Principles and Practice of Veterinary Technology PDF

Principles and Practice of Veterinary Technology FOURTH EDITION Margi Sirois, EdD, MS, RVT, CVT, LAT Program Director, Veterinary Technician Program, Ashworth College, Norcross, Georgia With 702 illustrations 1 Table of Contents Cover image Title page Procedures Copyright Dedication Contributors to the Previous Editions Preface Acknowledgments How to Use This Learning Package Part 1. Foundations of Veterinary Practice 1. Overview of Veterinary Technology Education of Veterinary Technicians Nomenclature Describing Veterinary Personnel Scope of Veterinary Technician’s Duties Career Opportunities for Veterinary Technicians Salary Ranges for Veterinary Technicians Credentialed Veterinary Technicians: Certification, Registration, and Licensing Veterinary Technician Specialties The Future of Veterinary Technology Veterinary Technician Professional Organizations and Resources 2. Ethical, Legal, and Safety Issues in Veterinary Medicine Ethics Law Safety 3. Practice Management Front Office Procedures The Office Visit Pet Health Insurance AAHA and Accreditation Practice Operations 2 Facility Maintenance Marketing Disaster Planning 4. Eﬀective Communication in Veterinary Practice The Communication Process The Human-Animal Bond Grief Counseling Summary 5. Medical Terminology Introduction to Word Parts Using Word Parts to Form Words Defining Medical Terms Using Word Analysis Combining Forms for Body Parts and Anatomy Suffixes for Surgical Procedures Suffixes for Diseases or Conditions Prefixes for Diseases or Conditions Plural Endings Suffixes for Instruments, Procedures, and Machines Terms for Direction, Position, and Movement Dental Terminology Specific Terminology of Anatomy and Physiology Part 2. Veterinary Diagnostics 6. Diagnostic Imaging X-Ray Generation Radiographic Image Quality Radiographic Film X-Ray Equipment Digital X-Ray Imaging Radiation Safety Darkroom Techniques Radiographic Artifacts Radiographic Positioning and Terminology Contrast Studies Diagnostic Ultrasound Endoscopy Computed Tomography Magnetic Resonance Imaging Nuclear Medicine 7. Hematology and Hemostasis Laboratory Instrumentation and Equipment Laboratory Safety Quality Control Sample Collection 3 Formation and Functions of Blood and Blood Cells Complete Blood Count Differential Blood Cell Count Evaluating the Blood Smear Erythrocyte Morphology Leukocyte Morphology Platelets Reticulocyte Counts Erythrocyte Sedimentation Rate Bone Marrow Examination Hemostasis Primary Hemostatic Tests Secondary Hemostatic Tests 8. Clinical Chemistry and Serology Sample Collection Sample Type Laboratory Selection Laboratory Equipment Features and Benefits of Common Analyzer Types Hepatobiliary Function Testing Basic Principles of Immunology Types of Immunologic Tests Molecular Diagnostics Common Errors and Artifacts Choosing a Test Kit Test Significance 9. Microbiology, Cytology, and Urinalysis Microbiology Characteristics of Bacteria Mycology Materials Needed for the In-House Microbiology Lab Immunologic Testing Antimicrobial Sensitivity Testing Quality Control Concerns Cytology Collection and Preparation of Samples from Tissues and Masses Collection and Preparation of Fluid Samples Urinalysis Formation of Urine The Complete Urinalysis 10. Parasitology Parasitology Classification of parasites Diagnostic techniques in parasitology 4 Part 3. Veterinary Therapeutics 11. Pharmacology and Pharmacy Drug Names Dosage Forms Prescriptions and Dispensing Medication Calculating Drug Doses Storing and Handling Drugs in the Pharmacy Storing and Prescribing Controlled Substances Therapeutic Range Dosage Regimen Routes of Administration How Drugs Exert Their Effect Drugs Affecting the Gastrointestinal Tract Drugs Affecting the Cardiovascular System Drugs Affecting the Respiratory System Drugs Affecting the Endocrine System Drugs Affecting Reproduction Drugs Affecting the Nervous System Antimicrobials Antifungals Antiparasitics Anti-inflammatories Disinfectants and Antiseptics 12. Pathology, Response to Disease, and Preventive Medicine Pathology Preventive medicine 13. Management of Wounds, Fractures, and Other Injuries Wound Healing Wound Management Wound Closure Covering Wounds Orthopedic Bandages and Splints Casts Management of Specific Wound Types 14. Veterinary Anesthesia, Analgesia, and Anesthetic Nursing Introduction Fundamentals of Anesthesia Steps of Anesthesia Large Animal Anesthesia 15. Principles of Surgical Nursing General Surgical Principles Basic Surgical Terminology 5 Preoperative and Postoperative Considerations Principles of Asepsis Care and Maintenance of Surgical Instruments and Supplies Preparation of the Operative Site Preparation of the Surgical Team Surgical Assisting Surgical Instruments Suture Materials Other Materials Used in Wound Closure Suture Removal 16. Fluid Therapy and Blood Transfusion Fluid Therapy Clinical Aspects of Fluid Therapy Fluid Choices Indications for Fluid Therapy Routes of Fluid Administration Intravenous Catheter Selection Intravenous Catheter Placement and Maintenance Fluid Administration Total Parenteral Nutrition Transfusion Medicine Clinical Evaluation of Bleeding Whole Blood and Blood Components Blood Types Sources of Donor Blood Blood Collection Blood Storage Blood Administration Transfusion Reactions 17. Emergency and Critical Care Emergency Readiness and Preparation Hospital Care Emergencies Emergency Procedures Oxygen Therapy Critical Care Summary 18. Small Animal Dentistry Oral Anatomy Dental Instruments Preparation for Dental Procedures Periodontal Disease Prophylaxis or Dental Cleaning Dental Records 6 Oral Radiology Home Dental Care 19. Physical Therapy, Rehabilitation, and Complementary Medicine Hands-On Therapy Alternative and Complementary Medicine Part 4. Animal Care and Husbandry 20. Animal Behavior What Is Behavior and Where Does It Come From? Preventing Behavior Problems in Companion Animals Preventing Destructive Behavior by Cats Preventing Destructive Behavior by Dogs Preventing Aggressive Behavior Problems Behavior in the Clinic Providing Problem Prevention Services Providing Problem Resolution Services Referring Cases to Behavior Specialists Behavior Problems in Exotic and Farm Animals 21. Physical Restraint Basic Animal Behavior Fear Free Practice and Low Stress Handling Restraint and Handling of Dogs Restraint and Handling of Cats Restraint and Handling of Small Mammals Restraint and Handling of Birds Restraint and Handling of Horses Restraint and Handling of Cattle Restraint and Handling of Goats Restraint and Handling of Sheep Restraint and Handling of Pigs 22. Patient History and Physical Examination Technician-Client Interaction Physical Examination Systematic Approach to Physical Examination Physical Examination in Emergencies 23. Nutrition Digestive System Energy-Producing Nutrients Non–Energy-Producing Nutrients Feeding Considerations for Dogs Feeding Considerations for Cats Pet Food Considerations Nutritional Support for Ill or Debilitated Patients 7 Feeding Considerations for Small Mammals Feeding Considerations for Reptiles and Amphibians Feeding Considerations for Laboratory Animals Nutrition of Livestock Feeding Management of Livestock Livestock Clinical Nutrition 24. Nursing Care of Dogs and Cats General Nursing Care Administering Medications Nursing Care in Special Circumstances Nursing Care for Recumbent Patients Care of Neonatal Puppies and Kittens Care of Geriatric Patients 25. Nursing Care of Horses General Care for Horses Monitoring Patients Care of Recumbent Horses Bandaging Administration of Medication Diagnostic Imaging Equine Dentistry Common Diseases 26. Nursing Care of Production Animals, Camelids, and Ratites Introduction Care of Cattle (Bovine) Care of Sheep (Ovine) Care of Goats (Caprine) Care of Swine (Porcine) Diagnostic and Therapeutic Techniques Care of Camelids Care of Ratites Common Diseases 27. Nursing Care of Companion Birds, Reptiles, and Amphibians Birds Avian Surgical Techniques Reptiles Hospitalization and Nursing Care Amphibians 28. Nursing Care of Orphaned and Injured Wild Animals Preparing Your Clinic for Wildlife Triage and Care Capturing and Transporting Wildlife Intake Procedures and History 8 Capture and Restraint of Wildlife Physical Examination of Wildlife Sample Collection and Diagnostic Testing Routes of Administration of Medications and Fluids Supportive Care of Wild Animals in the Hospital Long-Term Rehabilitation Ethical Treatment and Releasability of Wild Animals Common Diseases and Injuries of Wild Animals Wildlife Commonly Seen in the Clinic Zoonotic and Infectious Diseases in Common Wild Animal Species Isolation Caging Area—Preventing the Spread of Disease in the Clinic 29. Nursing Care of Laboratory Animals The Use of Animals to Advance Medical Knowledge: The Pros, the Cons, and the Laws The Role of the Veterinary Technician in Biomedical Research Animals Used in Biomedical Research Animal Models Small Mammals Kept as Pets and Used in Research Housing Sanitation Diet Rodents Rabbits Ferrets General Nursing Care Diagnostic and Treatment Techniques Venipuncture Identification Methods Used in Research Animals Anesthesia Glossary Index 9 Procedures Hematology and Cytology Abdominocentesis and Thoracentesis, 188 Avian White Blood Counts with the Leukopet System and Hemacytometer, 127 Classifying Fluid Samples, 193 Fine-Needle Aspiration, 186 Making a Wedge Smear, 132 Microhematocrit Procedure, 129 Microscopic Examination of Urine Sediment, 202 Plasma Fibrinogen Procedure, 148 Plasma Protein Determination, 131 Preparing Compression Smears, 187 Preparing Impression Smears, 186 Tracheal Wash and Bronchoalveolar Lavage, 189 Parasitology Baermann Technique, 235 Buﬀy Coat Smear, 237 Cellophane Tape Preparation, 234 Centrifugal Flotation, 233 Direct Smear of Feces, 231 Fecal Culture, 236 Fecal Sedimentation, 234 Manual Processing of X-Ray Film, 103 Millipore Filtration Procedure, 237 Modiﬁed Kno ’s Technique, 238 Modiﬁed McMaster Quantitative Egg Counting Technique, 236 Simple Fecal Flotation, 232 Wound Management Modiﬁed Ehmer Sling, 315 Applying a Robert Jones Bandage, 311 Applying a Velpeau Sling, 316 Applying a Wet-to-Dry Dressing, 303 Applying an Ehmer Sling, 314 Applying Soft Padded Bandages, 312 Cast Application, 317 Suturing, 306 Surgical and Medical Nursing Blood Cross-match–Tube Method, 432 Central Venous Pressure Monitoring Using IV Fluid Bag Method, 464 Chest Tube Placement, 460 Cleaning Dogs’ Ears, 609 Diagnostic Peritoneal Lavage, 463 Emergency Intubation, 456 Gastric Lavage, 453 Giving an Enema, 611 Indirect Systolic Blood Pressure Measurement, 628 Intraosseous Catheter Placement, 409 10 Intravenous Injection, 616 Nasal Catheter Placement, 462 Intravenous Catheterization, 649 Nasoesophageal Tube Placement, 582 Nasoesophageal/Nasogastric Tube Placement, 625 Over the Needle Intravenous Catheter Placement, 411 Patient Skin Scrub (sterile prep), 378 Peripheral Intravenous Catheter Insertion, 618 Peripheral Venous Cut-Down, 449 Surgical Personnel Scrub Procedure, 380 Thoracocentesis, 459 Through the Needle Catheter Placement, 413 Tracheostomy Tube Maintenance, 458 Tracheostomy Tube Placement, 457 Urinary Catheterization, 622 Wrapping a Pack, 372 Restraint Applying a Gauze Muzzle, 524 Applying a Hog Snare, 548 Applying a Horse Halter, 535 Applying a Twitch, 537 “Burrito” Technique for Wrapping a Cat for Restraint, 528 Flanking a Calf, 545 Halter Tie, 539 Placing a Horse in a Stock, 538 Placing Ca le in a Squeeze Chute, 542 Removing a Dog from a Cage, 525 Restraining a Cat in Dorsal Recumbency, 531 Restraining a Cat in Lateral Recumbency, 530 Restraining a Cat Using a Cat Bag, 528 Restraining a Dog in Lateral Recumbency, 527 Restraining a Dog in Si ing Position, 526 Restraint of Rodents, 532 Se ing up a Sheep, 547 Sternal Restraint for a Cephalic Venipuncture, 527 “Taco” Technique for Wrapping a Cat for Restraint, 528 Avian Nursing Air Sac Cannula Placement, 761 Intraosseous Catheter Placement, 409 Nasal/Sinus Flush, 748 Tracheal Lavage, 749 11 Copyright 3251 Riverport Lane St. Louis, Missouri 63043 PRINCIPLES AND PRACTICE OF VETERINARY TECHNOLOGY, FOURTH EDITION ISBN: 978-0-323-35483-7 Copyright © 2017 by Elsevier, Inc. All rights reserved. No part of this publication may be reproduced or transmi ed in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions. This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein). Notices Knowledge and best practice in this ﬁeld are constantly changing. As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary. Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein. In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility. With respect to any drug or pharmaceutical products identiﬁed, readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of practitioners, relying on their own experience and knowledge of their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions. To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any injury and/or damage to persons or property as a ma er of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein. Previous editions copyrighted 2011, 2004, and 1998. Library of Congress Cataloging-in-Publication Data Names: Sirois, Margi, editor. Title: Principles and practice of veterinary technology / [edited by] Margi Sirois. Description: Fourth edition. | St. Louis, Missouri : Elsevier, | Includes bibliographical references and index. Identiﬁers: LCCN 2016016043 | ISBN 9780323354837 (pbk. : alk. paper) Subjects: | MESH: Veterinary Medicine--methods | Animal Welfare | Animal Technicians | Animal Diseases--nursing Classiﬁcation: LCC SF774.4 | NLM SF 774.4 | DDC 636.089--dc23 LC record available at h ps://lccn.loc.gov/2016016043 Content Strategist: Brandi Graham Content Development Manager: Luke Held Senior Content Development Specialist: Diane Chatman Publishing Services Manager: Jeﬀ Pa erson Book Production Specialist: Carol O’Connell Design Direction: Julia Dummi 12 Printed in China Last digit is the print number: 9 8 7 6 5 4 3 2 1 13 Dedication For my family, especially Dan-the-wonder-husband, and my amazing children, Jen and Daniel. I would be lost without your constant support. 14 Contributors to the Previous Editions Carrie Jo Anderson, CVT, Tampa, Florida Elaine Anthony, MA, CVT, Pinellas Park, Florida Ron E. Banks, DVM, DACVPM, DACLAM, Denver, Colorado Jane Baron-Sorensen, BSN, MA, Santa Rosa, California Susan A. Berryhill, BS, RVT, Topeka, Kansas Robert L. Bill, DVM, PhD, West Lafaye e, Indiana James T. Blackford, DVM, MS, DACVS, Knoxville, Tennessee Christine Bre , RVT, West Lafaye e, Indiana Regina Brotherton, DVM, CCRP, PhD, Slidell, Louisiana Linda J. Brown, AAS, CVT, Urbana, Illinois Marg Brown, RVT, BEd AD ED, Sco sdale, Arizona Maria L. Calabrese, CVT, Philadelphia, Pennsylvania Mary Tefend Campbell, CVT, VTS (ECC), Montgomery, Alabama Lisa A. Centonze, DVM, Tampa, Florida Vincent Centonze, DVM, Plant City, Florida Phillip E. Cochran, MS, DVM, Portland, Oregon Joann Colville, DVM, Fargo, North Dakota Thomas P. Colville, Fargo, North Dakota Markiva Contris, LVT, BA, Lakewood, Washington Michael D. Cross, DVM, † Grand Blanc, Michigan Autumn P. Davidson, AHT, DVM, DACVIM, Davis, California Harold Davis Jr. BA, RVT, VTS (ECC), Davis, California Barbara J. Deeb, DVM, MS, Shoreline, Washington Jacqueline Ann De Jong, LVT, BS, Corvallis, Oregon Gael L. De Longe, DVM, Weyers Cave, Virginia Donald R. Dooley, Los Gatos, California John T. Ervin, BS, DVM, St. Petersburg, Florida Samuel M. Fassig, DVM, MA, Benne , Colorado David J. Fisher, DVM, DACVP (Clinical Pathology), West Sacramento, California Theresa W. Fossum, DVM, MS, PhD, DACVS, College Station, Texas Ruth Francis-Floyd, DVM, Gainesville, Florida Laurie J. Gage, DVM, Vallejo, California Franklyn B. Garry, DVM, MS, DACVIM, Fort Collins, Colorado Peter J. Gaveras, DVM, MBA, Milwaukee, Wisconsin Madonna E. Gemus, DVM, East Lansing, Michigan Richard A. Goebel, DVM, West Lafaye e, Indiana Elizabeth A. Gorecki, LVT, East Lansing, Michigan Shashikant Goswami, BVSc, PhD, St. Petersburg, Florida Sheila Grosdidier, BS, RVT, MCP, Evergreen, Colorado 15 Connie M. Han, RVT, West Lafaye e, Indiana Guy Hancock, DVM, MEd, St. Petersburg, Florida Christi Hayes, BS, Yorba Linda, California Suzanne He s, PhD, Li leton, Colorado Bruce Hopman, MS, DVM, Portland, Oregon Karen Hrapkiewicz, DVM, MS, Dipl ACLAM, Detroit, Michigan Cheryl D. Hurd, RVT, West Lafaye e, Indiana Muhammed Ikram, DVM, MSc, PhD, Fairview, Alberta, Canada Eileen M. Johnson, DVM, MS, PhD, Davis, California Tina Kemper, DVM, DACVIM, Yorba Linda, California Linda R. Krcatovich, LVT, East Lansing, Michigan Michel Levy, DVM, DACVIM, West Lafaye e, Indiana Bertram Lipi , DVM, Stratford, New Jersey Heidi B. Lobprise, DVM, DAVDC, Dallas, Texas Roger L. Lukens, DVM, West Lafaye e, Indiana Danielle Mauragis, AS, CVT, Gainesville, Florida Michelle Mayers, VMD, Charleston, South Carolina Shawn Patrick Messonnier, DVM, Plano, Texas Seyedmehdi Mobini, DVM, MS, DACT, Fort Valley, Georgia Sharyn Niskala, CVT, RVT, LVT, Palm Bay, Florida Jody Nugent-Deal, RVT, Davis, California Donna A. Oakley, CVT, VTS (ECC), Philadelphia, Pennsylvania Sarah Okumura, MA, RVT, CVPM, San Leandro, California Kristina Palmer-Holtry, RVT, Davis, California Catherine Ann Picut, VMD, JD, DACVP, Nutley, New Jersey Stuart L. Porter, VMD, Weyers Cave, Virginia Heather Prendergast, BS, AS, RVT, CVPM, Las Cruces, New Mexico Rose Quinn, CVT, BA, Glenwood Springs, Colorado Angel M. Rivera, CVT, Milwaukee, Wisconsin Bernard E. Rollin, PhD, Fort Collins, Colorado Rebecca Rose, AAS, CVT, Gunnison, Colorado Cheri Barton Ross, MA, Santa Rosa, California Christine Royce-Bre , RVT, West Lafaye e, Indiana Kathy Ruane, BS, RVT, Sco sdale, Arizona Sco W. Rundell, DVM, Morehead, Kentucky Katie Samuelson, DVM, Sco sdale, Arizona Philip J. Seibert Jr. CVT, Calhoun, Tennessee Howard B. Seim III DVM, DACVS, Fort Collins, Colorado Sally B. Smith, LVT, Blairstown, New Jersey Teresa Sonsthagen, BS, LVT, Fargo, North Dakota Kathy A. Sylvester, BA, RVT, VDT, Paramus, New Jersey Terry N. Teeple, DVM, Fort Steliacoom, Lakewood, Washington Amy E. Thiessen, DVM, Stillwater, Oklahoma Vivian Tiﬀany, CVT, St. Petersburg, Florida Mary E. Torrence, DVM, PhD, DACVPM, Blacksburg, Virginia C.L. Tyner, DVM, Mississippi State, Mississippi 16 Wendy E. Vaala, VMD, DACVIM, Kenne Square, Pennsylvania Steven D. Van Camp, DVM, DACT, Raleigh, North Carolina Robert J. Van Saun, DVM, MS, PhD, DACT, DACVN, Corvallis, Oregon M. Randy White, DVM, PhD, DACVP, West Lafaye e, Indiana Sheila M. Wing-Proctor, LVT, East Lansing, Michigan Cathy Winters, LVT, East Lansing, Michigan 17 Preface The roles and responsibilities of the veterinary technician and nurse have continued to evolve and expand, and veterinary technicians and nurses are increasingly expected to perform as independent yet interconnected members of the veterinary health care team. The knowledge required of veterinary technicians and nurses today has increased exponentially since the ﬁrst edition of this text. This fourth edition has been designed primarily for the veterinary technician student with a particular focus on providing a ready reference on the diverse information that will be needed once the student graduates and begins working in the ﬁeld. Discussions present the fundamental information veterinary technicians and nursing students should know and entry-level technicians and nurses will ﬁnd useful. This edition is organized into four sections representing the four major areas of responsibility for the practicing veterinary technician and veterinary nurse. Chapters related to veterinary diagnostics and therapeutics represent the latest advancements in veterinary medicine. Comprehensive information on nursing care of a wide variety of species is also presented with a particular focus on providing procedural details for a vast array of techniques. The increased numbers of avian and exotic animal species seen in companion animal practice is addressed, with greatly expanded chapters on nursing and medicine in these species. The text has been amply illustrated with color photos throughout. Large numbers of tables are used to provide a summary and handy reference for vital information. More than 80 procedures, many of them illustrated, show students exactly how to accomplish complex skills. Each chapter begins with learning objectives, a chapter outline, and key terms. “Technician Notes” throughout each chapter highlight important points and provide helpful tips to improve knowledge and skill. Recommended readings provide additional sources of detailed information on the topics. It is my hope that this new edition will become an essential reference in the teaching of veterinary technicians and veterinary nurses and will be utilized in their daily practice of veterinary nursing technology. Margi Sirois 18 Acknowledgments Many people are involved in the production of a book. I am grateful for the hard work of the contributors to the previous editions. I have been blessed to beneﬁt from the expertise of many mentors throughout my career and am grateful to all of them. I thank God every day for blessing my life with the world’s most amazing husband, Dan, and my children, Jen and Daniel. I am truly blessed to have them by my side. Finally, to all my friends at Elsevier that have helped and encouraged me through the years. Thank you! 19 How to Use This Learning Package Principles and Practice of Veterinary Technology is the ultimate learning package for preparing students to become veterinary technicians. It provides a solid foundation for the basic and advanced clinical skills students must master to achieve competence, and its student-friendly style clariﬁes even the most complex concepts and procedures to help prepare for the VTNE and certiﬁcation. Textbook Features 20 Evolve Website The Evolve website includes free learning resources available to instructors and students using Principles and Practice of Veterinary Technology. At the front of this textbook is a page introducing the Evolve site. All you need to get started is a computer with an internet connection. To register as a Student or Instructor, enter the following URL: h p://evolve.elsevier.com/Sirois/principles/. Follow the directions for either “Instructors” or “Students” to create an Evolve account. You will have to do this only one time. Student resources include: Image collection containing all of the images from within the book Exercises including matching, illustration labeling, multiple-choice questions, and more Answer Key to Review Questions found at the end of each chapter Instructor resources include: TEACH Lesson Plans PowerPoint Lecture Presentations Test Bank in Examview including more than 1400 questions Image collection containing all of the images from within the book Access to all the student resources AVMA-required tasks and competencies are mapped to procedures and discussions in the text Conversion guide Additional Resource Mosby’s Veterinary PDQ, Second Edition (ISBN: 978-0-323-24066-6) Margi Sirois, EdD, MS, RVT 21 You will be able to enter the clinical se ing conﬁdently with this full-color, pocket-sized reference that oﬀers instant access to hundreds of veterinary medicine facts, formulas, drug calculations, lab values, procedures, and photographs of parasites, laboratory diagnostic samples, and instruments for easy identiﬁcation. 22 PA R T 1 Foundations of Veterinary Practice OU TLIN E 1. Overview of Veterinary Technology 2. Ethical, Legal, and Safety Issues in Veterinary Medicine 3. Practice Management 4. Effective Communication in Veterinary Practice 5. Medical Terminology 23 1 Overview of Veterinary Technology OUTLINE Education of Veterinary Technicians Nomenclature Describing Veterinary Personnel Scope of Veterinary Technician’s Duties Career Opportunities for Veterinary Technicians Salary Ranges for Veterinary Technicians Credentialed Veterinary Technicians: Certification, Registration, and Licensing Veterinary Technician Specialties The Future of Veterinary Technology Veterinary Technician Professional Organizations and Resources LEARNING OBJECTIVES After reviewing this chapter, the reader will be able to: 1. Describe educational requirements of veterinary technicians. 2. Define appropriate nomenclature describing veterinary personnel. 3. Identify veterinary technician duties. 4. Differentiate between certification, registration, and licensing. 5. Compare career opportunities and salary ranges. 6. Recognize professional organizations supporting veterinary technicians. 7. Define Veterinary Technician Specialist (VTS) and identify paths to specialty certification. 8. Define trends in veterinary technology. KEY TERMS Academy Accreditation Policies and Procedures of the AVMA CVTEA Manual Certiﬁcation Commi ee on Veterinary Technician Education and Activities Credentialed veterinary technician Licensure Registration Society Veterinarian Veterinary Assistant Veterinary Practice Acts Veterinary team Veterinary Technician Veterinary Technician Specialist 24 Veterinary Technologist Veterinary technology Veterinary technology is a relatively new group of paraprofessionals in veterinary medicine, similar in many respects to nurses in human medicine. The ﬁrst class of Animal Health Technician students in the United States graduated in 1972. The National Association of Veterinary Technicians in America (NAVTA) began representing veterinary technicians in 1981. By the American Veterinary Medical Association’s (AVMA) deﬁnition, a veterinary technician must be a graduate of an AVMA- accredited college program in veterinary technology and work under a licensed veterinary practitioner (DVM or VMD). The emergence of educated veterinary technicians as members of the veterinary team has been an important development for the veterinary profession. This change was in its infancy in the 1960s, in the developmental stage in the 1970s, dynamically improving in the 1980s, and matured in the 1990s. Now, heading toward 2016, veterinary technology is projected to grow 30% and is considered one of the fastest growing careers. Veterinary technicians will continue to play an increasingly important role in the veterinary profession, such as nurses do in human medicine. Education of Veterinary Technicians At the present time there are over 200 AVMA-accredited veterinary technology programs, including 9 accredited distance education programs. To a ain AVMA accreditation, veterinary technology education programs must meet 11 minimum standards pertaining to facilities, faculty, admission requirements, and curricula. All programs are required to provide training in a variety of clinical tasks as speciﬁed by the AVMA’s Commi ee on Veterinary Technician Education and Activities (CVTEA). Each program must document that all students acquire technical skills to enable them to be productive employees and develop the capabilities to perform satisfactorily in a position of increasing responsibility. The curricula must be designed to provide hands-on experience to ensure that each student performs all essential tasks listed in the Accreditation Policies and Procedures of the AVMA CVTEA Manual. Proﬁciency outcomes for each procedure depend on the program emphasis and the number of times students have practiced these tasks. Students are required to complete an internship at a veterinary hospital (or similar se ing), honing their technical skills and learning the fundamental structure of working in a hospital. For the 2014-2015 academic year more than 27,000 students were enrolled in AVMA CVTEA-accredited programs, representing campus and distance education programs. More than 5000 veterinary technicians graduated in 2014. Further information can be found at www.avma.org. Nomenclature Describing Veterinary Personnel The AVMA recognizes the value of veterinary technicians as an integral component of veterinary medicine and urges full utilization of veterinary technicians. The veterinary profession is enhanced through eﬃcient utilization of each member of the veterinary healthcare team by appropriate delegation of tasks and responsibilities to support staﬀ. AVMA Policy on Veterinary Technology Preamble The following deﬁnitions provide more complete descriptions that encompass the latest developments in the profession from the AVMA. Veterinary technology is the science and art of providing professional support to veterinarians. AVMA CVTEA accredits programs in veterinary technology that graduate veterinary technicians and/or veterinary technologists. A veterinary technician is a graduate of an AVMA-accredited program in veterinary technology. In most cases the graduate is granted an associate degree. A veterinary technician’s duties are similar to, in human medicine, those of a registered nurse, nurse-anesthetist, operating room technician, dental hygienist, medical laboratory technician, or radiographic technician, all combined into one team member. Professional nursing-related duties that produce income are delegated to a veterinary technician by a licensed DVM in a fee-for-service veterinary practice. Veterinary technicians may also work in research, education, sales, or governmental positions. A veterinary technologist is a graduate of a 4-year, AVMA CVTEA-accredited program who holds a baccalaureate degree from veterinary technician study; or a graduate veterinary technician with a bachelor of science (B.S.) degree in another program with studies in supervision, leadership, management, or a scientiﬁc area. Duties of veterinary technologists include veterinary 25 technician duties, often in combination with personnel or hospital management. They may be employed as teachers, research associates, group leaders, sales managers, or clinical technologists in a specialty practice. Both technicians and technologists, by veterinary practice law, are unable to diagnose, prescribe medications, or perform surgery. A veterinary assistant is a person with less education and training than that required of a veterinary technician. Veterinary assistants can be compared with nurses’ aides in human medicine. Generally veterinary assistants are trained on the job (OTJ), but some short-term training programs exist. While accreditation of veterinary assistant programs is not required, NAVTA has a process whereby veterinary assistant programs can be approved. Individuals that complete NAVTA-approved veterinary assistant programs are eligible to take the “approved veterinary assistant” examination. Duties of assistants may include restraining, feeding, and exercising patients, cleaning hospital and boarding premises, and other clinical support tasks. These aides may also be described by the terms clinical, hospital, technician, ward, or veterinary combined with aide, a endant, caretaker, or assistant. They are most appropriately called technician assistants or clinical aides, rather than veterinary assistants. Confusion occurs when comparing duties to a physician’s assistant (PA in human medicine) who has more training and requires less supervision than a registered nurse, in contrast with the clinical aide (nurse’s aide). A veterinarian is a doctor of veterinary medicine. A veterinarian is a graduate of a 4-year AVMA-accredited veterinary college program. There are presently 30 AVMA-accredited veterinary schools in the US, as well as 5 in Canada and 14 in other countries that are also AVMA accredited. To practice veterinary medicine, veterinarians must pass a licensure examination in the states or provinces in which they wish to practice. Most veterinarians graduating today have 4 years of preveterinary studies, with a B.A. or B.S. degree, in addition to 4 years of study at a veterinary university, culminating in a Doctor of Veterinary Medicine degree (DVM or VMD). A veterinary team is a combination of doctors, paraprofessionals (veterinary technicians and/or technologists), and support staﬀ (receptionists, managers, technician assistants, and caretakers). The AVMA encourages schools, organizations, and regulatory authorities to use the standard terminology described above. Scope of Veterinary Technician’s Duties Through recent campaigns by national and state organizations, the general public is becoming more aware of the role of veterinary technicians and the compassionate, skilled care they provide to family pets, companion animals, and livestock. Continued support and improved management practices will leverage the role of veterinary technicians. In the past, veterinary management was doctor centered. Now as well-managed practices become client centered, benchmark standards are achieved and team eﬃciency improves. These advancements allow for increased employee satisfaction, retention, and salaries. Veterinary schools are teaching veterinary students to view themselves as the “delegators” and not necessarily the “doers.” With advanced practice management understanding, veterinary students learn team delivery systems and understand how tasks are delegated to the appropriate employee within the hospital. When practice owners, typically veterinarians, delegate duties to educated, certiﬁed managers, veterinary hospitals reach new heights in productivity and human resource potential. Because of the increased awareness and high demand for educated veterinary technicians, students graduating with a degree in veterinary technology have the choice of well-managed practices oﬀering salaries high enough to keep them in the profession. Technicians who are unhappy with their current job conditions must take a good look at all their options. There are veterinary clinics oﬀering beneﬁts, appropriate compensation, career advancement, vacation time, continuing education, and retirement plans. Veterinary technicians are now assuming a major role in practice by performing medical and surgical nursing procedures, laboratory testing, anesthesia induction and maintenance, monitoring during recovery, management, team training, and other clinical procedures. Veterinarians delegate many income-producing procedures to veterinary technicians and managers empower their teams to excel. This enables the veterinarian to concentrate on prescribing medications, diagnosing, and surgery, increasing his or her productivity (Box 1-1). For many years consultants have urged veterinarians to delegate technical tasks to technicians; now that advice is being passed on to practice managers and administrators. NAVTA considers delegating tasks to technicians a cornerstone in the eﬀective delivery of veterinary medicine. Table 1-1 contains an example to demonstrate practice revenue when a veterinary technician performs a skill versus the same skill performed by the veterinarian. In the calculation example, the task identiﬁed was for a blood draw, taking 10 minutes at a charge of $10, performed 80 times a week. In the equation, a technician is paid $15 an hour and the veterinarian is paid $50 an hour. Simply stated it is in a veterinarian’s best interest to delegate appropriate tasks to the appropriate employee. Imagine how valuable the technical staﬀ are when they are fully empowered and leveraged. Apply this tool to producing radiographs, calculating anesthesia and induction, taking a complete history, and completing diagnostic testing. B O X 1 - 1 S c o p e o f Ve t e r i n a r y Te c h n i c i a n ’ s D u t i e s Caring for the Hospitalized Patient Administration of medication Sample collection Physical therapy Specialized intensive nursing care Bandage/dressing application Nutritional management 26 Clinical Pathology Specimen collection Hematology procedures Microbiology techniques Parasite evaluations Biochemical analysis Cytology examinations Urinalysis Outpatient/Field Service Physical examination History taking Client education Administration of medication Administration of vaccines Specimen collections Radiology Patient preparation and positioning Radiation calculations and exposure Radiation safety Radiographic ﬁlm developing Maintenance of equipment Anesthesiology Preanesthetic evaluation Administration of local anesthetics Administration of general anesthetics Monitoring Patient recovery Dental Prophylaxis Examination of oral cavity Cleaning and polishing teeth Surgical Assisting Patient preparation Instrument/equipment sterilization Surgical suite preparation and maintenance Assistance during surgical procedures Postoperative patient care Wound management Oﬃce/Hospital Management Medical supplies inventory control Bookkeeping and practice management Supervision of hospital personnel Training of hospital personnel Reception duties and client education Biomedical Research In addition to the above areas of responsibility, veterinary technicians in research may also: Supervise operations in research colonies and biomedical facilities Assist in design and implementation of research projects 27 TABLE 1-1 How Delegation Can Raise Income for the Procedure: Blood Draw Fraction of Task Performed by Technical Staﬀ Income Estimate per Week Income Estimate per Year 0.00% 10.00% $ 180.00 $ 9360.00 20.00% $ 226.67 $ 11,786.67 30.00% $ 273.33 $ 14,213.33 40.00% $ 320.00 $ 16,640.00 50.00% $ 366.67 $ 19,066.67 60.00% $ 413.33 $ 21,493.33 70.00% $ 460.00 $ 23,920.00 80.00% $ 506.67 $ 26,346.67 90.00% $ 553.33 $ 28,773.33 100.00% $ 600.00 $ 31,200.00 Career Opportunities for Veterinary Technicians NAVTA has coordinated several national surveys, conducting the survey every 4 years. In the last survey (completed in spring of 2012), the average respondent had more than 12.8 years of experience, worked at the same hospital for 7.2 years, and was a 40- year-old woman. Ninety-ﬁve percent of respondents were women. The average yearly salary was $35,060 (Fig. 1-1) with part- time workers making an average of $16.80 per hour. Te chni ci a n N o t e You can easily track the average salary in your surrounding area or in a location you are considering moving to by researching information found on www.salaryexpert.com. Search the title Veterinary Technician, place in the zip code, answer a few questions, and receive a free report. Use this information when discussing a raise with your manager. NAVTA’s 2012 survey results did not provide speciﬁc salary averages for various sectors. However, according to the NAVTA 2007 survey, 84% of career positions for veterinary technicians are in veterinary practices. Technicians in mixed-animal practices were making the lowest yearly salary at $28,960. Technicians in specialty and food animal practices were making more than $39,000 a year (Fig. 1-2). Nonpractice career opportunities include veterinary technician education, university/college, diagnostic/research, not-for-proﬁt organizations, working for the government, and industry. Professional technicians working in industry were making $51,510. Those in diagnostic/research facilities brought home $45,060 (Fig. 1-3). Other facts to consider related to the 2007 NAVTA survey: 1. Since 1995 the largest jump in salaries was in food animals. 2. 26% of those working part-time were receiving $12 to $14.99 an hour. 28 FIGURE 1-1 Historic figures with average salaries for veterinary technicians. 3. NAVTA member beneﬁts were signiﬁcantly higher than their nonmember counterparts. 5. Seventy-seven percent of respondents had an associate degree, 34.2% had a baccalaureate degree, and 4.4% had a graduate degree. Salary Ranges for Veterinary Technicians It is clear that veterinary technicians can make varied salaries depending upon their career path. Technicians choosing to work in a small, rural, mixed-animal practice may make $14.50 an hour. A technician working for a progressive, well-managed specialty practice may make $20 an hour. A technician may choose to take on management tasks and be promoted to head technician. Along with that promotion comes more responsibilities and $19 an hour (according to an AAHA survey completed in 2007). Another option is working for a corporation as a sales representative ge ing both a commission on sales and $26 an hour. The choices are numerous, the salaries varied, the responsibilities diﬀer, and skill sets have transformed to meet the growing demand. A great tool at your ﬁngertips is www.salaryexpert.com. When viewing their site you can enter Veterinary Technician as the title, select a zip code or city you wish to research, answer a few general questions, and request a free salary report. You will be able to determine what the average hourly wage is for technicians in that region along with a few cost-of-living expenses. Recent research on NAVTA’s career center in conjunction with the Veterinary Career Network (VCN) revealed the following job openings for veterinary technicians: 222 Private Practice 11 Nonproﬁt/Association 8 Academia/Research 10 Other 3 Industry 1 Government/Military 29 FIGURE 1-2 Historic figures with average salaries for veterinary technicians in private practice. FIGURE 1-3 Historic figures with average salaries for veterinary technicians outside of private practice. There are hundreds of career-oriented sites allowing you to post your resume and search available positions. View career opportunities and increase your networking. Credentialed Veterinary Technicians: Certification, Registration, and Licensing Upon graduating from an accredited AVMA program, veterinary technicians are eligible to take the Veterinary Technician National Exam (VTNE). The Veterinary Technician Testing Commi ee (VTTC) of the American Association of Veterinary State Boards (AAVSB) is a commi ee of veterinarians and technicians appointed by various professional organizations to validate the VTNE. The AAVSB owns and administers the test. View their site to ﬁnd out exactly who gives the test in each state, www.aavsb.org. Under the veterinary technician section of the AAVSB website, you will ﬁnd contact information for the program administrator who can answer more of your questions. VTNE scores may be transferred to other states through the AAVSB Technician Information Verifying Agency (TIVA). Te chni ci a n N o t e Upon graduating from an AVMA-accredited program, you are eligible to take the VTNE. To learn more, visit www.aavsb.org. 30 All technicians who maintain their certiﬁcation, registration, or license after passing the VTNE are referred to as credentialed veterinary technicians. Depending on the state and type of governing body, veterinary technicians are considered certiﬁed, registered, or licensed; standards vary greatly among states. Contact your local technician association, veterinary medical association, or veterinary state board for further information. Certiﬁcation is generally kept by a private or professional organization (i.e., a state veterinary technician association) and is often voluntary. Registration and licensure are usually maintained by the state government, veterinary state board, or veterinary technician association and may be mandatory. Continuing education requirements, dues fees, and applications diﬀer from state to state. State technician associations vary in membership beneﬁts. Te chni ci a n N o t e All states credential veterinary technicians diﬀerently. Visit www.aavsb.org to ﬁnd out which agency maintains your credentialing. Veterinary technicians are educated to follow speciﬁc ethical and legal guidelines while working under the direction and supervision of a licensed veterinarian. The employing veterinarian has the ultimate responsibility for using a technician in an appropriate, ethical manner consistent with state and federal laws. According to the state Veterinary Practice Acts, only the veterinarian can legally diagnose diseases, prescribe therapy, perform surgery, and issue a prognosis (predicted medical outcome). Chapter 2 presents detailed information on the laws and ethics of veterinary practice. Veterinary Technician Specialties NAVTA’s Commi ee on Veterinary Technician Specialties (CVTS) oversees the specialty academies that credential Veterinary Technician Specialists. Your career will advance when you take on the commitment to become a specialist. There are currently twelve academies. More groups are petitioning to become an academy and others are in the society stage. The CVTS is comprised of NAVTA board members, general members, and liaisons from the academies. The commi ee meets regularly to review new petitions and to review annual reports. View www.navta.net for more information. Te chni ci a n N o t e Your national association oversees the guidelines and reviews veterinary technician specialties. Research your options at www.navta.net. Align your passions; set a goal; take your skills to the next highest level, become a VTS. In most cases a society is created by individuals with a common interest in a veterinary technician discipline; there are bylaws, dues, relationships built with allied groups, and leadership opportunities. Once a society has an established foundation of members and primary focus (e.g., Emergency and Critical Care Society), there is a survey completed indicating a need for the specialty; then there is a petition sent to the CVTS to create an academy. An academy has its own bylaws, leaders, application commi ee, testing commi ee, and credentialing commi ee. Academies set up guidelines and ethics for testing a specialist and only those society members who have completed rigorous training and passed the specialty test can become an academy member and specialist. Once a technician has become a specialist (e.g., VTS; Emergency Critical Care), the technician is required to maintain professional membership dues, a end speciﬁc continuing education courses, author articles or peer review papers, present technical lectures, and follow the ethical code related to that specialty. Box 1-2 contains a list of current veterinary technician specialty academies. Academies have similar applications and credentialing requirements. View their websites for complete information. Essentially, if there is a veterinary specialty, there is a chance for a veterinary technician specialty. Box 1-3 contains a list of current veterinary specialty colleges. Veterinarians who complete additional specialized training and pass a certifying examination are referred to as Diplomates of their respective veterinary specialty college. B O X 1 - 2 C u r r e n t Ve t e r i n a r y Te c h n i c i a n S p e c i a l t y A c a d e m i e s Academy of Veterinary Technicians in Anesthesia and Analgesia (AVTAA) Academy of Veterinary Behavior Technicians (AVBT) Academy of Veterinary Clinical Pathology Technicians (AVCPT) Academy of Veterinary Technicians in Clinical Practice (AVTCP) Academy of Veterinary Dental Technicians (AVDT) Academy of Dermatology Veterinary Technicians (ADVT) Academy of Equine Veterinary Nursing Technicians (AEVNT) Academy of Veterinary Emergency and Critical Care Technicians (AVECCT) Academy of Internal Medicine for Veterinary Technicians (AIMVT) Academy of Veterinary Nutrition Technicians (AVNT) Academy of Veterinary Surgical Technicians (AVST) Academy of Veterinary Zoological Medicine Technicians (AVZMT) B O X 1 - 3 C u r r e n t Ve t e r i n a r y S p e c i a l t i e s American Board of Veterinary Practitioners 31 American Board of Veterinary Toxicology American College of Animal Welfare American College of Laboratory Animal Medicine American College of Poultry Veterinarians American College of Theriogenologists American College of Veterinary Anesthesia and Analgesia American College of Veterinary Behaviorists American College of Veterinary Clinical Pharmacology American College of Veterinary Dermatology American College of Veterinary Emergency and Critical Care American College of Veterinary Internal Medicine American College of Veterinary Microbiologists American College of Veterinary Nutrition American College of Veterinary Ophthalmologists American College of Veterinary Pathologists American College of Veterinary Preventive Medicine American College of Veterinary Radiology American College of Veterinary Sports Medicine and Rehabilitation American College of Veterinary Surgeons American College of Zoological Medicine American Veterinary Dental College The veterinary specialty colleges, in the past, have been very supportive of the technician counterpart. These relationships are extremely important and aﬃrm the working relationships that have grown through the decades between veterinarians and their technicians. Veterinarians and technicians taking their careers to the specialty realm receive many beneﬁts: credibility, respect, and typically an increase in salary. Patients and clients are best served by specialists, and the perceived value is much higher. Te chni ci a n N o t e Join your local or state veterinary technician association. Beneﬁts include networking, personal and professional growth, camaraderie, and more. You will reap the most beneﬁts when you actively participate, sit on a commi ee, a end meetings, become a leader, and step outside of your comfort zone. The Future of Veterinary Technology For veterinary technology to advance as a profession, veterinary technicians must join state, specialty, national, and professional organizations to advance the cause for be er utilization of veterinary technicians, a ain greater professional recognition, develop more eﬀective continuing education programs, and generally represent its members in political, legal, and other related ma ers. Well-managed veterinary hospitals embrace, empower, retain, and support their veterinary technicians. Future advancements in utilization of veterinary technicians depend on the collective eﬀorts of veterinary technicians and allied organizations, to include veterinary hospital managers, veterinary medical associations, and specialty academies. Your involvement is crucial. Your career is what you make of it. No longer can technicians blame the veterinarians for low pay and dissatisfaction. There are veterinary hospitals and career options that can fulﬁll all your needs, ﬁnancially, professionally, and emotionally. Te chni ci a n N o t e Your national association is only as good as the number of active members. For you to receive the most beneﬁts of membership, you must be engaged. Become a member at www.navta.net. Trends in veterinary technology will likely be in veterinary technician specialties, alternative medicine to include animal massage and acupuncture, large animal procedures, pet hospice care, relief veterinary technician services, management, and industry’s increased awareness of the role veterinary technicians can play in corporations. Veterinary pet health insurance will have more policy holders, hence the need for veterinary teams to learn about and recommend third-party payments. More veterinary technicians will become practice owners, expanding their career options and the opportunity for veterinarians to sell their practices. (Check your state laws to see who can be a veterinary practice owner.) There may be a trend toward a title change to veterinary medical technician or even veterinary nurse. This demand may be initiated by the public and not necessarily the veterinary profession. And yet one more trend may be toward certiﬁcation of technician assistants. We will see what the next decade brings. Veterinary Technician Professional Organizations and Resources Te chni ci a n N o t e As a veterinary technician, your responsibilities are threefold: to care for the animals you tend to, work in harmony with your veterinary team, and build strong relationships with your clientele. Professionalism is imperative to your success, through 32 proper communications with your veterinarians, co-workers, and pet owners. Your career will reach new heights when you actively participate in professional organizations. Professionalism, eﬀective communication, networking, and outstanding technical skills in your career choice will make you stand out above the rest. There are numerous groups to choose from that will elevate your status and the choices are growing at a rapid rate. When you join you increase the membership base, open many doors for networking, and amazing synergy grows. Each state association has its own mission, vision, and values. National organizations also have deﬁned purposes and goals. Research the many organizations that align with your values and support your career. Box 1-4 lists a few of the national groups, organizations, and sites that support veterinary technicians and a brief synopsis of the beneﬁts to members. B O X 1 - 4 G r o u p s , O r g a n i z a t i o n s , a n d S i t e s t h a t S u p p o r t Ve t e r i n a r y Te c h n i c i a n s NAVTA The National Association of Veterinary Technicians in America was created in 1981 to be the national voice of the veterinary technician. Currently there are approximately 28,000 members. It is their goal to inﬂuence the future of NAVTA members’ professional goals, foster high standards of veterinary care, and promote the veterinary healthcare team. Their website oﬀers a career center, continuing education, state representative contacts, specialty section, quarterly journal (TNJ), information on student chapters (SCNAVTA) and National Veterinary Technician Week (NVTW), and more. www.navta.net AVMA Created in 1863, the American Veterinary Association currently has more than 86,000 members. They have a commi ee that accredits veterinary technician programs around the United States and Canada (CVTEA). The AVMA acts as the collective voice for the veterinary profession. It lists all of the state VMAs and may help you ﬁnd your state VTA. www.avma.org RVTTC The Registered Veterinary Technologists and Technicians of Canada has a career center, VTNE study guide, a list of technician programs, continuing education, and more. www.rv canada.ca CVMA The Canadian Veterinary Medical Association has a list of accredited programs, career center, and more. h p://canadianveterinarians.net/ IVNTA The International Veterinary Nurses and Technicians Association consists of member countries that seek to foster and promote links with Veterinary Nursing/Veterinary Technician staﬀ worldwide by communication and cooperation. www.ivnta.org AVTE The Association of Veterinary Technician Educators oﬀers a biennial symposium, continuing education, career links, a professional journal, recommended review materials for the VTNE, and newsle ers. www.avte.net VHMA Created in 1981, the membership of Veterinary Hospital Managers Association, currently 1500, includes a number of veterinary technicians. In fact, 25% of certiﬁed veterinary practice managers (CVPM) are veterinary technicians. This organization oﬀers continuing education courses, maintains certiﬁcation for practice managers, conducts surveys, generates a monthly newsle er, and is rapidly growing. www.vhma.org VetPartners VetPartners is a resource for veterinary consultants. Members consist of veterinarians, veterinary technicians, practice managers, industry leaders, lawyers, business associates, and more. Review their site if you wish to become a consultant, want to network with consultants, or need to hire a consultant. www.vetpartners.org AAVSB The American Association of Veterinary State Boards recently became the owner of the Veterinary Technician National Exam (VTNE). The exam is oﬀered during three examination periods each year. This organization will help you transfer your scores, oﬀers mock exams, lists state technician associations, and has a list of preparation reading resources for the exam. www.aavsb.org AAHA Created in 1933, the American Animal Hospital Association accredits nearly 14% of veterinary hospitals serving approximately 6000 practice teams. The standards of excellence expected in both veterinary medicine and practice management are quite high. Students and veterinary technicians can also become a member of AAHA, even if the veterinary hospital where you work is not a member. Continuing education, career center, and bookstore discounts are but a few of the beneﬁts of membership. www.aahanet.org VSPN 33 The Veterinary Support Personnel Network has been going strong since 1996 and is fully supported by Veterinary Information Network (VIN). Membership is free. They oﬀer online continuing education (since 2001), live chats, surveys, a bookstore, and more. www.vspn.org VetMedTeam Created as the ﬁrst site oﬀering continuing education to the entire healthcare team, VetMedTeam oﬀers VTNE reviews, membership polls, advanced course studies, and practice management and assistant classes. www.vetmedteam.com WhereTechsConnect The largest career center for veterinary technicians and staﬀ, this site was created in 2001. Simply post your resume, review career tips, view hospitals seeking technicians, and participate on their discussion board; all services free for veterinary technicians. Continuing education is also posted. www.wheretechsconnect.com MyVeterinaryCareer Created in 2007, this company provides personal career management and recruitment. Through their personalized approach, individual preference review, and your identiﬁed values, their team will help match you to a veterinary hospital that aligns with your personal mission, goals, and values. www.myveterinarycareer.com DVM360 Site oﬀering access to numerous magazine articles, such as Firstline, Veterinary Economics, DVM Newsmagazine, and Veterinary Medicine. www.dvm360.com VetFolio Site oﬀering access to numerous journals, conference proceedings, continuing education courses, and more. www.vetfolio.com NetVet Veterinary resource site for veterinary professionals and animal owners. h p://netvet.wustl.edu/ BLS.GOV The Bureau of Labor Statistics provides information about average technician salaries, projections, and more. www.bls.gov SafetyVet Created by a veterinary technician in 1998, this site will help you ﬁnd information on OSHA requirements, safety procedures, your rights as an employee, team training, controlled substance logging, radiation exposure, pregnancy precautions, and more. www.safetyvet.com SalaryExpert Site allows for geographical research of veterinary professional salaries. www.salaryexpert.com Financial Simulator Program Originally created for veterinary students, the website provides access to an exceptionally valuable personal budget program that resides at this University of Minnesota website. It was created by the Hospital Director at this veterinary school, David Lee, DVM, MBA with James F. Wilson, DVM, JD’s editorial oversight. The various elements of this budget program can be used by technicians and students to establish their personal budgets, make plans to repay educational and/or other loans, purchase or lease vehicles, buy homes, plan for retirement, and much more. www.ﬁnsim.umn.edu Review Questions Matching Match the team member with the description. Fill in the Blank Fill in the blanks using the answer choices provided. 1. Upon graduation from an AVMA accredited veterinary technology program, candidate veterinary technicians are eligible to take the ____________________________. 2. The ____________________________________ owns and administers the VTNE. 3. Duties of the ___________________ may include restraining, feeding, and exercising patients, cleaning the hospital and boarding premises, and other clinical support tasks. 34 4. In most cases, graduates of AVMA-accredited programs in veterinary technology are granted an _______________ degree. 5. Veterinary technicians and technologists, by veterinary practice law, are unable to diagnose, ___________________, or perform surgery. Veterinary Technician National Examination (VTNE) American Association of Veterinary State Boards (AAVSB) Veterinary Assistant Associate Prescribe Choose the Best Response Choose the best answer to the following questions. 1. How many years of college do most veterinarians a end to become eligible for a veterinary license? a. 2 b. 4 c. 6 d. 8 2. How many years of college do most veterinary technicians a end to become eligible for credentialing as a veterinary technician? a. 2 b. 4 c. 6 d. 8 3. What is the title used when a veterinarian completes additional specialized training and passes a certifying examination? a. diplomate b. VTS c. DVMS d. boarded 4. What is the title used when a veterinary technician completes additional specialized training and passes a certifying examination? a. diplomate b. VTS c. DVMS d. boarded 5. What organization accredits college programs for educating veterinarians and veterinary technicians? a. VHMA b. AVMA c. NAVTA d. NAVLE Recommended Reading Felstead K. The truth about the technician shortage. Firstline. August 2008. www.dvm360.com. Rose R, Smith C. Career choices for veterinary technicians: opportunities for animal lovers. AAHA Press, books and publications; March 2009. www.aahanet.org. Smith C. Team satisfaction pays: organizational development for practice success. Peshastin, WA: Smith Veterinary Consulting and Publishing, exercises for team development and personal assessment; 2008. www.smithvet.com. Technicians will weather the economic storm, report says. Firstline. February 23, 2009. h p://veterinaryteam.dvm360.com/ﬁrstline/article/articleDetail.jsp?id=583003. The NAVTA Journal. www.navta.net. Veterinary Economics. www.dvm360.com. 35 2 Ethical, Legal, and Safety Issues in Veterinary Medicine OUTLINE Ethics Ethics of Working with Animals Professional Ethics Ethics of Service to the Public Biomedical Research Obligations to the Animal Kingdom Law Laws that Ensure the Quality of Veterinary Service Laws that Provide a Safe Business Environment Laws that Control the Biomedical Industry Safety Occupational Health and Safety in the Biomedical Industry Biosafety Hazard Considerations in Biomedical Laboratories Occupational Health and Safety in Veterinary Practice LEARNING OBJECTIVES After reviewing this chapter, the reader will be able to: 1. Discuss ethical issues and guidelines relevant to the veterinary profession. 2. Describe the veterinary technician Code of Ethics. 3. List and describe general categories of laws relevant to the veterinary profession. 4. Define laws protecting veterinary employees against physical injury, sexual harassment, and discrimination. 5. Explain laws relating to ensuring quality veterinary service. 6. Define laws regulating the biomedical industry and Occupational Health Safety related to research. 7. Identify mechanisms to avoid hazards in the veterinary workplace. 8. Identify primary zoonotic diseases that pose a danger to veterinary personnel. 9. Describe procedures to minimize exposure to ionizing radiation and compressed gases. 10. Describe methods to prevent the spread of infectious diseases. 11. Discuss the content and uses of Material Safety Data Sheets. 12. Identify four biosafety hazard levels and precautions for each. KEY TERMS American Association for Laboratory Animal Science (AALAS) American Veterinary Medical Association/Professional Liability Insurance Trust Animal Welfare Act Board of Veterinary Medical Examiners Centers for Disease Control and Prevention (CDC) Comprehensive Drug Abuse Prevention and Control Act Controlled Substance Act (CSA) Department of Labor 36 Dosimetry badge Drug Enforcement Agency (DEA) Employee handbook Equal Employment Opportunity Ethics Ethylene oxide Federal law Formaldehyde/Formalin Hazardous materials plan Human-animal bond Malpractice/professional negligence Material Safety Data Sheet Negligence Nonexempt employee Occupational Safety and Health Act (OSHA) Personal Protective Equipment (PPE) Respondeat superior Right to Know Law Scavenging system Secondary container labeling Standard Operating Procedure (SOP) State law Veterinary Medical Association Veterinary Technician Association Veterinary State Practice Act Zoonotic hazards Ethics Our lives are governed by rules and laws. As children we are taught the diﬀerences between acceptable and unacceptable behavior. We quickly learn the standards by which to judge the actions of others and ourselves, and easily recognize negative behavior when we encounter it. As adults we intuitively know what is right, what is fair, and what is honest. Our society sets speciﬁc standards for proper living. An ethical person lives by these standards. Laws set the maximum limits from which we can deviate from the acceptable norm, established by the people, for the people, and made law through legislation. When someone does something unethical, is it something illegal? Not necessarily. Ethics are usually based on higher principles than the minimal requirements of the law, and as a member of a profession we are expected to adhere to ethical standards above those acceptable for the populace. Ethics can be deﬁned as the system of moral principles that determines 37 appropriate behavior and actions within a speciﬁc group. Members of the medical profession are expected to adhere to the highest ethical standards. The public accepts, without question, the decisions and judgments made by medical professionals because of their education and expertise. This text was wri en for individuals who work within the veterinary profession. We serve the public and the animal kingdom. A veterinary technician should have a profound commitment to honesty, compassion, proﬁciency, and hard work. Individuals with high ethical standards ﬁt perfectly into the veterinary community. The Veterinary Technician Code of Ethics can be found on NAVTA’s website. The NAVTA Ethics Commi ee created, reviews, and periodically updates the Code. NAVTA also publishes the veterinary technicians oath (Fig. 2-1). FIGURE 2-1 The veterinary technicians oath. (Courtesy of NAVTA) Ethics of Working with Animals The use and abuse of animals has been well documented throughout history. Practices such as rat baiting, dog and cockﬁghts, and the pointless slaughter of animals for sport have passed from commonplace to criminal acts. The American Society for the Prevention of Cruelty to Animals (ASPCA) was created in 1866 and anticruelty laws were passed the same year. Our culture demands that we treat animals with kindness, respect, and compassion. Animals once thought to exist only for our use and pleasure are now considered as individuals with the ability to feel pain and experience stress. Nowhere is this concept more important than in the veterinary profession. The human-animal bond, a very real and maturing concept, deﬁnes the special, healthy relationship between people and their pets. Te chni ci a n N o t e Try these websites to learn more about the human-animal bond: Human Animal Bond Trust, www.humananimalbondtrust.org Human Animal Bond, www.humananimalbond.org The Center for the Human-Animal Bond, www.vet.purdue.edu/chab 38 A veterinary technician is assumed to be an individual with a strong commitment to the care and welfare of animals. Technicians must make a personal determination concerning the status of the animals with which they share the world. There are many ways to look at this complex relationship. Some people ask if the rights of an animal should be the same as for humans; they believe that animals should not be used for any purpose. People, they maintain, are merely the highest form of animal life, and all life is important and equal. If you would not do something to a person, they argue, then it should not be done to an animal. Animal rights activists question the use of animals for food, clothing, entertainment, and biomedical research. Some even question the keeping of animals as pets. They question whether owning a pet is the same as slavery in people. The majority of Americans believe in regulated forms of animal use as long as it is compassionate, humane, and not of trivial importance. Although the public accepts the concept of animal use, it demands nothing less than exemplary care for animals. This is shown in many ways. The public has no tolerance for a dog owner who criminally starves a pet, a commercial puppy mill that houses puppies in unsanitary conditions, or a biomedical facility that violates federal laws that govern the care and use of animals in research. Society considers it a privilege to own an animal. This privilege can be taken away if the owner does not adhere to acceptable standards of animal care. The standards for animal care are continually rising, as well they should. Just as humans have made advances in other aspects of life, our relationship with the animal kingdom continually improves. The veterinary profession can take credit for many positive changes that have beneﬁted animals, and it will continue to strive for greater advances in the future. As your career evolves, you may experience unsatisfactory care and abuse of an animal. Know and understand your state’s laws regarding your obligation as a veterinary professional to report animal abuse to the authorities. There is well-documented evidence that links animal abuse and family violence. The presence of animal cruelty in a household often indicates abuse of other family members. If a veterinary technician is suspicious that an animal has been abused, speak promptly with your veterinarian and oﬃcial authorities. To learn more, contact your local law enforcement agencies, humane society, or veterinary medical association for proper training. Te chni ci a n N o t e View the Humane Society Veterinary Medical Association’s site at www.hsvma.org for details regarding state laws. Many states have statutes and regulations that provide immunity from civil and criminal penalties for veterinarians in connection with reporting animal abuse or neglect. Ethics of the Veterinary Profession Questions of ethics within the veterinary community tend to fall into several major categories. We will look at some of these more closely to be er understand the ethical challenges that can occur within the veterinary profession. Professional Ethics Medicine will always be an art as well as a science. Professional judgment is the freedom given to all veterinarians to treat a case in a manner that they think best. Sometimes the choices made by the professional are not those that others in the profession would commonly choose. There may be a ﬁne line between freedom and standard of care. Who decides the diﬀerence? Each state government has created laws for the veterinary profession wri en in the Veterinary State Practice Act. The Board of Veterinary Medical Examiners, made up of a combination of veterinary professionals and nonveterinarians, is responsible for interpreting the law and the standards of care oﬀered to veterinary patients. The Board’s mission is to protect the consumer and review cases brought against a licensed professional. It is the Board’s job to determine if there was medical negligence or malpractice. The Board of Examiners, in existence through government funding, may impose penalties on a veterinarian or technician when they have determined malpractice or negligence. The veterinary medical board may impose penalties and ﬁnes, require further education in record keeping, send le ers of guidance or admonition, or mandate retraining to avoid future complaints. Suspension of a license to practice is the ﬁnal weapon that a state board uses to ensure that all individuals are practicing to a high standard. You may view your state government website to review past agendas, upcoming meetings, and current professionals who have revoked licenses. In some states, the Veterinary Board of Examiner meetings are opened to the public. You will ﬁnd a ending a meeting is very enlightening. By si ing quietly and listening to the examiners review the cases, you will learn how to avoid revocation of a professional license, whether yours or your veterinarian’s. Te chni ci a n N o t e To locate the laws governing your profession, visit your state or provincial government site to download and read the practice act. State and national Veterinary Medical Associations work closely with their membership to promote and ensure professionalism among their organization. State and national Veterinary Technician Associations are trying to increase membership and awareness of the profession. A genuine eﬀort is made, within the professions, to correct deﬁciencies in individuals whose methods and choices are unacceptable. Licensed veterinarians and technicians may lose their licensing privilege as a result of a chemical substance abuse challenge. Some associations oﬀer peer assistance to help a recovering addict. As an employee, you have an ethical obligation to discuss any ma er concerning animal care that troubles you with the veterinarian. Keep an open mind. Often what may appear as inappropriate action by the veterinarian may be satisfactorily explained with a frank dialogue. In most cases honest discussion will resolve the problem. In extreme cases technicians may have 39 to address their concerns with another veterinarian or the Board of Veterinary Medical Examiners. Cases brought to the Board are critiqued objectively and fairly. Accurate records, documentation of conversations, dates, times, and witnesses are needed to create a solid complaint. Technicians working in the biomedical industry are able to report any suspected acts of animal neglect or abuse to review boards without fear of reprisals. Record keeping is the single biggest defense against a complaint. When writing in a medical record, follow the information outlined in Chapter 3. Properly identiﬁed radiographs, documentation of declined services, and itemized invoices can be reviewed in a case. All entries must be dated, initialed, and legible. Medical records can make or break a person’s professional career. Always consider that when documenting laboratory reports, treatments, conversations, history, postsurgical release forms and ﬁlling prescriptions. Ethics of Service to the Public People who work within the veterinary profession are obligated to serve the public, and in doing so to provide medical care and treatment at a level consistent with the standards of the profession. Members of the profession are morally compelled to report abuses inﬂicted on animals and legally responsible for reporting public health problems. It is well understood that the public pays veterinarians and their staﬀ for their services. In essence, the veterinary hospital enters into a contract with the pet owner, wherein for a certain amount of money, speciﬁc services are rendered. The owner is legally responsible for paying the bill. What are the obligations of the veterinary hospital? Aside from legal obligations of the hospital to competently render the service, the hospital is also morally responsible for treating the animal with care and compassion. Should the presence or absence of a fee determine if a sick animal is treated? Ethically, the veterinarian and the supporting staﬀ are obligated to provide at least basic lifesaving treatment and pain relief whenever possible to any animal in its care. This may include performing euthanasia on a badly injured stray in obvious pain. Veterinary professionals also act as teachers. There is an obligation to communicate with the public in clear, easy-to- understand language. The subjects may be as diverse as the care of an animal with diabetes, the correct use of dispensed medication, or nutritional tips. We are obligated to communicate and inform. Consent forms can be used as an educational tool and help deﬁne the veterinarian-client-patient relationship. Because of concerns regarding this special relationship, the American Veterinary Medical Association (AVMA) has deﬁned the relationship for the use of dispensing prescribed medications and establishing treatment plans. Biomedical Research In the ﬁeld of biomedical research, the veterinary profession is guided by the concept of the “Three Rs.” The concept was developed by William Russell and Rex Burch in 1959. The Three Rs stand for Replacement, Reduction, and Reﬁnement. The public has empowered the veterinary profession to ensure that research strictly follows these principles. Because of the Three Rs, animals are only used when there are no viable nonanimal models, the number of animals used is kept to a minimum, and the comfort of the animal becomes of paramount importance. Every research facility that uses animals must have ongoing veterinary care to ensure that the Three R principles are applied to all animal research. Obligations to the Animal Kingdom The primary function of the veterinary profession is to protect the health and welfare of the animals in our care. We are concerned with the treatment of the sick, the prevention of disease, and the general well-being of all animal life. We have become the animal’s advocate in society. We care, and are proud of our concern. Moreover, we are not hesitant to insist that anyone with animal contact show the proper respect for that living creature. We demand that pain and discomfort always be minimized if not completely eliminated. We understand the bond between animals and humans and foster that bond whenever possible. It is our mission and our duty. Law In the daily practice of veterinary medicine, the veterinarian and veterinary technician are confronted with a wide variety of legal issues that aﬀect their professional or business decisions. Bodies of law governing daily practices occurring within a veterinary clinic often overlap and fall into one of four categories: federal law, state law, local/municipal law, or common law. Federal, state, and local/municipal laws constitute legislative or wri en laws. Relevant governmental authorities and agencies enforce these laws, and violations may be punishable by ﬁnes and/or jail sentences. In contrast, common law is a body of unwri en law (legal interpretation) that has evolved from use and customs and by judicial decisions establishing precedential case law. Government authorities or agencies do not enforce common law in the same way as legislative laws. Common law is enforced by the judicial system when citizens who may have been injured by a violation of the law ﬁle civil lawsuits against the violators. The laws aﬀecting a veterinary practice can be divided into two groups: (1) laws that ensure the quality of veterinary service to patients and (2) laws that provide a nonhostile and safe environment for employees, clients, and the public. Laws that Ensure the Quality of Veterinary Service Practice Acts 40 The Veterinary Practice Act of each state and province is the law deﬁning which persons may practice veterinary medicine and surgery in the state, and under which conditions. Although Practice Acts vary in diﬀerent states and provinces, they generally deﬁne the practice of veterinary medicine and make it illegal to practice without a license, stating the qualiﬁcations for receiving a license, stating the conditions under which a license can be revoked, and establishing penalties for violating the Act. The Practice Acts deﬁne the practice of veterinary medicine and surgery as diagnosing, treating, prescribing, operating on, testing for the presence of animal disease, and holding oneself out as a licensed practitioner. Embryo transfer; dentistry; and alternative forms of therapy, such as acupuncture, massage, chiropractic medicine, and holistic medicine, are often regarded within this deﬁnition of veterinary medicine and surgery, although this may vary in diﬀerent locations. Allowing only licensed veterinarians to legally practice veterinary medicine may raise questions about the duties performed by veterinary technicians or veterinary assistants. After all, many of the procedures performed routinely by technicians (or assistants) fall within the scope of the practice of veterinary medicine and surgery, such as inserting an intravenous catheter, inducing general anesthesia, and extracting teeth (outlined in some practice acts). However, as long as the technician is under the direction and responsible supervision of a licensed veterinarian and the technician does not make decisions requiring a veterinary license, the licensed veterinarian and not the technician is practicing veterinary medicine in such instances. Read your governing body’s practice. Inquiry is your best bet; ask that your governing board enlighten you to your duties and responsibilities with updated literature. Whether a technician is under the direction and responsible supervision of a licensed veterinarian is a subjective determination that takes into account the degree of experience and competence of the technician, the task being performed, and the risks to the patient involved with performing the task. Regardless of how experienced the technician may be, in some states the veterinarian must be on the premises or reachable by telephone or two-way radio communication during and for a reasonable time after any veterinary procedure. Common Law Malpractice When a veterinarian agrees to treat a client’s animal, common law automatically imposes on that veterinarian a legal duty to provide medical or surgical care to that client’s animal in accordance with that of a reasonably prudent veterinary practitioner of comparable training under the same or similar circumstances. A veterinarian’s failure to live up to this particular duty constitutes negligence, which may also be referred to as malpractice or professional negligence. For malpractice to be subject to litigation, the plaintiﬀ must prove three elements: (1) the veterinarian agreed to treat the patient, (2) the veterinarian failed to exercise the necessary legal obligation of skill and diligence in treating the patient (negligence), and (3) the negligence caused injury to the patient. Veterinarians can be found negligent and guilty of malpractice for the injurious actions of a technician or assistant under the common law doctrine of respondeat superior. For example, if a technician mistakenly gave twice the recommended dosage of anesthesia to a patient and this doubled dose caused the death of the animal, the veterinarian may be found negligent and guilty of malpractice as if the veterinarian had given the wrong dosage. If the technician is licensed in the state, the license may also be revoked. Laws that Provide a Safe Business Environment Federal, state, and common laws exist to help ensure safe and nonhostile working conditions for employees of a veterinary practice, as well as safe conditions for the public. Occupational Safety and Health Act Every employer with one or more employees must operate in compliance with the Occupational Safety and Health Act (OSHA) of 1970. OSHA regulations are designed to provide a safe workplace for all persons working in any business aﬀecting commerce. The broad judicial interpretation of commerce includes the business of practicing veterinary medicine and surgery. OSHA requires that all employers “shall furnish to each of his employees employment and a place of employment which are free from recognized hazards that are causing or are likely to cause death or serious physical harm to his employees.” To view the oﬃcial site, go to www.osha.gov. A complete manual is easily downloaded. Material Safety Data Sheets, training, state rules and regulations, ﬁnes, and reporting can be located on the site. As an example, information regarding the 2009 H1N1 inﬂuenza guidelines can be readily downloaded. Common Law Ordinary Negligence Common law establishes for every business owner a legal duty to provide a reasonably safe work environment for employees, as well as a reasonably safe place for clients. Failure to provide this safe environment may constitute ordinary negligence on the part of the veterinarian/business owner. This ordinary negligence is distinguished from malpractice, which is negligence associated with the rendering of professional veterinary medical services. As with malpractice, however, ordinary negligence is not subject to legal action unless it causes injury to a client or employee. For example, if a practice owner provides poor ventilation in a surgical suite and an employee becomes drowsy from anesthetic gases, the employee could not sue and recover damages from the veterinarian unless he or she experiences injury as a consequence (for example, faints and hits his or her head on the countertop). In meeting the obligation to provide a safe environment for employees and clients, a veterinarian has a common-law duty to supervise proper restraint of any animal within the veterinarian’s control. When a client’s animal is being examined and the 41 client restrains the animal, it is the veterinarian and not the client who is primarily responsible for proper restraint of that animal. A veterinarian may be found guilty of ordinary negligence if he or she fails to use reasonable care to avoid foreseeable harm to the restrainer or to other people in the vicinity. The deﬁnition of reasonable care or foreseeable harm varies, depending on the experience or training of the veterinarian and the animal handler, as well as the procedure done on the animal. Veterinarians have been sued by clients because the client restrained his or her own animal during a procedure and the animal bit the client. To avoid a possible lawsuit, do not allow an owner to restrain his or her own animal within a veterinary hospital. Medical Waste Management Laws Veterinarians who own or operate a veterinary practice may be subject to the requirements of state law governing management and disposal of medical wastes (Fig. 2-2). Local laws may impose additional restrictions on what types of waste transporters and disposal facilities may be acceptable. Typical waste included under these acts are discarded needles and syringes, vials containing a enuated or live vaccines, culture plates, and animal carcasses exposed or infected with pathogens infectious to humans or euthanized with a barbiturate. State and local law may extend these categories of regulated veterinary medical waste to include all carcasses, animal blood, bedding, and pathology waste. Review your state and county’s regulations to determine what requirements govern your veterinary hospital. Companies specializing in the disposal of medical waste can also provide accurate information. Added cost of proper disposal must be addressed as overhead generally increases because of the direct cost of the regulation. Hospital policy manuals may outline how to identify hazardous waste and how to properly dispose of it. FIGURE 2-2 Syringes and needles must be discarded in a sharps container. Laws That Maintain a Nonhostile Working Environment There is a body of federal, state, and common law that restricts a veterinarian, as the owner of a business, from engaging in hiring or ﬁring practices that wrongfully discriminate against individuals. Firing an individual for discriminatory reasons constitutes a violation of the federal or state Equal Employment Opportunity (EEO) laws and may provide a basis for the terminated employee to sue the employer under common law for wrongful termination of employment. According to federal EEO laws, an employer of 15 or more employees may not discriminate against employees in hiring or ﬁring practices (or in any practice, for that ma er) on the basis of race, color, religion, sex, or national origin. Sexual harassment and discrimination on the basis of pregnancy or childbirth are forms of sex discrimination made illegal under federal law. Employers also cannot discriminate against individuals in hiring and ﬁring of employees on the basis of age between 40 and 70 years or on the basis of disabilities, including AIDS and rehabilitated drug abuse. At time of hire a manager and new employee may review the Employee Handbook together, discussing the hospital’s philosophies and policies. An acknowledgment of receipt may be signed and placed in the new employee’s ﬁle. Common law also protects employees because it prohibits an employer from terminating that employee for discriminatory reasons or other reasons violating public policy. Under the common law tort of wrongful termination, an employee can directly sue an employer for ﬁring the employee on the basis of sex, race, or religious discrimination, or on the basis that the employee is a whistle-blower (i.e., has complained of sexual harassment or other violations of the law). Laws That Govern Labor 42 The Fair Labor Standard Act (FLSA) establishes minimum wage, overtime, record keeping, and youth employment standards for employees working in the private sector and in government. As a veterinary technician or technologist you generally fall under the nonexempt category (unless you are promoted to an administrative position). At the time of your hire the manager will discuss time cards, overtime, vacation time, beneﬁts, and employment category. Nonexempt employees are entitled to paid overtime when working more than 40 hours in a workweek, even those on salary. Visit the Department of Labor website at www.dol.gov to ﬁnd information related to technicians and technologists. Te chni ci a n N o t e View www.dol.gov to research laws governing labor, wages, beneﬁts, exempt status, and more. Laws Governing Controlled Substances Controlled substances are drugs that may be subject to abuse by team members, clients, and people who burglarize a veterinary hospital. Federal and state laws have been adopted to govern their manufacture, sale, and distribution. In 1970 the US Congress passed the Comprehensive Drug Abuse Prevention and Control Act, regulating the manufacturing, distribution, dispensing, and delivery of certain drugs that have the potential for abuse. Title 2, known as the Controlled Substance Act (CSA), is the section most applicable to the veterinary community. The Drug Enforcement Agency (DEA) is the primary federal law enforcement agency responsible for combating the abuse of controlled drugs. State and provincial laws diﬀer regarding the regulations of controlled substances. Identify the laws governing veterinary hospitals and controlled drugs in the state or province where you work. Classiﬁcations of Controlled Substances are outlined in Chapter 11. Carefully follow all record keeping, storage, and ordering guidelines related to controlled substances (Fig. 2-3). Report possible abuse or tampering with controlled drugs to your supervisor, hospital manager, or veterinarian. Laws that Control the Biomedical Industry During the past century, the biomedical industry has changed our lives. Every antibiotic we use and every vaccine administered to animals and humans can trace its roots to animal research. The life expectancy of humans and their pets is constantly rising. We are living longer, with a higher quality of life, because of the accomplishments of the biomedical industry. These advances have been achieved at the expense of animal life; something that troubles most caring people. Everyone hopes that the day will come when animals are no longer used as research subjects. The reality of the present is that animal research still represents the best hope of mankind to solve its medical problems. The vast majority of our population understands this need and also demands that animal research be performed under strict rules and regulations that ensure the maximum welfare of animals. Hence, laws have been wri en to ensure that animal research is conducted to the highest standards. FIGURE 2-3 The Controlled Substances Act describes record keeping requirements for certain medications. Almost all federal laws on the care and use of animals within the biomedical industry originate from two sources: the Animal Welfare Act (AWA), under the direction of the Secretary of the US Department of Agriculture (USDA), and the Health Research Extension Act, directed by the Secretary of Health and Human Services. The Nati

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