employment of respiratory therapists is expected to grow by 21% from 2008 to 2018, a rate of growth much faster than the average for all occupations. California in particular has a relatively high vacancy percentage of respiratory therapists, thus providing ample job opportunities.

Part of the reason for this demand arises from the significant aging of the population in California leading to a substantial increase in the number of cardiopulmonary cases. Another reason can be attributed to the expanding role that respiratory therapists play with regard to case management, preventative medicine (e.g. ultrasound diagnostics), emergency services, and early detection of heart disease.

Salary Expectations for Respiratory Therapists

According the Bureau of Labor Statistic, California is one of the top-paying states for respiratory therapists. Across all states annual earnings were highest for those employed in general hospital and surgery centers followed by specialty hospitals (e.g. eye, nose and throat). Below is a listing of entry-level respiratory therapist salaries in four major cities (Salary.com).

About 26% of employers also offer sign-on bonuses of up to $5,000. Most employers also offer dental, vision, and life insurance, aid vacation sick leave, and pension plans.