Erin Spencer, MEd, CVT, VTS (emergency and critical care)
Erin Spencer is a certified veterinary technician in Massachusetts, a state that does not have minimum standards or licensing requirements for technicians. She recently testified before lawmakers that a credentialing requirement is necessary to protect pets and owners in the state. Along with working in the field and educating fellow technicians, she has held leadership positions with the National Association of Veterinary Technicians in America (NAVTA) as well as her state association and other professional organizations.
Early in my career, I was asked to fill in for a more experienced colleague to monitor an anesthetized patient in our practice. I was nervous, I didn't fully understand what I was doing and, to be honest, I had no business in that role. Unfortunately, the patient went into cardiac arrest and could not be resuscitated.
That experience was a turning point for me, crystallizing the fact that there was much I didn't know. Although I was called "technician" at the time, I was actually a very green veterinary assistant. A few months later I enrolled in veterinary technology school to truly earn the title. Now, decades later, I'm fighting for legislation to make sure patients, pet owners, technicians and assistants never suffer through a similar situation.
Initially, it was not my intention to be a pioneer for this cause. The individual heading up the legislative effort to require technician licensing in Massachusetts simply thought I might have insights and perspective that would be helpful. Little did I know where it would lead. As time went on, my passion for this initiative grew and became a major focus as I work toward my overarching goal: to leave the profession better for those who come after me.
In addition to getting licensing requirements established in Massachusetts and other states where they don't exist, I would like to see three things happen to bring about a paradigm shift in our profession. They are:
- Standardization of our title so that it is the same in every state
- A requirement that, to obtain that title, an individual graduate from an educational program accredited by the American Veterinary Medical Association (AVMA) and pass the national licensing examination
- The ability to relocate more easily across state lines (which will follow from steps one and two).
Let's look at these and related issues more closely.
Since the launch of the Veterinary Nurse Initiative in 2016, there has been lively discussion over whether we should be called veterinary technicians or veterinary nurses. My ultimate goal is to have one title throughout the country. When some of us are "registered," some are "licensed" and others are "certified" (depending on which state we work in), the public simply becomes confused.
I personally believe there is huge value in using the title "veterinary nurse." It communicates our role more clearly, cutting down on the need for massive public education efforts regarding what technicians actually do. In fact, many veterinary technicians find themselves explaining their job as "a nurse for animals" or "the equivalent of a nurse in the veterinary field" when asked what their job entails. It's a common way to help people understand our profession. And despite the backlash from a small but vocal minority who prefer to hold on to the word "technician," adoption of the term "veterinary nurse" is happening organically, at a grassroots level.
As mentioned earlier, I believe the minimum requirement to become a veterinary technician should be graduation from an approved program and passage of the Veterinarian Technician National Exam (VTNE). Now, I understand that credentials alone don't make you a better technician. Some of the best veterinary team members I know — people I would trust implicitly with my own animals — didn't go to school. But it took most of them much longer to get where they are today than it would have with a formal education.
At its heart, formal training equips veterinary technicians to understand the "why" of the skills they have mastered. They don't just learn, for example, where a vein is located and how to place a catheter. They learn the anatomy of that vein. They understand which parts of the body that vein serves. They're taught why they must use aseptic technique. And they learn it all faster in a more structured way. In the end, this results in better patient care — which is what our profession is all about, right? In the end, education and certification inspire respect and confidence in a way nothing else does.
In many states you can be called a veterinary technician even if you are not credentialed. That's confusing for our clients, who trust that we are appropriately trained to do our jobs. In human medicine, we don't say, "my registered nurse," we say, "my nurse," with the understanding that being a nurse carries with it all the education and certification needed to be called a nurse. I believe we need the same thing for veterinary technicians. We need to make it a profession that is truly licensed. And if someone doesn't have that license, they cannot be called a veterinary technician.
Scope of practice
When someone graduates from an approved program and passes the VTNE, we know they have a base minimum of education and training. This means veterinarians who hire credentialed technicians know those team members have been exposed to a certain list of topics and have learned and practiced a specific set of skills. They may not have mastered those skills, but they've at least learned them to the point of obtaining their credential. However, veterinarians often don't know what their technician is capable of and then default to performing those tasks themselves. Which leads us to...
As many of us are stating in this issue of Bowman Report (see the rest of the Technicians in Crisis issue), one of the most significant issues facing the veterinary technician profession is underutilization. This is a problem certification could help solve.
As things stand now, with no standardized certification from state to state, few veterinarians have a clear idea of what technicians are legally allowed to do, what they've been trained to do and what they've proved themselves capable of. This can cause veterinarians to become bogged down in performing procedures or tasks their technicians could be doing. When I ask a veterinarian something like, "Hey, do you want me to perform that cystocentesis?" their response is often, "Oh — you can do that?" Certification provides a minimum expectation of what technicians know and can help doctors utilize their technicians more fully and even help technicians grow.
This issue of underutilization has become especially evident during this pandemic. Our veterinary hospitals, veterinarians and technicians have all been overwhelmed caring for pets. However, if we understood exactly what can and should be expected of credentialed veterinary technicians, our workloads could be better shared among the team, relieving stress and leading to a more enjoyable workplace.
I also believe we need to stop teaching technician skills to veterinarians. I understand why it happens. Until very recently, veterinarians were not assured their technicians would have the skills to do these tasks, so veterinarians had to know how to do them just in case. With increasing emphasis on credentialing, this can stop. I realize this is a huge paradigm shift, but it must be driven by us as we advocate for ourselves that we are capable and ready to do our jobs with passion and excellence.
Finally, I believe proper utilization could help technicians experience more job satisfaction. Instead of completing routine tasks, they could expand their abilities and use their skills, training and intelligence. In the end, I believe it provides the framework for more opportunities to learn and grow.
Finally, a major benefit of standardized credentials would be the ability for veterinary technicians to relocate more easily. Some of my colleagues have worked for 20 years as credentialed technicians in one state and can't get licensed in another because the rules are so different. By standardizing our title and minimum credentialing requirements, it would become much easier for technicians to live where they want or have the freedom to relocate without sacrificing the accomplishments they've worked so hard to attain. This would also make it easier for practices that are short of technicians to recruit and hire them to fill empty positions.
We must speak up
For these changes to take hold in our profession, we must take responsibility ourselves for making it happen. No one is going to do it for us. Yes, we have allies: NAVTA is spearheading the effort as it represents and advocates for the entire veterinary technician profession, and the AVMA is a huge supporter. But the technician in practice needs to say, "I should be doing this skill. This is in my purview. This is my job description. And here's why I need to do it." That's the kind of self-advocacy that will ultimately drive the change that needs to happen.