​Happy new year! As the new year dawns, I often take the time to reflect on 2016. But living in the past is not productive, because it has already passed! You can only live into the future! So, I start to think of 3 different questions:

1. Who do I want to be?
2. What do I want to do differently?
3. What can I create this year to bring those to life!

So, what answers have I come up with for 2017? I’ll tell ya! Firstly, I want to be someone who continues to inspire others. That’s simple, right? Some may say, I am already inspiring. But that doesn’t mean I continue to live into that. What could I do to be more inspiring!? It means continuing to invent ways to be more inspiring, such as inventing new lectures, meeting more people, getting involved in new professional development activities. These would not keep me as an inspiring person, but would make me live into being someone who is inspiring!
Next, what do I want to do differently? Although I love what I do I need to continue to have a full life. And “work” as it seems to be called (right?) is only a part of that. Life includes things like family and pets (which are family, excuse me!), friends, exercise, sunshine, vacations, personal and professional growth, and that thing called work. If you imagine your life as 100%, how do you divide up your time? It seems that as veterinary technicians work should always be the majority- 51% or more. Why is that so? Why can’t you be an amazing veterinary technician and be 20, 15 or even 10% of your “life!?” I am striving to be an inspiring veterinary technician and have a life. Let’s see how that goes!
Now that we answered Questions 1 and 2, I always ask myself what actions I can take to bring those to fruition. It is great to think and dream but actions are what brings these into existence. So, what can you do? It may be a physical action like signing up for a conference or something as easy as asking an old friend to coffee. If you thought of who you want to be and what you want to do differently, what actions will you take to live into in 2017? Post below in the comments!

​--David

​5 Tips and Tricks for a More Efficient and Effective Comprehensive Dental Cleaning Procedure
​
Performing a dental cleaning procedure can be a challenge, especially if it is one those crazy, busy days at the practice and you’re being pulled in 10 directions.  That’s most days, right!?!  Here a few tips that will help with those dental cleanings. 
 

1.  Take Radiographs First
 
When you take the radiographs as the first step of your professional dental procedure, you give the veterinarian time to carefully review the x-rays, decide on a treatment plan and contact the owner if necessary, while you are completing the dental cleaning process.  Remember that x-rays are a vital part of a comprehensive oral examination.  Our patients can’t tell us where it hurts, so we need to look for pathology that may be only visible on a radiograph.  If there excessive amounts of calculus is present, you may want to “pop” it off before you take the x-rays, but frankly it has never been a problem in my hands. 
 
2.  Reducing the Bacterial Load in the Mouth
 
 When the oral examination is complete and the mouth has been charted, take a soft bristled toothbrush and thoroughly brush all of the teeth.  This can be done with water alone or with prophy paste.  Once the teeth are brushed use the air/water syringe and using both water and air and “power wash”  the mouth.  Tooth brushing alone will dramatically reduce the amount of plaque and the bacterial load in the mouth.  In addition to removing plaque it can remove any other debris that may be in the mouth, such as hair, food particles and other unpleasant materials.  Soak the toothbrush in chlorhexidine solution during the procedure and then send it home with the pet.
 
Rationale:  Ultrasonic scaling will result in aerosolization of the bacteria in the mouth and studies show that the bacteria can remain in the operatory for up to 8 hours.  Brushing first not only reduced the bacterial load but it removes much of the debris allowing for easy visualization of the calculus that requires a scaler to remove.  When the plaque and debris is removed, the technician can go directly to the calculus present with the scaler, saving time on the cleaning procedure and resulting in less time on each tooth preventing thermal damage.
 
3.  Scaler Tips
 
Use the correct tip of the scaler for the different parts of the tooth.  Many people use only the Universal tip and feel it is sufficient to clean the entire oral cavity.  The name implies that it is to be used everywhere on the tooth however this tip is not as effective on cleaning the crown and not effective below the crown due to the size of the tip.  Changing the tips will result in faster cleaning times.  Use the “beaver tail” or gross debris tip to clean the crown of the teeth.  This tip is only designed to clean the crowns of the teeth and should never be used below the gumline.   Clean all accessible crown surfaces with this tip before changing to the periodontal tip.  The periodontal tip has a fine tip that is designed to go below the gumline.  
 
Rationale:   The advantage of using this tip, in addition to a curette, to clean out periodontal pockets is the fact that the ultrasonic waves burst the cell walls of the bacteria and break up calculus that has formed under the gums and the water flushes the debris from the pocket.  The use of the correct tip reduces the amount of time required to perform the task.  It only takes a few seconds to change the tips but the time saved by using the correct tool for the job is huge. 
 
4.  Power Scaler Technique
 
Use a very light grip on the hand piece remembering that your hand is only a guide for the tip.  Using pressure or force only decreases the working power of the tip and can result in thermal damage to the tooth.  Stay in constant contact with the tooth when scaling as the constant off and on action can cause a concussive injury to the tooth. 
 
A good rule of thumb is to spend no more than seven seconds on a tooth before moving on to other teeth allowing the tooth to cool down.  After cleaning several other teeth, the technician can return to the tooth if additional cleaning is required
 
Rationale:  Power scalers range in speed from 8000 to 45,000 cycles/second resulting in an extreme amount of heat being generated.  By limiting the pressure used and the amount of time spent on each tooth, the risk of thermal damage to the tooth is decreased. 
 
 
5. Prophy Paste
 
Using the correct prophy paste is an important step in the cleaning process.  It is recommended to use either fine or flour grit paste for the dental cleaning.  You can purchase premade fine paste or make your own paste using flour pumice and glycerin and mixing it to a thick “cookie dough” consistency.  Flour pumice can be purchased for your distributor. 
 
Spend as much time polishing each tooth as spent scaling the tooth.  The polisher does produce heat so spend no more than seven seconds on a tooth before moving on to other teeth.  You can always come back to that tooth to finish.  The prophy angle speed should be slow (3000 to 8000 rpms) and move the prophy cup slowly allowing the cup and paste to do the work.  Using too high of rpms can result in thermal damage to the tooth and using too fast of movement will not result in a smooth surface.
 
Rationale:  The ultrasonic scaler will leave micro etches on the tooth surface.  These etches are the perfect location for bacteria to hide and propagate leading to more plaque and more calculus.  Polishing is done to smooth those etches out giving less surface area for the plaque to adhere.  Much like sandpaper, the courser grit of polish you have the more etches that may occur.  Therefore it is important to use only fine or flour grit pumice to return that enamel to the smooth surface that was intended. 
 
These are a few tips to help not only speed up the cleaning procedure but ensure that the procedure is a safe one for you and the patient. 

About Mary Berg:  BS, RVT, LATG, VTS (Dentistry)
 
Mary received her B.S. in Biology/Microbiology from South Dakota State University, her A.S. in Laboratory Animal Science from Redlands Community College, and her A.S. in Veterinary Technology from St. Petersburg College.  She is a Charter member of the Academy of Veterinary Dental Technicians and received her Veterinary Technician Specialty in Dentistry in June 2006. Mary is currently serving as the treasurer of the AVDT, the President-elect of the KVTA, and is the 2017 President for NAVTA.
 
Mary fell into this profession totally by accident.  After graduating from SDSU and following her military husband around the world, they settled in Lawrence, KS. She applied for a job as a microbiology lab assistant but wasn’t hired due to lack of experience.  However, the company saw that she had held many administrative and management positions since graduation so they offered her a position as an administrative assistant for a research company that conducted research for companion animal oral products.  Her career took off from there moving up to Vice President of Operations, all the while working as a researcher developing and implementing protocols to access the efficacy of products on plaque and calculus accumulations in dog and cats. .  She spent 13 years in research and continues to work with companies to evaluate their products and serves on the VOHC council.  In addition to her research background, she was the practice manager and dental specialist at a general practice for over 7 years, taught veterinary technology for 2 years and is currently the president of Beyond the Crown Veterinary Education, a veterinary dental consulting service as well as a national and international speaker and writer.  
 
The most difficult part of her job is her chronic, genetic, inability to say no.  She truly enjoys spreading the dental gospel and it’s hard to step back even when her schedule is full. The best thing about her job is that she gets the opportunity to meet so many wonderful people and help so many more pets than she did working in practice.  She can now ensure that housands of pets get good oral care by helping the doctors, technicians and staff, understand the importance of providing good dental care to their patients.   Her goal is to continue to spread the word of dentistry to all practices in the United States and elsewhere.  She will be happy when each veterinary practice is doing a thorough oral examination, taking a full series of x-rays and understanding how to treat or when to refer pathology that is found!
 
Her advice to technicians is to get as much CE as possible, get involved in your professional organizations either at a local, state or national level and NEVER say no to an opportunity.
 
Mary lives on a small farm in Kansas with her husband and enjoys spending time relaxing at her pool with her grandchildren and menagerie of pets.  When she’s not working she love to garden and along with her husband use the produce from the garden to create salsas, jellies, jams and other tasty treats as gifts for friends. 
 
Her favorite textbook is Small Animal Dental Procedures for Veterinary Technicians and Nurses edited by Jeanne Perrone.  Of course, chapter 2 is her favorite!!  Wink, wink!  Her favorite non-veterinary books include mostly murder mystery thrillers and the occasional mindless romance! 

​All The Places You’ll Go
Ten years ago I went to my first IVECCS conference and knew immediately that I wanted to pursue my veterinary technician specialty certification.   I thought that maybe I would get a small raise and be able to better care for my patients, but working in a small town emergency clinic in Maine that was only open nights and weekends made it nearly impossible at that time.  So I studied everything we saw and when I could I moved closer to the city and put in two years of intensive work on learning new skills and knowledge to submit my VTS application and pass the fierce exam.  Since I earned my VTS many people have asked me what has changed since I earned my VTS ECC.
The truth is, I really had no idea about the changes that would occur in my life.   Some have been financial but by far the greater number have been less tangible and more enriching.  I was able to move to California to work in a progressive, open practice, intensive care unit.  I was the only employee they have hired through only a phone interview.  It is a practice that understands the value of registered technicians and veterinary technician specialists in multiple areas of the hospital, and compensates appropriately for advancing knowledge and skills.  And I no longer have to deal with snow.
The increased working opportunities have also been numerous.  I began lecturing and have even been able to lecture at a national conference, I’ve also been asked to write chapters in veterinary technician texts.  Ever since I learned how to read I’ve wanted to be a published author.  Mixed acid base may not be the same as dragons, but I’m finally going to be published in two books since earning my VTS.   Although it is possible to lecture or be published without a VTS and a lot of people do, this is something I never would have experienced otherwise because I just didn’t have the confidence or support before working through the process.  I also had the opportunity to moderate for Veterinary Support Network, which has helped me so much in the past that I was ecstatic to give back
The increased knowledge and skills that I have learned from obtaining my VTS have made caring for my patients easier.  I am now better able to understand the processes leading to disease and how the process of healing can follow multiple different courses with differing results.  My skills have increased exponentially in the last few years.  I’m always on standby with the gold standards of care available when needed.  And I have greater support from my veterinarians than ever before.  Being part of a VTS we are encouraged to continue lifelong education. 
The greatest reward I’ve received from my VTS has been the relationships that I have developed personally and professionally during and after my application process, and it has been invaluable.  I’ve learned the value of mentorship though amazing mentors that have helped me and encouraged me.   I’ve also realized the incredible reward from mentoring others in their careers.  We can’t do this alone but together we can do anything.
I recently traveled to Texas for my 9th IVECCS, where I administered this year’s AVECCTs VTS exam.    I’ll also be continuing my education with an amazing group of technicians and veterinarians.  My focus has changed through the years, from just trying to learn everything I can to wanting to move my career forward but to also help define and advance the profession of veterinary technicians/ nurses.  I couldn’t be happier with the choice I made to pursue my VTS ECC.
 
Brandee L. Bean CVT, VTS (ECC)

About our guest author: Brandee graduated from the University of Maine with an A.S. in veterinary technology and became a licensed veterinary technician in 2001.  After 11 years in emergency and critical care medicine she earned her VTS (ECC) in 2013.   Brandee serves as co-chair on the exam committee for AVECCT.  Her areas of special interest include intensive care, toxicology, metabolic disorders, and the special challenges involved in treating felines.  She has authored chapters in two veterinary technician texts to be released in 2016.  Brandee shares her home with Sadie, a crazy lab mix, and Piggy and Jenny, the 2 cats that rule the roost.

 I plan to write some general, some management, and some veterinary technician blogs. This one is focused on managers, supervisors, administrators, well heck, anyone who leads staff meetings. Are your meetings shallow, dried up, stale and generally a bore? Here are some great ways to liven them up!

1. Feed the masses! It may be looked down upon by some but I feel that food is a great way to get attendance and encourage participation in staff meetings. It’s also a nice way to show appreciation to the staff for their hard work! Pick different types of snacks, and don’t forget your vegan or vegetarian staff members and any other dietary requirements that differ from the mainstream. Encourage healthy eating amongst your employees by picking healthier options. I try to provide a variety of rotating options at my staff meetings: Mexican food, sandwiches, snack platters, gourmet salads, etc!       
2. Make it lively! Be the cheerleader, coach, principal and best friend all in one. Encourage and support the staff with good news and progress and make a conscious effort to build staff morale. Energy and positivity are required at a staff meeting. Channel this attitude while remaining firm on policies and rules. Staff meetings should not be about all the bad, negative or poor things that happened in the previous time period. The staff meeting should be a town hall meeting to discuss current challenges, growth opportunities and successes. I always use an upbeat tone, energy, and positivity to lead staff meetings! 
3. Get buy in! Your staff have ideas, things to say, and suggestions to make. Post a blank agenda on the bulletin board or an empty envelope with little pieces of paper where the staff can write potential agenda items. Post this one week prior to the meeting and then review the topics for inclusion. Recognize staff for achievements, acknowledge new staff joining the practice, review new equipment, policies, and celebrate positive changes. A great way to direct the culture of the business is to introduce challenges, get staff solutions, and then implement new policies based on these staff suggestions. This is called “bottom up” management, versus traditional “top down” management structures. The majority of my staff meetings are made up of discussions around the agenda items I have included. My meetings tend to be less of me talking at the staff, but more discussion amongst the staff, which I find productive.
4. Encourage learning! At every staff meeting I include a 15-20-minute continuing education presentation. I encourage other staff members to also present. It could be on a topic that was new and relevant, like a new drug, or some issue that arose recently at the practice. Example topics include: reviewing a difficult case (what went right and wrong), new drugs on the market, equipment that was recently purchased, or general topics like ECG’s, CPR, nursing care, and client communication. 
5. Shut down the haters! Staff meetings should absolutely encourage open communication. They should also foster healthy debate and discussions. However, staff meetings are no place for directed negativity. I have a rule at my staff meetings: any complaint is always paired with a suggestion. If the complainer has no suggestion to rectify the issue they may not present the complaint. Also, passive aggressiveness is not tolerated. Staff are to politely and respectfully “call out” each other or departments if there is an issue, and that person or department will not respond defensively, but will respond calmly and professionally. Personal problems are also to be kept out of the staff meetings.
6. Consider the size: If you regularly hold staff meetings of 10 or more people in multiple departments really consider your goals. I find smaller department meetings that are held regularly are more effective than large 10+ people meetings with multiple departments. Supervisors in the department meetings can report issues to a management meeting to deal with inter-departmental issues versus entire departments discussing issues at a large general meeting. 

I hope this helps with your staff meetings! My final recommendation: show the staff you are working hard to make the staff meetings enjoyable, because they are useful in many ways! If you want to discuss your staff meeting strategies I am always available to at david@davidlissrvt.com. 

Are you new to veterinary technology?  Maybe you’ve been around a while and you’re looking to up your game?  Check out these tips from the VetTechXpert …

Anticipate … 
When I was a baby-tech, my first year in VT school, my Program Director talked about the difference between a $7 per hour tech and a $20 per hour tech.  He said the $20 per hour tech took a thorough history, and listened outside the door as the vet talked to the client, then gathered everything that the vet might need so when the vet came out of the exam room, the $20 tech would be standing there with the syringes and tubes ready for the blood tests, slides for the FNA of the mass on the patient’s flank, and the x-ray machine set up and ready to go.  His point was that you make yourself more valuable to your vet (and the rest of your team) if you can anticipate what’s going to be needed and have it ready.  This skill makes you the do-to tech at your practice, the one that the vet and other staff members can rely on.  Anticipation means putting on your critical thinking cap and synthesizing the data you collected during your history with what you overhear through the exam room door, and implement the hospital’s protocols to meet your vet’s needs, the client’s needs, and provide the best care for the patient.

Think outside of the (check)box 
Working in the ICU, each patient has a list of treatments that must be completed, usually on an hourly basis, or every two hours.  It is so easy to look at the list of treatments that need to be completed and use it as a checklist – go down the list, do the task, check the box.  If you want to be a TECHspert, I encourage you to go beyond the checklist! 

• Think about what medications you are administering, and what the patient may already be receiving: are there interactions you need to worry about?  Are there side effects you should be looking for?  Do you know why you’re giving this medication?  Do you know what effect is expected? 
• Think about your patient’s disease process: are there treatment items that you could suggest that might improve the patient’s care? Do you know the pathophysiology of the disease you’re treating? Who could you ask or where could you go for more information?
• Does it make sense to do these treatments at this time?  Are there treatments that could be grouped to allow your patient time to sleep and recover?  Are there medications or treatments that need to be separated?
• Is your patient clean and comfy?  Is their bedding clean and dry?  Often this requires more than just a visual check, especially with cats!  Reach under and feel that towel or fleece pad!  Is your patient interested in some TLC?  Do they have food?  Are they supposed to (LOL)?

Don’t be a robot or a slave to the checklist!  Engage your brain while working with your patients and provide the highest expert level of care.

Advocate for your patients 
Our patients don’t speak English, or any human language for that matter!  It is up to us to translate their body language, their vocalizations, and their behavior to determine their needs.  It is often said that the veterinary technician is the eyes and ears of the veterinarian (I would add the nose, too).  As such, it is up to us to speak on their behalf to make sure that patients receive the care they need and deserve.  Sometimes it’s more pain meds.  Sometimes it’s customizing an anesthetic plan to make sure a pet has a smooth and safe surgical procedure.  Sometimes it’s making sure there are feeding instructions on the treatment plan from the vet.  Sometimes it’s talking through a Quality of Life scale with a carer.  Whatever it may be, any TECHspert is first and foremost an advocate for their patients.

Commit yourself to lifelong learning 
It is part of the Veterinary Technician’s Oath.  It is part of the NAVTA Veterinary Technician Code of Ethics.  And if you want to be a TECHspert, you must fully commit yourself to staying on top of innovations and new knowledge in our field.  Science and medicine is ever evolving and changing.  In order to be the best advocate, to anticipate our veterinarian’s needs, and to be able to provide gold-standard care to our patients, it is incumbent on each of us to keep up with those changes and with veterinary medicine’s evolution.  How do you do it?  Read veterinary journals like Clinician’s Brief, Veterinary Team Brief, or scientific journals like the Journal of Veterinary Emergency and Critical Care or the Journal of the American Veterinary Medical Association.  Take a class through VSPN or VetMedTeam.  And attend continuing education classes and conferences: this is a place not only to learn new things from amazing veterinary professionals, but to network with other TECHsperts too!

Train your replacement – be a mentor!! 
Remember that none of us will be doing this forever!  Those of who achieve TECHspert levels of knowledge and skills owe it to the profession to pass them along to the next generation of technicians.  One of the best ways to do this is to be a mentor for new technicians and assistants.  Being a mentor may reinvigorate your passion for this career, while you're sparking that passion in a newly minted technician.
 
With these tips, you are guaranteed to become the next TECHspert – good luck!


Guest author: Liz Hughston, BA, MEd., RVT, CVT, VTS (SAIM, ECC)

After having a career in professional administration, Liz returned to her first love – veterinary medicine – graduating from the Foothill College Veterinary Technology Program and becoming registered in California as an RVT in 2006. In 2012, Liz was certified as a VTS in both Small Animal Internal Medicine and Emergency and Critical Care. She is currently working as a relief technician and consultant for specialty, emergency, and general practices in the San Francisco Bay Area. In addition to relief work and consulting, Liz is a frequent and sought-after national and international speaker on a variety of topics. She is a member of CaRVTA, NAVTA, AIMVT/ACVIM,
AVECCT/VECCS, IVAPM, and IAAHPC. In 2013, she received the inaugural RVT of the Year Award, presented by CaRVTA. Liz currently lives in San Jose with her husband, three spoiled dogs, and one cat who is the actual boss of the household. She can be reached at liz@VetTechXpert or via www.VetTechXpert.com.