‘That Lady At The Vet”

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Maybe you’ve read this article: Who you callin’ nurse?. Maybe you’re a nurse and you’ve ranted against us, the veterinary technicians, for wanting our title changed to veterinary nurses. Oh the nerve, right?

Wrong. It’s not an insult.

Veterinary medicine is medicine. Animals have all the same components and organs that humans do. At the very basic level, animals get the same disorders that humans do: cancers and endocrine problems like diabetes and hyper-(cats)/hypo-(dog) thyroidisms, reproductive disorders and emergencies, traumas, immune-mediated diseases, broken bones, upper respiratories. They require annual wellness visits and necessary vaccines. Likewise, there’s things that animals get that humans don’t; humans get that animals don’t. And then there’s the zoonotics, which gets us to meet in the middle.

I immersed myself in veterinary medicine starting at the age of 16. Then, like you, I went through a rigorous two years of the exact same curriculum. We had dry and wet labs, internships/externships and pre-clinicals. My school (Bel-Rea Institute of Animal Technology in Denver) functioned all year. There was no 3 month summer break or extended winter or spring breaks. Unless I chose to take a quarter off, which I didn’t. Glutton for educational punishment. I worked no less than three jobs at a time while going to school full time. I worked my way up in clinics while going to school, advancing my responsibilities as my knowledge base increased.

After graduating ‘tech school’, we also take a national boards exam. They put questions regarding whales on that thing. They never covered whales in school! Once we pass the VTNE, we apply for certification through our state and are required to maintain that certification with Continuing Education. Most of our bosses don’t cover that. If our jobs can even spare us the time off, the conferences come out of our own pockets. Like yours, they aren’t cheap. Unlike you, we don’t make much money. But veterinary medicine changes and evolves constantly. We have to always be on our game.

It took me over 10 years to pay off my student loans. Took me 15 years to make what entry level job seekers now want automatically. Took 8 years before I got a job that offered me paid vacation and sick leave. I honestly thought they were joking. Not that I ever was able to call in sick or actually take a vacation. When there’s only three of you running things non-stop, you can NEVER leave.

Unlike you, our certification title varies depending solely on the region we live. It is ridiculous. Fighting for a more accurate title is only part of our battle. Our profession also needs uniformity on many levels. I’m a CVT (Certified Veterinary Technician), which is the same as an LVT (Licensed Veterinary Technician) or an RVT (Registered Veterinary Technician). Only those who’ve graduated from an AVMA (American Veterinary Medical Association)-accredited program and have passed the VTNE (Veterinary Technician National Exam) can claim those initials. It doesn’t prevent many from calling themselves veterinary technicians. That is a sensitive silent debate, though.

There are veterinarians who don’t want to pay a school-educated, state certified tech what they’re worth and will hire only those they can train themselves. I’ve met some who’ve been techs in that way as long as I have, and they are very good. Some. To be fair, I’ve met some CVTs that weren’t . There’s a lot of derision and insecurity between job-trained and school-educated techs. I’ve been forced out of many clinics because of the hostility amongst coworkers. Even when I’ve kept my CVT status private from my non-CVT coworkers, it gets out somehow, and the trouble will start. Our veterinarians and state organizations don’t always have our backs, either. That’s probably why you’re starting to hear about us. We’re fighting for recognition and professional uniformity within our own ranks.

Human nurses get to pick a specialty and do only that, whether it be general, or trauma, or surgical, or cardiac, or pediatrics, or geriatrics, etc. They’re finally starting to offer that to us, where we can get further certification for what we’ve gravitated into best. It is rigorous and self-reliant. Emergency, cardiology, neurology, internal specialist, orthopedics, oncology, specialist surgeons (who travel from practice to practice to perform the surgeries a general practice vet maybe isn’t very comfortable doing), mobile clinics, and shelter medicine are some of the varied types of specialties within the veterinary community. Within all these spectrums there exist technicians who love their target health focus and take their jobs very seriously. Zoos, research facilities, aquariums, sanctuaries, wildlife rehabs, the government, the army all employ veterinary technicians.  If you’ve ever Run for A Cure (any cure), or did the ALS bucket challenge, or donated money to fund research, or hair for children with leukemia- if you work in oncology or endocrinology or have diabetes yourself- there are vet techs involved with the scientists, the PHDs, MDs, vets and the broad range of medical professionals trying to find an end to those diseases.

However, specialties are rare environments and in a standard veterinary clinic, we are ALL specialties. Including dentistry. We’re also quasi-behaviorists, trainers, counselors, dieticians, and educators……to both our furry patients and the humans they bring in. We see firsthand how pet and human health are inter-relational. We have to factor in the people in regard to the decisions made about the pet. There is a great initiative called One Health, with professionals on both spectrums of medicine working together.

My target species is a little more varied than ‘human’, though. There’s only one type of human. Aside from learning the Latin names and taxonomy of each species of animal, we study and memorize the anatomical, health/disease propensities, and breed differences of dogs, cats, cattle, horses, swine, fowl, rodents, rabbits, ferrets, and exotics (bird, pocket pet, reptile, amphibian, and chelonian). We can be like mini-geneticists and facial profile on sight (which is unethical for you to do). We also had to memorize every particular marking for horses and cattle, and coat colors for all the rest. Seriously thought my brain was going to implode. That was all first quarter stuff, though. You do not want to use the wrong terminology in front of an owner. You are instantly put on their shit list. Better know the sex on sight, too. Also immediate shit list.

It didn’t matter if we were never going into large animal, or lab animal, or small animal medicine, we had to know each for them all: anesthesiology, parisitology, hematology, radiology, physiology, pharmacology. (I feel like Doc Terminus in Pete’s Dragon). Blah blah blah, you did all that too. Yay us! Basics, like chemistry, English, and medical math. I tell my kids that algebra is important. I use it every day. Like you, we had classes in nursing care, both supportive and surgical. We crammed and studied and were tested on all equipment, surgical instruments, and sterile technique. Like you.

Same courses as you, except that every species of animal is different on a cellular level. Avian RBCs are elliptoid. Cows have a four-chambered stomach. Cats are induced ovulators. You do not fast rabbits prior to surgery. Ug, rabbits in surgery. Their heart rates are too fast for monitors to pick up. They also like to hold their breath while anesthetized. Monkeys have cheek pouches and like to stuff food in them and save for later. A day later. Aspiration can be an issue. Drugs that work on one will kill another. Dosages are vastly different. They get different diseases, different parasites, have different body structures, require different handling, have different estrous cycles and gestation lengths and day-night preferences.

After all that, some of us may then pursue a Bachelors in Veterinary Technology.

I can do a manual CBC on everything from a mouse to a monkey. I can get blood from everything from a mouse to a monkey, too. Place IVCs in them. Intubate. Keep them alive and multi-modally analgesed through surgery. I can go from surgical to lab to receptionist to dental hygienist to educator to emergency response within a matter of seconds.

None of our patients can speak. That’s where we differ. They can’t tell us: you know, I maybe shouldn’t have eaten those twelve pacifiers/thread attached to sewing needles/antifreeze/owners’ stash of drugs they’ll never admit to.

I stopped eating two weeks ago and my person just noticed last night.

Or, my person did notice two weeks ago, but only decided today that maybe they should be concerned.

I landed wrong when I sprinted after that squirrel this morning and there was a pop in my knee.

Our patients bite and scratch. According to TV, yours do too. You probably get slapped and hit and punched and screamed at, too. We have muzzles and e-collars! Drugs are everyone’s friend. Shake a tech’s hand and take a moment to look at it. See if you have time to count all our scars. Animals instinctively hide all symptoms of pain, distress, and disease until it’s almost too late. They can have an enucleation, with their eye attached only by the nerve, but they’ll meet your gaze like, No really. I’m good. Because there’s also a prey vs. predator animal difference in their psychology we have to factor in.

Ok. Also being human, I know you deal with that too, but more accurately like aggressor vs. victim psychology, right? Unlike you, we’re allowed to neuter the most aggressive first. Haha! Points for us!

A typical day for a general practice technician is this: be the first one there to open the clinic up. If it’s a small place, there probably isn’t any kennel staff. So we walk the hospitalized dogs, scrub their cages, get them fed and medicated, do rounds, scoop litter boxes, start the laundry, check the phone for messages, wash dishes, and pull files for the day……if the dog didn’t pull out his IV or walk through her vomit, and if someone’s not outside the door 10 minutes early with something urgent. If we haven’t gotten peed on yet, we’re off to a good start! Then the day begins. We answer phones, check clients in and out, go into exam rooms and restrain fractious cats and aggressive dogs. Nothing like a 2# cat to show you how weak you are, or a 200# mastiff to show you how strong.

I was a defensive child. It took five nurses to hold me down for shots. I’m sorry, really I am.

Techs clean ears, draw blood, walk a dog to collect urine from a DIY tool made from a soup ladle and a ruler, answer phones, talk to more people, teach a client how to give their dying 15 year old yorkie SQ fluids at home because she cannot accept or allow that he is dying. We teach another how to give insulin, calculate and administer the first surgery’s pre-op drugs, get surgery opened up, run a full UA on that other dog, do post-op follow-up calls, check on the micro in the incubator, prepare for the dental prophy, take an ’emergency call’ from a woman who’s just lonely, recreate the clinic’s health and post-op home care forms, counsel another client whom we’re pretty sure is in the beginning stages of dementia. She starved her cat to death last month. At the time it had seemed like he must have been sick or gotten into something she didn’t know about. Now another cat is showing the same symptoms and the woman’s not acting right. Hold a meeting: should social services be called? Deal with a child who tells us that her dog likes to be beat on, scrub the surgical patient (take a pick: orthopedic, foreign body, spay/neuter, wart removal, exploratory, emergency C-section, cysto, maybe a gigantic pyometra). Ah, I love orthos and foreign bodies. Wait, handle the pneumothorax, the hypokalemic cat, the animal found with a collar so tight its skin has grown over it, the HBC, the on-duty police dog that got injured, the CTA Rottweiler that may have been fed poison (CTA is Chicago’s public transportation service).

I loved that dog. I was five months pregnant, hated my hostile work environment and my fellow (not-schooled) ‘techs’, and was sitting on the floor over a garbage can lid with this adult (working, not a pet) Rottweiler in my lap who growled at everyone who came near me while he vomited onto the lid before us. I could have sat there all night with him.

Set up the other table, anesthetize and start cleaning another dog’s teeth. It’s a poodle. Their mouths are so disgusting, it’s as rewarding as a cat abscess. Run back and forth into surgery, even though you’re listening to two different heart monitors and know whose beat belongs to whom. Answer phones, recover patients, rush a blocked tom to the back, stock shelves, order animal food, run in-house bloodwork, do fecals. Start seeing appointments again, clean surgery, wrap packs, sterilize instruments, take xrays, fill prescriptions, euthanize a 15 year old lab with lymphoma we had cuddled at 2months of age when his people first got him.

Did we take lunch?

Explain diet and health requirements to a family with their first puppy/kitten/cold blooded something. Refer someone else to the nearest shelter as they just don’t want their older pet anymore. They’re bored with her. Do we think there’s any kittens at the shelter? (Pssst. California’s a rotten place to live. Apparently they don’t allow anyone to enter with their pets)

Most of the clinics I’ve worked at would take in unwanted pets and try to find them homes if all the employees were full. ‘Techs’ and vets take their work and patients home with them quite frequently.

BOP                         suni and luna

I’ve nursed an uncountable amount of wild birds back to health before setting them free again. I knew an assistant who specialized in orphaned squirrels. I’ve had so many orphaned kittens and puppies that required bottle feedings every two hours. Found dogs, broken cats, pets people never came back for. We don’t say no.

20140813_202015                                              bottle babies

Although, I do. To the guy who wanted to adopt a cat from us even though the last time he was in our clinic was because he threw his against the wall and killed it. Or to the woman I caught going through our trash ‘looking for vitamins’, who actually came inside the next week to get a cat because her boyfriend told her we turn off the heat every night and kill all our patients intentionally. Every single night. Meanwhile, her terrier’s trying to break his homemade rope leash to kill the closest cat.

I eventually made my way into an actual shelter/low-income veterinary clinic. Mostly spays and neuters. HaHa! I can’t explain how not-true that sounds. My boss could spay a cat in 7 minutes whereas a general practice vet would take at least 30 on one. Which meant that- while answering phones and talking to clients and accepting incoming patients and filling out patient records and calculating everyone’s drugs, doing any necessary pre-op in-house blood work- we’d be injecting one animal while prepping another while recovering the last and watching the stats on the current patient. Typically 15 major surgeries a day. About as many minor. And still, lots more emergencies and walk-ins and dentals in-between. Just like your dental hygienist (who probably earns more than my veterinarian): scaling, polishing, charting, xrays. Not digital. Had to develop those by hand.

Lab work. Always lots of lab work. Nurses get to send that shit out. Literally. We poke through the shit, do microscopic, trypsin, cultures, occult blood tests on it. If it comes in a box or a Tupperware or is wrapped in several bags, it’s not a good present. Hold your breath. Lots of UTI’s means lots of full U/As: dipstick, specific gravity, full microscopic evaluations. Ear cytologies (bug porn, really. they’re always in there screwing around), mass and fluid cytologies. Veterinary Technicians do ALL of that. That’s been my personal specialty since I began in this field: surgery and lab. When the vet needs to take your pet ‘to the back’ for testing, really, s/he’s taking them ‘to the techs’.

Treatments for hospitalized patients: drugs, fluids, walks, clean bedding. We will sit in the cages and hand feed our patients. Go home at night, cook chicken and rice for them. Go to the grocery store and buy- with our money- anything we think will get them to eat. Come in on our days off, on holidays, on weekends when the clinic is closed but patients remain.

I was the one to call other specialists and discuss odd cases with them, work on the phone with technical support when our lab machines and autoclaves went wacky, deal with food vendors and research new compounding companies. Through one year of a particular doctor, we were doing emergency orthopedics every week. Shattered pelvises and broken legs. So many broken cats. We’d go over the xray and then I’d pour through her books and tell her how to fix it while she continued with her appointments. Scrub in. Now I’m a scrub nurse while still monitoring anesthesia. And we’d send those broken animals back home to angry owners who whine how stupid their pets are that they keep getting hit by cars. God forbid they just keep their pets indoors. That’s inhumane. Very reminiscent of the dog owners who refuse to give a $15 vaccine, but spend hundreds every single time the new dog comes down with parvo, requires extensive hospitalization, and dies. And they go get another, refuse vaccines, and do it all over again. And we have to watch it happen. Go in every day cleaning blood/diarrhea, hold them, fight like hell to make them well, hold them again while they die, and know that in a week, the same people will be back. A little bit like being stuck in hell. We don’t have social services for pets.

When another doctor replaced the last, the broken cats came less often, as though the universe knew it wasn’t something she did, but the emergency c-sections came every Friday night as we were on our way out. Add obstetrics to my list of specialties. It’s the end of the day, but again, we don’t ever say no. Techs just about never leave work when they’re scheduled. No overtime pay, though. While a human C-section produces one or two babies, an animal C-section produces 6-12. 6-12 babies you are cleaning, and stimulating, and clearing the airways of, and encouraging to breathe and live. You only have a minute or two to accomplish this, and then to keep them alive and warm until mom completely recovers from anesthesia.

Then there’s the carcasses of half-eaten animals police bring in, wanting verification that it wasn’t some satanic thing, and the hours I spent going through Craigslist with only a collar and the color of the pet’s thorax as an ID, because the owner needed to know. Veterinary forensics is now an actual veterinary field.

I don’t think your patients are routinely thrown out of moving cars in your parking lot, bolted into boxes and coolers and left in your clinic’s relative area where someone may or may not find them. Thrown through the back door.

But I know you see other worse things. I know you also have stories to tell, and some you absolutely can’t. We’ve both been put into scenarios that make us hate humanity.

Or love it again.

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Unlike human nurses, vet techs are routinely vilified and criticized and sneered at. Which is the driving force of this editorial, obviously. My school- Bel-Rea- was founded in 1971. Despite appearances, we are not that new a profession. For as long as there have been veterinarians, there have been technicians, even if we didn’t start getting formalized until the 70’s. Yet we’re attacked regarding our education, our relevance, our worth. Poked fun at on major TV shows: (the season of Grey’s when she dated the vet, which was ridiculed as ‘not real medicine’; even though the show tried to give an IV injection into Meredith’s dog’s metatarsals, and Izzy miraculously recovered a dead deer with paddles. Those became jokes in my clinic that went on for like a year). We’re falsely accused by every pediatrician in every state: no, the kid did not get ringworm from the dog. It lives in the soil, aka playgrounds and sandboxes. The dog will get it from the kid.

You had that ignorant comment from The View. (I wanted to walk around with a stethoscope around my neck for you, honk my horn in support whenever I saw a Nurse license plate. I don’t think we have our own license plates.)

We legally assist in our patients’ deaths, or are required to euthanize due to overcrowding or some tiny technicality regarding getting them into homes. Or because of human-caused aggression. Being a technician through the weeks before Thanksgiving and Christmas is the roughest. Almost everyone is ‘cleaning house’ of old, embarrassing pets before company arrives. Before cute new puppies and kittens arrive. There would be extreme consequences should that happen on your side of the fence. The veterinary field is understandably riddled with emotional burnout, depression, and suicide.

I’m currently a surgical technician who rotates into the clinical pathology lab every few months. I’m teaching students, including ones who may one day become my boss, how to place IVs, how to intubate, draw blood, calculate drugs, monitor during surgery, scrub in, and restrain a range of species.

Yet I’m still ‘just a technician’ involved in fake medicine. Just a ‘lady at the vet’ who plays at knowing things.

Most of the nurses who come into my clinics are great. Lots come in to donate supplies. We do get a few who throw their title around and demand we run irrelevant diagnostics or perform treatments that aren’t related to their pet’s issues. Eh. I bet you get some PITA techs on your side of medicine. I’m sure you think us techs are weird, too. I ask for smears when my blood is drawn because I want to go back to work and do my own diff. No one ever does this. It’s frustrating and sad. Very sad. I also did my own full UA when I had a UTI several years ago, and argued with my doctor when he only did a dip and said there was nothing there. Did my boss’ son’s UA. (Ug, humans are gross.) My son slit his wrist on a fence when he was four. I cleaned it and then bandaged it with my dog-bone vetwrap before rushing him to emergency. The nurses and doctor sat there for a few minutes commenting on my bandaging. I’m sure you’ve also had people come in with deep lacerations and almost-severed body parts wrapped in layers of dirty clothes, shopping bags, and/or duct tape. People love duct tape, don’t they? Almost as much as they love the internet. Ug, internet diagnoses! When techs get drugs or require anesthesia, we’ll also ask what we’re being given and then want to have a professional discussion because it’s so much more interesting than our health issue. Don’t worry, we’re this way with our dental visits, too. Bear in mind that xrays and cleanings and extractions are part of our expertise.

I’ve had babies. It was nurses who spent the most time in the room with me, taught me how to nurse, how to bathe them, how to change them. I was also a sick child. Had surgery when I was nine. I know the doctors came into my room once or twice post-op, but I remember the nurse who opened the blinds in the morning, the ones who smiled as I woke up, who took my vitals. I remember the nurses before surgery was resorted to, who were the ones to do some painful diagnostics while I screamed and cried. I remember their voices, I remember them holding my hand and sincerely apologizing, trying to find ways to distract me. I never once hated them.

What person is unaware of what nurses do? Or would ever think to belittle your importance?

After my divorce, I took a second job cleaning at the Children’s Hospital on the weekends. I was surrounded by nurses, obviously. I interacted with you every day. I watched what you did, I watched you get onto a table and try to resuscitate a 12 year old, watched you try to reason with parents who behave much like pet owners. I watched what you handled. I talked to so many of you in several different areas of medicine. One was also a veterinary technician. Yet the one who was nasty to me was a nurse married to a veterinarian. Imagine that. I was cleaning the nurses’ lunch room one day and she stormed in, ranting much like that article, that how dare techs think they are anything like nurses- who are educated and licensed, who handle so much more than we techs can even think of. It went on for like 10 minutes. I could only stare at her. As much as I had wanted to defend myself, right then I was a lowly janitor, not a CVT who handles more than she- apparently- could think of.

What if, after your fight for education and licensure, your expertise, your 12 hour days, your title and degree, ‘nurse’ was stripped from you and you were called a ‘human technician’? Does that at all characterize or detail who you are and all that you do?

When people ask me what I do and I answer ‘Veterinary Technician’, even if they have pets they give me a blank look. Most usually ask: ‘You mean a veterinarian?’ No. Not a veterinarian. If we then say, like a human nurse, they understand a little better. This is why my side of medicine wants the name change to something more appropriate and relevant. I hate the word ‘technician’. Always have. Detest it with a passion. It’s demeaning. ‘Technical’ is something cold and sterile. Computers. Machines. Mechanics. It’s not even relational- obviously, if even human nurses can’t understand what we do, can’t comprehend that we’re even educated or actually take an active part in medical care. If even those intended to be our bosses have differing regard towards us! We, the vet techs, are waging a battle that encompasses our name, a uniformly credentialed title across the nation, and stronger regulations regarding who can call themselves a technician and what job duties can be performed under that heading. Nurses went through a similar battle, I hear.

You and we are alike. I don’t think either of us does more or less than the other. Our environments dictate what we do more than anything, and human medical places are structured differently than veterinary. My above ‘day in the life’ was not to boast, but to give you some background into ‘that-lady-at-the-vet’, to understand that we fought for our education, our licensure, our title, our career. We chose our similar career for the same reasons as you: we take care of things. It’s our calling. We are both compassionate, selfless, fiercely proud, educated, experienced, and driven. Just for different species. We aren’t trying to steal anything from you or somehow insinuate that you are less.

However, we are not less.

 

 

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