Empowered Technician, Healthy Practice

An Interview with Tasha McNerney, CVT, CVPP, VTS (Anesthesia and Analgesia), on Central Line: The AAHA Podcast

Hosted by Katie Berlin, DVM

Almost anyone who has spent any time in a busy practice would agree that veterinary technicians aren’t afraid of hard work. So why is it so hard to find and keep technicians?

In a conversation made possible with support from CareCredit, Tasha McNerney, BS, CVT, CVPP, VTS (Anesthesia and Analgesia), offered her thoughts on the ways our people and our practices thrive when we stop underestimating and underutilizing our credentialed technicians—and gives advice for techs struggling to speak up for themselves and their considerable skills and education.

Katie Berlin: You’ve done a lot of teaching about pain, and, as a technician specialist, you have a lot of qualifications and experience. But do you find that people approach you differently or are sometimes less receptive because you’re a technician?

Tasha McNerney: I will say that it depends on the culture of the practice that I go into.

I don’t have a problem being a little bit intimidating for good patient care, especially when it comes to pain management and analgesia. My job is to advocate for that patient if I see that that patient is suffering, stressed, and so on.

Some technicians are working in clinics where the technicians do not feel that they can go to the clinician or even offer a disagreement. I’m not talking about going up to your clinician and saying, “Hey, you gave this dog this and that’s wrong.” Of course, how we approach things is going to help our cause.

But at the same time, you need a culture within your practice [where] if a kennel technician is feeding the animal and notices they didn’t eat two of their meals, I want that kennel technician to feel like they can come to me and say, “Hey, I think the drugs this patient is on are making them nauseous. They don’t want to eat. What can we do about it?” I want everyone in that clinic who is spending time with that animal to feel like they have ownership in the management of that case and can go to the clinician with these concerns and have a conversation. We have to take the ego out of it.

To make and instill change, it really has to come from the top, where the management of the hospital and the clinicians are in agreement that this is where we want to go. We want to have the best pain management protocols and have everyone involved, and we want everybody to be proud of our patient care and our pain management.

Ultimately, you can make little changes here and there, but if you don’t have buy-in from the very top, it is going to be an uphill battle, and probably very frustrating.

KB: Every vet clinic I know is having trouble hiring and retaining staff members, and I have to think this is something you see as related to that. Would that be fair to say?

TM: One hundred percent. We have a lot of information out there to tell us, especially when it comes to technicians and assistants—it is not all about money. Technicians, especially certified veterinary technicians who went through an accredited program, who put the work in and put the time in and they want this to be their career, they want to use those skills. They want to be really fully utilized.

I stayed at [one general practice] for 15 years. I stayed after I got my CVPP, after I became a VTS. I stayed there because I was so fully utilized, and I got to use my brain and my skills so much every day. I was never bored, and I think that that practice still today does not have a very high turnover. This practice has figured out that if they really fully utilize the technicians, not only do the technicians enjoy their work, but also it makes it better overall for patient care. The overall practice efficiency is better, which means, guess what? The overall practice profitability and Yelp reviews are better.

I think part of it is some of the veterinarians don’t understand all that a certified veterinary technician can bring to the table. [Everyone who] went through vet school worked with really badass techs who just ran everything. If you had a difficult intubation, they were there to help you with it. Technicians have these really advanced skills that you could be utilizing in your general practice.

I worked with a clinician who saw that I was interested in anesthesia, and he said, “Hey, I see you have an interest in anesthesia. Would you want to be our technician point person for that?” And he sent me to anesthesia CE, and that really got me going in anesthesia and surgery and pain management and all of that. It was just having that mentor and having somebody say, “Hey, I see you’re interested in this. How can we help you flourish within that, and bring it, and make it even better at the practice?”

That kind of stuff is huge for technicians. They want to be fully utilized, and most of the time when technicians leave practice, it is because they are feeling stagnant. They’re feeling like they’re not learning anything. They don’t have any place to advance in their career. So not only is it going to be in the best interest of the practice [to utilize your techs] and you’re going to retain your technicians even longer, but the patient care efficiency and ultimately profitability is going to go up for your clinic. Utilize your technicians to the fullest extent.

KB: I know I’ve been guilty as a vet of feeling like I didn’t want to burden them with these things and saying, “Well, okay, I know I’m getting paid more than they are, and I can stay late and do my records. I’m going to get this done so that they don’t have to worry about it.” And working at a hospital with . . . I think we had 13 CVTs? It was insane how much could get done without me even there. And they could do it faster and better, and I could get my charts done.

They really thrived on being able to use those skills that they worked so hard to get, and I realized how much I had been laboring under that false belief in my mind that I was sort of foisting my work off on other people, when, in fact, it wasn’t my work. It was their work, and I’d just been doing it this whole time.

TM: Yes, yes. Let us do our jobs. Man, we want to utilize the skills that we have worked really hard for. And I think some of it may come down to simply that some clinicians don’t know exactly what a technician can [legally] do. So look into some of the practice laws or practice acts in your state because every state is a little bit different.

In Pennsylvania, once my clinician felt like he had seen enough to know I was capable, if we had a simple laceration repair or a urethral obstruction cat, we went over the anesthetic plan, we went over the estimate. Once everything was signed off, the patient pretty much got turned over to me as the technician.

So it was me as a technician and an assistant. We would sedate the patient. I would do the unblocking of the cat or the simple laceration repair. Think about it from the clinician’s perspective: He comes in, checks over everything, hands it over to me, the assistant and myself are doing it, monitoring the anesthesia, performing the tasks. And then when the patient is starting to recover, he comes in, does another exam, I’m the one writing up the discharge instructions, the assistant and I are filling the medications to go home and communicating with the client, and then at discharge, my clinician is talking with the client. So it really is a team effort. The clinician cannot and should not be doing everything.

KB: That is a disease, I think, that a lot of us have. We feel like we have to do everything and be everywhere, and then we get burned out and tired but we are taking all of that on ourselves.

Let’s use pain management as an example. Can you talk about how you would recommend a hospital use, say, somebody from the front office team and somebody from the technician team to sort of bolster that workflow and change it up a little bit, so that the whole team is involved?

TM: Yeah. I think it’s really important to have the whole team involved. One person can’t be the pain police for the entire practice and have a hand on every single patient that comes in. Just put it out there to your staff. “Hey, who’s interested in pain management? I want one technician representative, I want one kennel attendant representative, I want one clinician, and I want you to form a little task force on pain management.” This could be the practice manager talking, or the medical director. “I want you to talk about what do you think about instituting the Colorado State pain scoring here. How can we get everybody on board with that?”

And if everybody has a seat at that table to make the decisions, the buy-in is going to be greater.

We don’t want to just have these four task members, and then everybody else in the dark. You’re going to say, “Hey, at the staff meeting, the Pain Management Task Force is going to talk about some of the new things that we’re going to be rolling out. And we need your help with it. So if you have any ideas, let us know. Or if you want to try the Glasgow short form pain scoring instead of the Colorado, let’s talk about it as a group.”

[That way] they feel like they have some ownership in it. I think it doesn’t work if it’s just a memo from the medical director saying, “Hey, we’re going to start instituting pain scoring. Here’s a link to the pain score. We want you to do it.”

KB: I want to switch it up and think about what it would be like if you’re a CVT or an RVT or LVT and you’re in a practice where you feel you’re not utilized. You feel like your skills aren’t being used and you’re not being challenged. This is really a crucial conversation, the need to have a difficult conversation with somebody in management about what you’re not happy with at your job.

What can somebody like that do tomorrow to try to start investigating whether that situation can be changed and made better?

TM: I hear this a lot from technicians. They write to me or we talk in a practice, and they have asked if they could start doing CRIs or local blocks, and they kind of got shut down. And guess what? This job market right now—they’re looking elsewhere. They’re going to find some place that’s going to let them do those epidurals, or let them work on their VTS, or really foster their growth.

If your practice isn’t fostering growth, you’re going to be losing technicians. I don’t ever tell technicians, “Go in guns blazing and just quit your job.” Everybody in the practice has good intentions. I think the intent is good. Oftentimes, the execution is not. And that’s because sometimes management just doesn’t have the training tools.

If you have to go talk to management about something, [think about] whether you want to be thought of as nice or if you want to be kind. [There can be better outcomes] if we can get away from just being nice for the sake of being nice, saying what the other person wants to hear, and instead be kind. The kind thing for me as a technician is to go to my superior and say, “Hey, I’m not being utilized and I really want to do this with my career, and if that’s something that this practice cannot do, I totally understand, but I’m probably going to look elsewhere.”

That is a kind conversation to have. The “nice” thing to say would be, like, “Oh yeah, everything’s great,” and then the next day I give my notice. We don’t want that. We want people to say, “Hey, this is what’s happening. How can we fix it? And if we can’t fix it, maybe this isn’t the place for me.”

If I want to be further utilized, I have to advocate for myself and say, “Hey, I’ve had this training. I’ve done an epidural before. Let me try it with you and maybe we can work on it.” And if they’re really resistant to it and you’re not getting anywhere. . . . I never encourage people to quit their job, but at the same time, if you really aren’t being fulfilled, and that work doesn’t light you up in the same way you did when you were graduating tech school or vet school, find work that does.

KB: So have that difficult conversation, because you never know what’s going to come out of it, but don’t be afraid to look for a better situation if the one you’re in doesn’t seem like it’s going to change. It does seem fair to give that situation a chance, especially if you like other aspects of where you are. It never hurts to ask, especially if you do it in a clear and not accusing way.

TM: One hundred percent. This is not just a technician issue. It is about working together with the management or the hospital administrators to not only have a fulfilling workday, but also provide the level of patient care that you want to provide. You’re not going to go home at the end of every day thinking, “Oh my gosh, sunshine, sparkles, rainbows. This is the best.” But the majority of your days should be like that, and if the majority of your days are not lighting you up and you’re not proud of the work that you do and excited about it, then, yeah, I think you have to have a conversation with your management, and if it’s not going to be the place for you, that’s okay. Right? That’s okay. It is what it is, and if you have to move on, move on in the best way possible.

This episode was made possible with generous support from CareCredit.

Catch a new episode of Central Line: The AAHA Podcast every Tuesday on all major podcast platforms, YouTube, and aaha.org.podcast. Send us feedback or questions anytime at [email protected]. Find all of AAHA’s most up-to-date Guidelines, including resources for your clients and team, at aaha.org/guidelines. 

I want everyone in that clinic who is spending time with that animal to feel like they have ownership in the management of that case and can go to the clinician with these concerns and have a conversation. We have to take the ego out of it.

Katie Berlin, DVM, CVA, is AAHA’s Veterinary Content Strategist.

 

Tasha McNerney, BS, CVT, CVPP, VTS (Anesthesia and Analgesia), is a certified veterinary technician from Glenside, Pennsylvania. She is also a certified veterinary pain practitioner and works closely with the IVAPM to educate the public about animal pain awareness. McNerney has authored numerous articles on anesthesia and analgesia topics for veterinary professionals and pet owners.

Photo credits: Slavica/E+ via Getty Images