Registered veterinary nurses (RVNs) are a vital part of the veterinary profession, this is due to the supporting role they provide. They have been governed by the Royal College of Veterinary Surgeons (RCVS) since 1961 when they were known as Animal Nursing Auxiliaries. Over the years the development of the veterinary nursing progression has led to the creation of the Register for Veterinary Nurses ,2007, and the RCVS has provided the profession with regulation and guidelines in relation to practice and ethics.
Informed consent is a part of contemporary health care and is routed within ethical and professional obligations. According to Ashall, Millar, and Hobson-West, 2017, veterinary professionals should look towards the human medical field to perceive how valid consent can be obtained. Within the veterinary field, clients have the right to decide what treatment their animals will receive, due to UK law which states animals are a possession. However, due to welfare legislation such as The Animal Welfare Act 2006 (England and Wales) Veterinary Surgeons can overrule the client’s decision if deemed necessary for the animal’s welfare. It is the professional responsibility of the Veterinary Surgeon to obtain informed consent although due to the busy nature of veterinary practices, the task of admitting patients and obtaining informed consent from clients can fall upon an RVN to complete. Effective communication from an RVN is vital for the clients to understand what treatment their animal will receive. In the BSAVA Textbook of Veterinary Nursing, Chapter 9 it explains the importance of client communication and puts the use of verbal and non-verbal communication into perception. When completing the administration session of the patient, RVNs have the opportunity to ask the client questions in regard to the patient’s preferences in accordance to food, exercising times, enrichment and other animal specific questions.
By keeping a written record of the client’s response to the questions asked RVNs will have notes on the patient’s preferences. This then allows the veterinary team to consider the holistic care of the patient along with the medical care plan. This will improve welfare as the overall needs of the patient are being catered for. However, Lock,2011, argues that although holistic care plans are highly beneficial to patient care, they can be unfeasible due to the time it takes to complete individual care plans. Lock does mention that the information gathered for holistic care can be placed on the hospitalisation sheets and on kennel records for easier access and a quicker plan creation. RVNs could utilise displays and small questionnaires in the waiting rooms to allow clients to fill in any patient preferences and by having a scale of normal behaviour it could aid clients to notice any changes quicker. By placing a greater emphasis on the need for greater holistic care plans RVNs can standardise care plans more effectively and going through the nursing process in regard to the assessment and evaluation of a plan effectively reduce welfare concerns. By having a standardised holistic care plan chartered up, like pain scoring sheets, the time taken to create and implement them will be significantly reduced.
Kinnison, May, and Guile, 2014, highlighted why good inter-professional relationships and communication between RVNs and Veterinary Surgeons is beneficial to the clients, patients and the practice as a whole. By acting as a middle man RVNs can easily aid clients in understanding what the Veterinary Surgeon is explaining to them and help them to understand what treatment that their animal will be receiving along with being able to display care techniques during Veterinary Nurses consults. During these consultations RVNs have the opportunity to demonstrate to owners how to clip nails and for example how to get a cat to take oral medication in the form of tablets. If during Veterinary Surgeon consultations the owner mentions how difficult they are finding taking care of their animal the vet could suggest that the client attends a nursing clinic on the topic, for example obesity clinics for dogs. Belshaw, Robinson, Dean, and Brennan, (2018), did a study into the perspectives of clients and Veterinary Surgeons on the roles that RVNs provide in relation to preventive health care consultations. This highlights how more information should be made public for clients and for Veterinary Surgeons to clearly state the role that an RVN provides to the practice and the clients. By raising awareness on the idea that the modern veterinary nursing profession still has a way to go in regard to raising public profile and improving regulatory legislations.
Furthermore, Kinnison, May and Guile, 2014, linked the themes of hierarchy and communication between the Veterinary Surgeons and RVNs and the critical nature of being able to clearly and professionally communicate with one another whilst being able to abide by the Code of Professional Conduct for Veterinary Nurses (Code of Conduct). This links to Smith, 2016, who completed a report linking the strain of the veterinary field and how good inter-professional relationships are beneficial to the veterinary team in regard to mental health. Which is a responsibility within the Code of Conduct for RVNs to notice and report to the practice owner or to the RCVS committee.
As Aitken, 2014, mentions the RVNs have a vital role within client education in topical areas such as nutrition, and the benefits of providing the correct diet for animal’s life stage and the consequences. Additionally, Speight, 2016, highlights the importance of changing the client’s perception on animal care and welfare for species-specific environments. Through education Speight encourages RVNs to highlight the common misconceptions about rabbit care and to offer the clients additional information whether it to be in the initial consultation or by offering a leaflet on to how to optimise the environment for specific needs. Moreover, according to Ashall, Millar, and Hobson-West, 2017 clients are most likely to seek advice and reassurance from RVNs due to the idea that they are more accommodating to the questions that they have, this can be through nursing consults or clinics being run within the practice.
Due to the Schedule III Amendment Order 2002 of the Veterinary Surgeons Act 1966, RVNs can now perform minor surgeries that do not involve entry of a body cavity. However, the RVN has to be directed by the Veterinary Surgeon they are employed by, who has made a decision to delegate the surgery due to the RVNs qualifications and competence. Potentially in the future there could a greater career progression for RVNs in regard to being able to perform minor surgeries that do involve entering a cavity or the use of tools to remove teeth when performing dentistry’s. Dugmore and Morgan, 2017, highlighted that RVNs are the quiet voices of the veterinary profession and have in the past not engaged with initiatives for change, however, there has now been a shift in willingness for change for RVNs. This could be due to the high levels of RVNs who decide to leave the profession, Moore et al., 2014 and Black, Winefield and Chur-Hansen, 2011, linked decreased job satisfaction with higher levels of occupational stress. In Dugmore and Morgan, 2017, ‘Where do we see the profession in 2025?’ there was a mention of reforming Schedule III and to improve the structure and provide rewarding career paths which would maximise the skill sets of RVNs. An advance on surgical abilities by RVNs could provide the profession with greater career paths and allow practices to utilise the veterinary team more effectively by having Animal Care Assistants take over simple everyday tasks such as the cleaning of kennels and sanitisation, preparation of theatre.
Additionally, by reforming Schedule III there could be a greater mention to the importance of considering models of nursing. Davis, 2007, describes the importance of care plans and how the nursing process can improve patient care and client handling. When starting the nursing care process RVNs should ensure that they have adequate correct information in regard to the patient and their individual care needs. By evaluating the plan and model of nursing care RVNs can reflect on their practice to ensure the correct treatment plans are in place. Through reflective practice RVNs can refine their individual nursing processes, Wager, 2011, mentions how nursing care plans should regularly be questioned and assessed to ensure that they are efficient in providing proper support and care to the patients. Additionally, excessive documentation is a draw back from the implementation of nursing care plans. Wager suggested that where hospitalisation sheets are completed with enough detail they are sufficient in acting as care plans. Moreover, Wager suggests that the time required for direct patient care is severely impacted due to little consideration in veterinary nursing literature for easier implementations of care plans.
The RCVS Code of Professional Conduct for Veterinary Nurses states that RVNs must keep within their own area of competence and refer cases responsibly. By offering continuing professional development (CPD) the RCVS allows for the RVN to choose their own areas of expertise. This freedom to choose which areas they wish to advance or recap allows for the RVN to maintain professional competence. The RCVS, n.d. states that RVNs must complete a total of 45 hours of CPD in any three-year period. With the use of online tools to log CPD hours it does not require a lot to accurately record the hours completed. As RVNs hold a position of responsibility they are help accountable for their actions to the RCVS. If an RVN is found to be abusing their position, the RCVS Disciplinary (DC) and the Veterinary Nurse Disciplinary Committee (VNDC) pass judgement on what penalty the accused will receive. This transparency within the profession allows for the high standards of professional integrity and good reputation of the RVN profession. Once the accused if found guilty and given their penalty, it is then published in the RCVS’s newsfeed, which then discloses the nurses name and former area of employability. Whilst this transparency is good for the reputation of the profession, due to the small community RVNs could find it difficult to find another job within the profession.
To conclude the veterinary nursing profession has progressed to allow for the increasing demand for more complex treatments to be made available. Whilst the profession has expanded the role that RVNs can provide to patients and clients there is still room for improvement. As outlined by Dugmore and Morgan, 2017, the profession has the capability to become more if the Schedule III Amendment Order was assessed and evaluated to compensate for modern demands. The author suggests that through the use of education of the general public there can be a change of perception when dealing with species-specific care. This would help to improve the attendance to preventive healthcare consultations and clinics. Moreover, the education of the veterinary surgeon and the general public what the RVN can professionally provide will allow for the easier conveying of information. The further expansion of the procedures that RVNs are able to perform could potentially increase career progression. The author suggests that by offering more diverse roles to the RVN job satisfaction levels as mentioned by Moore et al., 2014 and Black, Winefield and Chur-Hansen, 2011 would increase. By raising awareness on stress levels, the RCVS could potentially reduce the ‘burn-out’ feeling that RVNs report. The author suggests that by increasing the supporting roles of lay staff and animal care assistants, the RVN will feel more supported in their role. By ensuring that RVNs are sufficiently supported it could reduce the numbers of RVNs leaving the profession after a number of years practicing.