Tech Talk: Leveraging veterinary technician specialists in practice

Bigstock/Rido81 The National Association of Veterinary Technicians in America (NAVTA) Committee on Veterinary Technician Specialties (CVTS) was formed in 1994 and is recognized by the American Veterinary Medical Association (AVMA). This was in response to a growing interest among veterinary technicians to attain a higher level of recognition for advanced knowledge and skills in specific disciplines. The CVTS provides guidelines to veterinary technician organizations to facilitate the formation of a specialty organization. Academies develop advanced pathways, which a candidate must follow and complete to be awarded the designation of Veterinary Technician Specialist (VTS) in their specific discipline. Our profession is growing, expanding, and changing, and it is an exciting time to be a veterinary technician! What is an academy? An academy consists of a group of credentialed veterinary technicians, who have completed a formal process of education, training, experience, and testing to qualify. In other words, to be a member of the Academy, you must be a VTS in that specialty. See “Requirements to become a veterinary technician specialist” sidebar.) Each Academy approves applications, develops, and administers the exam. Links to all the NAVTA-approved VTS Academies are available here. What is a veterinary society? Veterinary societies are not NAVTA-approved Specialty Academies. A society is a group of individuals interested in a specific discipline of veterinary medicine. The only requirement to join is being a veterinary professional interested in that type of veterinary medicine; no testing is required. The Veterinary Emergency and Critical Care Society is an example of this. Membership is open to veterinarians, interns, residents, technicians, students, managers, and administrators. Application fees and cost Additional continuing education specific to the specialty required to apply should be considered, as should the cost of purchasing text and reference books. Application and examination fees vary by academy, but in general, the application fees are around $50, and exam fees are approximately $200. Exams are given once a year, historically at the national conference associated with the specialty, making travel expenses to the exam site the largest financial commitment; however, many Academies now offer a virtually proctored online exam. What’s in it for me? The veterinary profession recognizes technicians who have obtained a VTS as having greater veterinary medical knowledge and having mastered advanced technical skills. Many technicians who have reached VTS status report an increased sense of job satisfaction and an increased level of respect among their colleagues. Some VTSs practice at a very advanced level, managing appointments and cases, working as an extension of the veterinarian once a veterinary/client/patient relationship has been established, presenting their findings, suggesting treatment plans, etc., to a licensed veterinarian for approval. Hospital or department policies, including standing orders drafted collaboratively by veterinarians and VTS, are invaluable. Below are two simple examples of how this can be done within current practice acts. Example 1: The veterinarian diagnoses a patient with diabetes mellitus, creates the initial treatment plan, and prescribes insulin and a therapeutic diet. The VTS: Educates the client on the disease, including the warning signs of crisis Teaches the client how to give insulin injections and how to handle insulin Schedules the pet to be dropped off for a glucose curve The morning of the glucose curve, the client comes to the hospital for a technician appointment, the VTS: Takes a patient history Admits the pet Performs the curve Drafts an updated plan for the veterinarian to review and approve or follows standing orders based on PE and curve When the client comes to pick up the pet, the VTS reviews the updated plan with the client schedules follow-up visits Handles follow-up calls and/or emails Schedules follow-up appointments Manages follow-up appointments following the written hospital protocol/standing orders they worked with the veterinarian to create for diabetic patients. The veterinarian does not need to be consulted unless abnormal findings are not covered in the protocol/standing orders. Example 2: A patient comes in for surgery, the VTS: Reviews the patient record and veterinarian’s notes Performs a physical exam Performs any necessary preordered diagnostics Creates an anesthetic plan, including a recommendation for additional diagnostics if indicated, for the veterinarian to review and approve Once approved, the VTS (performs or delegates and oversees) Premedication of the patient IV catheter placement Induction Surgical prep Arterial catheter placement Performing epidural Monitors the patient during surgery, adjusting the anesthetic gas, fluids, etc., based on the approved anesthetic plan After the surgery, the VTS Recovers the patient Monitors and manages patient pain based on the approved plan Drafts the discharge and follow-up instructions for veterinarian approval or standing orders Reviews instructions with the client at patient discharge Handles follow-up calls and/or emails Manages recheck appointments following the written hospital protocol/standing orders they worked with the veterinarian to create for diabetic patients. The veterinarian does not need to be consulted unless abnormal findings are not covered in the protocol/standing orders. Creating a new role Let’s take it a step further and create a new position on the veterinary health care team that could be implemented without changes to existing veterinary practice acts: the VTS practitioner. The job description could look something like this: A veterinary technician specialist (VTS) practitioner is an independent veterinary health care provider operating as an adjunct to a licensed veterinarian. The VTS practitioner is responsible for handling patient appointments, performing routine examinations, speaking with clients, completing diagnostic tests, treating patients, and coordinating care with a veterinarian and other team members. Independently develops treatment plans and adjustments to current plans, based on patient assessment and diagnostic results, for approval by the attending veterinarian. The VTS practitioner does not diagnose, prognose, prescribe, or perform surgery and cases must always have a valid doctor, patient, client relationship. Responsibilities: Obtain and record detailed patient histories and perform physical examinations and patient observations. Possess all technical skills commensurate with VTS discipline certification. Detailed knowledge and ability to perform advanced imaging studies. Perform basic diagnostic ultrasounds and review findings with a veterinarian for diagnosis. Understand patient diagnostic results and create proposed plans based on results for veterinarian approval. Independently implement approved treatment plans, delegating tasks to other team members as appropriate. Advanced technical procedures, including central line placement, intraosseous catheter placement, and arterial catheterization. Provide professional client and referring veterinarian communication. Work independently and have a desire to lead and train other technicians. Ensure medicine is delivered in compliance with national, state, and local regulations. Demonstrate leadership that fosters a culture of learning and continuous process improvement within the technician/nursing care team. Master detailed record-keeping regarding patient history, condition, treatments, progress and communications. Exceptional knowledge and use of multimodal anesthesia techniques, including CRIs and locoregional blocks, to achieve the safest anesthetic event for the patient. The ability to manage all types of critical care nursing cases while collaborating with staff clinicians to provide the best possible care for the patient from intake through to discharge. The ability to organize and manage cardiopulmonary arrest of a patient while collaborating with the staff clinician to provide care and support to the patient and their owner. Ability to organize, train, and oversee clinical training within the department to ensure the best quality nursing care is performed. Collaborates with medical director and other leaders on medical policy creation, implementation, and enforcement. Provide input with problem-solving efforts for daily operations. Develops constructive and cooperative working relationships across the hospital. Conclusion Obtaining a VTS also opens the way for various professional opportunities; lecturing, running wet labs at veterinary conferences or in veterinary hospitals, writing articles, books, book chapters, operating a consulting business, etc. The most important reason to obtain a VTS is for you! Do it because you want to learn, grow your skills, and have the satisfaction of knowing you have achieved specialty certification and to advance your career. Jamie Rauscher is a licensed veterinary technician at a 24/7 GP/ER practice in Atlanta. She has been at this practice for more than 20 years and is part owner of the practice, as well as the medical manager. She is the current president of NAVTA and the vice president of the Georgia Veterinary Technician and Assistant Association. Her interests include anesthesia, pain management, emergency and critical care, as well as hospice and palliative care. Requirements to become a veterinary technician specialist The specific application requirements vary by Academy. However, the basic requirements for all the specialties include the following: Applicants must be credentialed veterinary technicians for a certain number of years (generally three years or 6,000 hours) prior to beginning the application process; working a specific percentage of their time in the chosen area of specialization. Supporting documentation is required. Applicants must log cases that they have participated in managing and supporting over a one-year period (specific start and submission dates vary by Academy). Generally, 40-50 cases are required. In addition to demonstrating the variety of cases the applicant has worked with during this time, case logs also serve to demonstrate the advanced skills performed by the applicant. Applicants must have had a significant role in these cases. Professional written case reports, generally two to five are required, to demonstrate the applicant’s advanced knowledge of the diseases and patient management. Applicants must have had a significant role in these cases. An advanced technical skills list that must be signed off by a Diplomate, VTS, or in some cases another qualified veterinarian if a specialist is not available (requirements vary by Academy) attesting the applicant has mastered and is proficient in performing. An advanced knowledge list that must be signed off by a Diplomate, VTS, or in some cases another qualified veterinarian if a specialist is not available (requirements vary by Academy) attesting the applicant has demonstrated advance knowledge of the subject. Advanced knowledge and skills lists are created by each Academy and are based on role delineation surveys of veterinary specialists, current VTS members, and other stakeholders within the specialty. A minimum number of CE hours in the specialty, generally 40 to 50 hours. A specific number of potential exam questions, including the correct and three incorrect answers. All questions must be appropriately referenced. Two letters of recommendation from a Diplomate, VTS, or in some cases another qualified veterinarian if a specialist is not available (requirements vary by Academy). Applications are submitted once a year at a date determined by the Academy, have a specific review process, and, if approved, qualify the applicant to take the certification examination. Exams are given once a year at the national conference associated with the specialty. In 2021, NAVTA contracted with a secure remote testing company using facial recognition and exam monitoring using artificial intelligence to record the entire exam process and flag suspicious activities to allow for virtual testing due to the COVID 19 pandemic. Applicants who pass the exam become a VTS. Those who do not pass may take the exam again (usually up to a total of three attempts) without submitting a new application. The VTS must recertify once every five years. Requirements vary, but generally include continuing education in the specialty presented by a specialist, writing articles/books, lecturing, serving on Academy committees or holding an office. These activities are then applied to a point system towards recertification. Retaking the exam, although seldomly used, is also an option to recertify.

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Tech Talk: Leveraging veterinary technician specialists in practice

A look at the requirements for and benefits of this advanced education

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