See the Full Issue
October 2023
Technician Retention and Leadership
Technician retention and good leadership are inextricably tied, as we discuss in this Central Line podcast episode with Natalie Boursiquot, RVT, and Liz Hughston, MEd, RVT, CVT, VTS (SAIM, ECC). From the role individuals can play in systemic change to insights into how leadership can show technicians—and other employees—they truly matter, this conversation was full of helpful ideas for increasing tech retention.
A Conversation with Natalie Boursiquot, BS, RVT, and Liz Hughston, MEd,RVT, LVT, CVT, VTS (SAIM, ECC)
Technician retention and good leadership are inextricably tied, as we discuss in this Central Line podcast episode with Natalie Boursiquot, BS, RVT, and Liz Hughston, MEd, RVT, LVT, CVT, VTS (SAIM, ECC). From the role individuals can play in systemic change to insights into how leadership can show technicians—and other employees—they truly matter, this conversation was full of helpful ideas for increasing tech retention.
Katie Berlin: As an associate vet, I often felt in a similar boat to a lot of technicians, I think, where I just kind of felt like I was supposed to show up and do the things that I was supposed to do, and I wasn’t really supposed to have an opinion about how we did them because it wasn’t always welcome.
Natalie Boursiquot: Yeah. [A] lot of times, I don’t think we give veterinarians enough credit for the leadership role that they play. It’s important to recognize that, because even as I was learning as an RVT, most of my mentors were veterinarians, and so that role within the hospital is really important for us to foster as a leader. Having been in that practice manager role, I think it’s important from the leadership side to build that relationship between the veterinarian and the RVT or any staff member. Fostering that relationship is what really helps develop the environment that we need for everyone to do their job the best they can.
Liz Hughston: I think leading from within is one of the most difficult things that we can do as team members. It really is about the culture of the practice. I’ll put in a plug for AAHA publishing and just talk about Josh Vaisman’s new book [Lead to Thrive: The Science of Crafting a Positive Veterinary Culture, AAHA, 2023] that just came out, which is fantastic. If you have an environment of positive psychology and psychological safety, then it becomes much easier to lead from within. And I would urge leaders to take a really hard look at whether your environment is fostering that kind of psychological safety, so people feel comfortable speaking up when they see something that is wrong or that they want to change.
“It’s important from the leadership side to build that relationship between the veterinarian and the RVT or any staff member.”
—Natalie Boursiquot, RVT
When you’re in an environment where it’s not safe to talk about your hopes, your dreams, the direction you want to go, it becomes really difficult, no matter what role you’re in. We all have ideas about how we can make things better at the practice, not just for ourselves, but sometimes for everybody. And to be shut down, to be ignored, to feel like your voice isn’t heard, is a major issue.
So you say to your boss, “Hey, I feel like I’m not growing, I want to learn more, I want to get my VTS, I want to move into leadership. How can I do that?” And the boss says something like, “Well, I mean, you’re a technician, that’s what you do, and there’s nowhere for you to go.” Why would a person stay in an environment like that if they’re told there’s no more money for you, there’s no more responsibility, there’s no growth opportunity? All of that comes from a lack of leadership.
A true leader is someone who is open to hearing that kind of feedback and to finding ways to maximize the team that they have. Not only is that going to help the team members, it’s going to help the practice, it’s going to help the bottom line, it’s going to help everything. That’s where leadership is really key, especially in terms of retention.
KB: And the big difference is that when you ask them something, the good leaders don’t say, “We can’t,” and then list all the reasons we can’t. They don’t automatically say yes, but they’ll say, “Well, what would that look like if we could do that?” And they might give you homework to do, leg work: “Okay, you go figure this out, and then we’ll see if we can make it happen,” but they don’t just say no, and that is a huge culture shift on its own.
Natalie, the more you learn, do you find yourself identifying more with that sort of practice owner role, where their job is to keep ahold of the finances and make sure we don’t get too out of line, and don’t set a precedent, or do you feel like the more you learn, the more you realize is possible?
NB: I think definitely in my baby stages as a leader, I fell into that mindset for sure, always thinking about, “Well, that’s not going to work because of blank.” Or, “What’s our labor cost going to look like if I add that extra technician that this doctor is saying they absolutely need?” That’s always how it starts out. But I think a huge part of how we keep our technicians is culture, more than anything, and as I started to learn that, then I started to look at all sides of things.
LH: I think that is super challenging. I get why the knee-jerk reaction is a no. Because it takes a lot of effort on the part of leadership to think about how things might be different. Change is scary, and historically, in veterinary medicine, we’ve been a little bit risk-averse, a little bit change-fearful. I think leaders are now recognizing that, oftentimes, they’re put in a position without training, without mentorship, without their own growth in mind. It’s because they’ve been there the longest, or they want more money and they’re told the only way they can get more money is if they go into a management role, even if they don’t want a management role. I think the industry is starting to wake up to the idea that this isn’t the best way to create leaders in the practice.
And so now, I think there’s a much bigger focus on [making] sure we have the best leaders that we can, because we’re in this moment of crisis where we don’t have enough people in the profession to do the work, to care for the pets that we need to care for. And we have to find a way. We can’t graduate our way out of this crisis. We have to find a way to keep people, to bring people back to the profession. I can’t tell you how many veterinary technician groups I’m in where people say, “I left to go to nursing school and I regret it every day. I left vet med because of X, Y, Z, and I miss it so much. I wish I could come back. I wish that I could make a living and work only one job. I wish that I was respected as a professional. I wish that my title meant something.”
KB: It’s not that people are running away from vet med because they hate it. It’s work that really is a calling for a lot of people, and they just can’t imagine doing anything else—but they are forced to, either to care for themselves or to care for their families, or to be able to go home at night sometimes instead of going to be a hostess at whatever restaurant because they can’t make ends meet.
I know there are a lot of places that have good intentions, and execution may be lagging behind the intentions a little bit, because life is super busy and stressful. And even if you have a study that says it’s worth this much to really work on the culture of your practice and really work on psychological safety, it’s still hard to prioritize that. How have you seen that process get jump-started?
LH: It seems kind of trite, but it really does start at the top. If you have a commitment from the leadership—and the top can be your hospital manager if you’re in a corporate chain—I think we can all start at our own level to bring that to our work every day. Natalie hit it exactly right, that personal caring. “I care about you as a person. I want to know what’s happening with you as a person. And I want you to bring your whole self to work.” I’m talking about [having] the space to be able to . . . have a sit down once a week or once every two weeks. “How are things going? How are you feeling? Is there a support you need from us, from the practice? Are there things that you see we could change?”
But then the bigger piece is the follow-through, showing that you actually listened and then doing what you can to demonstrate that you have heard, that you’ve internalized whatever it is that they’ve talked about or brought to you. Without the demonstration, I think that’s where it all falls apart, because then people think, “They don’t really care. They’re not really doing anything.”
Because once people feel more connected to you, they feel more invested in the practice, they recognize that you are invested in them, and they’re going to give back. When we think about generational differences, I think that’s the biggest thing. Millennials, Gen Z, that’s what they want. They want to know that they matter, that their work matters, that what they’re doing has an impact and matters to someone beyond just what they’re bringing in terms of a financial difference.
KB: That idea of “you matter”—people distort it into “everybody wants a participation prize for just doing their job.” But the fact is that I have never seen a group of people as committed and dedicated for so little return as veterinary technicians. You all have been beaten down for a long time. It is a hard physical job. It’s an impossible emotional job. You get basically no recognition from pet owners about it, and very little recognition from the rest of the profession. It is amazing to me how much technicians do for so little and how absolutely committed, as a group, you are to sticking with it as long as you can.
And just knowing that so many technicians leave the profession—what is the average [technician] career, five years? They almost all say, “I want to go back, but I can’t.” Or, “These things would have to be true if I went back.” And they’re asking, “Please treat me like a human, and pay me enough so that I can pay my bills.” That’s literally it.
LH: Literally it.
KB: I feel like we know what we need to do, so why is it so hard for us to do it?
NB: I think a lot of us leaders know what the barriers are and we know why they exist. It’s the movement that is hard. We’re trying to make what little difference we can, but having more of these conversations, discussing the issues and bringing them to light, that’s what’s going to help us get there. It’s getting every leader in the profession to ask, “What can I do . . . to make a change within my own practice that will contribute to the bigger picture?”
LH: There are big systemic things that we can do, but those take real commitment and leadership that I think many people don’t feel they have the bandwidth for, or maybe they just feel like, “I’m just a lone technician, what can I do to fix these systemic issues?”
One big way [is in] state veterinary technician associations, because I think they are doing hugely heavy lifting right now in the profession to fix issues on a systemic basis and pushing the conversation forward in their own states. And that is the place where the impact is starting to be felt. State veterinary medical associations are feeling that a little bit more, and what happens then is it starts to trickle up.
People say they don’t like politics; they just want to come to work and do their jobs, but if we truly want to create the big change, we have to push it from the grassroots up into the areas of the profession where the decisions are really being made.
NB: Liz, I’m so glad you said that. Actually [my state’s] veterinary technician association dissolved within the past couple of years. And it broke my heart, because they were doing amazing things, putting on CE, but they just didn’t have the support or the bandwidth. So I’m wondering what we can do to help encourage . . . not just being a member of your state association, but taking those leadership roles and helping build upon that, so that we don’t have situations like [ours].
“When you’re in an environment where it’s not safe to talk about your hopes, your dreams, the direction you want to go, it becomes really difficult, no matter what role you’re in.”
—Liz Hughston, MEd, RVT, LVT, CVT, VTS (SAIM, ECC)
LH: That makes me so sad. I think a big thing practices can do is invest in their technicians and pay the dues for the state vet tech association . . . The other side of that, of course, is helping to make sure they have good work-life balance, [and make sure they’re] paid enough so that they can pay their bills with one job. And when you have technicians who are out there having to sell their plasma or do a bunch of work on the side then they can’t even conceive of having any time to do anything outside of that. So there really is a fundamental systemic and basic issue that they need before they can think about taking that next step and getting involved].
[Once that part is] done, now make sure they’re getting out on time because we’re adequately staffed, manage our schedule appropriately so that everyone is doing what they’re supposed to do . . . hire janitorial services so that people aren’t staying after the hospital is closed. And when people are getting home on time, when they have enough money to pay their bills, they don’t have to work three jobs, then they can start thinking, “How can I get involved to help change things for more people?” And then you can say, “We’re paying your dues for your state association, what are you doing to move the needle in the direction we want the profession to go?
KB: How can we get technicians to feel like they can make a huge change and it’s worth their time to try?
NB: I think it all just goes back to leadership, having someone in your corner that’s encouraging you and showing that they see you, that they see your strengths and what you’re capable of. It’s hard to feel like you have anything to contribute when there’s no one that’s supporting that. I think having [your] manager or another technician encourage you and say, “Hey, you’re really good at that, you should teach a wet lab on making blood smears,” showing you that you have something to contribute, is a huge part of that.
LH: We have to continue to remind people: We are co-equal members of the veterinary healthcare team. We serve a different role than the veterinarians do. I get that there is a hierarchy in terms of supervision, and I also think that when we work together, that hierarchy is pretty flat in an organization where technicians are utilized fully and respected as professionals. I think it’s slowly shifting now to an understanding that credentialed veterinary technicians are professionals who have invested in their profession and in themselves, and that they feel a sense of duty and responsibility, and that’s demonstrated by holding a license to practice. And so veterinarians who say things like, “Well, it’s all on my license if a mistake happens,” it’s not. Because I have a license that I also have to protect.
“It is amazing to me how much technicians do for so little and how absolutely committed, as a group, you are to sticking with it as long as you can.”
—Katie Berlin, DVM
Veterinarians do four things: they do surgery, they make a diagnosis, they deliver a prognosis, and they write prescriptions. Everything else, depending on level of supervision and your state law, should be [done by] either a credentialed veterinary technician or a veterinary assistant.
[We need to] stop denigrating ourselves, where we stop putting “just” in front of our title and stand up and say, “I am a proud RVT, and I am good at what I do, and I know what I know. I demonstrated proficiency in 240 hands-on skills and passed a national exam, and hey veterinarian, allow me to do these things. I am okay starting in a low-risk environment to demonstrate that I can do these things and build trust with you, and you have to give me the chance to do that.”
It’s going to take a profession-wide team effort, and we need veterinarians who are supportive of us to continue to push that with their associates, because we’re not in those rooms where decisions get made. If you’re in a practice and they have doctors’ meetings, I always hope there’s someone in that room advocating for the team.
[W]e have younger people coming in, credentialed technicians who have worked really hard to get where they are, demanding that treatment and respect, which is so heartening to see. And those of us who are in a leadership position, can encourage others to speak up for themselves. We have come through a door, and instead of closing that door [behind us], we need to reach behind us and pull more people through the door with us. And that’s how we’re going to bring more of those people into these organizations and allow them to flourish in a way that they can really show what they can do.
KB: We started out to talk about technician retention, and it evolved very quickly into a conversation about positive leadership and good culture.
LH: It’s the absolute key to retention. That’s why we keep coming back to it.
Central Line: The AAHA Podcast is generously sponsored by CareCredit.
Catch the full episode, and every other episode of Central Line: The AAHA Podcast, on major podcast platforms, YouTube, and at aaha.org/podcast.
Natalie Boursiquot, BS, RVT, is specialty area manager for Southern Veterinary Partners, and a former Banfield practice manager. |
Liz Hughston, MEd, RVT, LVT, CVT, VTS (SAIM, ECC) is a relief veterinary technician, trainer, and consultant in the San Francisco Bay Area. She is a Veterinary Technician Specialist in both Small Animal Internal Medicine and Emergency and Critical Care, and is president of the National Veterinary Professionals Union (www.natvpu.org), Co-Founder of the Veterinary Cannabinoid Academy (www.vetcannacademy.com), an Administrator of the Not One More Vet Support Staff group (www.nomv.org), Credentialing Committee Chair of the Academy of Internal Medicine for Veterinary Technicians (www.aimvt.com), and serves on the Editorial Advisory Board of dvm360. |
Katie Berlin, DVM, CVA, is AAHA’s Director of Content Strategy. |
Photo credits: ©AAHA/Robin Taylor, sturti/E+ via Getty Images, Courtney Hale/E+ via Getty Images, FatCamera/E+ via Getty Images, Photo courtesy of Debe Jorgensen, 1st Pet Veterinary Center