WV Board of Respiratory Care
Position Statements

Use of LPN’s in Respiratory Care
Patient Transports
NBRC Credentials
Sleep Medicine CEU's for Respiratory
Student Clinical Supervision

LPN in thePractice of Respiratory Care – October 17, 2008

On May 10, 2004, our board provided the WV Medicaid Division with our position on the issue of Licensed Practical Nurses performing services in regard to the practice of respiratory care. At the time the initial statement was issued our board performed a review of the Licensed Practical Nurse’s curriculum in an effort to determine the elements of education that were equivalent to the education a Respiratory Therapist receives.The findings of the Board include the following;

  1. The Licensed Practical Nurse with training in pharmacology has sufficient training to deliver medications via nebulizer upon the written medical order of a physician or others with prescriptive authority.
  2. The Licensed Practical Nurse has sufficient training for use of low flow oxygen devices, specifically simple oxygen delivery via nasal cannula.
  3. There was not sufficient evidence to support the Licensed Practical Nurse in the set up and delivery of care for more complex respiratory care devices, such as, positive pressure and negative pressure devices to include the following:
    1. CPAP devices
    2. Bi-Level devices
    3. Non invasive mechanical ventilation
    4. Mechanical ventilation via tracheotomy tube
    5. Mechanical ventilation via endotracheal tube
    6. Intermittent positive pressure breathing devices
    7. Intra-pulmonary percussive ventilation
    8. Negative pressure devices

The West Virginia Board of Respiratory Care recognizes the above procedures (a-h) to be within the practice of a Licensed Respiratory Therapist. The scope reads "Practice of respiratory care" means the practice of respiratory care, and any part of respiratory care, by persons licensed under the provisions of this article and shall be limited to that which has been learned through formal or special training including performance evaluation to evaluate competence. The practice of respiratory care may be performed in any clinic, hospital, skilled nursing facility, private dwelling or other place deemed appropriate or necessary by the board in accordance with the prescription or verbal orders of a licensed physician or other legally authorized person with prescriptive authority, or under the direction of a qualified medical director.Practice of respiratory care includes, but is not limited to:

  1. The administration of pharmacological, diagnostic therapeutic agents related to respiratory care procedures necessary to implement a treatment, disease prevention, pulmonary rehabilitative or diagnostic regimen prescribed by a physician;
  2. Transcription and implementation of written or verbal orders of a physician or other legally authorized person with prescriptive authority, pertaining to the practice of respiratory care;
  3. Observing and monitoring signs and symptoms, general behavior, general physical response to respiratory care treatment and diagnostic testing, including determination of whether such signs, symptoms, reactions, behavior or general response exhibit abnormal characteristics;
  4. Based on observed abnormalities, appropriate reporting, referral or implementation of respiratory care protocols or changes in treatment pursuant to the written or verbal orders of a person with prescriptive authority under the laws of the state of West Virginia; or
  5. The initiation of emergency procedures under the regulations of the board or as otherwise permitted in the article.

The WV Board of Examiners For Licensed Practical Nurses has accepted the WV board of Respiratory Care’s position in regard to the use of LPN’s in the practice of respiratory care; 10/2008.

Patient Transports - September 7, 2010

Respiratory Therapists as part of a “Transport Team” are subject to the licensure requirements of the State from which the “Transport Team” originates while they are performing patient transport within the State of West Virginia.

NBRC Credentials - March 16, 2011

The West Virginia Board of Respiratory Care no longer requires maintaining active credentials with the NBRC as a requirement for West Virginia license renewal. This does not impact requirements for issuance of an original license.

However, employers may have differing requirements in regards to maintaining active credentials with the NBRC based on specific job descriptions. The Board encourages all licensees to check with their employers in regards to this issue.

Further, other states may have differing licensure requirements regarding maintaining active credentials with the NBRC. Therefore, the WVBORC encourages all West Virginia licensees to consider their individual need for maintaining active credentials with the NBRC.

Sleep Medicine CEU’s in the Practice of Respiratory Care – May 2, 2014

Continuing Education Units (CEU) courses/activities related to sleep medicine shall be deemed acceptable for respiratory therapist’s initial application, reinstatement application, and/or renewal of licenses.

Student Clinical Supervision – May 5, 2015

§30-34-15. Exceptions
(a) A person may not practice respiratory care or represent himself or herself to be a respiratory care practitioner unless he or she is licensed under this article except as otherwise provided by this article.
(b) This article does not prohibit:
(1) The practice of respiratory care, which is an integral part of the program of study, by students enrolled in respiratory care education programs accredited by organizations approved by the board. Students enrolled in respiratory care education programs shall be identified as "Student RCP" and may only provide respiratory care under clinical supervision;

The West Virginia Board of Respiratory recognizes the importance of providing students enrolled in respiratory care educational programs accredited by organizations approved by the board opportunities to learn and apply knowledge and skill in the clinical setting. Hence, the exception in 30-34-15 (1) for providing respiratory care by students under clinical supervision.

The West Virginia Board of Respiratory Care acknowledges there may be variation in interpreting “clinical supervision”. Therefore, the following position statement is issued to provide clarity.

It is the position of the West Virginia Board of Respiratory Care that clinical supervision for students is defined by:

The licensed respiratory therapist assuming responsibility of the patient being treated by the student is to be within immediate proximity to the student when the student is providing direct patient care. Immediate proximity allows for the respiratory therapist to monitor, direct, and assess the student’s knowledge, application of theory, and interaction with patients. It provides the student opportunity to ask and receive questions and receive immediate feedback on performance. It also helps to fulfill the mission of the West Virginia Board of Respiratory Care to protect the life, health and safety of the public.

WV Board of Respiratory Care
Position Statements

Use of LPN’s in Respiratory Care
Patient Transports
NBRC Credentials
Sleep Medicine CEU's for Respiratory
Student Clinical Supervision

LPN in thePractice of Respiratory Care – October 17, 2008

On May 10, 2004, our board provided the WV Medicaid Division with our position on the issue of Licensed Practical Nurses performing services in regard to the practice of respiratory care. At the time the initial statement was issued our board performed a review of the Licensed Practical Nurse’s curriculum in an effort to determine the elements of education that were equivalent to the education a Respiratory Therapist receives.The findings of the Board include the following;

  1. The Licensed Practical Nurse with training in pharmacology has sufficient training to deliver medications via nebulizer upon the written medical order of a physician or others with prescriptive authority.
  2. The Licensed Practical Nurse has sufficient training for use of low flow oxygen devices, specifically simple oxygen delivery via nasal cannula.
  3. There was not sufficient evidence to support the Licensed Practical Nurse in the set up and delivery of care for more complex respiratory care devices, such as, positive pressure and negative pressure devices to include the following:
    1. CPAP devices
    2. Bi-Level devices
    3. Non invasive mechanical ventilation
    4. Mechanical ventilation via tracheotomy tube
    5. Mechanical ventilation via endotracheal tube
    6. Intermittent positive pressure breathing devices
    7. Intra-pulmonary percussive ventilation
    8. Negative pressure devices

The West Virginia Board of Respiratory Care recognizes the above procedures (a-h) to be within the practice of a Licensed Respiratory Therapist. The scope reads "Practice of respiratory care" means the practice of respiratory care, and any part of respiratory care, by persons licensed under the provisions of this article and shall be limited to that which has been learned through formal or special training including performance evaluation to evaluate competence. The practice of respiratory care may be performed in any clinic, hospital, skilled nursing facility, private dwelling or other place deemed appropriate or necessary by the board in accordance with the prescription or verbal orders of a licensed physician or other legally authorized person with prescriptive authority, or under the direction of a qualified medical director.Practice of respiratory care includes, but is not limited to:

  1. The administration of pharmacological, diagnostic therapeutic agents related to respiratory care procedures necessary to implement a treatment, disease prevention, pulmonary rehabilitative or diagnostic regimen prescribed by a physician;
  2. Transcription and implementation of written or verbal orders of a physician or other legally authorized person with prescriptive authority, pertaining to the practice of respiratory care;
  3. Observing and monitoring signs and symptoms, general behavior, general physical response to respiratory care treatment and diagnostic testing, including determination of whether such signs, symptoms, reactions, behavior or general response exhibit abnormal characteristics;
  4. Based on observed abnormalities, appropriate reporting, referral or implementation of respiratory care protocols or changes in treatment pursuant to the written or verbal orders of a person with prescriptive authority under the laws of the state of West Virginia; or
  5. The initiation of emergency procedures under the regulations of the board or as otherwise permitted in the article.

The WV Board of Examiners For Licensed Practical Nurses has accepted the WV board of Respiratory Care’s position in regard to the use of LPN’s in the practice of respiratory care; 10/2008.

Patient Transports - September 7, 2010

Respiratory Therapists as part of a “Transport Team” are subject to the licensure requirements of the State from which the “Transport Team” originates while they are performing patient transport within the State of West Virginia.

NBRC Credentials - March 16, 2011

The West Virginia Board of Respiratory Care no longer requires maintaining active credentials with the NBRC as a requirement for West Virginia license renewal. This does not impact requirements for issuance of an original license.

However, employers may have differing requirements in regards to maintaining active credentials with the NBRC based on specific job descriptions. The Board encourages all licensees to check with their employers in regards to this issue.

Further, other states may have differing licensure requirements regarding maintaining active credentials with the NBRC. Therefore, the WVBORC encourages all West Virginia licensees to consider their individual need for maintaining active credentials with the NBRC.

Sleep Medicine CEU’s in the Practice of Respiratory Care – May 2, 2014

Continuing Education Units (CEU) courses/activities related to sleep medicine shall be deemed acceptable for respiratory therapist’s initial application, reinstatement application, and/or renewal of licenses.

Student Clinical Supervision – May 5, 2015

§30-34-15. Exceptions
(a) A person may not practice respiratory care or represent himself or herself to be a respiratory care practitioner unless he or she is licensed under this article except as otherwise provided by this article.
(b) This article does not prohibit:
(1) The practice of respiratory care, which is an integral part of the program of study, by students enrolled in respiratory care education programs accredited by organizations approved by the board. Students enrolled in respiratory care education programs shall be identified as "Student RCP" and may only provide respiratory care under clinical supervision;

The West Virginia Board of Respiratory recognizes the importance of providing students enrolled in respiratory care educational programs accredited by organizations approved by the board opportunities to learn and apply knowledge and skill in the clinical setting. Hence, the exception in 30-34-15 (1) for providing respiratory care by students under clinical supervision.

The West Virginia Board of Respiratory Care acknowledges there may be variation in interpreting “clinical supervision”. Therefore, the following position statement is issued to provide clarity.

It is the position of the West Virginia Board of Respiratory Care that clinical supervision for students is defined by:

The licensed respiratory therapist assuming responsibility of the patient being treated by the student is to be within immediate proximity to the student when the student is providing direct patient care. Immediate proximity allows for the respiratory therapist to monitor, direct, and assess the student’s knowledge, application of theory, and interaction with patients. It provides the student opportunity to ask and receive questions and receive immediate feedback on performance. It also helps to fulfill the mission of the West Virginia Board of Respiratory Care to protect the life, health and safety of the public.