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Interview with Ann Wortinger, LVT, VTS (SA Internal Medicine/ ECC/ Nutrition)

 

 

Abbi:     Why did you become interested in the nutrition specialty?

 

Ann Wortinger:     I spent 16 years in internal medicine. That is dealing with a lot of guts. The doctor, well he wanted foods but he didn't have a big interest in nutrition and his idea of the ideal set up was he would come in and say I want a food that does this, this or this. Or has this, this or this in it and I would tell him what to recommend and that worked out very well for us. The more I studied the more information I learned, the more fun it was. Pretty soon I was doing that for all the doctors in the hospital, not just my doctor.

 

Abbi:     Why was this specialty a better fit for you opposed to the other specialties?

 

Ann Wortinger:     If you look at my credentials you will see I have a bunch of other specialties. I am currently the only technician who is triple certified. Emergency and Critical Care was the first specialty. I sat for that in the second class that sat, so in 2000. I was on the organizing committee for small animal internal medicine or for the internal medicine specialty. And I was on the organizing committee for nutrition. Nutrition has been my first love. There were not enough people interested in it when I took Emergency Critical Care to start a specialty. I had more than enough qualifications to sit for ECC so I sat and passed that exam. Since I was still working in internal medicine I still qualified to work on the organizing committee for small animal. Organizing committee actually is about a six to eight year commitment and I no sooner got that done in 2008. We had to find enough people that had the qualifications because to qualify for an organizing committee you have to have credentials that far exceed what a person sitting for the exam would be asked to qualify for. Instead of three years experience you have to have seven plus years experience. The credentials have to be impeccable.

 

Abbi:     Do you think there is a demand for more technicians with specifically the nutrition specialty?

 

Ann Wortinger:     Well last I checked every animal eats. I don't care what they are going in for, every animal eats. The more information you know about nutrition, the better you are able to help your clients. As I told you before I work in emergency setting right now. You will see a little nutrition calculation showing up on our emergency sheets. I talk to the clients about it. Sometimes I talk to the veterinarian about it. Everything has to eat so nutrition is important for everything. It's just how important you make it. Even if animals aren't sick, my cats will tell you that yes they are on a diet transition right now and yes the calories have been calculated and they still disagree with that. They would prefer to be 20 pound cats all around and things would be wonderful, but no. That's not what they signed up for.

 

Abbi:     What specific continuing education opportunities do you normally seek out?

 

Ann Wortinger:     Most of the major conferences have nutrition facts in them. If I can make it to those, typically I am the one teaching them and to be able to do a presentation especially at a national level, you got to know your stuff. Not everything that I present is old. I have got two new topics that I am presenting at ACVIM this year. That's a lot of research, a lot of writing, preparation to make sure that you don't' sound like an idiot when you get up there and start talking. Kara Burns and I do a lot of workshops together on nutrition. We've got a feeding tubes workshop that we do. We've got a nutrition calculations, we've got an advanced nutrition cases. All to bring nutrition to people.  Make it something that they are thinking about and something that they discuss. One of the things that the American College of Veterinary Nutrition is trying to get is every patient every time. You need to make a nutrition recommendation. It may be a simple as hey you are doing a great job, why don't we just continue with what you are doing. To - I don't think that food is appropriate for the condition that your pet is in right now, whether it's underweight, overweight. Whether you are feeding puppy food to an adult dog, these are some suggestions as to what we can do. Or if they start getting diseases. As animals get older things go wrong, are you making specific nutritional recommendations? Nutrition is never going to cure a disease but it can definitely make it easier to manage. It can make the animals more comfortable. It can make the clients more comfortable if they know that they are doing what's going to help. Make sure that they have realistic expectations for our therapeutic diets. We've got therapeutic guys coming out the wazoo now. But what can those diets actually do for clients? Or for their patients? Feeding a renal diet, what's it going to do? Well there is a lot of components in those renal diets that it's a lot more specific than just a lower protein diet to decrease the BUM. There is Omega 3 fatty acids in there, there is special fibers in there that are all going to help manage that disease. But if you can't get the patient to eat it, then it doesn't matter what you recommend. Or if you can't get the client to feed it, it doesn't matter what you recommend. Making sure that they understand the importance of it, of what this diet can do over what you are currently feeding and what we can expect long term. How will this make the animal more comfortable? One of the things that I would explain a lot to my internal medicine clients are we can feed this food or I can give you two other medications and you can feed what you're continuing to feed.  You have to feed your animal anyways so why not we feed something that is going to help and we will decrease the amount of medications you are going to have to give and we will help with long term maintenance.

 

Abbi:     What type of skills would someone expect completed and how would they be assessed?

 

Ann Wortinger:     Each of the specialty is going to have skills and a knowledge list that is unique to them and that is one of the things with the application for a new specialty. You have to show how your skills and knowledge list is uniquely different than another specialty. Obviously we are focusing on our skills list a lot of nutrition. We expect you to be able to calculate resting energy requirement, daily energy requirements. Be able to calculate volumes of food. Whether it's canned, dry. Be able to discuss nutrition with a client. Be able to do feeding tubes managements. To be able to do advanced diagnostics so assist with ultrasounds, radiographs, endoscopy, its the veterinarian that you work with does that. To know the difference in metabolism between a fat, protein and a carbohydrate and disease management and how nutrition relates to that. So, physiology, pharmacokinetics, those sorts of things.

 

Abbi:     Do you have any advice or helpful resources to prepare and write the in depth keys reports?

 

Ann Wortinger:     Well belonging to NATVA, belonging to your state association, networking is one of the best things you can do as a technician. If you are working on a single veterinary practice you may not ever work with another technician. You need to know what other people are doing and that they are dealing with the same things that you are dealing with. If you are looking at a specialty specifically make sure that you arrange your career to allow you to plan for that. If you want to get a specialty in nutrition then you need to work in a facility that is doing advanced nutrition work and you can do it in a general practice if it is a high quality practice that is doing feeding tubes, that is doing weight management, that is possibly working with a shelter so you get to deal with some debilitated animals and animals that have gone through periods of starvation. That is going to set you up the best. If you are just working in a surgery facility, you are not going to get the exposure that you need. If you are working in even emergency, to come into an emergency facility and gain the information you need is going to be pretty tough because mostly emergency are focused on keeping the animal alive.  Nutrition is a long-term goal. Re-hydration and stop the bleeding and feeding, the re-hydration and stop the bleeding comes first.  Make sure that you set things up so that you can succeed optimally. I didn't fall into any of my jobs. I worked general practice. I have worked emergency. I have worked specialty. I have done education. I have done emergency. Always leave options.

 

Abbi:     Are there different levels/degrees of this certification?

 

Ann Wortinger:     Not really. What you've got is the way that things are organized right now, you have the non credential person which could be anybody. You could be a non credential. We have the credential person who at this point in time is required to graduate from an AVMA program. I graduated from an AVMA program 32 years ago.  Now once you become credentialed, there is nothing to demonstrate that you are more skilled than somebody who just started. That is what the VTS has showed. They require usually three to five years experience in that field. Between 50 and 75% of your work in that field so you can't get your VTS any sooner than the three years. A couple of people have tried to wiggle on that and it's not possible. We've got non credentialed, credentialed and then our VTS. If we look at human medicine, that would be your nurse practitioner. Then after that you have your veterinarian, your doctor. It just provides another level. If I say that I am credentialed, then somebody would think that I have this, this and this skills. I know this, this and this information. Now if I say I have a VTS, okay well then I know that you can do this, this and this. There are lots of people within each specialty that has different areas. One of the things for emergency group care that I am really interested in is endocrine diseases. I get if somebody has an endocrine question or they need an endocrine topic, a lot of my friends will recommend them to me. Or if it's critical care nutrition they will recommend me. Within the nutrition specialty, Kara really likes the exotics so she will do a lot of the A typical breeds. My primary interest is a lot on feeding tubes. I have got another friend within nutrition, she really likes the government stuff. If she has got a feeding tube question or something comes through our list serve, with a feeding tube question, she sends it out to me. Once you get your specialty certification, you can still have distinct interests. I was the go to nutrition person for emergency critical care for years and years and years before the nutrition specialty started.

 

Abbi:     What is the likely outcome of becoming certified? Things like would you see a pay increase? Would more opportunities presented to you? Would it give you an edge over competing applicants for job positions?

 

Ann Wortinger:     It really depends on what the specialty is and where you’re working. You may or not. Some will support you monetarily and getting it there is a number of universities that are requiring it. We will see job applicants that a VTS is required for this position. That is starting to show up. Not always. Depending on what your specialty is as to whether it gives you a leg up on somebody else. I don't know if my specialties helped me get my job. Having a network and knowing people definitely did. My job never was posted. I think one of the biggest advantages and most people will tell you this of getting your VTS, is the people that you meet. The new people everywhere in Australia, in Canada, in Britain. The opportunities that you get. I have had friends speak in Sweden. I have had friends speak in England. I have spoken in Canada. I have had friends go to Australia and speak. If they have a choice between somebody with a VTS and somebody who doesn't, guess who is usually going to win? You know the VTS actually knows their information. Doesn't make you a good speaker. That comes with practice but it does give you the advantage, you can demonstrate more information.

 

Abbi:     Do you have anything else that I am missing that you would like to talk about or?

 

Ann Wortinger:     Set yourself up for success. Give yourself options and never stop learning. I can tell you 90% of what I do now did not exist when I was in school. Anything past a TPR and we weren't doing attitude assessments, we weren't doing pain assessments, we weren't doing body conditions. When I was in school that didn't exist. TPR, we could that. 99% of the equipment that we use did not exist when I was in school. If you think that when you graduate you know everything. You will have a very short career whether it's a career or a job.  Lots of people leave the field because they can't make enough money. I have not worked a single job, in probably 15-20 years. I speak usually once to twice a month. I've got a book, the second edition of a book coming out sometime this month. I have published article in the Nutrition Book second edition. I've got over 40 published articles. I have spoke at more than 200 conferences. Yes you can make a good living as a technician but you are not going to do it working in a general practice doing one thing. If that's what you want to do that is fine. Nothing wrong with that at all. But don't blame it on the job if you don't have enough money to survive. 

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