Expanding the Veterinary Nurse/Technician Scope of Practice as a Solution to the Field’s Staffing Shortage

As the veterinary field struggles with the shortage of veterinarians and veterinary nurses, the search for a solution continues. We know that there is no single, ideal solution that will magically fix the situation we are in today. A multipronged approach points toward:

• Encouraging more people to enter the veterinary field
• Retaining talent in the veterinary field
• Maximizing utility and efficiency for those currently in the veterinary field

By finding, keeping, and better utilizing veterinary professionals, we will be able to help more patients and catch up to the demands of veterinary care.

When narrowing our focus on the shortage of veterinarians–the only veterinary team member that is licensed to make a diagnosis or prognosis, prescribe treatment, and perform surgery–delegating some of these functions to a nonveterinarian has been identified as a potential solution.

The idea of midlevel practitioners or advanced practice professionals, who act like human medicine’s physician assistants or nurse practitioners but in the veterinary field, is gaining traction. Educational institutions are creating master’s degrees that aim to elevate the clinical decision-making skills of veterinary nurses. Interest groups are planning lobbying efforts to establish such professionals. Organizations such as the AVMA, NAVTA, and AAVSB are formulating positions and facilitating discussions to evaluate this role’s place and viability in the veterinary field. The debate surrounding the topic can be heated.

Promoting better utilization of veterinary nurses is a largely agreed-upon priority for the veterinary field. It contributes to better patient care, team efficiency, practice profitability, and team retention. What if there was a way to expand the scope of practice of veterinary nurses at a level comfortable enough for the majority of the field?

In California, there currently is a proposal made by the California Veterinary Medical Association that is being considered by the California Veterinary Medical Board to allow Registered Veterinary Technicians (RVTs) to establish a veterinary-client-patient relationship (VCPR) “to administer preventive or prophylactic vaccinations or medications for the control or eradication of apparent or anticipated internal or external parasites … if certain conditions are met.”¹ These conditions include the RVT working under direct supervision of a veterinarian and that there be established written protocols that the RVT follows.

In Arkansas, a law was enacted that allows Veterinary Technician Specialists (VTSs) to enter a “collaborative agreement” with a veterinarian to have an expanded scope of practice.² Under this agreement, a VTS may:

• Establish a preliminary VCPR and have the veterinarian officially establish the VCPR within 15 days of being seen by the VTS.
• Perform induction, maintenance, and monitoring of anesthesia.
• Perform minor dental and surgical procedures, excluding abdominal, thoracic, or orthopedic surgery and neurosurgery.
• Administer a drug or controlled substance to prevent suffering of animals, including euthanasia.
• Perform cardiopulmonary resuscitation, including drug administration and defibrillation.
• Dispense and administer medicine or therapeutic devices.

As of the writing of this article, restrictions by specialty in performance of scope of practice is not defined.

These changes are likely only the beginning of changes that delegate tasks restricted to veterinarians to veterinary nurses. One issue that members of our profession have had with the movement to establish “midlevel practitioners” (aside from the use of the term “midlevel,” which implies a hierarchical relationship going against the author’s personal belief in the veterinary team made of equal peers) is that many proponents are looking to establish the ability for those without a veterinary technology or veterinary nursing degree to go into the profession. Expanding the scope of practice of our profession, like California and Arkansas have, is a step forward in extending our clinical career path. Let’s take these lessons and advocate for the expansion of our scope of practice.