Handbook of Veterinary Nursing

Hilary Orpet, Perdi Welsh

• Publisher: Wiley-Blackwell
• Year: 2011
• ISBN:
  9781118279458
• Edition: 2
• Topic: Medicine
• Subtopic: Veterinary Medicine

Handbook of Veterinary Nursing presents essential guidance and helpful tips on developing and delivering high quality nursing care and skills.

Fully updated, this easy-to-follow guide reflects recent changes to veterinary nursing qualifications, current terminology and drugs in use. The emphasis is on the importance of working methodically, using high quality procedures, to help the whole veterinary team ensure the most successful outcomes in animal care.

Written in note form for quick reference by veterinary nurses and technicians at all stages of their training and career, this will be invaluable for both exam revision and quick reference in clinic.

Contents include:

The nursing process in veterinary care, physical assessment of the patient, managing the hospital environment, managing the operating room, surgical nursing activities, anaesthesia, diagnostic imaging, diagnostic tests, triage and emergency procedures, and essential calculations for drugs, fluids, nutrition and radiographic exposures.

Key features:

•Gives clinical advice quickly and simply
•Written by authors with many years experience of veterinary nurse training and education
•Contains essential calculations
•Illustrated in colour throughout

SECTION 1

CONTEMPORARY VETERINARY NURSING

INTRODUCTION

This section looks into the essence of modern day veterinary nursing by examining a brief history of veterinary nursing and considering how this heritage has had an influence on the way veterinary nurses practise in the 21^st century. The Registered Veterinary Nurse’s (RVN’s) responsibilities as a professional practitioner are identified in Chapter 1 and guidance given to help RVNs work their way through some of the issues that they will face in their day-to-day work. The concept of the nursing process and how this may be applied to the veterinary patient is covered in Chapter 2. Using this structure, the importance of a thorough assessment is highlighted through the remaining chapters in order to provide a more holistic approach to patient care. A framework of assessment is employed in the form of a model of care (the ability model) which has been developed specifically for veterinary nursing.

Chapter 1

Present-day Veterinary Nursing in the UK

In the relatively short time that veterinary nursing has been a recognized vocation, there have been developments in society which have had an impact on the way veterinary nurses practise in the 21^st century. A brief review of the history of veterinary nursing since its formal inauguration 50 years ago can help us begin to appreciate how our heritage and, to some extent, external influences have contributed to the way we currently practise. Reflecting on the past and present helps us to consider the future of veterinary nursing practice and should enable us to develop our profession to benefit patients, veterinary nurses and employers. The overarching theme behind all of the developments during this time has been to improve the relatively lowly status of veterinary nurses and ultimately achieve professional status and, with this, recognition.

A BRIEF HISTORY

Before 1961 veterinary nursing did not exist as a formally recognised career. There are accounts of people working as lay assistants and ‘canine nurses’ before this time, but the efforts of veterinary members of the British Small Animal Veterinary Association (BSAVA) were needed to convince the Royal College of Veterinary Surgeons (RCVS) that, if they were trained formally, these people could be of huge benefit to the veterinary profession. The RCVS introduced a training and qualification scheme which allowed the first Registered Animal Nursing Auxiliaries (RANAs) to qualify in 1963 (Pullen & Gray, 2006). This saw the start of a movement to create a support system and veterinary nursing community network for members of the vocation. A group of forward-thinking veterinary surgeons were instrumental in the setting up of the British Veterinary Nursing Association (BVNA) in 1965, which acted as a representative body for veterinary nurses.

Up until the late 1970s in the UK, the use of the title ‘nurse’ was protected by law and could only be used by nurses (midwives and health visitors) registered with the General Medical Council. Following a change in legislation to release the title from its protected status, the title nurse could be used by other vocations such as veterinary, dentistry and nursery workers (RCN, 2003) and the RANA title was changed to veterinary nurse (VN) in 1984.

A hugely significant development to the role and job prospects for veterinary nurses came in 1991 with the Amendment to Schedule 3 of the Veterinary Surgeons Act (1966). Prior to 1991, veterinary nurses were not recognized legally as being any different from other members of the public. It meant that only a veterinary surgeon was authorised to carry out medical treatment or surgery to animals (although animals’ owners were allowed to give some minor treatment). Following the amendment, RCVS-qualified, listed veterinary nurses were formally recognised and permitted to undertake certain procedures which were not permitted by lay staff or members of the public.

The way veterinary nurses were trained and educated underwent signifi-cant modifications and developments in the mid 1990s with the conversion of the veterinary nursing certificate qualification to a National Vocational Qualification and the launch of other accredited nursing qualifications such as the Diploma in Advanced Veterinary Nursing and the introduction of full-time university degree programmes in veterinary nursing. With these educational changes came a body of veterinary nurses with specialist and higher-level qualifications and the trend developed towards more widespread teaching of concepts and theories used in human nursing.

As part of the continued drive for veterinary nursing to achieve a higher status and become a profession in its own right, the first RCVS VN council was formed in 2002, comprised of elected veterinary nursing members. In 2007 the non-statutory RCVS Register of Veterinary Nurses was introduced which meant that all VNs qualifying with the RCVS after 2003 achieved automatic registration status. In a further bid to achieve professional status, the case for a system of regulating veterinary nurses has been proposed to help ensure the protection of the public through the mechanisms of regulation. At the time of writing, the RCVS disciplinary system for veterinary nurses is due for implementation by the end of 2010.

Increased recognition and status

Popular television series such as the BBC’s fly-on-the-wall documentaries Animal Hospital (1994–2004) and Super Vets (2006–2007) featured the veterinary profession at work and have undoubtedly raised the profile of veterinary nursing as a career in its own right and helped to increase the general public’s awareness of the role of the veterinary nurse.

The combination of events of the past 47 years, and the vocation’s drive towards professionalisation in the past 20 years, means that veterinary nurses can now enjoy improved career opportunities, increased recognition and improved employment status. Veterinary nursing practice is undoubtedly changing and so too is the VNs’ relationship with ‘professional’ issues such as the law, the RCVS and their ethical duties to patients and their owners. To achieve and maintain professional status RVNs must continue to respond to the changing environment and modify their working practices accordingly. They must also continue to be proactive in developing the profession.

THE REGISTERED VETERINARY NURSE AS A PROFESSIONAL PRACTITIONER

With greater responsibility comes accountability. The professional and legal responsibilities of RVNs extend not only to their animal patients, but to the animals’ owners, their professional colleagues and society at large. Professional responsibility, however, is a relatively new concept for veterinary nurses and so it is essential that RVNs ensure that they are aware of the legal, professional and ethical ramifications of any decisions they make or actions they take.

A professional person is legally accountable for his or her actions in four main areas (Dimond, 1995):

• to society through the criminal courts;
• to the client through the civil courts;
• to the profession through the Professional Investigation Committee (Royal College of Veterinary Surgeons);
• to his or her employer through contracts of employment and disciplinary procedures.

Accountability

Accountability forms an integral part of being a professional and relates to the legal, professional and ethical duties that we have towards other people. There may be times when the RVN is faced with a dilemma about how he or she should act in a particular situation. Responsibilities to patients, patients’ owners, the directing veterinary surgeon, employer and professional body can lead to situations where conflicts have to be balanced and it can be difficult for the RVN to know how to act. The RVN must be able to make and justify the correct decision or action.

LEGAL RESPONSIBILITIES

The law deals with maintaining and defining sets of rules and the systems for their enforcement. It is easy to think of the law as being concerned solely with crime and punishment, but in reality a great deal of law is concerned with the rights and responsibilities of individuals and companies towards each other.

Responsibility of the veterinary nurse to society through the criminal courts

Criminal law is concerned with acts which are forbidden in order to protect society and individuals from harm. Someone who commits a crime commits an offence against the state and the state may prosecute that person. A conviction can result in the accused serving a prison sentence or in some cases paying a fine and/or performing community service – the level of punishment depends on the particular crime and any mitigating factors. Criminal law is not just about things like murder, assault, theft and traffic offences. There are a number of laws which carry a criminal sanction which directly affect the work veterinary nurses do; these include:

• Veterinary Surgeons Act 1966;
• Health and Safety at Work etc Act 1974;
• Medicines Act 1971;
• Misuse of Drugs Act 1971;
• Dangerous Dogs Act 1991;
• Data Protection Acts 1984 and 1999;
• Animal Welfare Act 2006;
• Protection of Animals Acts 1954 and 1964;
• Animals (Scientific Procedures) Act 1986;
• Public Interest Disclosure Act 1998.

Veterinary Surgeons Act 1966

Section 27 of the Veterinary Surgeons Act 1966 (VSA) defines the practice of veterinary surgery as

… the art and science of veterinary surgery and medicine and, without prejudice to the generality of the foregoing, shall be taken to include –

(a) the diagnosis of disease in, and injuries to, animals including tests performed on animals for diagnostic purposes;

(b) the giving of advice based upon such diagnosis;

(c) the medical or surgical treatment of animals; and

(d) the performance of surgical operations on animals.

Section 19 of the Act restricts the practice of veterinary surgery to individuals ‘… registered in the register of veterinary surgeons or the supplementary veterinary register …’ and certain exempted categories of people and procedures set out in Schedule 3 to the Act.

Schedule 3 can be and has been changed from time to time by regulations. At the time of writing the current version of Schedule 3 of the VSA is contained in a Statutory Instrument (SI 2002/1479) which sets out the treatment and operations which may be carried out by ‘unqualified persons’. These include:

• minor medical treatment given to an animal by its owner, or a member of the owner’s family or the owner’s employee;
• certain specified procedures on animals used for agriculture by their owner or a person employed in looking after them;
• the rendering in an emergency of first aid for the purpose of saving life or relieving pain and suffering;
• certain specified procedures which may be done by anyone over the age of 18 years;
• certain procedures which can be carried out in specified circumstances by persons of 17 years if they are undergoing instruction in animal husbandry;
• provisions relating to veterinary nurses and student veterinary nurses which will be considered in more detail.

Paragraphs 6 and 7 of Schedule 3

Paragraph 6 of Schedule 3 permits:

Any medical treatment or any minor surgery (not involving entry into a body cavity) to any animal by a veterinary nurse if the following conditions are complied with, that is to say –

(a) the animal is, for the time being, under the care of a registered veterinary surgeon or veterinary practitioner and the medical treatment or minor surgery is carried out by the veterinary nurse at his direction;

(b) the registered veterinary surgeon or veterinary practitioner is the employer or is acting on behalf of the employer of the veterinary nurse; and

(c) the registered veterinary surgeon or veterinary practitioner directing the medical treatment or minor surgery is satisfied that the veterinary nurse is qualified to carry out the treatment or surgery.

‘Veterinary nurse’ is defined as meaning a nurse whose name is entered in the list of veterinary nurses maintained by the RCVS.

VNs must be aware that failure to satisfy all the various conditions constitutes a criminal offence. While they may carry out any medical treatment, they may only carry out minor surgery which does not involve entry into a body cavity, but in either case, they may only do so if all three conditions in (a), (b) and (c) are met.

Paragraph 7 sets out provision for student veterinary nurses, defined as ‘a person enrolled under bye-laws made by the {RCVS} for the purpose of undergoing training as a veterinary nurse at an approved training and assessment centre or a veterinary practice approved by such a centre.’ It contains similar wording to Paragraph 6 permitting:

Any medical treatment or any minor surgery (not involving entry into a body cavity) to any animal by a student veterinary nurse if the following conditions are complied with, that is to say –

(a) the animal is, for the time being, under the care of a registered veterinary surgeon or veterinary practitioner and the medical treatment or minor surgery is carried out by the student veterinary nurse at his direction and in the course of the student veterinary nurse’s training;

(b) the treatment or surgery is supervised by a registered veterinary surgeon, veterinary practitioner or veterinary nurse and, in the case of surgery, the supervision is direct, continuous and personal; and

(c) the registered veterinary surgeon or veterinary practitioner is the employer or is acting on behalf of the employer of the student veterinary nurse.

So the essential difference between what VNs and student VNs are permitted to do is that

• the treatment or surgery must be carried out in the course of the student’s training;
• the student must be supervised by one of the specified categories of people, and, in the case of surgery, the supervision must be direct, continuous and personal.

Failure to comply with these conditions is a criminal offence. It is essential that VNs and student VNs keep the limitations in mind and be prepared to insist on their being complied with. If a student VN were, for example, to carry out surgery without ‘direct, continuous and personal’ sup...

Table of contents

• Cover
• Title
• Copyright
• Preface
• Acknowledgements
• SECTION 1: CONTEMPORARY VETERINARY NURSING
• SECTION 2: MANAGING THE HOSPITAL ENVIRONMENT
• SECTION 3: MANAGING THE OPERATING THEATRE
• SECTION 4: THE OPERATING ROOM - SURGICAL NURSING ACTIVITIES
• SECTION 5: ANAESTHESIA
• SECTION 6: DIAGNOSTIC IMAGING
• SECTION 7: DIAGNOSTIC TESTS
• SECTION 8: TRIAGE AND EMERGENCY PROCEDURES
• Appendix: Calculations
• Index
• Wiley End User License Agreement