More details have emerged on how the National Association of Veterinary Technicians in America plans to move forward with its veterinary nurse credential change. NAVTA's board of directors announced May 15 the formation of the Veterinary Nurse Initiative Coalition to pursue legislative changes in all 50 states to establish the credential of registered veterinary nurse. It would replace the titles of registered veterinary technician, licensed veterinary technician, certified veterinary technician, or licensed veterinary medical technician. NAVTA's board approved the action to unite the profession under a single title, set of credentialing requirements, and scope of practice. The coalition is currently defining the legislative strategy and is targeting 2018 for the initial legislative reform efforts to begin in a handful of states.
Through the standardization and public awareness of the registered veterinary nurse credential, the entire profession will make significant strides towards better recognition, mobility, and elevated practice standards. All of this will lead to better patient care and consumer protection."
Kara M. Burns, president-elect, NAVTA
While the full impact of the changes on the veterinary technology profession remains to be seen, what is clear is that simplifying things will be anything but simple. The process could take years of hard, patient work. That said, NAVTA's leaders say much of what they are proposing to change addresses many of veterinary technicians' biggest issues.
"Through the standardization and public awareness of the registered veterinary nurse credential, the entire profession will make significant strides towards better recognition, mobility, and elevated practice standards," said Kara M. Burns, president-elect of NAVTA, in a press release. "All of this will lead to better patient care and consumer protection."
What's in a name?
Veterinary technicians have seen the profession go through many changes over 50 years—including previous title changes from animal technicians and then animal health technicians. Currently, a patchwork exists throughout the United States of varying credentialing requirements, titles, and scopes of practice (see map). For example, 11 states privately credential via their state VMA or veterinary technician association, and in each of those cases, credentialing is not mandatory. Utah is the only state that does not require any credentialing. When it comes to titles, 15 states use RVT, 19 use CVT, 14 use LVT, and only Tennessee uses LVMT.
NAVTA aims to create alignment within the veterinary profession with this initiative, as a unified title will create a national and global standard, according to a NAVTA FAQ. Indeed, Australia and the U.K. already use the title veterinary nurse. Further, "The term ‘Technician' implies an individual has mastered the science and technology involved with the profession. The term 'veterinary nurse' will incorporate the art of caring for our animal patients from a whole picture perspective in addition to the science and technology," according to the FAQ. "In addition, standardization with a title easily recognizable to the public aids in public awareness of our role. In human medicine, the term 'nurse' is widely recognized to describe a group of medical professionals working in collaboration with physicians to treat a patient. The term ‘registered veterinary nurse' will in turn have similar association in the public's eyes."
The scope of practice of a "registered veterinary nurse" is expected to be the same as it is currently for credentialed veterinary technicians. The new title would build from the current system and should not directly affect the amount of education required to qualify for examination or credentialing, according to the FAQ.
The initial suggestion for distinguishing between recipients of associate and bachelor's degrees in veterinary technology is to differentiate the degrees, much like the human nursing field designations RN, BSN, and MSN. For registered veterinary nurses, the proposed credential is RVN for those with associate degrees and BSVN for those with bachelor's degrees. Changing the credentials for veterinary technician specialists could be considered later. Currently they use the designation of VTS (Veterinary Technician Specialist).
What's up for debate is what will happen to veterinary technicians who haven't graduated from a school accredited by the AVMA Committee on Veterinary Technician Education and Activities and passed the Veterinary Technician National Examination.
"There will be a desire, just as human nursing did, to not punish people and reflect their expertise and find means to accommodate them. Having said that, I think NAVTA has been very careful about establishing basic two- and four-year accredited credential requirements," said Mark Cushing, who is a consultant to NAVTA for this initiative.
Cushing is founding partner of the Animal Policy Group, which provides government relations and strategic services for various animal health, veterinary, and educational interests, including Banfield Pet Hospital and Zoetis.
Sights set on state capitols
To tackle this ambitious agenda, NAVTA created the Veterinary Nurse Initiative Coalition to work with the AVMA, American Association of Veterinary State Boards, industry and professional veterinary organizations, and legislators to create common terminology, policies, and procedures "to ease the burden on individual states and associations in governing credentials," according to a NAVTA press release.
A single title and credential throughout the nation is the next step to improve the level of veterinary patient care, align public perceptions of veterinary nurses as they would be called, and bring clarity to the profession of veterinary medicine, according to the National Association of Veterinary Technicians in America.
Cushing will manage the lobbying effort, while Kenichiro Yagi and Heather Prendergast will co-chair the coalition and work with stakeholders. Yagi and Prendergast are registered veterinary technicians in California and New Mexico, respectively.
Cushing commented, "I work on a number of national and regional initiatives that end up before the legislature. It's going to take us time to even get a majority of states on board. State legislatures meet three to five months typically, and some, like Texas, every other year. We want to get this done and get it done right."
The coalition will start with five states in 2018, adapt the models from these states, and then work with legislatures throughout the U.S. The target state legislatures convene in January 2018, so the coalition will start to lay the groundwork in the third quarter of this year. They will not only work closely with veterinary stakeholders but also reach out to human nursing associations and schools to make it clear how the RVN credential will operate.
According to the American Nurses Association, at least 39 states have language in their Nurse Practice Act that either explicitly restricts use of the title "nurse" to those who are licensed or implicitly restricts use of any words implying someone is a licensed nurse.
"Whether or not nurses will get involved with the states where they have no claim to the name but want to use their political capital to oppose it, we'll see. Nurse organizations have been very active in 50 states regarding nursing practice rights and independent rights to write prescriptions, so they already have a fairly full political agenda," Cushing said.
He continued, "We would be consistent everywhere with using the full title so there's no chance for confusion. Plus, it's not like people are walking into a veterinary clinic expecting medical care (for themselves)."
Putting in the work
NAVTA already has done a lot of work to get to this point. Yagi said the process to evolve the name of a veterinary technician to a veterinary nurse began last year with extensive research on the legality of the name change and the level of industry support as well as a review of the current credentialing. NAVTA conducted a survey this past fall and received 4,700 responses from members of the veterinary profession, largely from veterinary technicians. In all, 81 percent said they would be in favor of or neutral to the name change.
"We've now come to the implementation phase and will address even more questions as things progress. But some of the concerns that come up, like when people ask if we should focus on other specific aspects of the profession, we argue it's all interconnected," Yagi said. "These are only the first steps to the changes needed in the profession. Long term, it will be more effective than picking and choosing what we need to work on."
He points out that ideally, legislation will standardize the scope of practice among states enough that reciprocity agreements will enable veterinary technicians to practice more easily in different states. Also, standardized credentials allow for better title protection and delineation of tasks among credentialed and noncredentialed individuals.
At the same time, NAVTA leaders acknowledge that veterinary practice acts are not all the same, and having identical language in all 50 states would be difficult. Currently, NAVTA is updating its Model Practice Act and speaking with veterinary leaders regarding credentialing to achieve as much consistency as possible. In addition, NAVTA has already built a network of veterinary technicians throughout the U.S. through its state representative committee and anticipates using that heavily during this effort.
Yagi noted the process could take several years because of the need to ensure legislative, industry, and individual alignment and support at the national and local levels.
"It's quite a collaborative process. We'll, hopefully, have a lot of people in states step up, and we have every reason to think we'll be successful," he said.
Visit the National Association of Veterinary Technicians in America to view the FAQ on its veterinary nurse initiative and obtain more information, or email vetnursenavta [dot] net.
Related JAVMA content:
Technicians to revamp credentialing system, title (Oct. 15, 2016)
Technicians pushing for new name: veterinary nurse (April 15, 2016)