RNs fight veterinary technicians over the word 'nurse'

The American Nurses Association says, "We are not suggesting any pet owner will confuse a staff member in a veterinary clinic or hospital as a human healthcare practitioner. The issue at hand is the title 'nurse' and the connotations and respect that come with that title." (Shutterstock.com)Webster's defines “nurse” as a person who cares for the sick or infirm. While the definition doesn't specify whether the recipient of that care is an animal or a human, the debate over whether to extend this title to veterinary technicians is a heated one.

The National Association of Veterinary Technicians in America (NAVTA) initiated the conversation about changing the title of veterinary technicians to “veterinary nurse” nationally in 2015. The Veterinary Nurse Initiative includes a proposal to establish a national credentialing process similar to that used for registered nurses. While NAVTA has support for the change within the veterinary profession, stakeholders in human nursing have not joined in the call to action.

‘Veterinarians are not called "physicians"; physicians are not called "veterinarians"'

Janet Haebler, MSN, RN, senior director of state government affairs for the American Nurses Association (ANA), says NAVTA first approached ANA about the change in 2015 after a referral from the National Council of State Boards of Nursing. While discussions have been ongoing, Haebler says NAVTA pushed ANA last summer for an official statement endorsing the change-something the ANA opted not to give.

In its official statement on NAVTA's proposal, the ANA shared concerns about the title change: “We are not suggesting any pet owner will confuse a staff member in a veterinary clinic or hospital as a human healthcare practitioner. The issue at hand is the title 'nurse' and the connotations and respect that come with that title.”

“Before 1903, anyone could be a nurse,” Haebler says, “and they fought hard to change that and improve credibility of nursing.” There are statutes limiting the title of "nurse" right now, she adds, and ANA discussed these distinctions with NAVTA.

“Veterinarians are not called 'physicians'; physicians are not called 'veterinarians.' There are four titles [for veterinary technicians] across the county, and it's confusing,” she says. “They should definitely standardize, or create a new title that accurately reflects the education and credential.”

Adopting the term "nurse," however, isn't necessarily the answer, according to Haebler.

“We're not saying they shouldn't be able to practice how they want to practice. We just don't want them to be called nurses. … We've already got a slippery slope with an evolution of roles,” Haebler says. “I would hate to see us put our political capital [in]to this when there's so many things happening. It just doesn't feel right.”

NAVTA announced plans to introduce legislation in several states to make the title change official last year, but Haebler says the state nursing associations in those states worked hard to oppose those efforts. Haebler says she's confident that NAVTA will reintroduce legislation in those states and expand their efforts.

‘Co-opting another profession's title to garner respect'

Tina Gerardi, MS, RN, CAE, executive director of the Tennessee Nurses Association (TNA), says TNA helped ANA draft its official position on the veterinary technician bill and worked to halt legislation in Tennessee for the 2018 session.

“We anticipate it will be back in 2019 in some form. While we laud the efforts of the veterinary techs to standardize their education and licensure, we believe the title 'nurse' should be protected and only used for the care of humans,” Gerardi says. “One of the reasons cited for the name change by the vet techs is the confusion over their titles and the lack of respect for what they do. The issue at hand is the title 'nurse' and the connotations and respect that come with that title.”

Like Haebler, Gerardi says that trust in the title of "nurse" is a big sticking point for the nursing profession in supporting NAVTA's proposal.

“For 16 years in a row, the Gallup poll has recognized nurses as the most ethical and trusted profession. We believe that a distinction should be made between those who provide care for human beings and other forms of life-just as those providing medical care for animals are called veterinarians, not physicians,” Gerardi says. “Rather than co-opting another profession's title to garner respect for what they do for animals, we urge NAVTA to unify under one of the four existing titles currently in use.”

Not everyone in the nursing profession shares the opinions of its leadership, though.

‘My understanding … expanded since my daughter returned to school to become a licensed veterinary technician'

Mary Ann Friesen, PhD, RN, CPHQ, says she was not supportive of the change to the title “veterinary nurse” when it was first proposed, but she has had a change of heart.

“As a member of the Texas Nurses Association, at the time I supported the title protection of RNs,” Friesen says. “However, my position has evolved. My understanding of the role of a vet tech has expanded since my daughter returned to school to become a licensed veterinary technician (LVT). I realized the range of course work, skills and clinical experience she needed to become a credentialed technician.”

The knowledge and skill of the veterinary technician includes the same foundational skills that are taught in nursing-assessment, planning, implementation and evaluation, Friesen explains, adding that continuing education requirements are also “robust and rigorous.”

“Now, having a better understanding of the requirements to become a credentialed technician-graduation from an accredited program, passage of a national board exam and application to practice as a vet tech from the state-I support the Veterinary Nurse Initiative and properly credentialed technicians using the title ‘veterinary nurse,' similar to doctors of veterinary medicine being called doctors,” Friesen says.

Her endorsement does, however, come with some stipulation and differentiation.

“While I do not personally agree with the title ‘registered veterinary nurse,' I do feel allowing properly credentialed technicians to use the title ‘veterinary nurse' is appropriate for their professional skills and educational achievement,” she says. “The term ‘nurse' would be more readily understandable to the general public and more reflective of the position in healthcare provided to animals.”

‘Changing the title … will allow veterinarians to call any personnel on their staff “registered veterinary nurse”'

But not everyone in the veterinary profession supports the change either. Liz Hughston, MEd, RVT, CVT, VTS-past president of the Academy of Internal Medicine Veterinary Technicians and current president of the National Veterinary Professionals Union-says she has a lot of concerns about the proposed title change because there are deeper issues at hand than just the name.

“I believe that a title change will not address the problems that veterinary technicians face in our industry,” Hughston says. “While some states have title protection for credentialed veterinary technicians, veterinarians can still hire personnel that are not credentialed and have no formal education or training as a veterinary technician and have not passed the Veterinary Technician National Examination (VTNE).”

Hughston says there are veterinarians hiring unlicensed personnel and giving them the title of "veterinary technicians," and the real problem is that there is no enforcement in the veterinary profession over who uses this title.

“Changing the title to registered veterinary nurse will then allow veterinarians to call any personnel on their staff ‘veterinary nurse,'” Hughston says.

Additionally, Hughston says she's concerned that the title change “may be a shortcut in gaining some public understanding, which is the primary reason given by the organization pushing for this change.”

“The bigger obstacles in our profession include standardized educational requirements, title protection, state reciprocity and enforcement of these measures to protect the future of profession,” Hughston says.

Fighting against the nursing profession for the name change might cause more problems, she says, without fixing the root problem.

“The national and state nursing associations as well as some associations within our profession are actively opposed to [these efforts]. The title ‘nurse' has some degree of title protection in at least 39 states. This means that if just one state does not pass ‘veterinary nurse,' we will not have a unified title across the United States, which will increase confusion and further muddy the public's understanding of what we do and our role on the veterinary healthcare team,” Hughston says. “There is no need to add another title to the mix and further confuse the public. I believe our profession should choose one of the existing titles to unify our profession. Registered nurses have worked for decades to earn respect for their title, and it's irresponsible for another profession to hijack it-especially without the infrastructure and enforcement to protect the title of veterinary nurse.”

Freelance writer Rachael Zimlich worked as a reporter for dvm360 magazine before returning to school to become a registered nurse. She now works at The Cleveland Clinic.