Trends®

The Veterinary Nurse Initiative: The Crux of the Debate

NAVTA launched its Veterinary Nurse Initiative (VNI) in 2017, with the goal of promoting professional standards for education and expanding career potential for technicians. But the initiative has been somewhat controversial, and much of the VNI debate centers (and stalls) on the word nurse itself, even while VNI proponents say that is not the real focus of the initiative.

Published May 1, 2020

by Roxanne Hawn

VETERINARY PRACTICES IN MANY COMMUNITIES CONTINUE TO EXPERIENCE continue to experience a shortage of credentialed veterinary technicians. A litany of pressures drives experienced technicians into other careers and potentially discourages new people from entering the profession: low wages, low respect and recognition for the education and credentialing required, poor utilization in daily practice, and lack of portability between states. Some practices even offer cash signing bonuses to attract veterinary technicians.

“The shortage is absolutely real,” said Judy Rose Lanier, CVPM, CVA, AAHA learning programs manager. “A lot of credentialed technicians have left the field for lots of reasons. [One reason] is culture. The job is very challenging—physically and mentally and emotionally.”

It’s estimated that the average practicing life for veterinary technicians is around seven years. For comparison’s sake, registered nurses (RNs) often leave the bedside after two years to work in less stressful nursing roles and settings, pursue career growth within human health organizations, or earn advanced nursing degrees or specialty certifications to increase their scope of practice—all of which often allow RNs to make more money and work better hours.

“We all believe that being a veterinary technician is a career choice that should be a long and personally and professionally fulfilling career path,” said AAHA CEO Michael Cavanaugh, DVM, DABVP (Emeritus). “Today, too many educated, credentialed colleagues leave their profession after five to seven years as they are either disillusioned or are not earning enough to continue their career. I see that as tragic. The Veterinary Nurse Initiative aims to also have veterinary technicians working at the ‘top of their degree,’ performing critical tasks and providing excellent client and patient care rather than being a glorified assistant.”

All of this is why the National Association of Veterinary Technicians in America (NAVTA) launched its Veterinary Nurse Initiative (VNI) in 2017. The initiative’s goals include:

Promoting professional standards for education and credentialing in all states
Increasing public recognition through better professional identity and focus on patient safety
Increasing professional recognition by clarifying scope of practice, role, value, and title
Expanding career potential through defined roles and activities

“The goal of the VNI is to really try to fix a lot of those issues,” said Kenichiro Yagi, MS, RVT, VTS (ECC, SAIM), current NAVTA president, cochair of the VNI workgroup, and veterinary education simulation lab manager at Cornell University College of Veterinary Medicine.

The Word Nurse

Much of the VNI debate centers (and stalls) on the word nurse itself. NAVTA’s 2016 survey found that 54% favored nurse, with another 9% undecided. More recent surveys by state-level veterinary technician organizations show growing support—more like 80%.

It’s estimated that the average practicing life for veterinary technicians is around seven years.

However, some inside and outside the profession express concerns that it’s illegal, improper, or inaccurate to say nurse. The American Nurses Association is among the VNI’s opponents.

NAVTA hired the Animal Policy Group to coordinate VNI lobbying efforts. Mark L. Cushing, Animal Policy Group CEO and founder, explained, “Nursing licenses are under the supervision/enforcement of boards of nursing. The authority of these boards only extends to persons licensed under the Nursing Practice Act or Code or persons fraudulently attempting to do so without a license. This act or code applies to human health and human nursing care. This act or code does not govern animal care or veterinary medicine. States divide up responsibility, privileges, and oversight among various healthcare boards: dental, medicine, nursing, veterinary medicine, etc. Each practice act has distinct boundaries.”

So what about title protection for registered nurses? Cushing went on to say, “Nurses have a ‘protected title’ within the scope of the Board of Nursing and Nursing Practice Act or Code. That’s it. No legislature has granted to nurses absolute control over, and ownership of, the term nurse, any more than MDs own or control the use of the term doctor, which is used by 10 or more professions in every state.”

Several degree programs, as well as some veterinary practices and publications in the profession, have already shifted terminology, including Purdue University in Indiana, Harcum College in Pennsylvania, Colby Community College in Kansas, the College of Southern Nevada, and Michigan State University.

“It’s definitely happening, no matter what happens legislatively state to state,” Yagi said about educational institutions making the switch, adding that state boards will have to look at these issues. “It may take a little bit more time to process [a new license for someone with a veterinary nursing degree]. Once they figure it out once, they’ll know they can go ahead and do it. I haven’t heard of anyone who has gotten their license denied. Many veterinary medical boards are now proactively looking at changing their rules to accommodate this.”

For now, AAHA continues to use veterinary technician. “We actually had a discussion about that in the Member Experience Department [which handles AAHA accreditations],” said Lanier. “And as a team, we decided not to, until it becomes an official term.”

Cavanaugh explained that, conceptually, AAHA supports the VNI’s efforts to use the term nurse.

“The challenge is that each state has different rules and regulations. AAHA will continue to recognize credentialed technicians as veterinary technicians,” Cavanaugh said. “Those without credentials will continue to be assistants in our vernacular. Once the ‘official’ change to veterinary nurse occurs, we will quickly adopt the new name.”

“I think in order to move our profession forward in the right direction, we have to have one unified name that has the same scope of practice.”
—HEATHER PRENDERGAST, RVT, CVPM, SPHR

Beyond the Title

“People start focusing on the title so much that they’re forgetting about everything else that we’re trying to do,” said Yagi. “We’ve been spending the past year trying to reframe peoples’ minds on what the initiative really is, and everything else that’s going on.”

Sue Allen, LVT, has been a veterinary technician in Texas since 1981, including when veterinary technicians there tried and failed to switch to the title veterinary nurse. She is not affiliated with the current VNI efforts and said, “I’ve never left the state, and my title has changed four times. We were originally called animal health technicians, then we were veterinary technician registered, then we became registered veterinary technician, and now licensed veterinary technician.”

Other than the title, not much changed. That’s why some argue that efforts should focus on standardizing credential requirements, defining the scope of practice, convincing veterinary practices to allow credentialed veterinary technicians to work to their full potential, and raising public and professional awareness of the role credentialed veterinary technicians play. Some states have or are considering sizable fines ($500–$1,000) for calling noncredentialed staff veterinary technicians.

Allen works as the veterinary technology program director at McLennan Community College, and she is the first and only LVT representative on the Texas Board of Veterinary Medical Examiners. As an educator, Allen focuses on teaching the more than 350 essential skills required in American Veterinary Medical Association–accredited degree programs, getting students hands-on internships with practitioners who use them to their full potential, and preparing graduates to sit for the Veterinary Technician National Exam. Texas requires a score of 75% or above for licensure, which is higher than the 70% required by other states.

Legislative Update

In prior years, the VNI pursued legislation in Georgia, Indiana, and Ohio. In Georgia, things got complicated when a state legislator insisted on revising the Registered Nurse Practice Act, which caused additional ire within the RN community. In Indiana, legislation lost by four votes—more for political reasons than the VNI merits themselves. Work in Ohio is ongoing because it’s a two-year legislative cycle. In 2020, the VNI plans to work in Oklahoma as well.

Members of the VNI workgroup speculate that the profession will see a domino effect once a few states approve legislation. Those early states will likely take longer, but once in place, VNI leadership anticipates things will go faster and easier with other states.

Sometimes, Allen arranges student internships with veterinarians who’ve never worked with a credentialed veterinary technician. She helps them understand how a formal education gives veterinary technicians not just the skills but also the what and why behind everything they do. Once the students and veterinarians with whom they are interning work out any kinks in processes or communications, it’s typically a positive experience that often results in job offers. One practitioner who’d never before had a credentialed technician told Allen, “She has made my life so much easier. . . . I never had that luxury before because I wasn’t comfortable letting a layperson do [this work].”

When that LVT later moved away to be closer to family, the veterinarian asked Allen for leads on someone else to hire, telling her, “I don’t want to work without one again.”

Heather Prendergast, RVT, CVPM, SPHR, director of operations for Encore Vet Group and member of NAVTA’s National Credential Task Force and the VNI’s workgroup, said, “I think what’s important is that in order to advance our profession, the veterinary industry as a whole, is that we do have to start being able to define the difference between veterinary technicians [who] are credentialed and veterinary assistants. And for the longest time, we have used the term veterinary technician for anybody who provides care to the animals. And that has led to such a lack of understanding of what a credentialed veterinary technician does, and it varies by state. We have such confusion. I think in order to move our profession forward in the right direction, we have to have one unified name that has the same scope of practice.”

Ask Yourself

Lanier said, “I think for AAHA members, we’d want them to really think about what is it that they want to come from this.”

Some critics express concerns that the VNI is causing fractures within the profession and that not enough people have had input on the goals and the order in which they’ll be pursued. This is a long process with much still in play at the state and national levels. Whether you agree or disagree with all or parts of the VNI, Yagi hopes everyone with a stake in the future of the profession joins the conversation.

“Our profession must work together to make the field a viable career path that will stop the leak in the bucket full of qualified professional veterinary technicians,” Cavanaugh said.

Voices of Experience

Danielle Glidden, CVT, RN, began working in a veterinary hospital while still in high school. After graduation, she earned a veterinary technician associate degree and CVT licensure. She worked in veterinary medicine for just shy of 10 years, primarily in an ER/critical care setting.

Glidden went back to school to become an RN primarily for financial reasons. She now works full time as an RN and still does per diem CVT shifts with her former veterinary employer.

“I was on the fence about the VNI for some time,” she said. “Now, having worked in both veterinary and nursing fields, I think I would consider myself softly opposed—perhaps hesitant would be a better word—for some very specific reasons.” She went on to explain these reasons:

Bigger problem. “I think the bigger problem, greater than simply a term for the profession, is the actual education of the public on what we do.”

Not the same. “One of the other reasons I have some hesitancy with the VNI is that, having worked as both, veterinary technicians are simply not the same as nurses. While I think each profession is equally important, challenging, and should be equally respected, there are vast differences. As an RN, I manage a patient load, monitor patients for stability or changes in condition, provide medications, and communicate with providers when necessary, which can be a very serious and difficult job. However, there are so many more resources available in the human medical field that are not necessarily available in veterinary medicine.” Glidden went on to explain that veterinary technicians have a greater variety of skills and demands, since they don’t have access to resources such as specialty nurses who only place IVs and central lines, work in surgery, or administer anesthesia. She also pointed out that human hospitals feature social workers and case managers to help families.

No change? “I think to simply call a technician a nurse doesn’t necessarily change the situation technicians face now. It does not increase the education or awareness of the public or the respect for the profession.”

Cheryl Shepard, RVT, RN, was a veterinary technician long before becoming a nurse. She maintains her RVT license and works as an independent contractor in a veterinary hospital and does Doppler blood pressure home visits.

Essentially, Shepard found herself at a crossroads and went back to school to earn a bachelor of science in nursing degree for academic, financial, and physiological reasons. She said, “After nearly 15 years of performing dental procedures on a regular basis (extractions, suturing gum tissue, oral cleanings, X-rays), my hands and neck were and still continue to be very painful and compromised. The daily lifting of heavy animals and long hours standing and working in physically demanding positions certainly took its toll on my body over the years.”

Even with all her experience, Shepard said, “Nursing school was one of the most difficult things I’ve ever done. The level of knowledge that an RN must understand and practice is much more in depth than an RVT. The element of critical thinking is more extensive. There are much higher standards of practice in human medicine, but at the end of the day, RVTs and RNs are still nurses trying to provide the safest and best care to their patients.”

Yes, Shepard supports the VNI. “The role of the RVT is more than just a technician,” she explained. “The RVT is a nurse and closely parallels the role of an RN. I believe that RVTs should get the recognition they deserve, which is a respected title.”

Both Glidden and Shephard said they feel more respected as RNs.

Glidden added, “I have actually been witness, in the human hospital that I work in, to a group of nurses laughing about how technicians want to be called nurses, but when I took a moment to educate them on all of the roles and responsibilities of a veterinary technician, they were quite surprised.”

Roxanne Hawn has been writing about veterinary medicine and pet care for two decades. She is the author of Heart Dog: Surviving the Loss of Your Canine Soul Mate and an award-winning website, Champion of My Heart.