The Role of the
in Small Animal General Practice
By Kayla Buchanan Wallace
Lecture- Jennifer Marshall
Word count- 2000
Table of Contents
TOC o “1-3” h z u The history of a veterinary nurse PAGEREF _Toc531190910 h 3Veterinary surgeons act 1966 PAGEREF _Toc531190911 h 3Animal welfare act 2006/ animal health and welfare ( Scotland) act 2006 PAGEREF _Toc531190912 h 4RCVS code of professional conduct PAGEREF _Toc531190913 h 6Veterinary medicines regulation 2014 and the misuse of drug regulation 2001 PAGEREF _Toc531190914 h 6Bibliography PAGEREF _Toc531190915 h 9Appendices PAGEREF _Toc531190916 h 10
In this essay the author will provide a critical evaluation on the role of a veterinary nurse(VN) in small animal general practice. The role of the VN within a veterinary practice is a very varied job, as daily the VN can be doing several different tasks, such as patient care and helping on reception. They can also be helping the rest of the nursing team and also the veterinary surgeon (VS) carry out a wide range of tasks in order to make sure the practice will run as smooth as possible.
The history of a veterinary nurse
The role of a VN has changed over the year since the first approved nursing training course in 1961 which was started by the RCVS to allow people to train to become Animal nursing auxiliary (ANA) and the course was only a year. The British veterinary nursing association (BVNA) was formed in 1965 but it name was then changed. In 1991 the veterinary surgeon act 1966 was amended to include the role of VN and schedule 3 was also introduced (RCVS Knowledge, 2018). In 2002 the schedule 3 amendment of 1991 was changed to include student VN (SVN). In 2003 any newly qualified nurse was automatically given the title of registered VN (RVN) and then in 2007 there was an introduction of non- statutory regulation.(MARSHALL PGCERT BSC(HONS) RVN, 2018)Veterinary surgeons act 1966
The first law that a RVN needs to deal with in their work is the Veterinary Surgeon Act 1966. This act defines the role of veterinary surgery as “The art and science of veterinary surgery and medicine” (Aspinall, 2012; Legislation.gov.uk, 2018) and then it outline various roles that the act goes on to include. This prohibits the role of the VN during the general care of a patient as it means that they can’t carry out acts of surgical operation on animals and that they also can’t diagnose or carry out diagnostic tests on an animal which they think might be in the animal’s best interest. (MARSHALL PGCERT BSC(HONS) RVN, 2018).
The RVN must only work in ‘direction’ of the VS in regard to treatment of an animal. However, there is exceptions to the rule and this is carried out due to the schedule 3 amendment of the Veterinary Surgeon Act of 1966 which was introduced in 2002. This allows a RVN to carry out first aid in an emergency to preserve the animal’s life and also relieve suffering which the VN can do without a VS present (Rcvs.org.uk, 2018; Legislation.gov.uk, 2018) It also means that the RVN or even a SVN can carry out minor acts of veterinary surgery, if they are deemed competent by the VS. This has limitation though as it prohibits the role of the VN since they can’t do any acts of surgery that enter the body cavity of an animal and it also allows the veterinary nurse to be liable for their actions.
Animal welfare act 2006/ animal health and welfare ( Scotland) act 2006The second legislation that the RVN needs to follow is the Animal Welfare Act 2006 in England and Wales and in Scotland the Animal Health and Welfare (Scotland) Act 2006. These legislations are similar but just have different names. These acts define an ‘animal’ as being any living vertebral animal. (Aspinall, 2012; Mullineaux, 2018) This means that not every animal is covered under this legislation. The legislation also is based on the five freedoms which were originally set out by the Farm Animal Welfare Council in 1979 in order to change how farm animals were treated. The Animal Health (Scotland) Act 2006 and the Animal Welfare Act 2006 adapted the five freedoms in order to suit small animals which are as followed.
Freedom from hunger and thirst
Freedom from discomfort
Freedom from pain injury and disease
Freedom to express normal behaviour
Freedom from fear and distress.
(Cooper, Mullineaux and Turner, 2011; Animal Welfare Codes Unit 304: Applied Animal Welfare, Health ; Husbandry for Veterinary Nurses, 2015). This means that when carrying out their job a VN needs to follow the act otherwise there could be further repercussions. This act however has some limitations like most other acts, due to the VN not being able to always follow the five freedoms as it depends on the situation that the animal is brought into the practice. This can happen when an animal needs to be starved before surgery. This means that when an animal is in the practice, the VN will be unable to provide for one or more of the five freedoms due to several different factors which in order to give the animal the care it needs. However, in order to provide the best care for an animal the VN may decide to carry out a nursing care plan in order to eliminate inconsistencies in the care and welfare needs of an animal are met to the best of their ability. (Ballantyne, 2018; MARSHALL PGCERT BSC(HONS) RVN, 2018) This is done through the use of care plans.
There are many different models of care plans (the main two are the Orem model of self-care and the Roper, Logan and Tierney activities of living) and these can all be started when the patient is admitted for a procedure. (Ballantyne, 2018 ; Lindley, 2015) ( appendix 1) (Nursing Care Plan, 2015) They can then be continued all the way through the animals stay in the surgery. This gives an advantage to the role of a VN as one person can’t be with a single patient all times and it allows other members of staff to monitor the patient and allow them to know what has happened previously as it has been written down. It also allows the veterinary team to monitor any abnormalities in patient care as they are able to see any changes that have happened. The care plan can be reviewed and changed as the patient’s health improves or deteriorates throughout their stay within the practice. They are also able to be used in relation to the nursing process which is a key part in the nursing profession. This is due to them being able to provide organised, structured and holistic care to the patient under their care by providing them with individual care that is suited to them rather than the disease that they have been admitted with. Care plans tend to focus on the illness. This allows the VN to come to a nursing decision about the care that the animal should go through and it has four to six main steps depending on what version you look at, one of which is the assessment of the patient. (Aspinall, 2012; Ballantyne, 2018) This allows the VN in a positive way to give the best possible care to the patients as they are able to adapt the care, they are giving to the patient by noticing when thing are changing. This process also helps, improve the welfare of the animals within the care of the VN. However, some VN may also say that the nursing process is negative to the job as they can be seen as a time-consuming task due to the number of different processes that you have to go through in order to complete the whole process and finding ways to implement it on a daily basis (Aspinall, 2012). The nursing care plans can also be used in conjunctions with other forms in order to give the patient the best possible care. They do this by being linked with pain scoring charts such as the Glasgow pain scale (see appendix 2) (Gla.ac.uk ,2018) which allows the patients pain to be monitored through their stay by allowing the animal to be monitored through a various of different means including their behaviour and how they respond to stimuli. It also can be given to the owner in a modified version to allow them to continue the care for the animal at home which makes it easier for the owner and will make them feel less uptight in the care of their animal.
RCVS code of professional conductAnother very import law that a RVN needs to follow is the RCVS code of professional conduct. This outlines to the way that a RVN should treat various aspects of their job such as the animals, client, the veterinary team and the public (Rcvs.org.uk, 2018). It also outlines the VN and SVN professional responsibility’s and that must always be followed. Some of the examples that the veterinary nurse must follow is that when dealing with a client the “Veterinary nurses must be open and honest with clients and respect their needs and requirements” and “Veterinary nurses must communicate effectively, including in written and spoken English, with clients and ensure informed consent is obtained before treatments or procedures are carried out” ( Rcvs.org.uk, 2018). This means that the VN must follow the clients wish and if they don’t, they may be disciplined for this. This did happen for a RVN as she was dishonest to several different people including the client as she took home a cat that was meant to have been euthanised. (Professionals, 2018). This can have an impact on the role of a VN as they must follow everything that a client wants and wishes even if it is not the right thing to do in their eyes. It may also result in VN and other members of the veterinary team losing their jobs and going through disciplinary (Rcvs.org.uk, 2018). This is a result in not following what a client would like which could have an implication for them when they try to get a different job and it may bring about a bad reputation to the practice.
Veterinary medicines regulation 2014 and the misuse of drug regulation 2001Another crucial legislation that the VN needs to follow is the Veterinary Medicines Regulation 2014 and the Misuse of Drug Regulations 2001. Both these regulations relate to the drugs that a VN can encounter in practice and how they should be handled and stored. This can have an implication the role of a VN also as drugs are classified differently (see appendix 3) (Marshall PgCert BSC(HONS) RVN, 2018) so if a drug falls within a certain category then a VN can’t prescribe it unless the VS has given authorisation to them, and the VS must have seen the patient within the last 6 months. It also means that the VN needs to do a regular check of all the drugs within the practice which could to take time due to the number of drugs that are being kept, which is called a stock take. This takes time away from general patient care and this could also lead to a disciplinary action being taken against the VN if they do not follow the legislations and then get found out. They could also break the Misuse of Drugs Regulation 2001 and end up with a prison sentence. (Legislation.gov.uk, 2018; Professionals, 2018). These legations mean that a VN can’t put through a prescription and present it to a pharmacy in order to get the medication as any prescription should be filled out by a VS. This may limit the role of the VN role as they are unable to just hand the client over the drugs that they require due to the need for the signature from the VS so they may have to keep the client within the practice in order to get the drug signed in between consult or tell the client to come back the following day if it not an urgent drug.
Overall the role of the VN is a varied job with lots of limitations in the way that the role should be performed, this is due to the various laws and regulations that are set out in order to keep the profession a safe profession and in order for clients to have faith in the way practices are run.
Animal Welfare Codes Unit 304: Applied Animal Welfare, health ; husbandry for Veterinary Nurses. (2015). .
Aspinall, V. (2012). The complete textbook of veterinary nursing. Edinburgh etc.: Butterworth Heinemann/Elsevier
Ballantyne, H. (2018). Veterinary nursing care plans.
Cooper, B., Mullineaux, E. and Turner, L. (2011). BSAVA Textbook of Veterinary Nursing. 5th ed. Quedgeley, Gloucester: British Small Animal Veterinary Association.
Edinburgh Napier Powerpoint (safe handling and dispensing medication)
Gla.ac.uk. (2018). University of Glasgow – Schools – School of Veterinary Medicine – Small Animal Hospital – Our services – Anaesthesia and Pain Management. online Available at: https://www.gla.ac.uk/schools/vet/sah/services/anaesthesiaandpainmanagement/ Accessed 16 Nov. 2018.
Legislation.gov.uk. (2018). The Misuse of Drugs Regulations 2001. online Available at: http://www.legislation.gov.uk/uksi/2001/3998/contents/made Accessed 16 Nov. 2018.
Legislation.gov.uk. (2018). Veterinary Surgeons Act 1966. online Available at: https://www.legislation.gov.uk/ukpga/1966/36 Accessed 16 Nov. 2018.
Lindley, A. (2015). The use of care plans in veterinary nursing: a recently qualified RVN’s experience. Veterinary Nursing Journal, 30(7), pp.204-206.
Marshall PgCert BSC(HONS) RVN, J. (2018). Administration of Medication.
Marshall PgCert BSc(Hons) RVN, J. (2018). Patient Assessment.
Marshall PgCert BSC(HONS) RVN, J. (2018). The role of the Veterinary Nurse within a multidisciplinary team.
Marshall PgCert BSC(HONS) RVN,, J. (2018). Nursing Models & care planning.
Marshall PgCert BSC(HONS) RVN,, J. (2018). Safe Handling and Dispensing Medication.
Mullineaux, E. (2018). An introduction to animal welfare science and veterinary ethics.
Nursing Care Plan. (2015). ( care plan examples)
Professionals. (2018). RVN Disciplinary Committee suspends Kent-based vet nurse. online Available at: https://www.rcvs.org.uk/news-and-views/news/rvn-disciplinary-committee-suspends-kent-based-rvn/ Accessed 16 Nov. 2018.
Professionals. (2018). RVN Disciplinary Committee suspends Northants registered veterinary nurse. online Available at: https://www.rcvs.org.uk/news-and-views/news/rvn-disciplinary-committee-suspends-northants-rvn/ Accessed 16 Nov. 2018.
Rcvs.org.uk. (2018). 19. Treatment of animals by unqualified persons – Professionals. online Available at: https://www.rcvs.org.uk/setting-standards/advice-and-guidance/code-of-professional-conduct-for-veterinary-surgeons/supporting-guidance/treatment-of-animals-by-unqualified-persons/ Accessed 16 Nov. 2018.
Rcvs.org.uk. (2018). Code of Professional Conduct for Veterinary Nurses – Professionals. online Available at: https://www.rcvs.org.uk/setting-standards/advice-and-guidance/code-of-professional-conduct-for-veterinary-nurses/ Accessed 16 Nov. 2018.
Rcvs.org.uk. (2018). Veterinary Nurse Conduct and Discipline Rules 2014 – Professionals. online Available at: https://www.rcvs.org.uk/document-library/veterinary-nurse-conduct-and-discipline-rules-2014/ Accessed 28 Nov. 2018.
RCVS Knowledge. (2018). Veterinary nursing timeline. online Available at: https://knowledge.rcvs.org.uk/heritage-and-history/history-of-the-veterinary-profession/veterinary-nursing-timeline/ Accessed 28 Nov. 2018.
Bva.co.uk. (2018). BVA policy – Veterinary medicines. online Available at: https://www.bva.co.uk/News-campaigns-and-policy/Policy/Medicines/Veterinary-medicines/ Accessed 21 Nov. 2018.
Models of nursing. (2015).
NOAH (National Office of Animal Health). (2018). Controls on veterinary medicines – NOAH (National Office of Animal Health). online Available at: https://www.noah.co.uk/briefingdocument/controls-on-veterinary-medicines/ Accessed 21 Nov. 2018.
Publications.parliament.uk. (2018). online Available at: https://publications.parliament.uk/pa/cm200708/cmselect/cmenvfru/348/348.pdf Accessed 21 Nov. 2018.
Rcvs.org.uk. (2018). 4. Veterinary medicines – Professionals. online Available at: https://www.rcvs.org.uk/setting-standards/advice-and-guidance/code-of-professional-conduct-for-veterinary-surgeons/supporting-guidance/veterinary-medicines/ Accessed 21 Nov. 2018.
Rowlinson, C.V., 2017. A review of relevant literature on the challenges involved in implementing nursing care plans within veterinary practice. Veterinary Nursing Journal, 32(8), pp.218–223.
Unit 301: Understand the Operational Requirements of a Veterinary Practice. Learning Outcome 1 Understand the roles of the veterinary team. (2015). .
Veterinary Medicines Regulation 2006. (2015). .
Veterinary Surgeons Act 1966. (2015). .
vsa1966asamended-jan14.pdf. (2014). .
Wallace, K. (2015). Professional Integrity in Veterinary Nursing.
Copies of care plans
Nursing Care Plan
Case Study Using Orem
Reason for admission:
Universal self -care requisites. Self-care abilities Self –care limitations Patient actions Nursing actions
Maintain intake of air
Maintain intake of water.
Maintain intake of food.
Balance activity and rest
Balance solitude & social integration. Prevention of hazards to life, well- being and functioning.
NormailtyNursing Care Plan
Case Study Using Roper Logan and Tierney
Position on Life Span: Neonate —————————————————-Geriatric
Activity of Living Nursing Assessment (patient’s ability to carry out activity of living) Patient Problem (dependant/independent)
Potential or Actual Nursing Goals Nursing Interventions Evaluation
Maintaining a Safe Environment
Eating ; drinking
Personal cleansing (grooming)
Controlling body temp
Working and Playing
Glasgow pain scale
Box 1 Short form (CMPS-SF) of the Glasgow Composite Measure Pain Scale.
10858516256000Short-form Glasgow Composite Measure Pain Scale 99
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Categories of drugs
SCHEDULE DESCRIPTION EXAMPLE DRUG
Schedule One These drugs have no place in veterinary practice Cannabis Heroin LSD
Schedule Two The opiate analgesics. These are subject to specific requirements regarding ordering, storage and supply. Their use must be kept within a register. Stored in a locked cabinet. Specific destruction requirements. Morphine Fentanyl Pethidine Ketamine
Schedule Three The barbiturates plus the opiate analgesics. These drugs have to be ordered by prescription but DO NOT have to be recorded in a register or kept in a locked cupboard.
(There are exceptions to this such as Buprenorphine ) Pentobarbitone Phenobarbitone Buprenorphine
SCHEDULE DESCRIPTION EXAMPLE DRUG
Schedule Four Benzodiazepines. These drugs when used in veterinary practice are not normally subject to any of the controls above Benzodiazepam Butorphanol
Schedule Five Certain preparations of codeine and morphine that contain less than a specified amount of the drug.Drugs that come under this schedule only need to have invoices kept for a 2 year period Codeine cough linctusKaolin and morphine anti- diarrhoeal suspension