RVT, VTS (ECC, Anesthesia & Analgesia)
Harold is a veterinary practice educational consultant and former manager of the emergency and critical care service at the UC Davis Veterinary Medical Teaching Hospital. He is a co-founder of the Academy of Veterinary Emergency and Critical Care Technicians, a charter member of the Academy of Veterinary Technicians in Anesthesia and Analgesia, and the past president of the Veterinary Emergency and Critical Care Society. He currently serves as President-elect on the Board of Directors for the NAVC. In addition, he is a Member-at-Large of the Board of Directors for the National Association of Veterinary Technicians in America. He has spoken at events in 12 countries and has published several book chapters and journal articles.Read Articles Written by Harold Davis
If you want to know your past, look into your present conditions. If you want to know your future, look into your present actions. —Chinese proverb
I recently returned from the 2016 NAVC (North American Veterinary Community) Conference, where the theme for this year was “What Moves You?” I reflected on this theme and thought about what moves me. I considered my career over the past few decades, the role of veterinary technicians, and the changes I have witnessed in the profession.
During my time as a veterinary technician (formerly called animal health technician [AHT]), I have seen many changes. The original American Veterinary Medical Association (AVMA) terminology for a veterinary technician was animal technician. In 1965 the AVMA Executive Board decided not to allow the use of the adjective veterinary with the nouns technician or assistant. The article “What’s in a Name?” appeared in the May 1968 issue of Modern Veterinary Practice. It discussed various terms to describe veterinary technicians, such as animal hospital nurse, animal hospital technologist, and nonprofessional assistant. Does this debate sound familiar? We are currently having a similar discussion—should we be called veterinary nurses? Then and now, the topic sparked debate and was controversial. It was not until 1989 that the AVMA approved the use of the term veterinary technician.
One of the ways veterinary technicians have been able to keep abreast of the latest in professional and medical advancements is through professional journals. The first journal published in North America for AHTs, Methods: The Journal for Animal Health Technicians, debuted in 1976. It was published by an AHT for AHTs. It was followed in 1980 by Compendium on Continuing Education for the Animal Health Technician (eventually renamed Veterinary Technician). Neither of those journals is still in print, but articles from the January 2005 to August 2013 issues of Veterinary Technician may be found on VetFolio.com (vetfolio.com/veterinary-technician-archives). Fortunately, two publications for veterinary technicians are currently available: Today’s Veterinary Nurse (published by the NAVC; todaysveterinarynurse.com) and NAVTA Journal, published by the National Association of Veterinary Technicians in America (NAVTA). Both journals have veterinary technicians as editors in chief.
When I started in the profession, technician utilization was a major issue. Technicians believed their skills were not being used to the fullest, and many states were struggling to determine what tasks AHTs and veterinary assistants would be allowed to perform. The discussion about veterinary technician utilization continues today. Working in a small animal practice was—and still is—a challenge for technicians. While we may be seeing some of the same types of medical conditions today that we saw back when I started, our understanding of the disease process has advanced. This advancement carries over into how we think and provide nursing care to our patients. It is important for veterinary technicians to have critical thinking skills as well as hands-on technical skills. Critical thinking is not innate; fortunately, it is being emphasized in veterinary technology curricula. Looking back, the highlight of my day was holding an animal for the veterinarian for catheter placement or tracheal intubation; both tasks are now routinely performed by veterinary technicians.
Advances in Products and Technology
Technologically speaking, great strides have been made since I started in this profession. Back then, in-hospital laboratory tests were limited. Leukocyte counts were obtained using a hemocytometer and Unopette system. If you were fortunate, your practice had an electronic cell counter, such as the Clay Adams Accu-Stat Blood Cell Counter or a Coulter counter. The dipstick or test strip method (e.g., Azostix, which is still used today, or the Urograph/Bun-O-Graph, which used chromatographic techniques to estimate blood urea nitrogen) was widely used. Blood chemistry analyzers included liquid reagent instrument-based units (e.g., the Mallinckrodt Serometer, the IL Clinicard, a spectrophotometer), which used the principles of photometry to perform the analysis. Today, dry chemistry units (e.g., Heska’s Element system, Abaxis VetScan, Idexx Catalyst) are common.
Sodium thiamylal (Surital or Bio-Tal), a thiobarbiturate, was a common anesthetic induction agent 25 years ago. Intramuscular ketamine–diazepam, acepromazine, or xylazine was used as an induction agent in cats. Methoxyflurane was on the way out as an inhalation agent, and halothane was becoming more common. We now have a variety of induction agents. Today’s options for inhalation anesthetics include isoflurane and sevoflurane.
Patient anesthetic monitoring focused on vital signs, eye position,jaw tone, and the use of cardiamps and respiratory/apnea monitors. The cardiamp was essentially an amplifier attached to an esophageal stethoscope, allowing heart and breath sounds to be heard without an earpiece. Respiratory/apnea monitors beeped when the patient took a breath and sounded an alarm if the patient became apneic. Blood pressure monitoring was essentially limited to teaching hospitals. Today, we have a great deal more in our anesthetic monitoring armamentarium: electrocardiography, capnography, pulse oximetry, arterial blood gas measurements, gas agent monitors, oscillometric or Doppler blood pressure, and thermistor temperature probes.
At one time, imaging was mostly limited to radiography and fluoroscopy. Today, our options include ultrasonography, computed tomography (CT), magnetic resonance imaging (MRI), flexible and rigid endoscopy, and laparoscopy. Technicians often are responsible for operating and/or maintaining this specialized equipment.
Have I dated myself yet?
No one even dreamed of technician specialization when I started as an AHT. We were busy trying to establish our profession. In 1994, NAVTA created the Committee on Veterinary Technician Specialties (CVTS). The CVTS was charged with overseeing the development of specialty academies. There was a bit of pushback from the veterinary community. A letter appeared in the September 1994 JAVMA Practitioner Exchange in response to the question, “Is it a good idea to form veterinary technician specialty boards?” It read, “What is the profession coming to? Why would any general practice want a technician who is advanced trained in fluid therapy, anesthesiology or clinical pathology? These are the domains of the veterinarian.”
Ultimately, the first technician academy, the Academy of Veterinary Emergency and Critical Care Technicians (AVECCT), was recognized, and I am proud to have been one of three founding members. We worked closely with NAVTA’s CVTS to develop the process of specialty certification and recognition. I believe our academy has laid the foundation for many others. We were first recognized in 1996, and this year marks our 20th anniversary. Today, there are 12 nationally recognized veterinary technician specialties.
Educational opportunities are better than ever. Whereas only a handful of annual continuing education (CE) meetings were offered years ago, today a major technician CE meeting is held practically every month. Distance learning is another option now available to veterinary technicians. It used to be that veterinarians spoke to technicians at CE meetings; now veterinary technicians are speaking to veterinary technicians at these conferences. Many technicians like me lecture at conferences internationally, enthusiastically sharing knowledge. Likewise, many of us have published journal articles, contributed chapters to textbooks, and edited our own text. The first textbook geared toward AHTs, Animal Hospital Technology—A Textbook for Veterinary Aides, was published in 1971. In 1995, McCurnin’s Clinical Textbook for Veterinary Technicians was published; it is currently in its 8th edition and is perhaps considered the bible for veterinary technicians. Many books are now available for veterinary technicians.
Before 1981, there was no national technician association. Then the North American Veterinary Technician Association (now the National Association of Veterinary Technicians in America) was established. There were, however, numerous strong state and local technician associations, many of which are still in existence today.
Presently, technicians serve on committees of the AVMA and the American Animal Hospital Association, as board members in professional organizations (e.g., the Veterinary Emergency and Critical Care Society, Western Veterinary Conference, and NAVC), and on veterinary medical boards or their subcommittees. This demonstrates that technicians have a voice in our profession. I was delighted to be elected as the first nonveterinarian president of the Veterinary Emergency and Critical Care Society, a 4000-member organization. I am also honored to be a board member for the NAVC, one of 3 veterinary technicians who have served on this board.
At 56 years, we are still a relatively young profession. Looking back, we have come a long way in a short time; however, we still have some growing to do. A name change is still being debated. The profession is investigating a national credentialing process. There are also some rumblings of an advanced-level veterinary technician on par with a physician assistant. There are at least 3 or 4 specialty groups hoping to receive NAVTA recognition as academies.
The issues facing us today are not so different from those of the past. I’m sure these issues will be vigorously debated. It is important to remember that it will take careful listening to all sides, thoughtful planning, and the willingness to find common ground. In the end I believe we all want what is best for our profession; with teamwork, we can achieve it.
What Moves Me
After all my years in the profession, I can’t help but be moved. I have had wonderful opportunities to connect with others who share my interests. I have seen and been a part of the change in our profession. I have helped a lot of patients and their owners. I have contributed to the training of future veterinarians at the number-one school of veterinary medicine in the world, UC Davis. I have had and continue to have the privilege of traveling the world and sharing my knowledge with others. So, what moves me? Being a witness to change, my passion for this profession, the contributions I have made and hope to make, and my enthusiasm to see what the future holds.
Oh, and in case you’re wondering: I celebrated my 40th anniversary as a veterinary technician in February 2016.
I hope I have shared with you a glimpse of the past with an eye to the future.