I start at 8.30am Monday – Friday although I’m usually here before this time so I can tackle my work e-mails and get sorted before we open for the day.
We start admitting patients from 8.30am, this usually involves a consultation with myself (registered veterinary nurse) to explain the consent form, answer any queries, weigh and check the animal over before admitting, the vet checks them over when she comes in as well.
Once we have admitted a patient they are transferred to the cattery, into a warm padded kennel usually with a nice warm heat pad in also, our hospitalisation areas contain Feliway diffusers emitting a pheremone to help ease your cat and make their stay that little bit more relaxing.
The key to a good anaesthetic is to keep the patient calm and stress free. So getting patients quickly settled in their own space and out of the cramp cat carrier will let them relax a bit before we start the morning.
Another of the first, but most important, jobs is to give animals that have been in-patients during the previous night some TLC! Their kennels arecleaned out, drugs and feeds given, as appropriate, temperatures, heart rates, respirations are monitored, then Sarah (the vet) checks them over when she comes in as well.
Between 9 and 11 am consultations take place. They can be anything from boosters to blood tests, or emergency appointments. I may have to help by holding the animals, helping them to remain calm when they are nervous or scared.
Normally, Sarah (our vet) starts operations at 11 am, but of course it can run over if consultations take longer or there has been an emergency case to deal with.
I ensure that the operating theatre is prepared: drapes, robes, instruments for each surgical procedure and sterilising equipment is checked and anaesthetic machines switched on
Each operation requires a specific set of instruments – it can be what’s called a ‘basic’ kit – that may consist of two pairs of forceps, a pair of surgical scissors, a scalpel handle, four towel clips and a pair of needle holders. We add to that as required – the vet may need some small artery forceps, a different type of scissors, some specialist instruments and so on. An experienced nurse should be able to anticipate what the vet will need for each operation, or at least have items quickly available. All of our surgical instruments are sterilised and stored in special packs that don’t let in any germs. They are carefully labelled and stored in their own place in the instrument cupboards.
Equipment and surfaces have to be cleaned up and kept sterile throughout and animals monitored. Notes and records are updated on the computer for each animal before the afternoon consultations begin.
Next, pre-meds and other medications are calculated and drawn up.
General anaesthetic can be divided into 4 phases:
Premed - is the first part of an anaesthetic. It is usually an injection under the skin of a drug which calms the patient down and makes them sleepy. It allows a smooth easy transition into the unconscious state. This phase usually takes anything from 10min to 30min depending on the individual patient.
Induction – this is when we take the patient from a sleepy state of premed into a managed state of unconsciousness. The vet will usually administer this as an injection into the vein of the front leg, which is clipped before hand to prevent the introduction of infection into the vein when injecting. A tube is placed into her throat and connected to the anaesthetic machine. From now until she is fully awake again the patient will be under constant observation from the veterinary nurse with regular heart rate, respiratory rate, anaesthesia depth and blood oxygen monitoring. This phase takes just a few minutes.
Maintenance - The patient is connected to the anaesthetic machine and a mixture of oxygen and anaesthetic gas is administered through the tube in the throat to the lungs. This allows us to keep the patient in a state of carefully managed unconsciousness so we can perform her surgery. All surgeons like to be efficient with their operations but care and precision are never sacrificed for speed during a procedure.
Recovery – Time to wake up! Surgery over and all is well, the anaesthetic gas is turned off and The patient continues to have oxygen delivered via the tube in the throat. As patients starts to come round from a state of unconsciousness to sleepiness the last of a painkiller injections are usually given, the tube is removed from the throat and the patient is returned to the kennel. As the patient is awake now and holding their head up we can leave them to recover from their anaesthetic, but the vet and nurse in charge of kennels always keep a quiet eye on all recovering patients.
Recovery time is hugely variable on the individual and procedure involved sometimes taking minutes, sometimes a lot longer. We always aim for a quiet steady recovery back to normal, much like waking up from a long deep sleep. This can be helped a lot by keeping the recovering patient in a warm, quiet, dimly lit area, with as little fuss as possible. Some pets can have quite dramatic responses during their recovery from an anaesthetic.
As many of the drugs we use have a similar affect as alcohol has on human behaviour, on occasion, we may see staggering about the kennels, seeing imaginary objects or vocalising (“singing”) from some patients, sometimes called “the happy drunk recovery”!
After patients have recovered, I offer the patients a small meal as they will have been starved overnight so they are probably very hungry by now
I then clean, package and resterilise surgical instruments, we use an autoclave in practice to sterilise our instruments using steam sterilisation. I then ensure all surfaces etc. are clean and ready for use, re-stock supplies, syringes, needles etc.
In-patients are monitored constantly throughout the day as most of my work is undertaken in the room directly next to the cattery, and if the door is closed there is a large window so I can keep a close eye on all the in-patients.
Post operative instructions are then completed ready for discharge. I ensure that all clinical notes are up to date and the account is ready for the discharge appointment. We ask owners to normally call around 2pm for an update and find out what time their cat is ready to go home.
I then arrange a discharge appointment for owners to collect their cats and I can explain post operative care and answer any questions they may have. In all cases we like to keep all patients in for as long as possible post anaesthetic to make sure there are no problems with the surgery and to monitor for signs of pain or discomfort. This care has to continue for the first night at home so we always advise to make provisions for a familiar warm and quiet place to let your pet sleep off the effects of their anaesthetic. In most cases after the first 12hrs they are back to normal, but in some cases it can take a bit longer.
Then, there’s more tidying and cleaning ensuring that everything has been cleaned thoroughly and all equipment has been put away correctly and is ready for use next time.
There’s a lot of time spent tidying up! More importantly, though, there’s a lot of time spent with the animals-they can be a bit groggy after the anaesthetic and need reassurance. When the owners come to collect them, we like to spend some time with them, to talk about their pet’s operation and after care and make sure they are OK too!” That is one of the main attractions of a small veterinary practice; we know our patients and clients by name. We are aware of pets’ backgrounds and health-often caring for them from birth to death
There is a great misconception about qualified veterinary nurses and student veterinary nurses. On average it is thought we cuddle animals all day and clean up after them. I have put up some of the goings on to clear up the misconception but decided to put up a bit more information on exams.
Inpatients need temperatures, pulses, respirations checked, kennel’s cleaned, body functions monitored, medications given.
Veterinary nurses are the anaesthetists for the vet and at times scrub in as assistants usually to hold pull or do whatever is required by the vet. We carry out lab work, and basic vein puncture for various tests or to place intravenous catheters.
If we are on nurse clinics that means discharges, post op checks, pre op admits, geriatric clinics, dental checks, general cat care, diet clinics, anal gland express, nail clips etc.
In smaller veterinary practices we are also cleaners and receptionists, so you will often see me ‘manning the fort’ on the reception desk at SimplyCats.
Being a qualified Veterinary Nurse is not a role to be taken lightly.
Here is a basic outline of some of the modules I studied to become a veterinary nurse.
Year one
- Relationships and accountability in veterinary nursing practice
- Health and Safety in veterinary nursing practice
- Anatomy and physiology
- Maintaining animal health
- Essential veterinary nursing skills
- Nursing support in the provision of veterinary services
- and last but by no means least 2 written exams papers
Year two
- Application of veterinary nursing care
- Practice and principles of diagnostics
- Laboratory practice
- Diagnostic imaging
- Pharmacology and pharmacy support
- Surgical theatre practice
- Anaesthesia
- and last but by no means least more written exam papers and practical exams.
I also had to complete portfolio of case studies in each year of my studies. On all areas of veterinary care including; surgical, medical, behavioural, exotics, health and safety, pharmacology, client care etc.
A registered veterinary nurse (RVN) is required to complete mininmum of 45hrs CPD (continuing professional development) over 3 years.
Badge presented to all qualifed veterinary nurses. (I don’t wear mine due to having no lapels on my uniform)
Claire York RVN
