Under the guidance of a veterinary surgeon, a registered vet nurse (RVN) in the UK can do the following in a veterinary practice:
Schedule 3 exemption 18.3
The Veterinary Surgeons Act 1966 (Schedule 3 Amendment) Order 2002 provides that veterinary surgeons may direct registered or student veterinary nurses, whom they employ, to carry out limited veterinary 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).
b. Student veterinary nurses under the direction of their veterinary surgeon employer to animals under their employer’s care. In addition, medical treatment or minor surgery must be supervised by a veterinary surgeon or registered veterinary nurse and, in the case of minor surgery, the supervision must be direct, continuous and personal. The medical treatment or minor surgery must be carried out in the course of the student veterinary nurse’s training (see paragraph 18.5).
Delegation to veterinary nurses taken from the Royal College of Veterinary Surgeons (RCVS) website
Theatre
A wide range of tasks for the nurses to be busy with.
Anaesthesia
- Assessing the patient’s anaesthetic risks
- Preparing equipment, materials, and patients for anaesthesia
- Maintaining the patient’s anaesthesia
- Monitoring the patient under anaesthetic
- Completing an anaesthetic monitoring form
- Performing a hand-over with the kennel staff on patient recovery
Patient preparation for surgery
- Clipping the patient’s fur
- Applying necessary dressings to prevent hair from entering the surgical site
- Cleaning the surgical site with the appropriate antiseptic scrub solution (chlorhexidine-gluconate and povidone-iodine being the most commonly used)
- Moving through from the preparation area to theatre
- Positioning the patient in theatre
Further training is available; from attending courses to studying for a level 5 diploma in advanced veterinary nursing (surgical).
Wound management:
- Assessing wounds to note down:
- Wound classification
- Wound healing phase
- Wound measurements
- Preparing materials needed for:
- Cleaning wounds
- Applying bandages
Further training is available by attending courses.
Assist in operations:
- Scrubbing into surgery by:
- Hand and arm washing
- Gloving
- Gowning
- Preparing the instrument trolley
- Assisting in draping the patient
- Passing sterile instruments, swabs, and equipment to the vet when necessary
- Assisting the vet with surgery when necessary
- Carrying out an instrument, swab, and equipment count before closure of the surgical wound
Further training is available; from attending courses to studying for a level 5 diploma in advanced veterinary nursing (surgical).
Dental hygiene work:
- Scaling teeth using an ultrasonic scaler
- Polishing teeth using a slow-speed handpiece, prophy head, polishing cup, and applying abrasive polishing paste
Further training is available by attending courses.
Minor surgery:
Paragraph 6 applies to veterinary nurses whose names are entered on the register maintained by the RCVS. They may administer “any medical treatment or any minor surgery (not involving entry into a body cavity)” under veterinary direction.
Veterinary Nurses and the Veterinary Surgeons Act 1966 taken from the RCVS website.
Further training is available; from attending courses to studying for a certificate in advanced veterinary nursing and level 5 diploma in advanced veterinary nursing (surgical).
Diagnostic testing and imaging
Most of these require a steady hand or a good eye.
Prepare and analyse samples:
Preparing different samples:
- Blood:
- Manual testing:
- Packed cell volume (PCV) using a Hawksley haematocrit reader
- Total Protein (TP) using a refractometer
- Saline agglutination test
- Blood smears using a microscope slide then staining with a Romanowsky stain (Diff-Quik)
- Manual testing:
- Urine:
- Manual testing:
- Dipstick
- Specific gravity
- Urine sediment using a microscope slide
- Manual testing:
- Dermatology:
- Skin:
- Skin scrapes using a microscope slide
- Tape impressions using a microscope slide then staining with a Romanowsky stain (Diff-Quik)
- Hair:
- Hair plucks using a microscope slide
- Skin:
- Cytology:
- Fine needle aspirate (FNA):
- Air-dried smears using a microscope slide then staining with a Romanowsky stain (Diff-Quik)
- Fine needle aspirate (FNA):
Microscopic analysis of:
- Blood smears to check red and white cells and platelets
- Urine sediment to check for crystals, casts and cells
- Skin scrapes to check for ectoparasites, bacteria, cells, and fungi
- Tape impressions to check for ectoparasites and fungi
- Hair plucks to check for ectoparasites and fungi
- Air-dried smears to check cells
Further training is available by attending courses.
Indirect blood pressure measurement:
Doppler ultrasound using a sphygmomanometer on conscious, sedated, or anaesthetised patients.
Electrocardiogram (ECG):
- Preparing ECG machine
- Supporting conscious, sedated, or anaesthetised patients
- Taking an ECG reading
Further training is available by attending courses.
Radiography:
- Preparing equipment
- Positioning conscious, sedated, or anaesthetised patients
- Snapping patient views of the cranium and all the way down to the tail. Including dental x-rays
Click on the IG icon below to check out Nick’s RVN page for useful information.
Further training is available by attending courses.
Ultrasonography:
- Preparing equipment
- Supporting conscious, sedated, or anaesthetised patients
- Nurses can also “drive” the probe
Click on the IG icon below to check out Jack’s RVN page for useful information.
Further training is available by attending courses.
Endoscopy:
- Preparing equipment
- Preparing patients before endoscopy investigations
- Supporting anaesthetised patients
Further training is available by attending courses.
Nursing care
One-to-one treatment with patients admitted to hospital.
General observation and monitoring:
Record keeping on the patient’s computer card and hospitalisation sheet:
- Monitoring:
- Mentation and demeanour
- Temperature, pulse, and respiration (TPR) values
- Food and fluid intake
- Urine and faeces output
- Post-operative recovery
- Wounds
Administer medication:
Calculating the dose required for the following routes:
- Oral
- Topical
- Rectal
- By injection- subcutaneous, intramuscular, and intravenous
Administer fluid therapy:
- Preparing the necessary equipment
- Calculating the required volume
- Monitoring the patient for signs of complications, e.g. over-infusion
Assisted feeding:
- Preparing the necessary equipment for an indwelling feeding tube to be placed in the following routes:
- Nasoesophageal – placed into the nose
- Oesophagostomy – placed into the oesophagus
- Gastrostomy – placed into the stomach
- Jejunostomy – placed into the small intestine
- Calculating the patient’s nutritional requirements
- Maintaining the feeding tube
- Monitoring for signs of complications, e.g. dislodgement
Pain management:
Dogs, cats, and rabbits are pain assessed using a measuring scale like the one pictured below. The questionnaire is made up of several sections, each of which has several possible answers. The appropriate score is circled and the total number is tallied up at the end to give a score out of twenty. Pain intervention is recommended with a final score of five or above.
Further training is available by studying for a graduate certificate in advanced veterinary nursing (analgesia and pain management).
Mental stimulation:
Spending time with patients to reduce kennel stress as much as possible:
- Out-of-cage time; aka walkies +/- zoomies!
- Grooming
Consultations
A chance to educate clients and show off skills in front of a large audience (mum, dad, three children, nan, and the neighbour).
Second vaccination+/-Microchip:
Any health issues mentioned by the owner or noticed by the nurse will require vet guidance before administering the second vaccine. At this appointment, important topics are discussed and advised such as flea/worm treatment, behaviour, neutering, and dental care.
Since April 2016, it has been required by law that all dogs in England be microchipped and registered on a database from eight weeks of age.
In-patient discharge:
The vet will have updated the owner before this appointment, leaving the nurse to get on with:
- Re-describing the procedure performed or treatment administered
- Re-explaining the medication dispensed
- Discussing post-operative diet
- Advising on exercise
- Stressing the importance of correct wound and bandage management at home
- Informing of any follow-up appointments
Basic grooming:
A routine nail-clip on various species; dogs, cats, rabbits, hamsters, and birds. Pugs need not apply! Fungal infections, torn nails, or infected ingrown nails are some examples that would be referred to the vet.
Triage:
Assessing the patient’s condition to determine if it’s life-threatening, requiring immediate veterinary attention.
Various check appointments:
Including:
- Post-operative checks following surgical and non-surgical procedures, to check the patient’s recovery status and surgical wounds. It may also include removing dressings and sutures
- Flea/tick checks to go through the various parasitic treatments available
- Weight checks to discuss a diet protocol and keep a record of the patient’s weight, body condition score (BCS) and neck, chest, and waist measurements
- Dental checks to perform oral examinations to check for signs of dental disease and talk about home oral care
Collect samples:
Of the following:
- Blood – manual and machine testing and blood smears
- Dermatology – skin scrapes, hair plucks, and tape impressions
- Cytology – FNA biopsy (not involving entering a body cavity)
Further training is available by attending courses.
So there you have it, an outline of what a UK vet nurse can do. Much more than what some people think…
Shoutout to Emma for providing the pictures of work-life in practice.
Veterinary Blog 