Inducing anaesthesia under Vet surgeons directions

RE: Inducing anaesthesia under Vet surgeons directions

PSA-David — Wed, 01 Jun 2016 13:36:26 GMT

think the both departments need to start talking to each other then, as it appears on of them are giving false information. but that doesn't clarify the "lay person term" that they used.

RE: Inducing anaesthesia under Vet surgeons directions

WelshyNurse — Wed, 01 Jun 2016 12:28:46 GMT

I have had confirmation from a Standards & Advisory Officer at the RCVS.

A practice DOES NOT have to employ an RVN.

So there we go

RE: Inducing anaesthesia under Vet surgeons directions

PSA-David — Thu, 26 May 2016 11:47:10 GMT

touchy!! please relax, there appeared to be quite a bit of aggression behind that reply. the document is on the RCVS website. the Confirmation was clarified by calling the RCVS Practice registration team.

following your statement of [quote user="Sal the 1st"]What raises alarm for me is that some of the nurses we are turning out now WITH qualifications are pitifully inadequate and ill prepared for a career in veterinary nursing (title holders or not)[/quote]

if there are so many poor newly qualified as you state, certainly there is a problem with the training structure and the clinical coaches!!

RE: Inducing anaesthesia under Vet surgeons directions

Sal the 1st — Thu, 26 May 2016 08:50:36 GMT

[quote user="PSA-David"]

with the statement of practices never employing a qualified vet nurse. this raised some alarm for me. after a few discussions, it appears they may be breaking the regulations.

also I had been appointed to a specific document on the RCVS website with regards to being called a RVN VN. of which this statement was put forward to my self

"lay person" means a person who is not and never has been a registered or listed veterinary nurse or a registered veterinary surgeon, and is not and never has been entitled to apply to be so registered or listed;

[/quote]

link me that document and I will go and wave it under some noses. If the link refers to the PSS please remember that there are still practices who, for whatever reason, do not subscribe. This has been discussed and discussed and discussed and until both sides come together meaningfully there is always going to be this perpetual argument. I am done with scrapping over a bloody name, if there was as much energy put into actually doing the job as there was over this one issue maybe just maybe veterinary nursing might be the better for it. Until there are enough veterinary nurses to go around , an absolute requirement for training (and a training that is actually wanted by the practices that are employing nurses) there are going to be unqualified nursing staff - like it or not that is how it is and how it will be. Accept it.

[quote user="PSA-David"]

with the statement of practices never employing a qualified vet nurse. this raised some alarm for me.

[/quote]

What raises alarm for me is that some of the nurses we are turning out now WITH qualifications are pitifully inadequate and ill prepared for a career in veterinary nursing (title holders or not) - yes some of them will develop their skills and make good nurses over time but far more will fall by the wayside or even worse in my book go onto teach the next generation how to do a job they weren't even able to do themselves in the first place.

As this thread was about inducing anaesthesia maybe its time we went back to the subject of the thread rather than your 'can of worms'

RE: Inducing anaesthesia under Vet surgeons directions

WelshyNurse — Wed, 25 May 2016 15:04:42 GMT

If this is correct. How does it work with multi branch practices?

There is a well known multi branch practice that only has 1 RVN in 2 of its practices (The ones that are training practices). The rest (5 practices) only have unqualifieds.

RE: Inducing anaesthesia under Vet surgeons directions

PSA-David — Wed, 25 May 2016 13:52:17 GMT

main reason why I done it as I know a few also. its actually concerning that the information I required I had to actually call them,.

RE: Inducing anaesthesia under Vet surgeons directions

WelshyNurse — Wed, 25 May 2016 13:19:55 GMT

Well I know of a few practices that has no RVNs.

I may look into this myself.

RE: Inducing anaesthesia under Vet surgeons directions

PSA-David — Wed, 25 May 2016 12:39:19 GMT

hi,, as this keeps occurring over and over. I have just got confirmation from the RCVS by directly phoning them. A veterinary practice Must employ a registered VET and NURSE or a then VN that has actually undergone examinations.

Lay persons are not to be involved.

RE: Inducing anaesthesia under Vet surgeons directions

WelshyNurse — Wed, 25 May 2016 12:11:27 GMT

It's not breaking regulations if the vets are happy to do the work an unqualified VN cant and are happy to take responsibility

RE: Inducing anaesthesia under Vet surgeons directions

PSA-David — Wed, 25 May 2016 11:30:33 GMT

with the statement of practices never employing a qualified vet nurse. this raised some alarm for me. after a few discussions, it appears they may be breaking the regulations.

also I had been appointed to a specific document on the RCVS website with regards to being called a RVN VN. of which this statement was put forward to my self

RE: Inducing anaesthesia under Vet surgeons directions

Sal the 1st — Mon, 23 May 2016 20:14:23 GMT

its only a can of worms if that is what you want to make it - mine was purely a statement of fact , there are places that don't and haven't ever employed qualified nurses, preferring instead to train their own - and the only reason I mentioned that at all was because if it becomes the case that only qualified nurses monitor anaesthetics there will be practices where this will not be possible

RE: Inducing anaesthesia under Vet surgeons directions

WelshyNurse — Mon, 23 May 2016 14:28:45 GMT

Of course. I don't see the relevance to this discussion though. ANA and unqualified vet nurses monitor anaesthetic, and that's unlikely to change.

RE: Inducing anaesthesia under Vet surgeons directions

PSA-David — Mon, 23 May 2016 10:27:16 GMT

[quote user="WelshyNurse"]How is that opening a can of worms. Sal is right. Practices I've worked in, the RVNs and more than happy and quite prefer if if the ANAs or unqualifieds do the theatre work. [/quote]

do you not remember the debate you were involved last time regarding, being registered and qualified.

RE: Inducing anaesthesia under Vet surgeons directions

WelshyNurse — Mon, 23 May 2016 09:52:08 GMT

How is that opening a can of worms. Sal is right. Practices I've worked in, the RVNs and more than happy and quite prefer if if the ANAs or unqualifieds do the theatre work.

RE: Inducing anaesthesia under Vet surgeons directions

PSA-David — Mon, 23 May 2016 09:07:11 GMT

[quote user="Sal the 1st"] There are still practices where no RVN has ever set foot, and that doesn't make them all bad practices either.[/quote]

and the can of worms have opened up again...the registered, student and non qualified ANA argument again.

RE: Inducing anaesthesia under Vet surgeons directions

Sal the 1st — Sun, 22 May 2016 18:10:10 GMT

[quote user="WelshyNurse"]

Every practice I've worked in, there are more ANAs than RVNs, and all the ANAs monitor anawthetic. If this ever changed to being a schedule 3 job, practices would struggle.

[/quote]

agreed - which is what happened the last time the RCVS tried to enforce it and SPVS and others said no. There are still practices where no RVN has ever set foot, and that doesn't make them all bad practices either. Will be interesting to see how this pans out. Anybody know what the uptake has been on the monitoring anaesthesia qual for non RVNs?

RE: Inducing anaesthesia under Vet surgeons directions

WelshyNurse — Fri, 20 May 2016 16:48:20 GMT

Every practice I've worked in, there are more ANAs than RVNs, and all the ANAs monitor anawthetic. If this ever changed to being a schedule 3 job, practices would struggle.

RE: Inducing anaesthesia under Vet surgeons directions

sananbaz — Fri, 20 May 2016 15:16:52 GMT

Predictably, as far as I'm aware, there is no clarification on this yet. If (when) the changes are made to include inducing anaesthesia and maintaining anaesthesia as within the schedule 3 remit of an RVN or supervised SVN, then yes unqualified staff will not be permitted to do this. However, there is a difference between maintaining an anaesthetic and monitoring an anaesthetic. The first involves make clinical decisions as to the depth of anaesthesia and making alterations to drugs administered. The latter means to monitor vital signs and record, but not to make a clinical decision as to actions that may be necessary - this would fall to the VS. There have been strong calls for monitoring AND maintaining anaesthesia be protected by schedule 3, so only RVN's or supervised SVN's can do it. However, the current recruitment shortage and the fact that some practices don't employ RVN's at all, may mean that they leave monitoring as something that can be carried out by a suitably trained individual. If they do this, it is likely that that suitable training would be clarified to a specific level of training.

HTH

RE: Inducing anaesthesia under Vet surgeons directions

WelshyNurse — Fri, 20 May 2016 14:42:05 GMT

When the changes are made, will this mean unqualified vet nurses will not be able to monitor anaesthetic?

RE: Inducing anaesthesia under Vet surgeons directions

sananbaz — Fri, 20 May 2016 07:45:09 GMT

Yes, you are correct. All injectable and inhalational anaesthetics are given to effect, so the VS 'should' be the one making any changes to dose - including making the decision to increase or decrease the vaporiser setting. However, the RCVS, BVNA and BVA have acknowledged that the schedule 3 amendments are needing updating to reflect changes within practice. So whilst you are correct that most operating VS's couldn't be less interested in the vaporiser setting as long as the patient is alive and not moving (!), as the law stands at the moment, it is necessary to keep the VS informed of the monitoring you are observing/recording. This is due, in part, to the fact that anyone with 'training' can monitor an anaesthetic at the moment, but there is no definition of what that training must be. So until the amendments are updated, giving RVN's and supervised SVN's the legal authority to induce and maintain anaesthesia under the direction of the VS, you need to be aware of what is currently permissable. To protect yourself (and your future registration when you qualify), making verbal comments during monitoring can ensure the VS is aware of the anaesthetic e.g. "the patient's heart rate has increased, with increased jaw tone and slight palpebral reflex present. I'm going to turn the vaporiser up to 3%". The VS can then either agree, disagree or ignore, but at least you are protecting yourself.

As an SVN, it's important that you are aware of the ins and outs of schedule 3 and the code of practice - not only to pass your exams, but also to keep yourself out of trouble with the RCVS disciplinary committee!

HTH

RE: Inducing anaesthesia under Vet surgeons directions

Freckle — Thu, 19 May 2016 23:20:13 GMT

[quote user="sananbaz"]

No. Propofol is 'given to effect', so although you can calculate an expected dose, the patient may or may not need that amount. RVN's's are not allowed to give drugs that are given to effect currently, although this is going to change once the schedule 3 amendments are made. It has been agreed that suitably qualified and competent RVN's will be allowed to induce anaesthesia (including those given to effect) but there is currently no date when this change will come. Potentially this year, but RCVS won't commit to a deadline!

HTH

[/quote]

Surely inhalation agents such as Iso are given to effect too? Glad to hear that the RCVS are reviewing this, most if not all RVNs that I know are in sole control of 'The Dial' during a GA, and have vets giving dodgy advice if asked!

RE: Inducing anaesthesia under Vet surgeons directions

Freckle — Thu, 19 May 2016 23:13:26 GMT

[quote user="PSA-David"]

I do laugh slightly at this RCVS statement

Maintaining anaesthesia is the responsibility of a veterinary surgeon, but a suitably trained person may assist by acting as the veterinary surgeon’s hands (to provide assistance which does not involve practising veterinary surgery), for example, by moving dials.

cant recall a vet saying move down move up . etc

[/quote]

Hmm yep I agree! Most vets I have worked with want to whack it up to 3% or even 5% if the patient is unsettled under GA and don't understand when I object!

RE: Inducing anaesthesia under Vet surgeons directions

PSA-David — Thu, 19 May 2016 18:19:58 GMT

I do laugh slightly at this RCVS statement

cant recall a vet saying move down move up . etc

RE: Inducing anaesthesia under Vet surgeons directions

sananbaz — Thu, 19 May 2016 00:01:51 GMT

Yes. Giving a specific dose of a drug prescribed by a VS is fine. This includes drugs which are not given to effect, such as double and triple combos. Technically, this would probably be classed as heavy sedation rather than inducing anaesthesia. All injectable and inhalational anaesthetics (that I can think of) are given to effect, so currently only in the remit of the VS.

HTH

RE: Inducing anaesthesia under Vet surgeons directions

Freckle — Wed, 18 May 2016 23:31:02 GMT

Would it be OK for an RVN to induce anaesthesia by precalculated and double checked doses of dom/torb/ket if OK'd by the VS then?