Are There Opportunities for RTs to Advance in LTACHs? Dusty Bower Says Yes!

July 31, 2023

Long-term acute care hospitals (LTACHs) serve a vital role in the health care system, caring for medically complex patients who need extended care after a hospital stay. Respiratory therapists are key clinicians on the LTACH team, but are their opportunities for advancement for those who choose to work in these facilities?

Dusty Bower, MHA, RRT, RRT-NPS, is proof the answer is yes. As CEO of Select Specialty Hospital-Weirton, a 49-bed LTACH in Weirton, WV, she oversees a multidisciplinary team of professionals who work tirelessly to ensure their patients leave the hospital with the best quality of life possible.

In this interview, Bower shares her journey from bedside RT to the LTACH C-Suite —

When did you become interested in a career in respiratory care and what drew you to the profession?

I became interested in hospitals and health care when I was a pre-teen and my grandmother became ill. As we spent time with her, I became fascinated with the various clinicians and day-to-day workings of the hospital. I was comfortable in the hospital, and even at that young age I felt a sense of belonging. Thus, my pursuit of a health care career began. As I began to learn of the opportunities afforded by health care I found respiratory care. I was drawn to the profession and knew it would be my goal to become a respiratory therapist.

How long did you work in traditional roles in respiratory care before moving into the long-term acute care setting?

18 years. I worked in a Level 1 trauma center in Pittsburgh, PA, and loved every minute.

While I worked in all areas of the hospital, my focus became neonatal and pediatric respiratory care, I worked in the NICU, PICU, the pediatric general floor, and was a member of the transport team. This concentration led me to pursue and receive my RRT-NPS credential. I always felt this area of respiratory care required me to be at the top of my game in terms of critical thinking, clinical aptitude, and clinical skills, and I thrived on it.

How did you move up the ranks and what did it take to get your current position as CEO at Select Specialty Hospital-Weirton?

I became a charge therapist, a lead therapist, and supervisor over my first 18 years before transitioning to long-term acute care as a manager. I cannot stress enough the importance of seizing opportunities to learn and be involved. I worked to achieve my bachelor’s and master’s degrees, yes, but I also sought opportunities to sit on committees, to join survey and regulatory activities, to participate in policy and protocol creation, and to be active within our professional organizations.

These opportunities grant knowledge and experience to move into roles with increasing responsibility and they absolutely allow for a well-rounded and intentional approach to operational oversight. Every experience I have had over the past 33 years has lent to my ability to be a CEO.

What does the position entail and how does your RT background help you in the job?

My role is to oversee hospital operation management in a critical care environment. I provide hands-on leadership, strategic direction, and operations with a focus on business development, physician recruitment, fostering health care partnerships, exceptional quality patient care, and fiscal accountability. No day is the same and they are jam packed with one situation after another; it is exciting, challenging, and enlightening daily.

The role requires someone who can analyze complex situations and execute decisions effectively, and that is where being a respiratory therapist gives me a profound advantage. As therapists, we find ourselves in complex situations every day and our critical thinking abilities, calmness, authoritative natures, and our ability to make quick, concise, decisions are exactly what is needed to be an effective executive leader.

What are the biggest challenges, and biggest rewards of working in your current position and why?

For me, the biggest challenges I face are rising costs, staffing shortages, having and sustaining sound employee and patient experience processes, and keeping pace with technologic advancements. But as challenging of an environment as it can be, it can be, and is, equally rewarding. I am privileged to witness my talented leadership team move mountains, to see my amazing clinical team bring meaningful impact to peoples’ lives, to forge partnerships that bring quality and accessible health care to our community, and to learn something new and innovative on an ongoing basis.

RTs are needed in hospitals that specialize in long-term care for complex cases. What would you like to say to therapists about the career opportunities they will find in your setting?

Our setting provides a much needed level of our care to our community but, equally important, it provides a level of professional growth and autonomy to respiratory therapists not often seen in other areas. LTACHs embrace the team approach to care

and leadership. Because of this unique approach they seek out diversity of professions in their leaders. There is no other environment, in my career experience, that allows a therapist to move into so many varied career paths — education, compliance, quality, and leadership alike.

What are your top 3-4 bits of advice for other therapists who might like to follow in your footsteps and move into an upper leadership position in the LTACH setting?

  • Capitalize on educational opportunities and pursue advanced degrees.
  • Be involved in the operational side of your role. Join committees, go to meetings, be part of the process.
  • Speak up. Bring ideas forward, share your experience, and mentor.
  • Be brave. Take a leap of faith. Take a chance.

Heading to the New Era

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