The Essential Veterinary Assistant

Veterinary Assistants are absolutely essential to the well functioning veterinary clinic.  Veterinary assistants obtain vital signs, restrain patients, run blood work, administer medications, assist with taking x-rays and administering medications....without assistants, veterinarians and veterinary technicians would be overworked (more than they are), stressed, and unable to perform their duties to the fullest extent.  

A quality veterinary assistant is proactive - always thinking a step ahead to anticipate the DVM's needs, and working alongside the Credentialed Vet Tech to keep the cogs of the clinic moving.  They communicate with team members and clients, and provide tender loving care to the pets that come through the door.

I have been fortunate to have encountered and worked with some extremely capable veterinary assistants.  Frequently, veterinary assistants are trained on the job.  This means they start working with no veterinary experience at all, and are taught, over time, how to help out and be a part of the team.  The best sort of veterinary assistant is always observing and asking questions, and after extensive training and experience, is able to offer more quality care to their team members and patients.

Experienced veterinary assistants, those who choose to make it a career, are my personal favorite.  They've been in the field so long, they know when to speak up as a patient advocate, read their DVM to anticipate patient needs, and the line may seem to blur between a veterinary assistant with extensive experience and a credentialed veterinary technician.  The thing to remember is that credentialed veterinary technicians are graduates of a school that is accredited by the American Veterinary Medical Association, they have passed a national exam and a state exam, they are allowed by law to practice veterinary medicine as long as they do not diagnose/provide prognosis/perform solo surgeries, they are allowed by law to perform certain tasks and procedures that veterinary assistants cannot legally perform.  They are also held legally accountable for their actions (assistants are not - the vet is held accountable), have a degree in veterinary technology, and are required to have a minimum amount of yearly education to keep their fingers on the pulse of veterinary medicine.  An assistant may or may not have a certificate of completion for a veterinary assisting program, which introduces them to the world of vet medicine in a fantastic way, but is not currently required.

This is not to say that credentialed veterinary technicians are better than veterinary assistants.  That is far from the truth!  Both positions are beneficial to a veterinary practice.  Veterinary assistants and veterinary technicians are different titles to differentiate between whether a person is formally or informally educated in the field, their level of legal liability, and legal abilities to perform duties.  It's like an EMT vs a paramedic, or a CNA vs an RN.  One has more education and responsibility than the other, and both are necessary.  No one is "better than" anyone else, but they are on different levels, professionally and legally.

There are a few reasons why someone would choose to be a veterinary assistant instead of a veterinary technician.  First of all, it's a non-regulated field of work.  There is no degree, certificate, or diploma that is required to be a veterinary assistant.  This means that they can get into the field with no experience - generally working their way up from "kennel tech" to an assisting position based on what the clinic asks them to do.  The supervising veterinarian is held liable for any actions that the veterinary assistant takes, and the assistant is held accountable only by the supervising entity of the practice they work at.

Second, because it does not require regulation or a degree/certificate to perform the duties asked of them, the veterinary assistant does not have any student loans to pay off.  There is no 2-4 years of student debt, no yearly continuing education requirements/fees, no testing fees, no yearly license renewal fees.  This means that those who cannot afford school can work in the veterinary field, albeit at a lower salary and fewer legal tasks.  For many veterinary assistants, this is fine by them.  Because placing catheters and drawing blood is a teachable task, as is running blood work and performing lab tests, this is as far as they desire to go in veterinary medicine and do not feel as though they want/need to learn more.

Third, someone who has been working up in a clinic since they were in high school may choose to remain a veterinary assistant because they either feel they know all they need to know, or they plan to go to veterinary school to become a DVM.  Going to veterinary technician school is either something that they feel is unnecessary, or they will be obtaining a more thorough degree through veterinary school and would like to keep their position at the clinic through vet school.  This gives them a leg up on becoming a veterinarian.

The problem with learning on the job is that the knowledge that is given is one or two vets' choice as to how their clinic is to be run.  School shows the global and national standards of medicine, and any given clinic could be either 20+ years behind the current standards, or fully up to date and on the cutting edge of medicine.  One of the most dangerous phrases is, "because we've always done it that way."  Don't be That Guy.

Please don't look down on veterinary assistants.  The experienced, ravenous-for-learning VAs can be just as good as the experienced, ravenous-for-learning Vet Techs.  There is a difference in title and responsibility, but there's no difference in the love of what we do.  And that's what counts. 

VAs, OWN your title.  Don't pretend to be something you're not, just because you think that it's better than what you have.  Be the best damn VA there ever was, and kick ass.  You get out of life what you put into it.  And YOU are more than enough.

Addendum, Credentialed Vet Techs Post

There is one more thing that I inadvertently left out of the blog post the other day, and it has been gnawing at me a little.  There is one more discussion that non-credentialed veterinary assistants tend to bring up that really irks me.

"I learned everything the hard way.  In the trenches."  "I didn't take the easy way out."
I am not sure how exactly this argument works.
The easy way, the person is stating, is to spend 40 hours a week at school, hold down a job, perform another 10-20 hours of homework a week, deal with wet labs, years of debt repayment, months of studying for a national exam, weeks of studying for a state exam....and then go on to a career where you're required to take time off to go to continuing education and learn more and more every year.  A career where you also clean cages, speak to the willfully ignorant or cognitively dissonant, and are lumped into a category of people who may not know a trachea from an esophagus.  People who think that you are a sellout for going to school, and that you think you're better than them.  So they automatically put you down, from Day 1.

How is this the easy way out?  How is being told exactly what to do, and when to do it, without any additional information on the hows and whys over years and years, the hard way?

Not only that, but when school is over (and for a lot of us, during school).....we are also in the trenches.  Learning what Book Smarts translate to Real World Smarts.  An assistant's 5 years of experience is not more difficult or more special than a credentialed Tech's 5 years of experience.  They're both 5 years of experience, both "in the trenches."  So how does the argument work?

It doesn't.

We, as C/R/LVTs, are literally being shamed for making our dedication to our career legal and responsible, and putting ourselves in a position to provide our patients and DVMs with the best possible start to our career.

The fact of the matter is this.  As with all things in life, you get out of it what you put into it.  There will be amazing assistants that I would trust to care for my pet, because I know that have gone to IVECCS/AVMA/WVC/AAHA symposiums, absorbed any and all information, and most importantly....they know what they don't know.  Because those people are amazing.  I trust that if anything was to happen, they would alert the DVM or the LVT, and go from there.  I know that they would ask questions.  Provide a sounding board.  Be a great assistant.

It's the people who don't know what they don't know, the people who insist that veterinary medicine doesn't need credentialed, legally responsible Vet Techs that I am worried about.  I know many of these people, and some of them are DVMs or DVMs in training.

Veterinarians rely on their LVTs to provide a checks and balances system for the clinic.  No one person, as godly as the DVMs seem to be, is perfect.  I am far from perfect, but I know that my DVMs appreciate when I discuss cases with them, and provide a different perspective.  I appreciate that my DVMs are open to discussion and teaching and having LVTs who want to learn.  I know for a fact that our patients have benefited from having multiple people on the case with educational backgrounds that cover the universal quality of care that is expected of Veterinary Medical professionals.

Credentialed Veterinary Technicians

Articles lately in Veterinary Team Brief, coupled with the NAVTA Veterinary Nurse Initiative, have nudged me into writing about this seemingly hot-button and controversial topic.  I honestly don't see why this topic should be so controversial or tender, because it seems pretty cut and dried to me.

A veterinarian is a licensed professional who has a minimum of a DVM degree, who take a national exam (NAVLE), and obtain licensure in their state of practice.  They are required to stay up to date with Continuing Education throughout the year, and are required a minimum number of CE hours to keep their license and remain abreast of new developments in medicine.  They are held accountable by state and federal boards and agencies, including the DEA, as they are medical professionals that compare to MDs in the human field.

A Veterinary Technician is a licensed, registered, or certified professional who has a minimum of an AAS in Veterinary technology, has passed a national exam (VTNE), and has registered or is licensed in the state of which they reside or practice.  They are required to stay up to date with Continuing Education throughout the year, and are required a minimum number of CE hours to keep their license and remain abreast of new developments in medicine, just like DVMs.  In licensing states, there are laws regulating what licensed VTs can do, and what non-credentialed veterinary staff (assistants, receptionists) cannot do.  The closest human medicine counterpart would be the RN, though Vet Techs have a little more freedom, legally, with patients.

A veterinary assistant is a non-licensed professional who is either 'off the street' or has gone through a certificate program that covers the basics of veterinary assisting - restraint, basic anatomy, basic overview of medications, etc. that provides an excellent basis of knowledge for assisting the veterinarian and technician in day to day functions.  A veterinary assistant is not required to stay up to date with Continuing Education at this time, nor are they held to any state or national standard.  The closest thing in human medicine would be anywhere from a candy striper to a CNA, depending on the certificate status of the assistant.  (Ideally, in my opinion, all assistants would have gone through the certification program, but at this time it has not been deemed necessary by the powers-that-be.  Hopefully sooner rather than later, however, since all aspects of veterinary medicine should be as regulated as human medication.  But this is just my opinion)

Now.  Here's the kick in the balls that I keep seeing everywhere, on every veterinary forum that I plan to break down for y'all.

Those who call themselves vet techs who are not credentialed, no matter how many years they have been in the field, think that they are exactly the same and frequently say they are worth more than a credentialed veterinary technician.

Let that sink in a minute.

People who do not hold a license to practice medicine, who choose to practice medicine anyway, vociferously announce that they are equivalent, more knowledgeable, and more skilled than those who have spent time, money, and energy on the legal ability and responsibility to practice medicine.

Up until 2012, non-credentialed veterinary assistants/staff could sit for the VTNE in order to grandfather into the credentialed Vet Tech family.  This was intended to show the non-credentialed staff that their experience and knowledge is valuable, and these people had to study their asses off in order to pass the VTNE.  They had to take the initiative and read books, take practice tests, learn things they never would have thought they needed to know.  There was not one single non-credentialed vet professional that I can find that took the VTNE and passed without studying and broadening their horizons.

(This means, in layman's terms, that y'all had the chance to prove yourselves worthy of the exam, and if you didn't take it, you can't complain.  You knew this was coming.  And for those who weren't in the field back then, all you've ever known is this requirement for Vet Techs and so there's no use in complaining that it isn't fair, because it's always been this way and you can still go to school.)

This means that, in order to pass a national test and become credentialed, even 30+ years of experience is not enough to become accredited as a Veterinary Technician.  This alone may show that experience is not enough to use the title Vet Tech.  However, those who say that a degree and license isn't necessary to call yourself a Vet Tech would disagree.  And so there is more.

Here are the arguments I have seen from non-credentialed veterinary staff:

1. "I've worked X Number of Years and I would outshine any credentialed tech fresh out of school!"
This one makes me laugh to keep from crying.  Really?  Your X# of years of experience means you can do better than someone with zero experience?  YOU DON'T SAY?!?  Wow.  You must be SO good at your job that you could take someone with no experience and do better than them.

Seriously.  I saw it no fewer than 6 times in an hour on the Veterinary Team Brief post....do people actually think this is a valid argument?

2. "Getting your degree is a waste of money."
This one always hurts.  I do not feel it was a waste of money.  Why?  Because I learned the AVMA standard of care.  I learned more in 18 months (2 years for those who didn't test out of classes) than I could have learned in 10 years of practice experience.  Know why?  Because the school teaches everyone the same stuff that licensed vets and techs need to know.  School teaches the standard of care, which is higher than most General Practice DVMs require, but need to.  Experience won't teach you the reasons we monitor six parameters in anesthesia, or how gas exchange works.  Experience won't teach you not to give certain meds without a filter needle unless there are fatal consequences.  Experience won't teach you how to know when it's been too long since your patient urinated....until it's too late for the patient.  Experience won't teach you why phenobarbital is contraindicated in patients with liver disease, why you don't give Diazepam subcutaneously or leave it in a syringe for more than 30 minutes.....experience doesn't teach you the hows AND the whys.  But school does.

Experience is based entirely on who you have worked for/with.  It has absolutely NO bearing on whether or not you are following the AVMA standard of care, or even practicing good medicine.  If someone teaches you how to do something, and it's wrong/outdated, how would you know?  You wouldn't, unless you worked with someone who is credentialed, knows their stuff, and is willing to teach.

3. "Not all credentialed techs are good at their job."No, they aren't.  And not all hairdressers are, either.  And not all RNs, EMTs, etc.  As with any job and education, you get out of it what you put into it.  You don't get to float along on your credentials forever.  Focusing only on the negative is a good way to be ignored due to the vast majority of credentialed techs being awesome at their jobs, and working around people who don't always know what they're doing.  Not only that, but we have to wade through a lot of people who refuse to acknowledge that being a credentialed tech is a worthy career, who dilute the field with ignorance and low pay.  Being a credentialed tech is HARD, which is why a lot of people don't do it.

4. "I know a ton of non-credentialed techs who are amazing at what they do."Awesome.  I do as well!  Most of my professional friends are non-credentialed, and I love them.  Heck, I taught them all something at some point because I am a firm believer in everyone being edumacated - and they've shown me stuff, too!  It isn't education OR experience....it's a combination of both.  You cannot have education alone, nor can you have experience alone.  Well, you can, but you won't get far.  At least with education, you're starting out far ahead of those who don't have education.  And you can always gain experience just like everyone else.

My biggest concern with non-credentialed veterinary professionals calling themselves vet techs is that it cheapens the title, and cheapens what we do.....and it's DANGEROUS.  Maybe not as much with those specific people who have lots of experience, but if we lump all the non-credentialed people together who call themselves techs......I shudder to think how many deaths could be prevented.  I can guarantee that animals have died because of those who refuse to admit that an education should be required for any medical professional.

If someone who has been in the field either  just a day or 16 years calls themselves a vet tech, it dilutes the field into a bunch of candy stripers who want the title.  They want to be considered as badass as the licensed vet tech who spent the time, energy, and money to become the most knowledgeable at what they do, and be a patient advocate.

If a non-credentialed professional wants to be called a vet tech, they can go to school, get their degree, and take the national exam.  BOOM.  Instant vet tech.  If they're as good as they seem to be or say they are, school will be a breeze and they'll ace all their classes.  Except they won't, because they're just a badass in whatever practice they've been in, and they will have to learn the national/global standards of care.  It's scary, and it will be difficult.  So they choose to abuse the title Vet Tech instead, and kvetch that it isn't fair that they can't use it.

http://belrea.edu/blog/vet-vet-tech-or-assistant/

The bottom line here is that, if you actually value Veterinary Technicians, if you value the pets that come to the clinic/hospital for care, and if you value patient care over all else (including your ego), you would promote all Vet Techs going to school and requiring a degree and license to practice.

Put your own feelings towards what you've accomplished aside.  I don't give a heck if you've been in the field 3, 5, 10, 20 years.  Look at it from the perspective of the owner and the pet.  Do you want your kids or yourself to be assessed and triaged by a kid off the street, or do you want your furbaby....your child.....yourself....to be in the arms of a licensed professional who is legally bound to stringent standards?

Veterinary Medicine is moving towards an excellent goal - to have credentialed Vet Techs.  And NAVTA is once again striving to change our title to Veterinary Nurse.  I approve this change, and I approve the use of the term veterinary assistant for anyone who is not a credentialed Vet Tech/Nurse.  Because gosh darn it, I did my time in school, I am still paying my dues, I am abiding by the Vet Tech Oath and the NAVTA Code of Ethics.  I hold myself to a higher standard, and I hold my peers to the same standard.  Without striving for excellence, there is no reason to be a Vet Tech.  And refusing to acknowledge excellence, credentials, and standards for Vet Techs, we all lose.

There is nothing wrong with being a veterinary assistant.  Nothing.  So please stop saying you're a vet tech and you're just as good.  This cheapens it for everyone, for the sake of your pride.  Stop it.

About me:
I graduated from Bel-Rea in December 2001, have been a credentialed Vet Tech since January 2002, and began working in a veterinary facility in August 2001.  I taught Veterinary Technology for 18 months from early 2009 - mid 2010.  I have 1 year GP experience (fresh outta school), 2 years Internal Medicine experience, and 12 years Emergency and Critical Care experience with an emphasis in anesthesia.  My goal is to one day hold my VTS (ECC) and maybe more.  If I go a shift without learning something, it is a day wasted.  If I go a shift without teaching someone something, it is a day wasted.

Hind sight....

Lost memory that came to me today....
When I was freshly engaged, the ex and I went to an Engaged Encounter weekend, which is something the Catholic Church makes you do as a team building and future planning thing.  It's a good thing.

Well, I had packed us to go because the ex procrastinated till I ended up doing it for both of us, after I'd driven down to Denver from Greeley, picked him up, and drove to CoSprings by 5pm.  Turns out I'd only brought one comforter for sleeping, and a sheet that was pretty thin.  The ex told me that, because I'd not packed another blanket, that he got the comforter and I had to deal with the sheet.  In November. In a drafty Catholic school room. For two nights in a row.  I froze my ass off, got no sleep, and was miserable the entire weekend.  And that's when I should have known that he was an asshole.

But no, I blamed myself for it.  Despite him not packing anything or even caring about the weekend.  He bitched the whole time.  And I'm the one that had to freeze. 

Funny thing, the classroom that the women slept in was on the third floor and full of drafty windows.  The room the men slept in was an internal room with two small windows that was not remotely drafty.  So he could have dealt with the sheet just fine....but to prove a point, he didn't.

I was so blind.  Whether by choice or not. 

Can't Make This Shit Up

This conversation actually happened on January 22, 2016.

From the "you can't make this up" category. I seriously thought I was being punked....

Phone rings....
Me: Good evening, (clinic name), how may i help you?
Girl: hi, so I just got a puppy and haven't gotten it the shots yet or anything...
Me: (thinking oh crud, parvo, poor dear) OK, what's going on with your sweet puppy?
Girl: so it pooped on the floor and I didn't see it and I dropped my earphones into it and didn't really notice...
Me: OK...
Girl: and then I put them in my ears and am I going to get HIV? Or something?
Me: .......
Girl: I just don't know what to do.
Me: well, you won't get HIV from your puppy, and there are precious few communicable diseases you can get from his poop. I recommend cleaning out your ear and your headphones and you should be good to go.

She wouldn't let go. I had to talk her down about zoonotic diseases and ear infections. I told her to talk to her MD if she gets sick....wow.

So here's the deal.  You cannot get Human Immunodeficiency Virus from a dog.  They don't carry it, they aren't hosts or vectors.  It.  Won't.  Happen.  In fact, unless your dog has pinworms or giargia or coccidia and you touch the feces and then touch your mouth, there isn't anything you can get from your dog's feces.

Survival Mode

I've been in survival mode for a few days

Had a chain of anxiety attacks earlier this week that I am struggling to recover from

Like a blister I protect myself

Haven't listened to the radio for three days too much stimulation to my ears

Haven't eaten without vomiting it all back up in 50 hours

Haven't tried to contact my Man in 36 hours because I want Him so badly to help but I can't bear to be disappointed so I don't try

I sealed myself into a container with fiber fill fluff and put myself on a shelf

Heading to work with a sandwich sitting in my stomach like a cold lead ingot

I need to vomit this is so uncomfortable

I will overcompensate with manufactured happiness

Until I heal

Could be weeks

Emotional exhaustion just sleep it away

At least I'm numb