Lump removal

RE: Lump removal

jojofruits — Tue, 15 Nov 2016 14:56:38 GMT

Schedule three is much clearer than it used to be, all online on the rcvs webstie, and if in doubt the RCVS will clarify for you if you write to them or give them a call :)

RE: Lump removal

Arlo Guthrie — Mon, 14 Nov 2016 20:48:25 GMT

[quote user="Leggy"]can anyone tell me as an RVN can we do lump removals (all I mean is simple ones not complicated ones)

I thought we could and even attended a sch 3 CPD course a few years ago that covered lump removals. I have a vet that is arguing that we can't do them especially if no FNA has been done on them to determine type of mass (because after all how would we know what margines to take)[/quote]

This is getting a bit Punch and Judy.

Can I?

No you can't.

Yes she can.

Oh nooo she can't.

Oh yessss she can.

Sounds to me like your vet is saying you are not legally allowed to do them, full stop, which I think is incorrect.

You are (as I am sure you knew, and others have said) entitled to perform minor acts of surgery, not involving entry to a body cavity, as per the VS code of professional conduct here:

http://www.rcvs.org.uk/advice-and-guidance/code-of-professional-conduct-for-veterinary-surgeons/supporting-guidance/delegation-to-veterinary-nurses/

The caveat is that it has to be under the supervision of and at the direction of a veterinary surgeon.

So it really comes down to whether the VS is prepared to supervise/direct. If they are, you can. If they aren't, you can't.

One of the problems is, of course, that Schedule 3 has never been defined beyond 'minor acts of surgery'. I think it would be very helpful to the nursing profession if there was a list of the sorts of things that are deemed to fall within the description of 'minor act of surgery' - precisely for situations like this.

RE: Lump removal

WelshyNurse — Mon, 14 Nov 2016 18:09:26 GMT

A veterinary nurse or student veterinary nurse is not entitled independently to undertake either medical treatment or minor surgery.

18.4 Under this Schedule 3 exemption, the privilege of giving any medical treatment or carrying out minor surgery, not involving entry into a body cavity, is given to:

a. Registered veterinary nurses under the direction of their veterinary surgeon employer to animals under their employer's care. The directing veterinary surgeon must be satisfied that the veterinary nurse is qualified to carry out the medical treatment or minor surgery (see paragraph 18.5).

RE: Lump removal

molladog — Thu, 03 Nov 2016 08:19:58 GMT

Sorry but I was under the impression that the original post was just questioning if we are allowed to remove lumps , WHICH WE ARE if the vet is happy for us to do it. Obviously if vet says no then that is the end of it but legally we can do it and vets need to appreciate that.

RE: Lump removal

Sal the 1st — Wed, 02 Nov 2016 21:14:48 GMT

[quote user="WelshyNurse"]

But if the vet in charge says they are not happy for you to do it. Then you cannot

[/quote]

agreed -and like it or lump it we are working under the direction of a vet ....

RE: Lump removal

WelshyNurse — Wed, 02 Nov 2016 20:56:32 GMT

But if the vet in charge says they are not happy for you to do it. Then you cannot

RE: Lump removal

PSA-David — Wed, 02 Nov 2016 18:06:41 GMT

[quote user="WelshyNurse"]No, if the vet says no, you can't. [/quote]

I actually think you might have got this wrong. Under RCVS RVN guidelines. Legally we can carry our any surgery that does not involve entering the body cavity. most of the time nurses would only be allowed to do this on specific types such as encapsulated lump,warts and fattly lumps etc, with low chances of complications.

RE: Lump removal

Abs1 — Wed, 02 Nov 2016 11:38:10 GMT

Principals involved with the determination of whether nurses can perform procedures directed by the surgeon involves certain criteria stipulated in the Vet Surgeons Act 1966 as well as the code of conduct for veterinary nurses and the code of practice for surgeons. Initially the procedure should not enter a body cavity; care must also be taken to assess the current health status of the animal. If a lump removal is to be performed, condition of the underlying tissues must be assessed, as well as the size and position of the lump and an estimation of the histopathology of it. This includes proximity of the lump to structures such as major vasculature as the complexity of its removal and subsequent skin closure. Moreover the competency of the nurse should be included in the principals, ultimately responsibility and autonomy of the nurses actions are her own, therefore before delegation the surgeon should discuss with the nurse the level of competency and discuss the level of supervision required. Supervision can be direct or continuous, the surgeon must be within the vicinity and the care of the animal must be under the surgeon.

RE: Lump removal

molladog — Wed, 02 Nov 2016 09:48:35 GMT

Yes you can do lump removals.

RE: Lump removal

Nicola Smith — Wed, 02 Nov 2016 08:31:27 GMT

Yes as it's not entering body cavity though as said above should any lump be removed without fa first to know what it is otherwise how do you know what margins to take.

Do they let you do other sch 3 - suturing ? Maybe ask to start with that then as they get trust in you they may allow you to do more.

RE: Lump removal

Sal the 1st — Tue, 01 Nov 2016 22:19:59 GMT

I have done them before and unless its changed yes they are allowed. Would I be happy removing a lump not knowing what it was or having a pretty good indication of what it was? Probably not. Its ages since I did any surgery or sutures - do I miss it? not one little bit, was never a favourite part of the job

[quote user="Leggy"]

I have a vet that is arguing that we can't do them especially if no FNA has been done on them to determine type of mass (because after all how would we know what margines to take)

[/quote]

sorry to answer a question with another question but .... how many vets are removing simple lumps without doing an FNA? - and my answer to that from experience would be plenty. Could your vet direct you to the information that says you can't?

At the end of the day is it really worth the hassle? - if the vet wants to keep their lumps I suspect whatever proof you come up with there will always be another 'reason' why you shouldn't. There are loads more aspects to the job that nurses excel in

RE: Lump removal

WelshyNurse — Tue, 01 Nov 2016 22:04:54 GMT

No, if the vet says no, you can't.