Median RT earns $80,450. Median RN earns $93,600. But the NPV picture is closer than it looks when you stack credentials and shifts.
$80,450
RT Median
$93,600
RN Median
$13,150
Salary gap
13% (2024-34)
RT growth rate
All salary figures from BLS OES May 2024. RT = SOC 29-1126. RN = SOC 29-1141.
| Factor | Respiratory Therapist | Registered Nurse |
|---|---|---|
| Median Annual Salary (BLS May 2024) | $80,450 | $93,600 |
| 10th Percentile | $61,900 | $63,910 |
| 90th Percentile | $108,820 | $132,000 |
| Hourly Median | $38.68/hr | $45.00/hr |
| Education (entry path) | Associate (2 yr) | ADN or BSN (2-4 yr) |
| Typical tuition cost | $18,000 - $60,000 | $20,000 - $80,000 |
| National board exam | NBRC TMC + CSE | NCLEX-RN |
| Total employed (BLS 2024) | 135,200 | 3,200,000+ |
| BLS projected growth (2024-2034) | 13% | 6% |
| Scope of practice | Cardiopulmonary specialisation | All body systems, med admin |
| Primary settings | Hospital, home health, sleep lab | Hospital, clinic, community, school |
| Prescribing / administration rights | No (protocols only) | Medication admin under physician order |
| Advanced practice pathway | No NP equivalent | NP, CRNA ($120k-$220k+) |
| Night shift differential | $3-5/hr | $3-5/hr |
| Licensure renewal cycle | Every 2 years (state) | Every 2 years (state) |
The entry-level investment is nearly identical for both careers. The material difference appears later, in advancement ceiling and advanced-practice earnings.
2-4 yrs
Training time
$18k-$60k
Typical tuition
2-4 yrs
Training time
$20k-$80k
Typical tuition
The median salary gap is $13,150/yr. Over 10 years at 4% discount rate, the raw NPV gap is approximately $107,000 in favour of nursing. However, an RT with RRT + ACCS credentials, night shift differentials, and 5 years of ICU experience can push total compensation to $95,000-$105,000, narrowing the gap to $50,000-$75,000.
| Year | Base RT | Stacked RT (RRT+ACCS+nights) | Base RN | Gap (base) |
|---|---|---|---|---|
| Year 1 | $58,000 | $60,000 | $64,000 | $6,000 |
| Year 2 | $62,000 | $68,000 | $68,000 | $6,000 |
| Year 3 | $66,000 | $75,000 | $72,000 | $6,000 |
| Year 5 | $72,000 | $86,000 | $80,000 | $8,000 |
| Year 7 | $77,000 | $92,000 | $87,000 | $10,000 |
| Year 10 | $83,000 | $100,000 | $95,000 | $12,000 |
| Cumulative (10 yr) | $706,000 | $831,000 | $798,000 | $92,000 |
Projections assume 3% annual raises. "Stacked RT" includes RRT + ACCS credential premiums and night differential value. Actual salaries vary by employer, state, and negotiation.
RTs are cardiopulmonary specialists. Depth over breadth.
RNs provide broad patient care across all body systems. Breadth over depth.
This is the most important long-term differentiator. RNs can advance to Nurse Practitioner ($120,000-$160,000) or CRNA ($200,000+), creating a second earnings step-change at year 5-8. RTs have no equivalent advanced-practice pathway recognised by state boards.
New Grad RT
Year 0
$56-60k
Staff RT (RRT + 2 yrs)
Year 2-3
$64-72k
Senior / Lead RT (ACCS or NPS)
Year 4-7
$72-85k
Charge RT / Supervisor
Year 5-8
$80-92k
Manager / Director
Year 8-15
$95-125k
Travel RT (peak years)
Any
$93-145k
New Grad RN
Year 0
$62-70k
Staff RN (3+ yrs)
Year 2-4
$75-90k
Senior / Charge RN
Year 4-8
$85-100k
Nurse Practitioner (NP)
Year 5-8
$120-160k
CRNA
Year 6-9
$185-220k+
Nurse Manager / Director
Year 6-12
$95-140k
Key insight: If you are certain you want a management or clinical leadership career, the RN advanced-practice pathway gives you a second major earnings uplift that RT does not offer. If you are drawn specifically to pulmonary and ventilator work and do not want the breadth of nursing, the RT path offers a faster and more focused route to cardiopulmonary expertise.
In California, Washington, Alaska, and Hawaii, highly experienced RTs with specialty credentials approach or exceed median RN wages. In most states, median RN pay leads.
| State | RT Mean | RN Mean | RN Premium |
|---|---|---|---|
| California | $104,500 | $132,300 | +$27,800 |
| New York | $95,240 | $115,600 | +$20,360 |
| Alaska | $89,370 | $101,200 | +$11,830 |
| Washington | $87,450 | $101,000 | +$13,550 |
| Hawaii | $83,060 | $103,400 | +$20,340 |
| Texas | $68,520 | $82,500 | +$13,980 |
| Florida | $62,840 | $75,100 | +$12,260 |
| Ohio | $71,430 | $79,800 | +$8,370 |
RN figures from BLS OES May 2024 SOC 29-1141. RT figures from BLS OES May 2024 SOC 29-1126.
Some RTs decide after 2-5 years of clinical work that they want the broader scope of nursing. Accelerated BSN programmes (ABSN) typically take 15-18 months for candidates who already hold a bachelor's degree. For RTs with an associate's, a bridge associate-to-BSN followed by ABSN is a 3-year total path.
The reverse path (RN to RT) is rare and not well-supported by bridge programmes. RNs seeking pulmonary specialisation typically pursue NP with a pulmonology focus rather than retraining as an RT.
Sources: BLS OES May 2024 (SOC 29-1126 Respiratory Therapists; SOC 29-1141 Registered Nurses). Projections from BLS Occupational Outlook Handbook 2024-2034. Salary projections are illustrative estimates based on PayScale and AMN Healthcare survey data. Actual compensation varies by employer, state, and experience.