Lone working as a student

RE: Lone working as a student

Stacey1 — Thu, 08 Oct 2015 11:34:55 GMT

This discusses call outs more than anything; but it does also discuss what students should and don't be doing in their own. I am also a student, and struggle with the battle of the on call situation. Hope you find the answer you are looking for ! Good luck!

B.V.N.A. FACT SHEET SERIES (NO. 23)

CALL OUT

The BVNA Industrial Relations Helpline often receive calls regarding call out pay. Here are the employment facts:

• If you are on call at the place of work

In a situation were you live in at the Practice or Hospital and are waiting for work, you are on call and should be paid for the hours you are working. On-call duty performed by a worker where they have to be physically present on the employer’s premises is classed as “working time”, regardless of the work actually done.

• If you are on call at home

Should you be able to carry on with your normal routine at home, with no restrictions set by your employer and maybe go to bed, then the employer does not have to pay you.

• On call at home or not able to carry on with normal social/domestic routines

If you are on call at home, and might have to answer the telephone or drive to the Practice, the responsibility to the employer is increased. You may be restricted in what you can do, for example, you might have to remain in the house to answer the telephone, or avoid alcohol because you might need to drive to the Practice. Practices are often split on whether they pay a nominal sum for this type of on-call work, such as £20.00/£30.00 per day/night when this type of on-call is required.

With regard to on call duties where on call is part of the rota, student and non-qualified nurses need to be mindful of the duties they can perform.

Student Nurses

(From the Veterinary Nurses and the Veterinary Surgeons Act 1966)

7. The directing veterinary surgeon must be satisfied that the veterinary nurse is qualified to carry out the treatment or surgery. RCVS will advise from time to time on veterinary nursing qualifications which veterinary surgeons should recognise.

10. Paragraph 7 applies to student veterinary nurses. A student veterinary nurse is someone enrolled for the purpose of training as a veterinary nurse at an approved training and assessment centre (VNAC) or a veterinary practice approved by such a centre (TP). This does not include those who are undertaking the BVNA Animal Nursing Assistant.

11. A student veterinary nurse may administer “any medical treatment or any minor surgery (not involving entry into a body cavity)” under veterinary supervision.

12. The animal must be under the care of a veterinary surgeon and the treatment must be carried out at his or her direction. The veterinary surgeon must be the employer of the veterinary nurse or be acting on behalf of the nurse’s employer.

13. The treatment or minor surgery must be carried out in the course of the student veterinary nurse’s training. In the view of RCVS, such work should be undertaken only for the purpose of learning and consolidating new skills.

14. The treatment or surgery must be supervised by a veterinary surgeon or a listed veterinary nurse. In the case of surgery the supervision must be direct, continuous and personal.

15. In the view of RCVS, a veterinary surgeon or listed veterinary nurse can only be said to be supervising if they are present on the premises and able to respond to a request for assistance if needed. “Direct, continuous and personal” supervision requires the supervisor to be present and giving the student nurse his or her undivided personal attention.

The Veterinary Nurses and Veterinary Surgeons Act 1966 also details what medical treatment and minor surgery may involve:

16. The Act does not define “any medical treatment or any minor surgery (not involving entry into a body cavity)”. Ultimately it would be for the courts to decide what these words mean.

17. The procedures which veterinary nurses are specifically trained to carry out include the following:-

- administer medication by mouth, topically, by the rectum, by inhalation or by subcutaneous, intramuscular or intravenous injection;

- administer other treatments, including oral, intravenous and subcutaneous rehydration, other fluid therapy, catheterisation, cleaning and dressing of surgical wounds, treatment of abscesses and ulcers, application of external casts, holding and handling of viscera when assisting in operations and cutaneous suturing;

- prepare animals for anaesthesia and assist in the administration and termination of anaesthesia, including premedication, analgesia and intubation;

- collect samples of blood, urine, faeces, skin and hair; and

- take x-rays

There are instances where student VN’s are “on call” and attend Practices alone. This will be acceptable if a nurse was attending a practice to fill water bowls, walk animals, change bedding etc, but not to administer medical treatment or carry out minor surgery without the direct supervision of a veterinary surgeon who is on the premises.

Health and Safety

The employer has a duty of care to all staff and this includes time spent on call at the premises. Our advice is for a Risk Assessment to be carried out, reviewing lighting, car parking, the area the Practice is situated in, the risk of access to medical supplies, equipment, patients, cash etc.

Telephone links, alarmed premises, personal alarms etc should all be considered for the protection of staff.

If you have any questions regarding call out, or your own experiences please contact the Industrial Relations Services on 01822 870270.

H.R.S.C provides the BVNA Industrial Relations Service

Tel No: 01822 870270

RE: Lone working as a student

Amandspands — Wed, 07 Oct 2015 21:15:22 GMT

As an experience student, I have been doing 'night checks' at 10pm on my own with nobody in the practice for a year before I was registered (and continued to do so). My duties included all that comes with nursing and I would need to give IV medications and at times things like methadone. It wasn't until recently when we had an RCVS inspection that it was changed to no IV meds and especially not methadone (and related drugs). So fairly basic nursing is permitted but no IV and scheduled drugs should be given.

RE: Lone working as a student

Tania Ford — Wed, 07 Oct 2015 12:02:07 GMT

[quote user="C Jenkins"]

I totally understand your point. Seems in my area they are always recruiting RVNs and the pay isn't very good.

The last 2 jobs I went for and got were actually advertised wanting RVNs.

[/quote]

I have always said to unqualified work colleagues to just 'go for it' if a job is being advertised as RVN, because there is nothing to loose. Good, experienced unqualified nurses are often much better at their jobs than RVN's. Unfortunately over recent years, too much emphasis has been put on the qualification. through the years I have seen many 'qualified' nurses that simply aren't suited to the job and have only gained the 'said' qualification for the glory of being able to use post nominals after their name and being able to say that they are a para professional. It really should be more a case of being good at your job, having empathy and good morals so far as im concerned and i have no problem working with good trained unqualifieds and RVNs alike and everyone should be taken on their own merit. A lot of good unqualifieds are often much more educated as they have had to prove their worth to colleagues over time and speaking from experience I undertook much more CPD than the 45 hours required by the RCVS if you are a RVN. I wish you well in your chosen career x

RE: Lone working as a student

Sal the 1st — Wed, 07 Oct 2015 11:51:45 GMT

the same happened with me - unqualified, practice sold onto a group. I found a training practice and qualified. Vet nursing has never been just a job for me either. I used to be passionate about training other people once I qualified so that they had some of the chances I waited so long for but as I stayed listed for as long as I could I wasn't deemed responsible enough to be training others, - now that I can because of the magical 'R' I just cannot be bothered anymore. I have lost heart. I want a future for vet nursing where people do have access to affordable relevant training and a qualification and where practices do want to train nurses again without all the garnishing and extra costs they have now - I suppose thats why I get so annoyed when I see vet nursing being slowly destroyed as it is now, its like every time you try you get another kick in the teeth from the powers that be to make sure you know your bounds and stay in your place. Its soul destroying and at the moment I am not sure how much longer I want to do this

And on that note I am off to work

RE: Lone working as a student

Tania Ford — Wed, 07 Oct 2015 11:19:22 GMT

I have to say that I only decided to gain my qualification when I was made redundant after 11 years service because i was not qualified. this happened when my old boss decided to retire and the practice was bought by a large company, who didnt wish to put the time and effort into qualifying me, so fully understand why you do not feel the need to gain your qualification. I felt much the same as you do, but circumstances forced my hand. I have to say though that I now feel much more secure in the knowledge that i could gain employment as a VN should the same thing happen again. For me Veterinary Nursing has always been a vocation and not just 'a job' and after more than 30 years in the business, i could never imagine doing, or wanting to do anything else, so i did feel the need to protect myself against future redundancies etc.

RE: Lone working as a student

Sal the 1st — Wed, 07 Oct 2015 10:38:09 GMT

I understand what you are saying - I did 10 yrs in practice as an unqualified myself, but whilst there are practices that are happy to employ unqualified then there will always be a place for unqualified staff.

[quote user="katseyez"]

this is not acceptable in this day and age.

[/quote]

but unacceptable to who? Unacceptable to nurses maybe but not unacceptable to some employers

[quote user="katseyez"]

The most important thing to remember is that the lives of many precious pets are in our hands on a daily basis and that training should play a very important role. Too much emphasis is placed on theory instead of practical skills, and i think this is one of the reasons some nurses are scared of training and think the examination process is too difficult (especially if you have been out of school for many years like i had been).

[/quote]

absolutely agree with you on that

RE: Lone working as a student

Tania Ford — Wed, 07 Oct 2015 10:17:30 GMT

Please do not take my post as complaining about unqualified nurses. I fully understand that qualified ANA's play an important role within a practice. I myself had worked for over 20 years as an unqualified nurse before being given the opportunity to successfully train and qualify. My concern is that we will end up reverting back to the dark ages and not progress as a recognised profession, especially if practices continue to use unqualified staff - by this i mean staff that have undertaken no formal training and not ANA's/VCA's. I have worked with many people over the years who have no intention of gaining a qualification so long as they are doing all of the 'nice and interesting' jobs within their veterinary practice, and this is not acceptable in this day and age. We should be proud of the RVN title and protect it where possible. The most important thing to remember is that the lives of many precious pets are in our hands on a daily basis and that training should play a very important role. Too much emphasis is placed on theory instead of practical skills, and i think this is one of the reasons some nurses are scared of training and think the examination process is too difficult (especially if you have been out of school for many years like i had been).

I have probably gone a little off the beaten track in answering tho original question, but in my opinion anesthetics should be monitored by someone that has had some form of professional training. IE ANA's/VCA's/RVN's etc and not just anyone, as the lives of these patients does lay in the hands of the anesthetist and not the really th VS who is concentrating on the surgical procedure and generally not the patient.

RE: Lone working as a student

Sal the 1st — Wed, 07 Oct 2015 09:57:05 GMT

[quote user="katseyez"]

YES!!!! Most owners are probably unaware of this. Im sure there would be a public uprising if they did! There is a course to train lay people in anaesthesia, and costs around 1000 pounds. Not sure any practice boss would be willing to pay this, especially if they are not willing to employ/use qualified RVN's! Makes bit of a mockery of bothering to put all of the time and effort into qualifying these days. It will be a sad state of affairs when we have to go back to the 1980's when it was rare to find a qualified VN because of the lack of training practices and the cost of the course. Something needs to be done and relatively quickly i think

[/quote]

actually if you go back to the 1980s there were more training practices, the training wasn't as screwed up as it is now and it was more affordable, it was quicker and it turned out nurses that were suitable for general practice and on the whole hung around long enough in practice to do the job they trained for - I am sorry but while people are busy being fired up protecting a title that will make absolutely zero difference to veterinary nursing the real issues go unchallenged. Its all smoke and mirrors.

THERE IS ABSOLUTELY NO LEGAL REQUIREMENT FOR PRACTICES TO EMPLOY QUALIFIED NURSES,

laystaff who are carrying out nursing duties are not doing anything wrong, they are doing what the practice that employs them requires them to do and the way they want it to be done. If qualified nurses are not providing the service that is required or are providing it at too high a cost or with too many complications then this is what happens.

As to the public uprising - it aint going to happen, without exception everywhere I have worked that has employed laystaff has been totally upfront with its clients on the status of its nursing team.

RE: Lone working as a student

Tania Ford — Wed, 07 Oct 2015 08:57:51 GMT

RE: Lone working as a student

Rachel Woodcock — Tue, 06 Oct 2015 16:48:24 GMT

So in theory anyone off the street could monitor a GA?! That's awful!!!!

RE: Lone working as a student

Sal the 1st — Tue, 06 Oct 2015 11:01:55 GMT

[quote user="katseyez"]

Giving IV medication is classed as a schedule 3 procedure and should only be undertaken by a RVN or an enrolled and supervised SVN, so legally the answer is no. As for monitoring GA's, the Royal College has deemed it permissible for anyone to undertake so long as adequate training has been given and is under the direct supervision of a Veterinary Surgeon. I think you will find that most RVN's do not agree with this and would like the legislation to be changed!

[/quote]

but it won't change whilst there aren't enough nurses

RE: Lone working as a student

Sal the 1st — Tue, 06 Oct 2015 10:55:16 GMT

anybody can monitor an anaesthetic legally if the vs is happy delegating that task to them

RE: Lone working as a student

Tania Ford — Tue, 06 Oct 2015 10:51:01 GMT

RE: Lone working as a student

VetNurse Anon a/c — Tue, 06 Oct 2015 10:43:24 GMT

What about receptionists monitoring GAs and giving meds including iv?

RE: Lone working as a student

Rachel Woodcock — Tue, 06 Oct 2015 10:22:26 GMT

[quote user="C Jenkins"]

I'm an ANA and have always done lone working/sole charge

[/quote]

do you give meds etc?

RE: Lone working as a student

Sal the 1st — Tue, 06 Oct 2015 10:18:16 GMT

[quote user="NickyVN"]

Giving meds is classed as schedule 3 so lay people shouldnt do it, and students should be under direct supervision - though i expect this is not the case in many practices

[/quote]

not all meds fall under schedule 3 - and lay staff can administer medication in some instances - just to clarify

http://www.caw.ac.uk/courses/veterinary-care/the-role-of-the-veterinary-care-assistant/

further to that

'who can give medication in a veterinary practice? During normal working hours - only RVNs & enrolled student nurses are permitted to administer medication (oral, topical & parenteral routes). However, the RCVS have stated that if a lay staff member has been suitably trained, they are permitted to administer routine/basic medication orally & by subcutaneous injection during out of hours shifts.'

this is taken from a BVNA response to a question on a previous thread

whole thread is here

http://www.vetnurse.co.uk/f/5/t/16515.aspx?pi1429=6

so from that comment it would seem that at night when nobody else is around so long as they have been suitably trained s/c injections are allowed too

RE: Lone working as a student

Nicola Smith — Tue, 06 Oct 2015 07:23:41 GMT

Giving meds is classed as schedule 3 so lay people shouldnt do it, and students should be under direct supervision - though i expect this is not the case in many practices

RE: Lone working as a student

Louise Rennison87 — Tue, 06 Oct 2015 00:10:41 GMT

Thank you very much!! We have a nurses meeting tomorrow so I'm going to try get something together for then and mention it all again!!!

RE: Lone working as a student

Rachel Woodcock — Mon, 05 Oct 2015 23:44:16 GMT

I know when I did my training I wasn't allowed to be on my own and there was always a vet or a nurse in the building at least. I've just been on the rcvs website but am struggling to find the legislation relating to students and lone working but I did find a paragraph in the veterinary surgeons act that says that students should be under direct supervision of either a vs or RVN. I guess it's a grey area as lay people can give meds etc so may be able to get round it this way.

Feel free to pm me if you want a chat. I work nights so know how you feel

RE: Lone working as a student

Louise Rennison87 — Mon, 05 Oct 2015 23:35:47 GMT

I have spoken to college and they weren't any help on the matter at all. Mentioned it to my clinical coach who also basically said "this is how its always been" its a tricky one!!! Thanks for the reply!!!

RE: Lone working as a student

Rachel Woodcock — Mon, 05 Oct 2015 23:26:28 GMT

id speak to your college about this but as far as I remember an svn needs to be under supervision of an RVN or vs but I may be wrong. If you're struggling then is there anyone at the practice you can speak to for support?