VNs; Very Necessary!

Re: VNs; Very Necessary!

Fuzzyduck — Wed, 23 Jan 2013 21:41:00 GMT

I totally agree that if nurses find the practice they are working in doesn't meet their expectations, for whatever reason, they should move on and find one that does. No practice is perfect from my experience no matter now far up the scale you go. It's just about finding a happy medium. I don't however agree that the current training is wrong or that nurses are learning too much, personally I would rather know too much than too little, and if that little extra knowledge helps in any way it can only be a good thing. Veterinary medicine has to move with the times, people are expecting more from vets and nurses, so I think teaching nurses less would be going in the wrong direction

Re: VNs; Very Necessary!

Sal the 1st — Tue, 22 Jan 2013 23:04:06 GMT

yes I agree with you but I absolutely hate to hear nurses wittering that they cant do this or they cant do that or the practice should be doing things this way and not the way the practice finds works for them. If that is the case then its down to the nurse to either ship out and find somewhere that does live up to their expectations or find a way that they can work happily within their existing practice, not condemn a practice just because it doesnt work the way they think it should.

The way things are now its just setting nurses against vets, it just doesnt add up to a productive, happy team. I can see it from both sides that there are nurses frustrated that they cant do things that they have been trained to do and also that there are vets out there who just dont want their nurses doing certain things or as an employer would prefer things are done to their rules rather than being dictated to by an employee.

When people feel they are being threatened/bullied/dictated to they get defensive and it doesnt matter who they are thats what happens. Wouldnt it be better all round if the training was more in line with what was wanted and then people could work together more easily?

Re: VNs; Very Necessary!

Fuzzyduck — Tue, 22 Jan 2013 22:17:29 GMT

[quote user="Sal the 1st"]

[quote user="therainyj"]

I think that the nursing career has not been 'created', I think it has emerged from the need for specialized support staff for veterinary surgeons.

[/quote]

And thats fine so long as you realise that the degree of specialism that has emerged is often far higher than is actually needed or required and to me this is the basis of a lot of the disatisfaction expressed by nurses.

[/quote] I think this totally depends on the practice Sal and there are plenty of opportunities for nurses to work in no matter what level of speciality they want to achieve, just as there is the same out there for vets

Re: VNs; Very Necessary!

Fuzzyduck — Tue, 22 Jan 2013 22:04:39 GMT

I think standard of care has to be tailored to the client in question, if they cannot afford, or simply don't want what most people would deem 'gold standard' then they should get what they want. But we cannot simply either assume they won't want to pay for all the extras and therefore not offer them. Some clients may be happy to risk their animals to an anaesthetic with no one monitoring it but should the animal die, and they were not told this was the case, then they would be totally within their rights to sue. I dont think there is a right or wrong way, but I think there has to be a level of honesty with the clients. I have recently moved to referral work and surprising to me we get numerous referrals from the PDSA whose clients I would assume would not be able to afford referral, it just goes to show you can't judge a book by its cover.

Re: VNs; Very Necessary!

Sal the 1st — Tue, 22 Jan 2013 22:00:46 GMT

[quote user="therainyj"]

I think that the nursing career has not been 'created', I think it has emerged from the need for specialized support staff for veterinary surgeons.

[/quote]

Re: VNs; Very Necessary!

therainyj — Tue, 22 Jan 2013 21:23:52 GMT

I agree with the fact that not everyone can afford vet care, or that some people think that their pet 'is not worth it' - that's why I think methods of care should be discussed and offered with a range of prices where appropriate as I mentioned in my original post At the end of the day, there is still no animal NHS and this should be considered before getting a pet (although I appreciate that people often do not think of this). Just as if you travelled abroad and had to go to hospital - without travel insurance, you have to pay, and the better the care, the more you pay.

I think that the nursing career has not been 'created', I think it has emerged from the need for specialized support staff for veterinary surgeons.

Thanks for your replies guys

Re: VNs; Very Necessary!

katy garlick — Tue, 22 Jan 2013 11:53:40 GMT

I too agree. Infact i agree with every opinion on this discussion.

Unfortunatley I believe that the vet discussed in the inital post has a very irresponsible opinion on anaesthesia monitoring, without any consideration for the welfare of the animal on the table. Welfare of a patient plays a massive part in obtaining 'gold standards' - obviously everyones opinion of what this is varies, but we must not forget it is vets and nurses 'first consideration'.

I know I quote the code, which only RVN and MRCVS are obliged to follow but it is an excellent tool for everyone to look up to. Yes there may be some areas which are questionable, but it definatley makes clear what is most important.

Re: VNs; Very Necessary!

molladog — Tue, 22 Jan 2013 09:16:15 GMT

I tend to agree with you Arlo.

Re: VNs; Very Necessary!

Arlo Guthrie — Tue, 22 Jan 2013 08:33:28 GMT

[quote user="therainyj"]The vet, however, disagreed. She said by following the Gold Standard, we have to use more resources, passing more costs to the client and pricing some people out of the market - especially those without pet insurance.[/quote]

Preparing to be shot down in flames, but I agree with what I think this vet is trying to say.

Isn't the story exactly the same in human medical care? Fuelled largely by science, the standard of care and range of treatments improves almost daily. We live longer as a result. Problem is that, as a country, we won't be able to afford all these treatments for an increasing aged and less productive population for much longer.

And for our pets, the same thing. The standard and range of veterinary care gets better and better until it simply prices itself out of the market in one of two ways:

People can't afford it
People don't think it's worth spending on a dog

[quote user="therainyj"]our attitudes should be to aim high and offer the best service we possibly can.[/quote]

Of course, and I agree with you, BUT I think the 'best service we possibly can' needs to be tempered by an awareness of the economic realities, especially in a recession.

Re: VNs; Very Necessary!

Sal the 1st — Tue, 22 Jan 2013 00:00:02 GMT

In some ways I can see where this vet is coming from (note only SOME). I have come across vets that do feel bullied or threatened by their nursing staff into doing things differently to what they would like. It doesnt always mean that the vet is a penny pincher, doesnt have the interests of the animal or client at heart or is old fashioned and behind the times but just that they would maybe approach things differently or have different priorities and they may have good clinical reasons for doing so that the nursing staff are not even aware of.Don't forget that the majority of nurses in this country are employed by vets and at the end of the day an employer has a reasonable expectation that their employees will work according to their needs and the needs of their customers, and thats how it is I'm afraid. Look back at some of the threads on here on the fabled 'gold standard' the gold standard means different things to different people. You could say if a practice lacks a certain piece of equipment it falls below the gold standard, but then it may compensate in other ways. ie a practice without a haematology machine but has a member of staff that is absolutely s**t hot at looking at blood smears and doing manual pcvs - which would you then say was the gold standard esp if the haematology machine you are talking about is a QBC which really struggles with platelets and isnt that happy with immature rbcs and its the platelets among other things that you are interested in?

I still feel a lot of the problems between vets and nurses happen because of the way they are taught. There does seem to be a lot of inflexability within some of the nursing staff these days - for many nurses now with all the extra learning they are making decisions for themselves on how things will or wont be done based on what they have seen at college/university and when they start dictating to the person who is paying their wage it simply isnt appreciated. Far better to work with your employer and find ways you can both live with and at the same time offer the best standard possible for the practice you work in. I am not saying that learning is wrong but that the learning may be a lot more than is required for the role that the vet needs the nurse to fulfill - and that situation is going to cause problems if the nurse has ambitions higher than the practice can cope with.

I do agree that to some extent the RVN is trying to ensure their own futures at the cost of everybody elses. In an ideal world yes every nurse would be registered but to do that the training needs to be more accessible to a greater number of people and every member of nursing staff needs to have access to a basic training and be given the opportunity to train - and that training needs to be mandatory and something that is useful to your average practice - if it isnt you have the situation we have now where there is a minority group (and the RVNs when you take into account all nursing staff in practice are still the minority group) dictating what will and wont happen, it puts peoples backs up. So yes if you locum vet has had 'bad' experiences I can see where they are coming from

Re: VNs; Very Necessary!

JaneRVN — Mon, 21 Jan 2013 16:16:39 GMT

Agreed Mark! Can also be euphemsim for "totally unneccesary". Used to work in practice where any panc dog was scanned - which doesn't actually change dx or tx, just puts up the bill, Also all had cPLI taken... Good practice in an unresolving or recurrent cases but really necc in the first 24 hours ona new case?

Re: VNs; Very Necessary!

Mark Hedberg — Mon, 21 Jan 2013 16:03:50 GMT

What an unusual attitude from yonder vet! I don't deny that some new graduates lack confidence, but that's what your colleagues are for - support and encouragement. Certainly I never had anywhere near the support of a multi-vet multi-nurse practice when I first graduated; I don't begrudge the fact that some new grads had support I never got.

I do think that sometimes "Gold Standard" is used incorrectly; most people use "Gold Standard" to mean best care; I've heard of some places that use "Gold Standard" as a euphemism for "most expensive". This is probably going to open a can of worms, and I apologize in advance

Re: VNs; Very Necessary!

JaneRVN — Mon, 21 Jan 2013 15:24:36 GMT

Sounds a bit confused to me. On the one hand charge clients and price some out of the market for "gold standard care" then negate that by saying no GA monitoring is required. If you are up to your elbows in a fat pyo you aren't monitoring the subtle changes that can indicate GA problems...

How do they put the pulse ox back on when its fallen off a slippery tongue... or is sterility a bit "unneccesary too"?

Re: VNs; Very Necessary!

bongo — Mon, 21 Jan 2013 14:54:01 GMT

This has angered me somewhat and is a very old fashioned apporoach to looking at it.

VNs should be proud of the fact that they strive to provide gold standard of care. How can a vet performing surgery monitor and record an anaesthetic chart which as far as I am aware is a legal requirement!

Yes it may end up costing more to the client but in my opinion people these days are prepared to pay more insurance or no insurance. Maybe you should go on strike and then see how the vet gets on with their day to day job

Re: VNs; Very Necessary!

GremlinNurse — Mon, 21 Jan 2013 14:45:24 GMT

Mmmmm, everyone is entitled to their opinion but some are just wrong! lol

The Gold Standard should always be offered, and strived for IMO. If we don't offer every option to the client, we are assuming things we shouldn't be assuming and are not getting informed consent(sorry doing VN19 at moment).

As for GAs not being monitored, well that's just crazy, even if we gave clients they option and it was cheaper, they are not in the position to know whether this is ok or not. Well, and it might be ok, but we've all had 'routine' anesthesias go wrong, they are often the one's that do rather than the geriatric, obese, diabetic, heart dieased, very high risk patient . As for 'pricing people out of the market' owning a pet is expensive and is a privilege, 'nuff said.

Oh, and our latest new grad is fantastic and appreciates nurses and what we stand for.

Nurses do a very different job to vets...but we are both necessary in practice, one couldn't do without the other and I think mutual respect is very important