Thursday, October 19, 2017

At The Very Heart Of It All

I've been in practice for 27 years. When I'm asked what the biggest change has been over that time I sit back, rub my chin thoughtfully, adopt my best wise old man tone, pause dramatically and then quietly say, "techs". Not all the new drugs - in 1990 we had hardly any pain medications we could send home. Not all the new in-house lab equipment - in 1990 we sent most samples away and waited a day or two for results. Not all the new diagnostic imaging equipment - in 1990 ultrasound was not generally available and xrays were developed in a dark room with dip tanks of stinky chemicals. Not all the new dental equipment - in 1990 I used a hacksaw blade to cut apart large teeth that needed to be pulled. Not all the new knowledge, not all the new techniques, not all the new computerization. None of that. These things are important, crucial even, but the most pervasive change that has touched every aspect of veterinary practice is the role of the veterinary technologist (aka RVT, aka registered veterinary technologist, aka animal health technologist, aka veterinary nurse, aka tech).

To put it simply, since I began in 1990 techs have moved from being overqualified, underutilized animal holders and kennel cleaners, to being at the very heart of almost every small animal practice. In 1990 many veterinarians simply trained people in house to perform whatever simple technical duties the veterinarian didn't want to do himself (and it was usually a himself, not a herself, in those days). The actual college trained vet techs did very little more than these informal techs, which was a demoralizing and frustrating situation that contributed to a high rate of turnover and burnout. Looking back it was a bizarre situation. As the veterinarian I took most of the blood samples, placed most of the IV catheters, took most of the xrays, induced most of the anesthetics and cleaned most of the teeth, even though the college trained techs were perfectly qualified to do all of this. I was basically an expensive (although not that expensive in those days...) tech for about half my job.

Today techs do practically everything except what the law reserves for veterinarians: diagnosing, prescribing and operating. Today, in our practice, techs take every blood sample, place every IV, take every xray, induce every anesthetic and perform every dental prophy and cleaning. Moreover, they command an in-house laboratory that looks like a miniature version of NASA Mission Control, they perform blood transfusions, they hook up ECGs, they monitor and care for critical hospitalized patients and they counsel clients on weight management, behaviour, post-operative care and a host of other subjects. And they do it all well. Very well. Each one is a medical nurse, an ICU nurse, an emergency nurse, a surgical nurse, a laboratory technologist, a nurse anesthetist, a dental hygienist, an xray technologist, a neonatal nurse and a palliative nurse... All of that, and more.

In 1990 I could do absolutely everything in the clinic. I knew what every knob on every piece of equipment did and I knew how to make it do that. I knew exactly how to get blood on every patient (well, almost every patient) and I could wield every instrument and administer every treatment. Today I am more or less useless. Ok, I'm exaggerating for effect. More accurate is that I am useless without my techs. Absolutely useless and helpless.

Most clinics are designed with a large room in the centre called the treatment room. This is where all the action happens. It is the physical heart of the clinic with the laboratory, patient wards, anesthetic prep area, operating room, pharmacy, dental area and xray suite radiating from it. And at the heart of this heart - at the very heart of it all - are the techs. Thank you Jen, Kim, Mela, Brandi, Marnie, Melissa, Jamie and Jasmine. Thank you for making me so much less useless. 

1 comment:

  1. You are correct - your techs are awesome! It would be great if they could all become vets... special shout out to Brandi - she ROCKS!