Soliman, Lea2026-07-222026-07-222026-05-202026-07-09http://hdl.handle.net/1993/39889Introduction: Terminal extubation and ventilator withdrawal are complex aspects of end-of-life care that require respiratory therapists (RTs) to navigate technical, emotional, and ethical responsibilities. During the COVID-19 pandemic, increased mortality, visitation restrictions, staffing shortages, and changing clinical protocols intensified these experiences. Despite their central role in ventilator management, RTs remain underrepresented in the literature. Purpose: This thesis explored how respiratory therapists in Manitoba describe their experiences with terminal extubation and ventilator withdrawal during the COVID-19 pandemic, and the self- reported impacts on their clinical practice, professional identity, and personal well-being. Methods: A qualitative descriptive design was used, employing semi-structured interviews with 10 practicing respiratory therapists in Manitoba, Canada. Data were analyzed using thematic analysis to identify patterns and themes across participant narratives. Findings: Across 9 emerging categories, 4 themes were identified from the data – Practice in Retrospect, Shocks to the System, Quality Care & Motivation Struggles, and Working in the Aftermath. These themes can be interpreted temporally along the pandemic timeline, or conceptually through key findings in shared accounts. Participants described their role in terminal extubation as both technically specialized and emotionally demanding, with their roles grounded in technical competence despite the limited involvement in decision-making. The emotional and ethical burden of ventilatory support withdrawal intensified during the pandemic, contributing to moral distress, burnout and emotional detachment. The COVID-19 pandemic fundamentally changed the experience of terminal extubation by disrupting established practices, increasing system strain, and creating lasting changes to work4lows and perceptions of quality end-of-life care. Conclusion: This thesis highlights the lasting impact of pandemic-related end-of-life care on Manitoba RTs and emphasizes the need for organizational and psychological supports to sustain compassionate care during future healthcare crises.engrespiratory therapistterminal extubationCOVID-19distressqualitative descriptionManitobapandemicfrontline worker