2nd vaccinations

Re: 2nd vaccinations

Craig McDonald — Tue, 15 Oct 2013 00:45:30 GMT

We do all 2nd vaccines and lots of other nurse consults. Vets book the appointment with the nurse but recently haven't been writing on clinical notes can have 2nd vaccine in 2/3 weeks time so I always say to them can they have 2nd vacc? Do the vets have to write this on notes or is it enough for them to book it on our diary with there initials (which could obviously be written by anyone). Just want to know where we stand with regard to this.

Re: 2nd vaccinations

Beholden — Tue, 18 Sep 2012 22:33:58 GMT

[quote user="Jill Macdonald"]Charging for nurse consults is a bit of a contentious issue, and many practices keep them free as a 'loss leader' - to get the clients into the practice, however I've always advocated charging for them - why not? We are trained professionals giving advice based on our training and experience; our time and use of the practice is not free, so the consult shouldn't be either. I've never had any negative feedback from clients with charging - I think they all assume there will be a fee anyway. It also really helps to raise nurse morale and worth, and give them/us a feeling of bringing something back to the practice. [/quote]

I'd agree - there should be a charge, maybe half or 75% of what the vet consult is. Fact is, if they ask something or are concerned about something that you feel you are not qualified to answer/needs vets opinion, you are going to refer to the vet anyway ... not just say 'I don't know' or ...'you'll have to pay for that advice as its from a vet!'

We currently do discharges (included in surgery price but costed to account for vets time) nail trims, AG's, stuff like that... if they pop up on the reception log and we are free and queue is long - its charged at same price. Oh and clients are usually delighted, they get to skip the queue and talk to someone who actually was hands on in the care and recovery, as admitting/discharging vet may have been consulting all day.

I just wondered if we were to implement 2nd vacs, full price doesn't seem approapriate, but definately a charge as you suggest.

Re: 2nd vaccinations

Selena Carnell — Tue, 18 Sep 2012 21:17:51 GMT

Do the bets tell you or write down on the computer which vials are required for the second vaccinations.

Re: 2nd vaccinations

Jill Macdonald — Tue, 18 Sep 2012 10:57:53 GMT

The primary vacc course includes first consult with vet (always) and 2nd vacc with nurse, so it's an all in price. If they haven't been seen before and need just a 2nd vacc, then this would be with a vet. Whilst it works well at taking the pressure off the vet for nurses to do the 2nd vaccs, the primary benefit is that the nurse is very well equipped to discuss issues such as toilet training, nutrition, worms, fleas etc, and can allocate more time to do this - imagine the vets consults being taken up by loads of 20 minute 2nd vacc slots!

Charging for nurse consults is a bit of a contentious issue, and many practices keep them free as a 'loss leader' - to get the clients into the practice, however I've always advocated charging for them - why not? We are trained professionals giving advice based on our training and experience; our time and use of the practice is not free, so the consult shouldn't be either. I've never had any negative feedback from clients with charging - I think they all assume there will be a fee anyway. It also really helps to raise nurse morale and worth, and give them/us a feeling of bringing something back to the practice.

Re: 2nd vaccinations

Beholden — Tue, 18 Sep 2012 03:37:46 GMT

Can I ask a question relating to these types of consults and how they are run? Sorry if slightly OT.

Do your clinics charge less for a 2nd vac with a nurse? Or is it just something you do to take pressure off the vets in consults as they are usually time consuming?

I work in a busy walk in clinic, no appointments - we can't run nurse clinics as you would never find a consistant slot. However, on the odd day, its quiet down back, and busy in the consults ... we could potentially do 2nd vac visits as they come in.

We do rehoming, which usually involves the same thing, giving a 2nd vac (if they opt for it at that time) talking through all of the above things with the new owner .. but its free, lol. Love doing it though.

Re: 2nd vaccinations

Helen Tottey — Wed, 05 Sep 2012 16:32:55 GMT

I have been doing 2nd vaccines for years and to be honest, after the initial question re any coughing/sneezing or sickness/diarrhoea it is mainly fleas, worms, insurance, diet & neutering. What i think is important though is to let it be the clients chance to chat and you will pick up on their main concerns and tailor your advice accordingly. I did a 2nd vaccine this am and spent most time talking about socialisation and behaviour and then next one was more about types of insurance policies as they had had a bad experience before. If by the end of it, the client has left with their individual concerns answered and haven't felt you are working to a script, they will bond with you and the practice.

With regards clinical questions i think they are also dependent on what you and your practice are comfortable with. the more you do the more you will find your own way of dealing with things.

Re: 2nd vaccinations

FINNIGAN — Sat, 25 Aug 2012 17:10:38 GMT

i was told by rcvs that as qualified vet nurse we can sign the vaccination card for 2nd vac, as long as its not a ppet passport certificate, and as long as vet has done 1st vac and health check, we are allowed to sign the card for 2nd vaccine

Re: 2nd vaccinations

Sophie Bedford RVN CertVNECC — Fri, 24 Aug 2012 10:22:13 GMT

We've always signed the cards but our new vet has just informed us that as Paulette said if it's a certificate then that's technically illegal which I hadn't realised. I guess that if we get the VN title protected that is something else that may change?

Re: 2nd vaccinations

Paulette — Thu, 23 Aug 2012 23:47:25 GMT

I generally get them to wait if the vets have a spare few minutes to come and check-if it's not urgent ie not a wound etc then they can book in to see a vet if they are short for time/vet is busy. Legally vet nurses are not allowed to sign anything that is a certificate. VNs are only allowed to sign a record of vaccination. I always get the vet to sign anyway. :)

Re: 2nd vaccinations

Jill Macdonald — Thu, 23 Aug 2012 13:53:16 GMT

Re non-routine stuff (eg lumps, sore ears, FAD etc).. it has to be clear to clients that nurse appointments are for routine issues only, so this comes from how you educate clients in the first place - receptionists and all staff have to be part of this. If something like this does come up, then I'd get them to see a vet there and then if there's one free, or re-schedule if not.

I always used to sign certs for 2nd vaccines, but where I am now we get the vet to do this - so I'd be interested to know what the 'correct' protocol is and what others do too..

Re: 2nd vaccinations

Suze — Thu, 23 Aug 2012 12:22:31 GMT

If the clients ask yeah to check lump or something yeah arent comfortable assessing do yeah get them to wait for a vet to check it then or do yeah reschedule them for another appointment??

Just curious Also, are yeah singing the vacc certs or getting the vets to do it for yeah?

Re: 2nd vaccinations

Jill Macdonald — Thu, 23 Aug 2012 10:52:10 GMT

Really good to see so many are already doing 2nd vaccs and running nurse clinics - as someone said, they are generally so under-utilised!

I think that the nurse doing the 2nd vacc also gives the client a really good 20 minute opportunity to ask any questions (and the good owners always have some!), and generally have a chat about their animal, and to cover all the routine (fleas, worms, insurance) stuff already mentioned. I always give them a little 'lesson' in how to get their animal used to being examined - ears, eyes, mouth etc - makes our job so much easier in the future!

Out of interest- how many of you charge for your nurse clinics - not your 2nd vaccs as of course they're included as part of the course - but all your other appointments?

We charged for them at the last practice I worked at, and are just about to apply charges now. I've been advising clients that this will happen, and haven't had any negative feedback so far. I think they actually expect to pay, and are surprised when they're not asked to!

Me and the other nurse have lots of ideas for where we can have an input with nurse consultations - can't wait to get started!

Re: 2nd vaccinations

Selena Carnell — Mon, 20 Aug 2012 20:28:45 GMT

Just started doing 2nd vacs it something I have never done, I was suddenly told there was one waiting and had to ask what vials to use, is there a list any she of which combinations to use? E are using merial pure ac and also nobivac vaccines. I need to ask the old nurse for a crib sheet on which vaccinations they have.

Re: 2nd vaccinations

Maisy — Wed, 21 Apr 2010 18:48:35 GMT

It does make sense if VNs are able to do 2nd vaccs in practice, for the vet to obviously do the initial health check and 1st vacc and for us to go through the rest next time. Forgot to add before I always do a TPR and obviously check if there was any problems noted after the first injection.

Nurse clinics are so underutilised, I don't understand why they aren't promoted more

Re: 2nd vaccinations

Gem Sprague — Wed, 21 Apr 2010 18:43:30 GMT

Hi! I've just started doing 2nd vac appts, and am really enjoying them. I promote worming, flea treatment, dental care, training, microchipping, neutering etc. I wondered what other VNs did about signing the vaccination card, as i have been getting the vets to sign for me?? Enjoying doing them so much!

Gem x

Re: 2nd vaccinations

Kim Buckley — Wed, 21 Apr 2010 18:25:49 GMT

Thanks for everyones suggestions!

Think we are going to try and get it so that the vet see's the animal for it's first vacc and will do the health check and they then see the nurse to talk about everything else. Can then go over anything they want to again at 2nd vacc. I'm loving nursing clinics! Wasn't allowed to do it in my old practice and I think it's such a waste!

Re: 2nd vaccinations

Felicity Caldwell — Wed, 21 Apr 2010 16:27:48 GMT

Hey,

I used to do 2nd vacc's in one of my last jobs - really really enjoyed them because there was always so much interaction with both pet and owner! We used to give them a clinical examination, discuss worming, flea treatment, weight, feeding, insurance, dental care etc. It was a really good opportunity to promote our other nurse clinics for the future once pup/kitten had grown up a bit or aim it to the needs of older pets whos vaccines had lapsed e.g. mobility clinics, dental checks, weight clinics.

Awww, don't do VN clinics now i'm in referral practice...and thought I would never ever miss them.

Re: 2nd vaccinations

Claire Cameron — Wed, 21 Apr 2010 14:55:40 GMT

I also do second vaccs, our vet is fantastic and normally covers everything but running over things twice can sometimes help things 'sink in' with clients.

I cover, flea treatment, worming treatment, insurance, weight, lifestage nutrition, discuss what food they are feeding, feeding regimes, insurance, top to tail examination, check testes are descended, microchipping, discuss neutering and dental care, and any other questions they may have

Re: 2nd vaccinations

staceyvn — Wed, 21 Apr 2010 14:42:43 GMT

i also do 2nd vacs - chk males for descended testes, dentition then give them general advice on puppy/kitten care, the nice thing about nurse 2nd vacs is you have the luxury of spending more time with owners - always find asking if they need to be shown how to do anythin helps too (ear cleaning etc)

Re: 2nd vaccinations

Kay Eminson — Wed, 21 Apr 2010 14:42:29 GMT

When I do second vacs, always ask if there have been any problems. weigh the animal. talk about feeding..how many meals a day the puppy is on, explain worming protocols by this point they would need another wormer in a week, explain flea treatment.

Push for microchipping, explain insurance pros and cons what to look for when getting it, if they are not interested then explan how much diabetes cost per week always gets them thinking

Also subjects based on the breed to animal so huskys enquire if they will do husky runs etc or working dogs doing trials/ agility.With cats from multi cat household i explain the importance of mulitple resources/ somewhere safe to hide. Feliway too if there are older cats!

Other small talk is to ask where they got the puppy from, larger/small litter, if they have thought about training classes, this helps you to decide what other advice they may need especially if they have never had this breed before.

Invite them to puppy parrty and invite them back at 6 months for a free nurse check (that is if they are not coming in for neutering)

Sometimes owners just dont want to listen and you'll get that idea straight away, I dont bother wasting my breathe especially if they have had dogs before...this always makes them the expert!!

Re: 2nd vaccinations

Anonymous — Wed, 21 Apr 2010 11:14:15 GMT

speak about the risks of not neutering? the risks for how long they leave it and when to get it done?

Re: 2nd vaccinations

Maisy — Wed, 21 Apr 2010 08:27:06 GMT

Does your vet discuss much during the first vacc such as training/chipping/general care? If not, you could go through that especially if you give out puppy packs you can discuss the pack with them.

Re: 2nd vaccinations

dinkyd — Wed, 21 Apr 2010 08:19:03 GMT

Could you possibly push microchips,insurance etc?I know so many clients thats come in and you offer them the free insurance and they turn it down or say we'll think about it etc - always worth checking up on them cos there always the ones that need it lol!

Re: 2nd vaccinations

Heather Barlow — Wed, 21 Apr 2010 07:40:57 GMT

How about suggesting more wormers and flea treatment along with future registration in a socialisation class. (FOR DOGS I MEAN) Then if you think it might help they buy a good book about the species they have bought such as the doglopaedia, catlopaedia etc.