Episode 12 – The Dedication Behind An Emergency Vet Caregiver

In this episode we chat with Miranda David, a Registered Veterinary Technician at our Frederick location. Miranda talks to us about the commitment that goes into getting a Veterinary Technician Specialist designation in Emergency and Critical Care. A VTS is an advanced degree that signifies that a vet technician has demonstrated advanced knowledge and expertise in a specific area of veterinary medicine, beyond the general scope of practice.

To gain her VTS, Miranda has to meet specific requirements, including experience, continuing education, and more. The process is broken into several parts, each of which take an enormous number of hours to complete, and that’s before a tech can even be accepted to take the exam. Learn what this designation means for Miranda and for the patients who come to Partner.

What You’ll Learn?

How to start the process of becoming a VTS.
What’s involved in applying for the application.
The difference is between a case report and a case log
The number of hours that go into gaining this certification.
How Miranda tackled all of this while working full-time.
What the next steps are for this ambitious caregiver.

Are you a veterinary professional looking to make a difference? Learn more about Partner and how you can join our team by visiting our careers page at https://partnervesc.com/careers/.

[Music]

Narrator:

Welcome back to “Did You Know?”, a podcast by Partner Veterinary. In this series, we explore all things veterinary medicine and all things Partner. In each episode, we answer some of the most common questions we are asked—from HR to emergencies and everything in between. If it happens at Partner, we’ll cover it.

In this episode, we’re joined by Miranda David, a registered veterinary technician from our Frederick team. Miranda pulls back the curtain on what it really takes to earn a Veterinary Technician Specialist (VTS) designation in Emergency and Critical Care—and trust us, it’s more intense than you might think.

Miranda David

My name is Miranda David, and I am a registered veterinary technician here at Partner Veterinary Emergency and Specialty. I have my bachelor’s in veterinary technology, which allowed me to get my veterinary technician license.

Jen Mellace:

How did you get started in the veterinary profession?

Miranda David

When I got married 10 years ago, I knew I wanted to get my bachelor’s degree. The small town in New York that my husband and I moved to shortly after getting married happened to have one of only seven bachelor’s programs for veterinary technology at the time. So I thought, “I like animals, I’ll give it a shot.” I had no idea what it meant to be a vet tech. I went to my Vet Tech 101 class and quickly realized I was in over my head. I had no idea how much responsibility I’d be given. So I started volunteering at an animal hospital just to get my feet wet, and I’ve been hooked ever since.

Jen Mellace:

What brought you to Partner?

Miranda David

I’m very excited to be part of the Partner team. I joined about four or five months after the hospital opened, just as I was starting my VTS journey and looking for a hospital that could support me through the process. That’s what brought me here.

Jen Mellace:

When did you decide to apply for the VTS exam?

Miranda David

I’ve been interested in getting my VTS since tech school. It’s always been something I wanted, but it takes many years before you’re even eligible to apply. I knew, starting two years ago, that last year would be my application year. So I started researching and prepping with the skills lists about a full year before I actually submitted the first part of my application.

Jen Mellace:

What do you have to do to be eligible to apply?

Miranda David

The application process varies by academy, but I’m speaking specifically about the Emergency and Critical Care Academy. Just to apply for Part A, you need to have already completed 25 CE (continuing education) credit hours, which doesn’t sound like much, but they must be specifically taught by either a criticalist or a VTS in emergency and critical care. They’re very particular. You also need 6,000 hours worked solely in emergency medicine, all as a registered veterinary technician, and those hours must be completed over at least three years. This helps ensure a work-life balance, since you can’t claim more than 40 hours a week. For Part A, you also need two reference letters written by either a VTS in emergency, a doctor who is a criticalist, or a member of the VEX.

Jen Mellace:

What does this certification mean for you and your patients?

Miranda David

For me, the certification is my ticket to longevity in this career. I love what I do, and I’m very passionate about it, but I know my body won’t be able to handle the physical demands of tech work forever. I’m hoping this will open doors for me in education—I love to teach and would love to lecture. So, hopefully, one day this will bring those opportunities.

For my patients, having a deep understanding of why we do what we do, and how to best monitor and care for our critical patients, allows me to provide them with the best care possible.

Jen Mellace:

What did you have to do to start this process?

Miranda David

The process is broken into three parts. Part A is what I described earlier: submitting those CE credits, proof of licensure, and proof of work history to confirm the 6,000 hours in emergency and critical care. The reference letters are submitted at the same time. Everything is usually due around March, and then you have about a month before you find out if you passed Part A. The application is very particular—you have to follow instructions exactly, from how you upload documents to how you label your files. If you upload something as a PDF when it should be a different format, it won’t even be opened. Attention to detail is critical. I submitted all of Part A last year and was accepted. You then have one calendar year to work on Part B, which is the tough part: it consists of 75 case logs documenting exactly what you did to influence patient care, four case reports (each about five pages long) detailing the disease process and your skills, and a skills list. For emergency and critical care, there are 38 skills, and you must master 29 of them, uploading photos as proof.

Jen Mellace:

Can you give some examples of what’s included on the skills list?

Miranda David

Absolutely. There are 38 items on the skills list, but I only have to master 29, since some skills may not be permitted for licensed veterinary technicians in certain states or hospitals. In Maryland, and at this hospital, I’ve been allowed to do these procedures, which is exciting. The skills range from recognizing normal heart and lung sounds with a stethoscope, performing all aspects of CPR, placing central venous and arterial catheters, to procedures like thoracocentesis or abdominal centesis. It’s fun and exciting to do these skills. Some require photos, which must be taken carefully—no identifying features of the animals, just a snapshot of the skill itself.

Jen Mellace:

This is really intense. There’s so much that goes into this—so much work.

Miranda David

Yeah, you’re right. A core part of this application includes creating four comprehensive case reports and a large number of case logs.

Jen Mellace:

What’s the difference between a case report and a case log?

Miranda David

A case log is basically a brief breakdown of what you did for a case. For each case, I kept a Google Doc to stay organized, listing admit date, discharge, outcome, disease process, diagnosis, and every single thing I personally did for that patient. If something was done but I didn’t personally do it, I can’t include it. For example: assessment, TPR, administering blood transfusions, monitoring for adverse reactions, giving medications, placing IV or central lines—anything I did goes in the log. You’re limited on character count and abbreviations, which makes it tricky for long hospital stays; you have to pick and choose what best shows your advanced skills.

The case report is more like a five-page essay. You start from the patient’s presentation, discuss diagnosis, go in depth into the disease process, explain why you monitor for certain things, potential adverse effects of treatments, and so on. You also have to cite your sources very specifically. These reports take a lot of time. Usually, just having the patient in the hospital is about a week, then my rough draft would take about a month, which I’d submit to my mentors for feedback. Another month for revisions and corrections, so each case report takes about two months from start to finish.

Jen Mellace:

How many hours do you think went into developing each report?

Miranda David

Oh my goodness—so many. It took a lot of time and effort.

Jen Mellace:

And you tackled all of this while working full-time, right?

Miranda David

Yes, and Partner has been great. A lot of what I do at work is basically studying for my reports and for the test, so I could do both at the same time. Of course, many hours were logged outside of work, but it all goes hand in hand.

Jen Mellace:

How do you choose which cases to develop into reports?

Miranda David

That’s tricky. I wanted my case reports to have it all—a disease process I could really discuss, advanced skills to show what I could do, and cases where my monitoring and nursing care influenced the outcome. Finding cases with all three elements is really difficult. By the time I found my fourth case, I was only two months from the deadline and sweating it.

Jen Mellace:

Yeah, in the ER you never know what’s coming in the door.

Miranda David

Exactly—it adds another layer to the intensity.

Jen Mellace:

You mentioned your mentors earlier. Are your mentors part of Partner?

Miranda David

I have mentors both in and outside of Partner. I have to give props to Heather Carter, who has been outstanding in helping me. She brings an attention to detail and writing capability that I didn’t have before. Looking at my first report compared to my last, I really grew a lot thanks to her. Dr. McCoral was also very helpful, making sure my reports were correct and that I understood the textbooks. I also have a mentor who is a VTS in ECC from another work experience who met with me monthly to go through my reports and logs.

Jen Mellace:

It sounds like having mentors and people to help you through is really important.

Miranda David

It’s so important. I really owe a lot to them—they helped ground me throughout the process. I was a stress bucket the whole time.

Jen Mellace:

What happens next? What’s the next step?

Miranda David

Next, you get the opportunity to sit for your national exam. It’s offered once a year, usually at IVECCS, the critical care symposium. Ideally, you get six months from acceptance to taking the test. I don’t know how others do it, but starting in January, I meet with a group of women I met online who are also in the process. We break down textbook material and go through seven to nine chapters a week. It’s a lot—I feel like all I do right now is read—but it’s helpful to go through it together. This is a very intense process, and I think it’s good for people—both those in the industry who haven’t started this journey and clients coming into the hospital—to understand what goes into it. The knowledge, schooling, and time invested to care for our patients is a lot.

I think it’s important to educate our clients, too, because most people have no idea what we do. When I started, I was stunned by the types of things I would actually be doing. I try to explain it to my family, and they still don’t fully understand. It’s definitely a commitment and a passion—thank goodness for people like you who are willing to do this training and care for our pets.

Jen Mellace:

Do you know how many people have this certification?

Miranda David

I’m not 100% sure, but looking at the academy’s website, it seems like there are about 600 active members worldwide with a VTS in Emergency and Critical Care. It’s an international academy.

Jen Mellace:

That’s very few for the entire world.

Miranda David

It’s not many.

Jen Mellace:

If you aren’t accepted to take the exam in March, what’s next for you?

Miranda David

Statistically, it’s not likely I’ll pass on the first try, and that’s okay. I’ve already started collecting cases to reapply if needed, because this is my goal—I really want this certification. If I don’t get accepted with my Part B, I have to completely restart the process: redo Part A, get new reference letters, resubmit all my CE. There’s no “placeholder” where you just redo the section you didn’t pass. It’s daunting, but I’m prepared and have my application ready to go if needed.

Jen Mellace:

For someone who didn’t come from a background in veterinary or human medicine, to come so far and take this path is really impressive. Thank God for people like you.

We wish you the best of luck. We’re all rooting for you and cheering you on. We hope you’re accepted to take the exam in March, that you pass, and you move forward from here. Congratulations so far on your journey, and thank you so much for sharing your experience and letting us know what goes into this—it’s very impressive.

Miranda David

Thank you—it’s so fun. I love it.

Narrator:

“Thank you for listening to ‘Did You Know?’ Is there something about Partner that you want to know? Email us at [email protected]. Who knows? We might turn your question into an entire episode! And you can now find us wherever you listen to all of your other favorite podcasts. Subscribe now!”