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BONUS: Technician Interviews

Below are interviews with Kenichiro Yagi, MS, RVT, VTS (ECC), (SAIM), and an extended interview with 2020 NAVTA Veterinary Technician of the Year, Dru Mellon, RVT, CVT. Both spoke with freelance writer and former AAHA editor-in-chief Constance Hardesty, MSc.

See Hardesty's other interviews with veterinary technicians who are leading the way in their profession in the October 2021 issue of Trends magazine. 

Click on the link below to listen to an audio interview with Yagi, where he talks about establishing the technician pay scale of $20-$40.50/hour.

AUDIO INTERVIEW with Kenichiro Yagi, MS, RVT, VTS (ECC), (SAIM)

 

Kenichiro Yagi, MS, RVT, VTS (ECC), (SAIM)

Program Director, RECOVER Initiative, Chief Veterinary Nursing Officer, Veterinary Emergency Group

Yagi head shot Photo Courtesy Kenichiro Yagi.jpg“Break out of the four walls of the practice. … Don't be told how to think.”

Constance Hardesty: One initiative that has been especially beneficial for technicians is specialty credentialing. How has specialization in emergency and critical care enhanced your career and personal fulfillment?

Kenichiro Yagi: It's one of the best decisions I've made. Earning the specialty credential let me break out of the four walls of the practice to meet others in the field. There are so many people in our profession with the shared passion to make the world better. That's what keeps me going, and that’s what fulfills me.

CH: You've been quite involved in the Veterinary Nursing Initiative (VNI). The VNI has paused efforts to gain legal recognition for the title veterinary nurse. What now?

KY: The VNI is about more than changing the title. It’s also about standardizing the credential, having a well-protected title, and having a defined scope of practice. While direct legislative activities are on hold, the VNI is very much active in advocating for the profession.

The VNI is also about preventing changes we don't want to see. There have been apprenticeship bills proposed to allow people to become technicians based on experience. We see that as lowering the standards of our profession. With the legislative network that the VNI has established, when bills like that pop up, the national organization can coordinate opposition statements with state organizations.

The VNI has shined a spotlight on our profession’s issues, raised veterinary nurses’ awareness of professional advocacy, and catalyzed efforts towards a better tomorrow.

CH: What’s the difference, really, between a veterinary technician and a veterinary nurse? KY: The term technician is associated with the expertise and the science and technology of what we do. But it implies a task-based way of performing our role.

I consider myself a veterinary nurse because my job puts together the science and technology with critical thinking and clinical judgment. Veterinary nurses are able to assess patients, evaluate their response to treatment, and synthesize nursing care plans in a patient and family-focused manner.

CH: You’ve recently been named chief veterinary nursing officer for a group of 20 emergency practices. It’s a new role in that organization and perhaps the profession. What do you hope to achieve?

KY: My mission is to reimagine emergency veterinary nursing around three pillars. One, to be the paradigm of emergency nursing, which is really about the clinical elevation of our profession. Two, nursing is going to be a lifelong career. Three, to inspire the field of veterinary nursing.

CH: What do you see as the hallmarks of a truly vibrant veterinarian nursing profession, and what work remains done to be done in order to make that a reality?

KY: The hallmarks of a truly vibrant veterinary nursing profession are the level of professional awareness and professional pride.

We need to advocate for ourselves, to create the change that we want to see. That means being organized around the legislative effort, elevating ourselves clinically through evidence-based nursing practice, and owning our own profession to drive change.

CH: What would you say to a veterinary technician who would like to become involved in leadership to advance the profession?

KY: First, break out of the four walls of the practice. See what the profession looks like so you can identify today’s issues.

Don't be told how to think. Come up with your own conclusions and decisions on what needs to change, then work with other people to come up with a common solution.

 

From Dream to Reality: How Technician Credentialing Arrived in Utah

An interview with Dru Mellon, RVT, CVT

GS_Mellon.jpg2020 National Association of Veterinary Technicians in America (NAVTA) Veterinary Technician of the Year, Secretary, Utah Society of Veterinary Technicians and Assistants; veterinary technician, Mountain West Veterinary Specialists, Layton, Utah

Dru Mellon was instrumental in achieving credentialed status for veterinary technicians in Utah. In October 2021, AAHA’s Trends magazine published a version of this interview, edited for clarity and space. Here is the full, uncut and unedited interview.

Constance Hardesty: Just to clarify: In Utah, what distinguishes a veterinary technologist (4-year degree) from a state certified veterinary technician (4-year degree)? Is it primarily the VTNE and CE requirements?

Dru Mellon: Before I get too far in answering this, I just wanted to note that a State Certified Veterinary Technician (CVT) can still have a 2-year degree. With that said, the veterinary technologist designation was created in the Veterinary Practice Act (VPA) well before I moved here. I suspect that this is because BYU used to offer a 4-year veterinary technology program, though that hasn’t existed for years now. I don’t know when that program closed down, but the wording in the VPA probably originates from that.

You are correct that to become a credentialed technician in Utah, one must either apply through the alternate route or graduate from an AVMA-accredited program, and then pass the VTNE. From there they can become certified, and that’s when CE requirements go into effect. However, you are also correct, on paper the two are very similar, with the CVT standing out by having ongoing credentialing requirements.

CH: The Utah regulation does not specify that state-certified veterinary technicians must work under any form of supervision. Am I reading that correctly? I am not criticizing the Utah reg, just want to know whether that is significant or a minor anomaly that will be corrected later.

DM: While I’ve looked at this document many times throughout the amending process, I somehow never realized that they had not clarified the supervision wording in that section. The original bill was specifically written to allow CVTs to work under indirect supervision, giving us more freedom to perform their job than uncredentialed veterinary technicians, who are defined as having to work under direct supervision. So this is an unfortunate oversight.

Looking later on in the VPA, it does kind of address this in section 58-28-502 (“Unprofessional conduct”), part 2) a) ii) where it states that “‘Unprofessional conduct’ does not include ... delegating to a state certified veterinary technician, while under the direct or indirect supervision of a veterinarian licensed under this chapter, patient care and treatment that requires a technical understanding of veterinary medicine if the veterinarian provides written or oral instructions to the state certified veterinary technician”. So, in a roundabout way it notes here that indirect supervision is allowed. But you’re correct, it would have been clearer and more consistent if it had been stated in the section highlighted.

At this point, I do want to be clear what these definitions mean, just so there is no confusion:

‘Immediate supervision’ means that the veterinarian must be physically present while the tasks are being performed, and this level of supervision applies to veterinary assistants.

‘Direct supervision’ means that the veterinarian must be on the premises and available to be physically present as needed, and this applies to uncredentialed veterinary technicians.

‘Indirect supervision’ means that the veterinarian must be available by phone, facetime, etc. As we discussed above, this applies to veterinary technologists and State Certified Veterinary Technicians

Those are all described in ‘Definitions’ section of the VPA, but I just wanted to make sure we’re on the same page when discussing these terms.

CH: How does state certification benefit technicians in their daily work and/or in the bigger picture?

DM: One of my main goals for credentialing in this state was to help veterinary technicians be utilized to their fullest extent, so that we can achieve job satisfaction from getting to perform our jobs to the highest level. Part of this is because I want every technician to be able to feel enriched by the job we do, which we all deserve for choosing to work in such a difficult profession. But the other part is that we lose so many veterinary technicians from the profession to burnout each year, and I wanted to try to give people a reason to stay. 

Alternatively, while credentialing itself isn’t a guarantee of increased pay, it’s my hope that employers will use it as a tool to identify individuals that they should want to hire and retain. A smart employer should offer credentialed techs better wages, just as they would to any employee identified to have additional training, knowledge, and skills. The hospitals where I have worked in Utah do in fact pay their credentialed techs an additional wage increase, along with other benefits such as CE reimbursements and covering the cost of taking the VTNE once, and it’s my hope that all other hospitals everywhere follow suit.

CH: How did the drive to certify technicians get started? What was your inspiration, and what was your first step? How long did the process take from start to finish?

DM: I moved to Utah almost 6 years ago, and I wasn’t sure what to expect when I got here. Coming in, I knew that there was no credentialing here, and we were one of only a couple states remaining with that status. And by the time credentialing was implemented, we were actually the last one standing. Prior to moving here, I had only ever worked in a state with credentialing (California, where I am an RVT). When I arrived, I found that many doctors had a much more guarded level of medical trust with their technicians, and many advanced technician skills were often only handled by veterinarians. Some of my coworkers split their week working at other, more restrictive hospitals; where I’m told technicians weren’t allowed to perform even basic tasks, such as intubation or IV catheter placement.

Personally, I attribute this underutilization of techs to the absence of credentialing, which means a technician’s skill level is solely dependent on the place they had been trained, and this could vary wildly. Even now, when I meet an uncredentialed technician where I work, some come with excellent skill levels and knowledge, while others had worked primarily kennel attendants at their previous job; yet both workplaces still called both individuals veterinary technicians. 

From my prior experience, I knew that the credentialing process empowers technicians with initial knowledge and skills to enter the workplace and contribute more. It allows us to contribute to raising the level of medicine, increase patient care and safety, and perform the tasks we have been trained to do. I believe that if veterinarians dealt with more veterinary technicians that have been more fully trained and educated, then they would be able to trust us to do our jobs. This, in turn, frees them up to do theirs.

That being said, I had no idea how to take the next step towards credentialing in this state. The only thing I could think to do was support the local vet tech population by getting involved with the state association: the Utah Society of Veterinary Technicians and Assistants (USVTA).

One day, as a USVTA board member, I happened to sit in on an online webinar led by a technician mentor of mine from back when I was an intern, Ken Yagi. He was speaking about the Veterinary Nurse Initiative, discussing how they were supporting national standardized credentialing. I message him afterwards and asked what I could do in Utah to help, and he suggested the USVTA develop a relationship with the Utah Veterinary Medical Association (UVMA), because we would be able to accomplish more together with them than without.

In February of 2018, I reached out to the UVMA, and they allowed me to attend their quarterly board meeting that month as a USVTA representative. From day one, they welcomed us with open arms, and at the end of that first meeting, one of their board members raised the question why Utah didn’t have credentialing for technicians. I was happy to discuss the topic and make my case for it, and I consider that meeting the first real step to accomplishing technician credentialing in Utah.

Throughout it all, the UVMA was a hugely supportive partner, without whom we would still be in the earliest stages of the process. From that meeting to the moment that DOPL’s veterinary technician credentialing section went live in October 2020, it took 2 years and 8 months to achieve credentialing in Utah, which is a breakneck pace for such a complicated, lengthy process.

CH: Please briefly describe the major steps in the process of convincing the DOPL to certify technicians. (So others have an idea what's involved.)

DM: The Division of Occupational and Professional Licensing (DOPL) is not a governing body, so they just apply the laws as they are written. In order to implement veterinary technician credentialing, the Veterinary Practice Act had to be amended, which (like Schoolhouse Rock taught me) required a bill to be passed through both houses of the state legislature and then signed by the governor. This is a tall order, because for this to happen, you first need a either a state representative or state senator who will sponsor and draft a bill, and that’s a complicated relationship to initiate and develop.

We were incredibly fortunate in Utah, because as I mentioned earlier, the UVMA is very supportive of their veterinary technicians. After lengthy discussions with them explaining what the USVTA wanted credentialing to look like, they were on board and willing to back us on the topic. Luckily, the UVMA had hired a policy analyst the year before to help them with a legislative issue, and they had made political inroads from that. Through these connections, they were able to help us find a receptive legislator willing to sponsor the bill.

However, that was just the first step of many; as you saw, there was a lengthy questionnaire that had to be filled out before his office could begin to create a draft of it. And then there were committee hearings that I had to take time off from work in order to attend, hearings where I had to answer detailed questions from the representatives on the committee about the questionnaire, about what credentialing looks like elsewhere, and about why I even thought it was needed in the first place. 

Once the bill passed through committee, it still had to finish being drafted, go through the legislature, and then be signed into law; all of which was completely out of my hands. The only thing I could do then was log onto the government website and anxiously watch for those events to show as completed, which they finally did during the final week of the legislative session.

CH: What was most challenging or difficult about the process and how did you handle it?

DM: The most personally challenging aspect of all of this for me is the fact that I suffer from social anxiety. From joining the USVTA’s board, to attending UVMA board meetings and introducing myself to a group of veterinarians that represent the entire state, to speaking before congressional committees (some of whose members do not believe in creating more restrictive legislation); the whole process was an exercise in fighting back my screaming brain and ignoring my wrenching guts so I could stand up for my fellow technicians.

This peaked in the moment when, at the first congressional committee meeting, I saw that the committee was on the verge of rejecting the bill, preventing it from going to the House floor for a vote. The initial version of the bill was planned to be more restrictive than what was ultimately implemented; at the time, the goal was to create full licensure, which would create title protection and a limited scope of work, which restricts certain tasks only to credentialed technicians. The majority of the committee was already opposed to creating more restrictive laws in general, and they specifically worried this would prevent some veterinary practices (particularly rural ones without credentialed staff) from being able to work.

The bill was on the chopping block, and I saw the entire effort slipping through my fingers. But at the last moment, one committee member suggested we pursue state certification instead rather than full licensure. By Utah legal definitions, this creates an elevated position within a profession without restrictions on others working within it. Everyone looked at me immediately for an answer, and the choice was in my hands. I had seconds to decide: either insist on full licensure and see the bill killed in committee (with no promise we would have another opportunity any time soon), or accept the compromise of certification. As everyone knows now, I accepted the compromise; but the anxiety of that decision has never left my shoulders.

CH: I found the DOPL questionnaire you completed, with about 50 questions. (https://le.utah.gov/interim/2020/pdf/00001922.pdf). Who answered the questions?

DM: That questionnaire was required by the legislature for the bill to be drafted. Answering it was a group effort that included the UVMA executive director, the UVMA’s policy analyst, the USVTA president (Michiko Berceau), and myself. There were many late-night phone calls and text chains as we tried to sort out answers to every question so we could submit it in time.

CH: How did USVTA and NAVTA help you work with DOPL? (For example, does NAVTA have a tool to help you answer the state's questions?

DM: At the time, the USVTA’s executive board consisted of myself and two others, so we did what we could, but our resources were (and continue to be) limited to what files we had on our computers and in our emails, or what we could find with a search online. 

NAVTA and the VNI were invaluable resources, and by the time we worked on the questionnaire, they had already equipped me with a wealth of answers to countless questions. In order to show the UVMA that credentialing was right for Utah technicians, I already had to share with them at great length about what it should look like and how it had worked (or not worked) elsewhere. This left me pre-equipped to answer a great many questions that I faced on that questionnaire and before the congressional committee. Without the constant help and guidance received from the VNI, I would never have had a clue how to answer any of those questions, and it’s only through their support that we were able to get these things right.

CH: Objections often reveal concerns that lead to better solutions. Did you encounter any objections that resulted in improvement?

CH: Recognizing the value of experience, the Utah regulation allows experienced veterinary assistants who pass the VTNE to become certified veterinary technicians. (Do I understand that correctly?) What prompted that? (Not all states allow it.

CH: The Utah regulation allows assistants with about three years’ experience to become state certified technicians by completing the VTNE, among other requirements. Other states don't allow that. Please talk a bit about why you included that in the regulation.

DM: (I’ll answer these three together, as I feel the answer to the first ties directly into the answer of latter two, both of which are very similar.)

In the initial discussions about credentialing in Utah, the number one concern that we heard was no one wanted to disenfranchise existing, uncredentialed veterinary technicians, all of whom had been legally working in the state up until now. This came up both when talking to technicians and also to veterinarians, who particularly wanted to protect the vet techs working with them. 

Mellon at statehouse Photo courtesy of Tammy Mellon.jpgWe had no desire to take away anyone’s job, or to chase anyone out of this profession; so the solution that made the most sense to the USVTA was to ensure the existence of an ‘Alternate Route’, or what some like to call ‘grandfathering’. This creates a pathway to credentialing wherein working technicians with years of experience can still become credentialed. We felt that requiring these individuals to still pass the VTNE was an acceptably high bar, given the difficulty of the test.

This Alternate Route was not a provision specifically written into the bill, but there is wording in section 58-29-309, under 2) e) that allows for credentialing if “the applicant meets other criteria determined by division rule in consultation with the board”. Technically, this is incredibly vague and allows DOPL a huge amount of leeway, and we had some reservations about that wording, but once the bill was drafted there is unfortunately little that we can do to change it. In the end, we were happy to see that DOPL only used it to create the Alternate Route.

Upon the creation of credentialing, many other states also started off with a similar Alternate Route; but in almost every case, each version has eventually been closed down. To my understanding, the handful that remain either have a sundown clause for when they will end or there are talks about enacting one. At this time, there is no such clause in Utah. I asked about this at a recent DOPL meeting, and they have indicated that they will consider it if more brick-and-mortar technician programs become available. Right now, only one such program exists in the entire state and, despite the existence of online programs, DOPL worries that this will be too restrictive for people that want to enter the profession. Until more physical locations become available, they have decided to keep this route open. 

CH: Any lessons learned?

DM: It takes a community for something like this to happen. Some people try to congratulate me personally for getting technician credentialing to happen Utah. But I didn’t! When I joined up with the USVTA, Michiko Berceau had been driving the organization forward for years without me. And she was just one of multiple people who took it upon themselves to work together to create it years before. Without them, where would I have been? I certainly couldn’t have accomplished anything like this by myself.

And then, after joining the USVTA, it took Ken Yagi to provide the information and contacts I needed within NAVTA and the VNI. Without the wealth of information they continuously shared with us, I would never have known what to ask for or avoid when it came to creating credentialing guidelines. When the UVMA asked us what we wanted credentialing to look like, I wouldn’t have had an intelligent answer to give them.

Speaking of the UVMA, when I talk to technicians from other states, some of them tell me about their strained relationship with their state’s VMA, and my heart breaks for them. In Utah, we’re exceedingly fortunate to have a champion for veterinary technicians in the UVMA. Without their support, the conversation about credentialing could have stalled within the USVTA. If it wasn’t for their help, we’d still be knocking on doors at the state legislature to find a sponsor. Furthermore, one of the things the congressional committee loved was that the UVMA and USVTA came forward together to support this. Without their support, even if a bill gets drafted, does it pass through the committee without them? I honestly don’t know.

It took the strength and passion of the entire veterinary community for credentialing to happen in Utah, and I know that none of the credit is mine. This is an accomplishment for and by all of us.

CH: What’s next for you? Do you see other opportunities to advance the profession?

DM: Personally, my sights are still set on Utah’s veterinary technicians. Right now, I want to see more Utah technicians take advantage of the credentialing opportunity that has been given to us. But in the future, I’d like to see us get full licensure, creating title protection and a limited scope of work. And someday I’d like to see a veterinary technician on the veterinary licensing board at DOPL. To accomplish either of those means new amendments to the VPA, which means going back through this whole process again in the future. But hopefully, at that point I’ll have passed the torch on to someone else.

When I look nationally, I continue to keep a close eye on the VNI, who is actively contributing towards credentialing legislation in multiple other states. I’ve spoken with other state associations who are trying to go through a similar process to Utah, and I’m excited for their success.

CH: What advice do you offer to other technicians who would like to advance the profession?

Become a member of your professional organization and get involved! Sometimes it’s easy to think organizations like the USVTA or NAVTA are some sort of monolith with endless resources and people behind them, but these groups are truly only as strong as their members. The USVTA struggles to maintain a full executive board year after year, and membership fees are our primary source of funding. A single person can make a huge difference! We try to offer benefits like CE to our members, but RACE-providership is expensive. Trying to pivot to keeping things running and offering online CE during a pandemic has only made things harder. 

I’m reminded of a time when I was speaking to a Student Chapter of NAVTA at a technician program, and a student asked what they get in exchange for their membership fees. I tried to describe those things above to them, but they walked out before I even finished answering. And honestly I get it, a dollar spent on the USVTA or NAVTA is a dollar no longer available for food or rent or electricity. But what people don’t realize is that if they don’t support these organizations, then they can’t continue to exist. This student was attending an AVMA-accredited program in a state that didn’t have credentialing at the time – I wish I could go back and tell them that membership fees supported the organization instrumental to credentialing to this state! Going back to their dollars, that credentialing brings their professional value up, which hopefully equates into a return on that investment in wages. It’s a hard thing to see because it’s certainly not a short-term gain; but these organizations are invaluable for all of us in the long-term.

 

Photos courtesy of Kenichiro Yagi, Dru Mellon, Tammy Mellon

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