Assessing the requirement for qualified VNs in farm animal practice by Fiona Mullan

ABSTRACT: A review of literature regarding the history of veterinary nursing training within the UK. and the content of current training programmes abroad, were explored and combined with an independent survey of the veterinary and farming communities; in order to establish the demand, practicality and possibility of having qualified farm veterinary nurses within large animal practice.

The role of the veterinary nurse (VN) has evolved tremendously since the introduction of the first animal nursing qualification in 1961.1&2 VN education and training in the UK has predominantly focused on the teaching and care of small animals, with larger species only briefly explored for comparative purposes.

The small animal veterinary nurse remained as the norm until 2000, which saw the first equine veterinary nurses (EVN) qualify with their own specialised National Vocational Qualification.3

This article explores the potential for VN training to take on a formal farm animal component, to discover what such training could entail, and to determine how well received this would be by the farming and veterinary communities.

The article is based on research undertaken for the authors dissertation in 2010 at the University of Bristol.

Literature review

A literature search was conducted using the following online database sources: Ovid Medline, CAB Abstracts, CINAHL, Google Scholar and Web of Science.

Meeting Minutes from the RCVS in 2003 revealed that the proposal for either a ‘stand-alone’ or ‘top-up’ qualification, based on farm animal nursing, had been explored but later rejected owing to insufficient demand at the time.

Representatives from the attending veterinary organisations – the British Cattle Veterinary Association (BCVA), Sheep Veterinary Society (SVS), Pig Veterinary Society (PVS), Society of Practising Veterinary Surgeons (SPVS), British Veterinary Nursing Association (BVNA) and the Department of Environment Food and Rural Affairs (DEFRA) – were asked for their views on what tasks a farm veterinary nurse could perform legally, bearing in mind that VNs must at all times abide by 'Schedule 3’ of the Veterinary Surgeons Act, 1966.

The tasks that the members of the group thought suitable for qualified VNs to perform on the farm included:

• assistance with surgical procedures

• animal handling and restraint

• administering medications under direction, e.g. routine vaccination

• sample collecting for herd checks

• minor procedures e.g. disbudding/dehorning, potentially castration of calves and lambs but only at certain ages in compliance with the Veterinary Surgeons Act 1966

• postoperative checks and revisits.

The members of the group also highlighted a number of other tasks that could potentially be undertaken by a veterinary nurse in a farm animal capacity. The examples listed above are, therefore, by no means exhaustive.

A review of the role in other countries also revealed what veterinary nurses are currently doing in a farm animal capacity. In the USA, VNs or veterinary technicians (VT) are more commonly involved in farm animal work.

As well as the tasks previously outlined, Kahler (2002) stated that ‘practices that capitalise on the skills of a technician can better meet client needs while increasing practice output and efficiency’, and noted that VNs and VTs could play a significant role in ‘preparatory work and in reporting signs they observe in patients’.4 This is comparable to the role that veterinary nurses are already performing in small animal practice.

In New Zealand, Massey University also offers a farm animal component embedded into their VN diploma, whilst Otago Polytechnic runs a one-year, part-time, stand-alone, rural animal technology certificate.

Lindvay (2008) agreed that large animal technicians could improve practice efficiency, as more tasks could be accomplished with the assistance of a nurse; and which, therefore, could save time spent on farm visits.5 An additional benefit was cited as the potential reduction in farmers’ bills when nurses are delegated to perform specific tasks, since their time could be charged at a lower rate than that of a veterinary surgeon.

Rollin (2003) discussed the subject of veterinary nurses acting alone and drew comparisons with the existing role of nurse practitioners in the human field who are permitted to work independently of doctor supervision, carrying out nursing procedures and making autonomous decisions for which they are accountable.6 Such decisions include forming differential diagnoses, prescribing medications and developing care plans based on clinical examination and patient assessment.

In terms of the ethical considerations of VNs acting under indirect supervision on a farm, it can be argued that if the nurse encountered a problem, the potentially significant delay associated with the veterinary surgeon reaching the premises in time could have patient welfare implications.

On the other hand, a VN should not be sent to carry out any task which he/she is not competent or confident at fulfilling unaccompanied, or a procedure that contains excessive risks to the patient.

Research summary

To elicit data about the issue, three different questionnaires were devised and sent to three sample groups in the South West of the UK:

1. livestock farmers

2. farm animal veterinary surgeons

3. veterinary nurses in mixed veterinary practice.

The sample population was restricted to the south-west region of the UK as it is an area of intense livestock farming. Each of the questionnaires contained a selection of open, closed and multiple choice questions, producing both qualitative and quantitative data.

A response rate of 55% (n=55) was achieved from the farmers’ survey, 13.5% (n=11) from the veterinary surgeons’ survey and 5% (n=4) achieved from the veterinary nurses’ survey.

Farmers

Farmers suggested that assistance with surgery, Caesareans and calving/lambing difficulties were the main cases in which a veterinary nurse would assist the vet on a visit. When asked ‘How often are you required to assist the vet with procedures?’ only five respondents answered ‘Never’; supporting the contention that the main assistant farm veterinary surgeons use is the farmer.

Restraint of animals was then given as the most common type of assistance provided. When asked if they thought veterinary nurses would be beneficial on a farm visit, 54.5% of farmers answered ‘Maybe’ and 18.2% answered ‘No’ which was significantly lower than anticipated. Those who answered ‘No’ elaborated that cost was the primary reason for this.

‘Our vet charges £100 per hour. If a nurse came, charges would increase. Farmers cannot afford this.’ (Respondent 48)

Thirty-five per cent of respondents stated that the extra cost of a nurse would not make a difference to them, which was a higher than anticipated response.

‘If the additional charge made the difference between saving the life of a valuable animal or not, then it would be worth the cost.’ (Respondent 30)

‘The health and welfare of the animal is paramount, and when cattle are now worth up to £1000 to £2000 each, health is important.’ (Responde
nt 31)

Veterinary surgeons

The answers given by the veterinary surgeons generally mirrored those of the livestock farmers. Again, assistance with surgery was the most common reason for taking a veterinary nurse on a visit. Farmers were listed as the person who most commonly assists them, and when asked, ‘Do you think it would be financially viable to have a specific farm animal veterinary nurse within your practice?’, 63.6% of veterinary surgeons answered ‘No’.

“Difficult to see how you make a farm nurse position pay. Would require a significant effort to involve them and sell the superior service to cost-conscious farm clients.” (Respondent 5)

Veterinary nurses

The veterinary nurses’ answers revealed that the majority enjoyed working with farm animals and would be interested in additional farm training. However, they did question whether or not it would be necessary, as they considered the majority of tasks could be learnt by bn the job’ training provided by vets who are happy to teach.

It can also be highlighted that a number of skills would be transferable from small animal practice and little additional training would be necessary.

Conclusion

Survey analysis would appear to demonstrate that, whilst there are potential roles for the qualified VN to perform in farm animal practice, there is insufficient demand to warrant a ‘stand-alone’ formal qualification or compulsory element in nurse training programmes at this time.

However, the size of this study is by no means representative of the total veterinary and farming communities in the UK, although the target area is rural and contains a high proportion of farms as a result.

If levels of demand were to increase, a ‘top up’ or ‘add-on qualification, similar to the rural animal technology programme offered in New Zealand, would probably be the preferred option in the UK, rather than compulsory farm training for all VNs. The appeal of a programme of this type is that it gives those who want to, the option to specialise, and does not impose it on those who have little desire to work outside the small animal sector.

Finally, in spite of the current financial climate, the veterinary nurse remains an integral part of veterinary practice, and whilst there is little opportunity for increased specialisation at present, it is likely that veterinary nursing training will become further specialised and may thus begin to mirror the teaching and work carried out overseas.

The author would like to acknowledge, and express thanks to, Andrea Jeffery MSc Dip AVN(Surg) Cert Ed RVN for her role as dissertation supervisor during the research process.

Author

Fiona Mullan Bsc (Hons) RVN VNPA

Fiona graduated with a degree in Veterinary Nursing and Practice Administration from the University of Bristol in 2010. After qualifying, she began working in small animal practice at Crossroads Veterinary Centre in Buckinghamshire.

To cite this article use either

DOI; 10.1111/j.2045-0648.2012.00172.x or Veterinary Nursing Journal Vol 27 pp 170-172

References

1. TURNER. W T [1984] The History of Animal Nursing Part 1: The Beginnings. Journal of Small Animal Practice. 25: 289-292.

2. TURNER. W T. [1984] The History of Animal Nursing Part 2: Modern Times. Journal of Small Animal Practice. 25: 307-311.

3. COUMBE. K. [2001] Preface In Equine Veterinary Nursing Manual. Oxford: Blackwell Science Ltd

4. KAHLER. S. [2002] Stretch your bovine practice potential – use technicians to the max Journal of the American Veterinary Medical Association 221 [12]: 1672-1673.

5. LINDVAY. A. (2008) Integration of Licensed Veterinary Technicians in a Large Animal Practice Proceedings of the North American Veterinary Conference. 22: 76-78.

6. ROLLIN. B (2003) Veterinary Medical Ethics: An Ethicist's Commentary on Veterinary Nurse Practitioners'. Canadian Veterinary Journal. 44 107-109.

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