would like your thoughts on inpatient care

Re: would like your thoughts on inpatient care

gymgams — Sat, 16 Aug 2014 06:58:42 GMT

[quote user="PHA86"]As we're on the subject... Can anyone recommend some free CPD that'll help introduce our ANAs to nursing care plans, so they can assist the nursing team accordingly. Online/after work/lunch and learn stylee is going to be best!

[/quote]

I really like the 5th edition (pink cover) BSAVA textbook of veterinary nursing. With my students I always photocopy the nursing care plans chapter (and usually scribble all over it).

I also printed off a template I found online for the ability model nursing care plan and I think it is the easiest model to introduce nurses to (although several of the students still cannot grasp what "actual" problem and "potential" problem mean... unless you say... what is wrong with the patient now? what could happen to the patient as a result of this?... and "nursing intervention"... might as well be a foreign language unless you say "what are you going to do to help the patient reach its goal?")

I had a student come back from college in tears because she "just didn't get it" from listening/reading in class. So we went round kennels with a care plan and just discussed it. Getting her to put the care plan and the patients together was much less frightening than a lecture at college. This is something that can easily be done in lunch breaks for free :-)

Hope this helps?

Re: would like your thoughts on inpatient care

Jill Macdonald — Mon, 11 Aug 2014 16:33:40 GMT

It's an age-old issue, and you've raised some really good points Alison.

I think it's really important that vets take responibility and the 'lead' for inpatient care - I'm not saying they try to just leave it to us, but I think often they concentrate on consults etc first, and that all-important catch up with the inpatients can be missed. I think this comes down to practice protocol, and having a clear SOP in place wherby the FIRST thing vets do is check over inpatients and offer any ongoing instructions.

Nursing having enough time to devote to inpatients is another story isn't it?!

NCP's really help as they offer a consistent idea of what we should all be looking out for/assessing - even more important if you have students looking after inpatients.

Re: would like your thoughts on inpatient care

jc91 — Mon, 11 Aug 2014 12:14:50 GMT

Thank you for your reply. Yes I feel as though as though i am letting the in patients down to do other tasks that are not really my job to do. In-patients should come first and yes i agree as to what clients would think if they knew the truth!

Thank you again

Re: would like your thoughts on inpatient care

PHA86 — Mon, 11 Aug 2014 12:07:20 GMT

As we're on the subject... Can anyone recommend some free CPD that'll help introduce our ANAs to nursing care plans, so they can assist the nursing team accordingly. Online/after work/lunch and learn stylee is going to be best!

Re: would like your thoughts on inpatient care

Alison Clare Hickman — Mon, 11 Aug 2014 12:00:47 GMT

At many First Opinion practices I have worked at, due to staffing levels (lack of) and multi-tasking requirements, the recovering patients are (routinely) kept within close eye and ear shot of the nurses/vets whislt they are doing other procedures (as opposed to a directly dedicated recovery nurse/kennel nurse). As examples, rabbit/cat patients are kept in a wire carrier on a (covered) heat pad on the floor / a safe shelf near the (Prep) operating table or watched by another (non nursing) staff member with instructions to alert immediately on concerns re breathing etc ... not at all ideal but the very best that can be done in the circumstances. Obviously once the patients have their heads up and have full mentation they can be returned to a kennel environment and the watchful eye/ear can be reduced to a check every so often (as agreed by the vet depending on the procedure the animal has had). Again, not at all ideal, but the best in the circumstances.

I have often wondered what our clients would think if we were truly honest with them about the general level (adequacy?) of post-operative nursing/monitoring in many of these First Opinion practices...

I would always want to give my full and consistent attention to my recovering patient and full and consistent attention to my hospitalised patient. Ideal if one can. I strive for that ideal as I know every other nurse/vet does. I will state that I have been able to this in the Referral practice's I have worked at and it feels right, good and I know I am doing my job without having to compromise. Happy nurse!

Ali h

Re: would like your thoughts on inpatient care

jc91 — Mon, 11 Aug 2014 11:15:08 GMT

Thank-you. We are a little short staffed too so I worry when the kennel nurse has to help with op's and is gone from kennels for hours whilst doing a dental.

Re: would like your thoughts on inpatient care

Chippet — Mon, 11 Aug 2014 10:32:09 GMT

Generally depends on the case. Vets will come in and examine patient when they start (we all start at the same time), form a hospital sheet, listing Meds required. Hospital nurse is responsible for giving those and doing TPR checks, which are done 3 times a day for low risk patients. Some animals need more regular checks and will be monitored as such. We struggle a little as are short staffed, so our hospital nurse is not constantly on the ward, but we manage the best we can. Normally updates are given to the client, first thing by the vet and then 1-2 other times by the nurse throughout the day.

Re: would like your thoughts on inpatient care

Dreamcatcher — Sun, 10 Aug 2014 21:39:39 GMT

I work at a 24 hour hospital and the in-patients are looked after by one of the nurses (mostly qualified, but we do have a couple of students) who is usually supported by a kennel assistant. There are other nurses available to help out if the hospital is particularly full. Our patients are checked once in the morning by the vet (more frequently if critical) and TPRs done again by a nurse later in the day. Clients are updated in the morning by a team of office staff who are also RVNs. They are then updated again by a vet later in the day as and when they are free. They usually get another update in the evening from the kennel nurse or vet, as well as after any procedures performed that day.

Re: would like your thoughts on inpatient care

Steph Worsley — Sun, 10 Aug 2014 19:08:29 GMT

I work in referral so slightly different to "normal" practice but how we work:

we have qualified nurses and auxillaries in the ward areas at all points during the sday, including service specific nurses who come and check patients amongst their other duties.

vets will come and assess their patients a minimum of once a day, more frequently if they are more intensive care patients or if the nursing staff are concerned about them

Owners have an update left at reception in the morning and then get at least one phone call from the vet later on in the day generally after any procedures have been carried out.