VNs on call in hospitals

Re: VNs on call in hospitals

loobylou — Tue, 15 Sep 2009 13:45:44 GMT

We are a small animal hospital and do use svn's for night and weekend cover. We usually have them working for approx 1 year before they go onto the rota and always make sure they are confident/ competent in all areas. Also its always a group decision so that the svn, all vets and all nurses are happy with the situation. We always have a qualified vn on standby should any emergencies come in.
It is difficult to gauge when the svn is ready, our boss said they have to know what to do in all situations. Ive tried to tell him thats impossible and until situations arise the svn wont know if they are confident to deal with it. It all comes with experience and that is why there is always a vn on standby.

I trained at this practice and started nights as I was starting my level 3 training. I never felt pushed into it, felt confident with my general nursing and never worried about ringing qualified staff if I was worried. The vets are also very good at coming in if we are worried. All the phone calls go through an answering service too.

Re: VNs on call in hospitals

Laura James — Sun, 06 Sep 2009 22:59:20 GMT

Hey guys, I'm currently working in a practice where an untrained newbie is expected to work night shifts by themselves after just TWO WEEKS of shadowing other nurses - so they get two night shifts with someone else!!! I know one laughed when on the phone to a client whose dog was bloated - funnily enough it was a gdv. Luckily though 2 svns and a qvn were still in the building (we were in the middle of the hand over) and we had to ring them back to get them down to the surgery asap!!!!

So personally i feel that is really bad practise and only svn's with a few months training or more should be allowed to cover a night shift - and that is only if felt they are competant and know a list of things to be looking for in the case of an emergency

Re: VNs on call in hospitals

Victoria Nielsen RVN — Sun, 06 Sep 2009 17:01:02 GMT

I currently work in a Hospital, and SVN's are also on the shared on call rota with the QVN's and I qualified earlier this year, and yes, I've been pretty unlucky and have had to deal with GDV's and C-Sections at 2am in the mornings, but it's been great for the experience and I am confident to deal with those emergencies in the future. There is always a first time for everyone and unfortunately, there isn't enough QVN's to go round so SVN's have to be used. I think they should be enrolled with the RCVS before going on the night duty rota and be trained adequately to a standard where they feel confident enough to nurse the inpatients and tend to emergencies while on call, there is usually a QVN that is second on call for a while until the SVN feels happy to be primary on call etc. In an ideal world, just QVN's (and RVN's) should be the only ones to do night duties etc, but sadly we aren't in an ideal world!

Re: VNs on call in hospitals

Saskia Quinn — Sun, 06 Sep 2009 12:16:37 GMT

I have found with time and experience, the new grad's coming into practice now wont work in a practice with little nursing support, and I have also found them to be extremely conscious of the fact that, yes, animals do feel pain and should be treated accordingly.

Maybe its time for the old school to take a back seat and let the younger generation of vets show them how it is done and should be done

Re: VNs on call in hospitals

Sal the 1st — Sun, 06 Sep 2009 12:15:58 GMT

i was commenting on the number of people that had viewed the thread as apposed to the number of people that have made a comment as i say seems to be very popular this one!

Re: VNs on call in hospitals

Caro Laithwaite VN — Sun, 06 Sep 2009 12:13:26 GMT

I would have said the views are comments are views.. ie all interchangeable. All of the view/comments say that patients and clients were and are being short changed. The excuse is that there is not enough qualified vn's as if it is our fault. However if a decent wage was paid, good conditions were in place and respect was given then a huge amount of the problem that is there would not be there.

All to often vn's and students and unquals go the extra mile but how extra do the bosses go?

The buck may stop with the vn's as scapegoat ... we keep leaving the profession but the buck starts with the practices willingness to do as l suggest above.

Re: VNs on call in hospitals

Sal the 1st — Sun, 06 Sep 2009 12:04:13 GMT

very popular thread this one Has had a lot of views - Lot more views than comments

Re: VNs on call in hospitals

Debbie Summers — Sun, 06 Sep 2009 11:44:08 GMT

[quote user="sal the 1st"]

I know it still happens and I know it is countrywide but I think it is important to say that not all practices are like this - there are some very good practices out there.

[/quote]

I agree with you Sal, and I have had the good fortune to have worked in some excellent practices too. When a practice gets it right, it makes a real difference.

Re: VNs on call in hospitals

Deemus — Sun, 06 Sep 2009 11:36:55 GMT

I know how you feel Debbie. My place has just taken on a newbie with no previous experience. I felt it was important to get her up to speed with reception before doing anything with actual patients. Well, you'd think I was the devil incarnate! One of our vetsthinks that I should have her up to speed on theatre before her first weekend. That's simply not going to happen. I have already said that I will second her if necessary for ANY procedure.

Give the poor trainee a break, there's far too much to learn in the early stages without concerning her about theatre and all the lovely weekend emergencies that may come with it! We are chronically short staffed at the moment so any time I get to teach her anything is short and far between session. She will get training but there's only one of her and one of me!

Re: VNs on call in hospitals

Sal the 1st — Sun, 06 Sep 2009 11:35:34 GMT

I know it still happens and I know it is countrywide but I think it is important to say that not all practices are like this - there are some very good practices out there.

Re: VNs on call in hospitals

Debbie Summers — Sun, 06 Sep 2009 11:14:16 GMT

Unfortunately it is still happening - only a couple of years ago I had the misfortune to join a practice, and I little realised what a step back in time I was taking. I only lasted 3 months, one of which was my notice period! I had to fight tooth and nail just to give pain relief!!!! It is astounding what is happening in some practices, covering a wide range of issues from inexperienced nurses being left alone at night on call, through to basic neglect of duty on behalf of vets.

I think this is also the reason why so many nurses leave the profession - the stress suffered in the course of attaining the qualification can be enough to make us think twice about taking jobs later on, and preferring positions where no on call is necessary. We put up with a great deal as a student - firstly because we do not know any better, but also because we so desperately want that badge & title. As qualified VN's we must stand up for student and lay staff, I have and fallen out with bosses over it. In fact I once worked 6 weeks without a day off, just so that my new student nurses would have qualified back up whilst they were on call weekends & nights. I got no thanks from my boss, but I at least knew my students were covered, and the patients would not suffer. It was worth it, and I would do it again if need be.

Re: VNs on call in hospitals

Saskia Quinn — Sat, 05 Sep 2009 21:20:11 GMT

[quote user="Debbie Summers"]

I recall my very first weekend duty - can only have been working at the practice 6 weeks - and was not yet training. We had a phone call, which I was made to take (I had a qualified VN and the Vet in the room with me). I ended up putting the client on hold 4 or 5 times running between phone & vet /VN for advice, as the cat had a 'lump' (seroma) around its spay wound. The owner got very agro with me, mainly for being put on hold so many times, but also because despite my having passed all the info to the vet a) he refused to see it, and b) refused to talk to the client. The next day (Monday) the client brought the cat in to be seen, and the vet (same one!) had ago at me for not making him realise how serious it was, as the seroma was so large the stitches were being pulled apart!!! I was made to feel guilty - and it is something I have always felt very angry about.

The other thing that really upset me as a student VN was being left to do dentals alone - whole caboodle, GA, scale & polish & extractions. I recall having to run around the practice trying to find a vet to check the animal, having asked another nurse to keep an eye on my patient whilst they were x-raying!!!!!!!! It was awful, and led to a very, very bad experience in which a cat suffered brain damage and was subsequently PTS......I came within a cats' whisker of giving up training at that point. Needless to say I left that clinic as soon as I could after I qualified.

[/quote]

that is terrible what you had to do there that would definitely have put some trainees off nursing for life.

We have a policy in our practice for weekends, if the vet refuses to see an animal, it is up to them to speak to the owner on the phone and explain why, not left up to us nurses.

This should be a compulsory thing in every practice, of course we know thats never going to happen

Re: VNs on call in hospitals

Kim Buckley — Sat, 05 Sep 2009 13:59:18 GMT

Our vets are really good. They'll come out if ever you have a concern with an inpatient and we are told to put all phone calls through to the vets (I sometimes don't if it''s very obviously not an emergency).

Re: VNs on call in hospitals

louiseRVN — Sat, 05 Sep 2009 13:52:39 GMT

I dont think anyone should be put in that position, Either QVN or not. I have been lucky to work in place where there is a vet on site all the time to answer any queeries.

Where I work now as much as I love it there is not always a vet to hand and being the only QVN there its scar to think if anything happens its my thats on the front line if I cant get hold of a vet.

I agree with whats been said until there is regulations about lay staff and QVN people will always go for the cheaper option. Although saying that I know some lay staff which are better than some QVN I have had the pleasure of working with.

Re: VNs on call in hospitals

Nick Shackleton — Sat, 05 Sep 2009 13:12:11 GMT

remember one weekend on call as 2nd yr SVN. Owner called up with a dog that was non-productive vomiting, had been out for a walk recently after food, Alarm bells were ring in my head GDV! Told them to come straight down and I'd get hold of the vet.

So went to call the vet, home line engaged, not answering mobile, and didnt even response to pager! Luckily she lived next door to the practice so ran round and bangged on her door!

Finally she answered the door "what the hell do you want???"

"Ermmmmm Gastric Torsion on its way down, so you better get over to hospital ASAP"

"Oh let me finish my phone call 1st"

God it makes me angry!!!! And yeah I was right GDV. Think the year a bit experience I had compared to a complete newbie made me more able to understand when a true emergency is on cards.

Re: VNs on call in hospitals

Debbie Summers — Sat, 05 Sep 2009 12:58:53 GMT

Re: VNs on call in hospitals

Nick Shackleton — Sat, 05 Sep 2009 12:34:48 GMT

I think its wrong expecting anyone, whether qualified or not to take phones (I have done it in the past and never really liked it), think it should be down to the vet to make decissions regarding whether a patient needs seeing or not!

Re: VNs on call in hospitals

Sal the 1st — Sat, 05 Sep 2009 12:08:35 GMT

its something that makes me really angry - I can remember doing phones and out of hours nursing when I was training (actually before I was officially training) I never felt happy about it

Re: VNs on call in hospitals

Louise B — Sat, 05 Sep 2009 12:01:04 GMT

[quote user="sal the 1st"]

This is precisely one of the things that worries me the most - unqualified staff should not be put in this position EVER but I have seen it happen so many times. Even as a qualified nurse I have had problems either getting a response from a vet or getting a vet to turn out out of hours - ie I called a vet once to say that their Newfie pyo was bleeding +++ from the wound, their response was - well use your common sense - apply an abdo bandage and run some bloods and ring me back with the result. I was the only person there, the dog was off its legs - as it had been since admission, was as nasty as hell ( probably because of inadequate analgesia which this practice didnt seem to believe in) , the bit of mms that I could see was somewhere in the 'dulux range' ie white with a hint of pink. When I eventually got the vet to come in we had to open the dog up and replace a slipped ligature. The dog survived.

Would a SVN have been as persistent as me and put up with the abuse over the phone? or would they have been made to feel guilty in the morning because the dog had died because the vet wouldnt come out? (and yes I have heard of this happening as well)

Its a real eye opener what you come across when you are locumming

[/quote]

Yep - I have had almost the exact same problem as a nursing newbie. The boss was on duty and an absolute ar*e about coming out and eventually didn't. Told me to give it a massive dose of domitor instead to drop its blood pressure. The dog died. I would have been alot more persistent and knowledgeable with more experience,

Re: VNs on call in hospitals

Sal the 1st — Sat, 05 Sep 2009 11:57:22 GMT

Its a real eye opener what you come across when you are locumming

Re: VNs on call in hospitals

Maisy — Sat, 05 Sep 2009 09:30:59 GMT

Have just completed a locum position in a hospital where SVNs would take part in the OOH rota (and would be on site at all times) after about 3 months of starting or once the Head VN was in agreement. The only thing I found a little concerning was that it was a sort of unwritten 'rule' that the vet was only contacted if the nurse felt the case required seeing that night, or if the client insisted. Can a student after three months really determine if a case needs seeing? This was partly down to the fact that the vets on the whole didn't appreciate being called back for something they considered not important.

Re: VNs on call in hospitals

Nick Shackleton — Fri, 04 Sep 2009 13:32:37 GMT

When I was back in GP we had SVN who would only do on-call and overnight stays once up to speed with anaesthesia (would do a couple with a QVN), but woul donly be left alone once fully happy with what was expected of them

Re: VNs on call in hospitals

Sal the 1st — Fri, 04 Sep 2009 12:32:19 GMT

Emma it was the bit about having an RVN on site all the time right at the beginning of the post - it just annoys some of us who are VN's without the R by choice. Arlo has done it quite a few times too and I have growled at him for it as well - its nothing personal I just think it is important that even tho we havnt taken the 'R' for whatever reason we are still acknowledged as qualified nurses.

If it ever happens that it becomes mandatory for all nursing staff to be either qualified (at whatever level) or at least formally training Then I would accept the 'R' - but whilst it is still perfectly ok to employ laystaff ( and call them nurses) that are not regulated and in many cases are allowed to do more than qualified staff I will stay a plain old VN for as long as I am able

Re: VNs on call in hospitals

Emma Cooper — Fri, 04 Sep 2009 11:55:39 GMT

Hi guys,

Er, I never actually mentioned listed nurses in my original post (but you're quite right, I should have)...I do know the difference between listed and registered, honest! I'm using the terms qualified and registered interchangably now (as they should be one ane the same)...

But the fact remains that you could be a student VN with a couple of weeks experience in a hospital and expected to cover nights...(Not that this would happen, I hope).

Any further thoughts would be appreciated!

Re: VNs on call in hospitals

hissycat — Thu, 03 Sep 2009 20:13:47 GMT

At the hospital where I work currently there are only two VNs on the nursing rota covering night shifts, one of which is myself and I am leaving shortly. At times I have been the only VN. So it would be pretty impossible to have just VNs covering these shifts. As well there being a shortage of VNs in general I think it is just very difficult for pactices to recruit for this sort of work. I don't have a problem with the SVNs covering nights, I think the ones we have do an amazing job and I would trust them with my own pets, they have the common sense to know when to call the vet back in. As long as they are competent/confident in their basic general nursing then that would be acceptable to me as long as they have a vet/VN as backup if they need it. I do however think that clients should be informed of who is looking after their pet. I think a lot of clients assume that the nurse is qualified/experienced when this isn't always the case.