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Of nurses and unions

Two emerging campaigns – the Veterinary Nurse Initiative and hospital unionization – could radically change the industry.

Of nurses and unions
Key questions in both initiatives are whether clinic morale and teamwork would be affected positively or negatively.

2018 marks the year when two vastly different efforts are emerging to address the status, professionalization and health care outcomes involving veterinary staff in animal hospitals throughout the United States.

  1. The National Association of Veterinary Technicians in America, the national organization for credentialed veterinary technicians, launched the Veterinary Nurse Initiative in Ohio and Tennessee and has plans to reach all 50 states.
  2. A group of veterinary staff on the West Coast launched the National Veterinary Professionals Union.

Each sets out on a different course and could have disparate impacts on animal health care in America. Let’s explore.

Registered Veterinary Nurse

The Veterinary Nurse Initiative seeks two outcomes:

  • Standardize requirements for credentialed veterinary technicians. These requirements are a degree from an American Veterinary Medical Association-accredited veterinary technician/technology program and passage of the Veterinary Technician National Exam, which is administered by the Association of American Veterinary State Boards. These requirements currently are mandated in a number of states for the titles of registered veterinary technician, licensed veterinary technician, certified veterinary technician or licensed veterinary medical technician.
  • Replace the various credentialed titles so that any title holder in a state with the two requirements outlined above would automatically become a registered veterinary nurse. In those states without a credentialing process, the legislation would institute these requirements and the title of registered veterinary nurse.

Vet tech titles are established in veterinary practice acts adopted by state legislatures, so any changes require action by the legislatures and would be enforced by state veterinary medical boards.

The initiative addresses a pair of issues:

  • Clients do not understand what “vet tech” means. They often assume it has something to do with equipment.
  • Clients and pet owners have no idea that credentials, educational requirements and national board examinations stand behind each vet tech.

These misunderstandings lead clients to undervalue the knowledge, skills, training and competencies of vet techs despite the fact that their credentials and training can match those of nurses in human medicine. These same clients and pet owners are content to receive their own medical care from nurses, yet they don’t assign the same value to vet techs for the care of their pets. Veterinarians also fail to leverage the skills of vet techs in the same manner that human doctors do with nurses.

The Veterinary Nurse Initiative will require some time, given the need to pass legislation in all 50 states, but hopefully momentum already gained will speed the process. This will be aided by the support of veterinary technician/technology programs such as the one at Purdue University, which announced that going forward it will award associate and bachelor’s degrees in veterinary nursing.

Unionization

The National Veterinary Professionals Union seeks to organize the non-veterinarian staffs of hospitals and clinics so that they operate like unions in other industries. The veterinary union announced in a Facebook post that the International Longshore and Warehouse Union (ILWU) will be its partner:

“The ILWU will help us with logistical and organizational support, as well as legal resources we didn’t have access to previously. It is our hope that affiliating with the ILWU will help us reach more practices and organize more quickly.”

This partnership with an international union inexperienced in animal care promises to draw a great deal of attention as the ILWU has a long and aggressive history in organizing, strikes and political activities. The unionization effort seeks to address compensation, morale, working conditions and benefits issues for non-veterinary professionals.

The new union and its longshoremen partner will pursue bargaining rights in veterinary clinics through elections governed by the National Labor Relations Board. This requires a vote by the non-veterinarian staff in each clinic the union seeks to organize. The unionization effort does not address titles, credentials or training of non-veterinarian professionals. The National Veterinary Professionals Union won an initial vote at a hospital in the San Francisco area.

The union has indicated that it will focus, at least initially, on larger or corporate practices, although it has not identified any differences in compensation or working conditions between corporate practices and smaller, independent clinics.

Let’s Compare

It is hard to view the unionization effort as not impacting the financial conditions of veterinary hospitals. If practices are forced to bargain with the ILWU-backed union, one could expect salaries and benefits to go up and working hours or conditions to be affected. Veterinary practices might absorb the costs or pass them along to the pet owner, and there might be pressure to reduce staffing.

How all this will affect operations, the mood at practices or internal relations is anyone’s guess. A pressing question will be the effect on practices if the union decides to strike or protest when bargaining is unsuccessful. We might soon see pickets and protesters outside of U.S. small animal clinics.

So far, organized veterinary medicine has been cautious regarding the National Veterinary Professionals Union, but this may change as the threat of widespread unionization or strikes and a string of elections and organizing activities dominate the landscape. The effort has had relatively little visibility, but this could change with the longshoremen’s engagement and resources.

Meanwhile, some veterinarians fear that changing a veterinary technician’s title to registered veterinary nurse will raise salaries, which in turn could be absorbed by the practice or passed on to clients. Veterinary nurse advocates explain that the legislation doesn’t do this and that salaries will rise only if the practice performs better when it has more highly valued professional staff serving pet owners.

Some veterinary groups favor the title “registered veterinary nurse,” and some are neutral. As far as NAVTA is aware, none are opposed. The Veterinary Nurse Initiative’s goals are to gain the endorsement of local, state and national veterinary associations as well as vet tech programs.

What’s Next?

Both initiatives aim to address longstanding issues in the veterinary marketplace concerning career tracks, economics and the morale of non-DVM professionals. Veterinary practice owners are challenged by staff turnover. A title upgrade and national standardization for registered veterinary nurses could increase client confidence and engagement, improve utilization of pet health care services, and grow practice revenues. This could lead to higher compensation and less turnover.

Union advocates might claim that higher wages and better working conditions would reduce turnover and create a longer career track. Many working conditions and employee protections already are mandated by federal and state law, so it is unclear which additional mandates would be pursued through bargaining.

Key questions in both initiatives are whether clinic morale and teamwork would be affected positively or negatively. Would veterinarians embrace registered veterinary nurses as partners in the delivery of health care services to pets? Would union organizing activities and the looming presence of the longshoremen’s union permanently alter the internal dynamics of veterinary practices, or would a new normal be achieved? Would pet owners experience either change as driving up the price of veterinary services?

The sooner the animal health profession actually has a public discussion — preferably a debate — about these issues, the better. I know that the Veterinary Nurse Initiative has participated in many public and industry forums, including legislative hearings, but we’ve yet to see the same from the union.

Let’s hope the debate starts soon.

Politics & Policy columnist Mark Cushing serves as legislative consultant to the Veterinary Nurse Initiative. He is founding partner of the Animal Policy Group and a former litigator. He serves on the Today’s Veterinary Business editorial advisory board.

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