Home Visits

Re: Home Visits

Fiona Leathers — Tue, 24 Mar 2009 13:23:13 GMT

We do house visits for lots of things, as many of our clients seem to be house bound! We never go alone, not even the male boss, cos if he's alone with a female all sorts of accusations could arise!

Re: Home Visits

Sandra Taylor RVN, MBVNA — Sun, 22 Mar 2009 18:25:57 GMT

I think in an ideal world Hissycat, you would use a practice vehicle, certainly when I was thinking this all up I was associating it with a practice I used to work at (kind of a template) if you like.

The Health and safety issues as I said, you would have to assess them on an individual basis, and probably offer to clients who are already well known to the practice, and if you were unsure then take another member of staff ie a student along with you.

When I worked with human nurse years ago doing tuck in's we were given a leaflet from the susie lamplugh trust on issues of lone working, and there were quite a lot of hints and tips in regards to your personal safety within the community.

One thing for sure would be that the practice knew where you were at all times, and after certain calls, you had to check in via a phone call.Another if you felt uneasy or unsafe in any way shape or form, then obv you would abandon any visit.

Re: Home Visits

hissycat — Sun, 22 Mar 2009 18:05:18 GMT

I like it too We used to charge £20 for a nurse visit plus whatever we were doing. Sometimes picking up and dropping off a pet for surgery to an elderly owner is such a weight off their minds and makes them more likely to book their animal in for treatment. Unfortunately because of safety and handling issues I am not sure if I would want to do these alone which might make them financially unviable for the practice. There was also the issue of insurance if not using a practice vehicle, would you be insured for driving to/from clients and damages if you and their pet were involved in an accident etc. It would be great if maybe one day a week two nurses could do home visits/clinics though instead of being at the surgery. I'm sure there is a market for it and if you could iron out the problems it would be a great service.

Re: Home Visits

Sandra Taylor RVN, MBVNA — Sun, 22 Mar 2009 16:10:21 GMT

[quote user="S-J"]

actually sandra, the idea of a community nurse sounds quite good and although may not create much revenue for the practice would prob be really good for bonding the clients, there would have to be set guidelines and stuff to stop it being abused but

i like it

[/quote]

Thankyou

Re: Home Visits

S-J — Sun, 22 Mar 2009 13:07:54 GMT

i like it

Re: Home Visits

Sandra Taylor RVN, MBVNA — Sun, 22 Mar 2009 12:19:15 GMT

I for one am all for home visits, and I am not just talking about the ooh pts ones.

I had an idea a few months back about community nursing, like they do in the human field.

Human nurse visit patients homes on a daily basis, to medicate, change dressings etc.

Now if you take the amount of elderly, disabled clients and offer them a service of a VN coming to their home instead of them having to come to the surgery then surely that will only bond the client more.

Also while working in practice, the amount of people who would say while you were handing over meds..."I cant do that" this used to annoy me, because in my head I would be saying.... do you want me to come do it for you?? and actually after a while I though that was not such a bad idea. Again this would bond clients to you if you are offering a service like this.

Your diabetic patients who become stressed in surgery and their BG is increased, so you are never getting a true representation of the actual BG, surely they would benefit from sampling at home, either from a VN or even in the owners themselves, as seems to be the case in a few places now.

I think there is scope for a whole host of things that a VN could do and above are only a few of the ideas I have, and this can only enhance the practice, enhance the importance of the VN, and hopefully create more revenue for a lot of practices as word of mouth spreads as to the great services offered.

As I had said before I looked into this a few months back, and actually went as far as a survey, and even I was astonished at the high percentage of people who would welcome their practices to offer such a service. I even asked if they would be willing to pay for such a service, and how much they would pay.

The amounts ranged from£5 to a whopping £50!!!! but the average was £10.

The percentages of people who would appreciate help with medicating etc was 87% and the percentage of people willing to pay for the service was 81%

I understand there are Health and safety issues doing home visits, but I think if planned carefully, and if possible a VN and a student go where the client is not so well known to the practice, then I think any H an S issues can be kept to a minimum.

I understand that this probably has little to do with what Joel was initially on about in home visits, and I also understand that some would definitely require a Vet, but I just think a lot of practices instead of treating home visits as a pain and an inconvenience, should maybe try and turn the tables and create some good publicity and hopefully revenue for their practices.

PS, I know and fully understand that small places probably could not offer such a service, due to lack of staff, but there are few reasons why some of the larger practices could not offer this.

Even better, employ a nurse who is specifically a community nurse for the practice.

Sandra.

Re: Home Visits

Kerry Spain — Sat, 21 Mar 2009 14:22:26 GMT

What if you've only got 1 vet on and they can't physically get out to do a home visit?

What if you've got a rake of ops on or an emergency?

I don't understand how they can inforce this as a lot of the time it's at our discretion as to when we can get out to do visits. I personally think that 90% of home visits are unecessary anyway. The cost of them soon puts people off when you tell them and it's amazing how they can suddenly find transport at the drop of a hat.

Re: Home Visits

hissycat — Fri, 20 Mar 2009 22:48:10 GMT

In previous practice we would regularly do day home visits for anything from PTS to clip nails, usually as owners were elderly or disabled. We would also do nurse visits (always two of us) to pick up animals who had died at home (to known clients) or to transport ops to and from the surgery. I felt people really appreciated the service and really didn't mind doing it. I would actually rather PTS at home as I feel for the majority of animals it is so much less stressful. OOH unfortunately was often a different story as a lot of people would demand a home visit while being verbally abusive (often drunk and with very poor excuses for not being able to get to surgery) and were refused on safety grounds, however were always offered a consultation at the surgery. One night we went to collect a dog from someones home at night and it was an uncomfortable experience, it was a top floor flat in a run down area and there were a quite a few people in the flat at the time ( did not know who they were or what they were doing there) but atmosphere was not very nice. Was glad to be with a male locum vet. I would never suggest one of our female vets did a home visit alone especially at night unless they knew the client very well. It can be an incredibly stressful situation to be put in and sometimes just frightening. You just never know what you might be walking into, and even the most placid of clients can become irrational/aggressive when faced with a sick pet.

Re: Home Visits

Vicky RVN — Wed, 18 Mar 2009 19:54:53 GMT

That is awful Maisy!

Most of our house visits are for PTS's, but we do the occasional one to people who are unable to get in for whatever reason. When they aren't PTS cases we explain to owners before going out to them that it is limited what we can do for their pet in their home due to what equipment/drugs we have with us, so if necessary we may need to bring the animal back to the hospital with us. We only do arranged visits, no OOH visits as a vet and nurse will go on visit together, which would leave the hospital empty at night. People are generally ok with this and manage to get in to us if they need to OOH. I often find that if they call at night requesting a house visit they are in a panic so haven't thought through who they could ask to bring them in, and when you make suggestions as to who could help them (friend, family, neighbours) they can get a lift in. We have one client that one nurse will go out to on their own, she's an elderly lady who finds it hard to get into us so we'll pick the dogs up for her so the vet can treat them at the hospital then we'll drop them back home. This is fine because we know her well, she's been a client for donkeys years and is harmless! We would never send anyone on their own to an unknown client! We're in the South.

Re: Home Visits

Claire Cameron — Wed, 18 Mar 2009 17:44:51 GMT

where abouts in tyne and wear did u work maisy? x

Re: Home Visits

Maisy — Wed, 18 Mar 2009 17:41:12 GMT

Forgot to say that occured when I was working in Tyne and Wear, currently work in Surrey.

Re: Home Visits

Maisy — Wed, 18 Mar 2009 17:39:45 GMT

Our practice usually has a vet and nurse on home visits, and this is very rarely out of hours (i.e other staff need to know who has gone where). On occasion we may go out to pick up an animal/drop off medication to elderly clients or those who cannot get in for any reason, but this is to clients we know and isn't a service generally offered otherwise.

At my first practice I was told to go and pick up a rottie who we had been treating, sent home due to owners demands (and financial constraints) and later died at home. As an 18 year old who wouldn't have said anything otherwise, off I trundled in the van to a dubious area at the best of times, only to find 4 men waiting including the owner who was drunk/stoned and yelling at me for killing his dog. Managed to calm owner down and get help from one bloke to bring the dog out to the van and told my boss and head nurse about what happened. HN's reply 'oh well, you will meet some unsavoury characters in practice' Staff safety wasn't either of their strong points and there is absolutely no way I would ever allow any of my nurses to have themselves put in that sort of position.

Re: Home Visits

Dodo bird — Wed, 18 Mar 2009 16:40:46 GMT

Hi I work in Bradford and we usually do home visits for euthanasia cases or animals who get very stressed at the surgery. 1 vet and 1 nurse usually attend but we do stipulate that we only do visits within normal working hours and the visit must be pre arranged - ie no RTA cases etc.

Re: Home Visits

Nicola Smith — Wed, 18 Mar 2009 09:24:31 GMT

We do visits when requested usually vet and nurse but vet may go on his own if not possible. At a previous practice I did some visits on my own, very large dogs suture removals etc if the owners had no transport, and also to apply flea treatments or nail clips for elderly clients.

Never feel worried as only on my own to people we knew and with vet to others. Most prctices by us will not do house visits at all even for PTS in daylight hours to their clients - poor show. I am in the West Mids/South Staffs area. Most people needing visits are elderly anyway, costs are always discussed before we go. We also have a friendly local pet taxi who offers people another option to a visit. I get really cross when other practices say it is policy not to do visits - every case needs to be looked at individually you can't just say you don't. Got called to the park once for a dog impaled on a fence - they couldn't bring that in!!!!

Re: Home Visits

S-J — Tue, 17 Mar 2009 21:34:34 GMT

ours are mainly pts or for an elderly client. usually it is a vet or nurse, unless just a vet on his way home drops in.

Re: Home Visits

Saskia Quinn — Tue, 17 Mar 2009 21:28:15 GMT

I work in a mixed practice. Whenever possible, the small animal vet does all the home visits. On occassions if he has been too busy, then the large animal vet will do them.

Most of our visits will be to euthanase a pet. Personally I do not have a problem with this type of visit as when the time comes for my own pets, I will not subject them to a drive to the surgery to await their fate. I have it all planned to a t.

We do visits to a breeder to vaccinate pups.

However, we have one client in particular who requests a visit to clip her dogs nails!! The only reason it is a visit is because the dog is cross!!

Any visits are always a vet and a nurse.

Re: Home Visits

dinkyd — Tue, 17 Mar 2009 21:20:46 GMT

We also do home visits - mostly for pts- but do the odd booster etc if very elderly client and have no way of getting to surgery - these are usually for clients who have had this before and vets usually take a nurse.

Re: Home Visits

Faye Sewell — Tue, 17 Mar 2009 21:11:49 GMT

We do a few home visits a month although have done 2 in the last week, most visits are for a PTS although recently to check newly born puppies and to do bulk vaccinations on litters.

We never do a visit alone we always go with a vet. so cant say we ever fel vunerable. I would be very surprised if you find any nurses who do home visits alone?, can say ive every know that to happen and ive worked in the South West and now in the North West - Bolton!.

Hope that helps!

Re: Home Visits

Claire Cameron — Tue, 17 Mar 2009 21:11:23 GMT

Hiya

I have started a conversation with you x