Long before and well after the American Veterinary Medical Association adopted the term “veterinary technician” in 1989, debate bubbled about how best to identify these critical members of the veterinary-care team.
Over the years, states made their own determinations, establishing practice acts with varied education and credentialing requirements, and spawning four different titles across the country for essentially the same job. The lack of uniform standards has created real challenges for veterinary technicians, contributing to job dissatisfaction and high turnover, many in the profession agree.
Today, discussion over the “veterinary technician” title is amplifying, as the 13,000-member National Association of Veterinary Technicians of America (NAVTA) pursues an ambitious fix: Unite the profession under the single title “Registered Veterinary Nurse” and standardize credentialing requirements and scope of practice across the country.
Under NAVTA's long-term plan, unlicensed veterinary technicians no longer will exist; as registered veterinary nurses, they'll all have completed the same educational requirements. Streamlining the profession's medley of standards and titles will help advance it, proponents maintain.
Through these changes, “the entire profession will make significant strides toward better recognition, mobility and elevated practice standards,” Kara M. Burns, a licensed veterinary technician and NAVTA president-elect, said in a prepared statement earlier this year. “All of this will lead to better patient care and consumer protection.”
The idea isn't new; “veterinary nurse” is the official title of technicians working in the United Kingdom and Australia. But in the United States, the concept is gaining momentum for the first time — and generating resistance, as well. One source of potential friction is human medicine, where veterinary technicians are not necessarily considered the professional equivalent of nurses. Much as the titles “veterinarian,” “physicians” and “pharmacist” are defined by state regulations, so is “nurse,” in many jurisdictions.
NAVTA is undeterred. In May, the group announced the formation of an 11-member Veterinary Nurse Initiative Coalition to pursue title amendments in 50 states under the guidance of lawyer Mark Cushing, a seasoned lobbyist and founding partner of the Animal Policy Group.
Starting with the 2018 legislative season, NAVTA will lobby lawmakers and other stakeholders to adopt the title “nurse." Cushing says the effort may take five to 10 years to complete.
The thinking is that “nurse” is better understood and respected than “technician” in a health-care setting by pretty much everyone. Additionally, initiative proponents argue, nursing in human medicine lines up well with the scope of practice and training required for veterinary technicians in most states.
“Veterinary technicians in general aren’t very well understood by the public in terms of what we do. Even within the profession not everyone knows what a veterinary technician is,” initiative co-chair Kenichiro Yagi explained during a recent interview. Yagi is a registered veterinary technician and ICU manager at a Los Altos, California, clinic.
Veterinary technicians are educated to assist veterinarians in many ways. They compile patient case histories, collect specimens, perform laboratory procedures, provide nursing care, assist in medical procedures, administer anesthetics, take radiographs, advise and educate animal owners, supervise and train personnel and more.
In states with no requirements or protections, Yagi said, veterinarians can hire untrained, uncertified and unlicensed assistants and call them “technicians,” which creates frustration among those with credentials, drives down pay in the occupation and hurts morale.
A recent NAVTA survey of members and nonmembers found 56 percent of respondents changed jobs within the previous seven years, with 45 percent of those leaving the field entirely. Top reasons given for the career change were low wages, lack of respect and burn out.
A title change and elevated standards could generate some well-deserved prestige, proponents say.
“It may sound cliché, but I do think a majority of the general public sees us as people who play with cute little animals all day,” Robyn Baillif, a registered veterinary technician who works with Yagi, explained in an interview by email.
“I believe that having a national credential can help us be taken more seriously as medical professionals,” Baillif said. “I feel that having our title changed to nurse will begin to help pet owners and the general public better understand what our role in veterinary medicine really is.”
NAVTA consultant Cushing said the benefits of the new title would extend beyond veterinary technicians.
“It’s good for veterinarians, it’s good for vet techs and it’s good for pet owners,” he said. “If you want to do something for your practice, elevate respect and understanding for what these professionals can do for your office. Making it a strong, attractive career is going to go a long way to solving the turnover problem that all veterinarians face.”
An unscientific survey last week of members of the Veterinary Information Network, an international online community for the profession, suggests that veterinarians are neutral on the question of changing “veterinary technician” to “veterinary nurse.” Of 921 respondents, 99 percent had no opinion.
Before the title "veterinary technician" came into common use, the AVMA referred to those in the position as "animal technicians." According to the Washington State Association of Veterinary Technicians, the AVMA in 1988 voted down a resolution to change “animal technician” to “veterinary assistant.” The following year, the association’s House of Delegates approved the change.
The AVMA did not respond to VIN News Service requests to talk about the “veterinary nurse” initiative.
One veterinarian who supports the change is Dr. Gary R. White, owner of Huntington Veterinary Hospital in Monrovia, California. “I think they should be called nurses,” he said. “It’s just naming a position that’s already there and helping to better delineate what the terms are.”
He explained, “The public thinks of technicians as people who provide simple services like change their oil or fix their computer. To that end, many human nurses closer fit that bill.”
White, who serves on the advisory committee for the RVT program at Mt. San Antonio College Community College in Pomona, thinks it’s better for veterinary medicine overall “to create parallel terms” with human medicine.
Others doubt that new terminology and standards are enough to transform the profession.
“I don't believe it will change the jobs, technicians' attitudes about their jobs, or the public perception in that small percentage that care about the specifics of the title,” Dr. Chiara Switzer said by email. “Unfortunately, I don't think enough pet owners are truly aware of the differences in the education, skills or certifications of their veterinary health-care team, and that includes veterinarians as well as the staff. To too many pet owners, we're all the same — at least until their experiences show them a difference. That's a shame, but I think it's a reality.”
Switzer is a relief veterinarian in Canada, where registered veterinary technicians or technologists must graduate from an accredited school, pass an exam and maintain provincial licensing requirements. By contrast, compulsory credentials for U.S. veterinary technicians are not required in 12 states.
Uniform standards more important than title?
To Charlotte Waack, the first line of action on behalf of technicians shouldn’t be a new title. It should be to make sure all states establish baseline qualifications for veterinary technicians in state practice acts. A certified and registered veterinary technician, Waack is director of the Veterinary Support Personnel Network. (VSPN is an organization of VIN, which is parent of the VIN News Service.)
In an interview, Waack said she believes the title-change initiative has been pushed through without broad support from the profession by a coalition with uneven geographic representation: of 11, four come from Florida and none from the Midwest.
A recent poll by NAVTA of its members and nonmembers, including students and individuals with varying degrees of credentialing, generated 4,700 responses. Sixty-one percent were in favor of “veterinary nurse,” 20 percent were neutral and 19 percent favored “veterinary technician.” Veterinary technician specialists, those with bachelor's degrees, those who work in universities, and veterinary technology students were more apt to support the “nurse” title than the average.
Waack said the discussions on the topic date back to at least 2002 on VSPN message boards. A former NAVTA board member, Waack has been critical of the idea because “nurse” is protected in so many states. “I said, ‘We are going to have a battle,’” she remembered.
By the ANA's count, the title is protected in at least 39 states.
“The ANA is very concerned about introducing another title ‘nurse,’ as it may confuse the public,” said Janet Haebler, ANA senior associate director for state governmental affairs.
In the past, state protection usually has been invoked in response to situations in which the title is assumed by people without proper credentials, such as someone advertising as a “baby nurse.” Haebler conceded, “Veterinary nurse is more likely different in the minds of the public.”
Thus far, the association has not issued an official statement in support of or opposition to the veterinary nurse initiative. “ANA is absolutely willing to talk it through,” Haebler said. But she pointed out that title changes aren’t a national issue, per se, because they happen at the state level.
And that’s guiding NAVTA strategy.
“We often hear that nurses will not allow the title,” Yagi said. “But I think that’s not going to be in the majority of the states.”
According to his math, 11 states don’t have “nurse” title protection at all, around 16 states have protection but the rules are “friendly to other professions” being able to use the nurse title, and then there are states with “definite conflict.”
“So, we would start working with states that don’t have the title protection or have friendly title protection,” Yagi said. As of early this week, he was unable to confirm which states will be targeted in the first go-round.
This approach does not, at least initially, tackle the thornier — and, for many, more critical — issue of standardizing education requirements and scope of practice across the country. Nor does it focus on introducing minimum compulsory standards in states with no requirements.
Another concern over the strategy is that opening state practice acts to make a title change will leave them vulnerable to outside groups, such as animal rights organizations that might try to use the opportunity to push for different types of revisions.
Cushing, who has managed state legislative activities for various national animal-health groups, said he understands the concern but in his experience, legislatures tend to be skeptical about outside groups trying to make changes in areas other than what’s under discussion. “There’s no history of that leading to widespread practice-act changes,” he said.
In March 2016, the New York State Association of Veterinary Technicians (NYSAVT) issued a statement opposing the veterinary nurse initiative, which was then under discussion by NAVTA. The 1,000-member New York group argues that the national organization oversimplifies the process and understates the difficulty of revising legislation in 50 states.
It won’t happen in New York, NYSAVT board president Garnetta Santiago said in an interview: “We are constrained by our legislation.” New York state gives protection to the title “licensed veterinary technician” as well as to the title “nurse.”
Even the strategy of starting with “friendly” states and holding off on those that have tougher nurse title protections and those with no credentialing for veterinary technicians at all doesn’t sit well with Santiago. “The problem is, if you’re a national organization, you can’t put some states aside,” she said. “This just muddies the water.”
A licensed veterinary technician working in the pet food industry, Santiago questions the wisdom of putting so much time and resources into an effort that she believes is likely to fail. She knows the challenges for her constituencies — issues including low pay, lack of respect and underutilization — that drive the initiative. But she doesn’t agree on the solution.
For its part, NYSAVT tackles the problem through an ongoing effort, Santiago said, to improve public awareness about the role veterinary technicians play; to educate and collaborate with veterinarians so that they recognize and support their credentialed counterparts; and to empower veterinary technicians so that they advocate for themselves, whatever their title.
“I look at this huge mission [NAVTA has] undertaken and it doesn’t address those concerns,” she said. In fact, she suggested, it could make things worse.
Santiago said her members worry that being called nurse will narrow what veterinary technicians get to do — exacerbating that sense of being underused. “I have LVTs who feel their scope of work far exceeds even what a nurse is doing,” she said. “An LVT is doing six or seven jobs.”
Yagi believes the concern is overstated. He concedes there are some areas in which veterinary technicians do more than nurses — such as performing dentistry procedures, taking radiographs and doing laboratory work — that in the human medical field would not be permitted of nurses who aren’t specialists. But the differences are small, he said.
“[T]here is about a 90 percent overlap [in job responsibilities]. We don’t see that as a huge reason to say that we are a completely different entity than nurses … because in terms of the majority of our scope of practice, we are going further and further into nursing care that focuses on the patients,” Yagi said.
Cushing puts it another way: “Some vet techs think, ‘Well, gee, we do more than nurses.’ In reality, the public doesn’t understand that. I’ll tell you what the public understands: When the public is asked every year which health professions they trust the most, they’re always one and two. Number one is nurses. Number two is veterinarians.”
NAVTA hopes to capture all that trust in the title “veterinary nurse.”