I work as a senior nurse in the internal medicine department at Anderson Moores Veterinary Specialists. The practice is based in Hampshire and was set up five years ago by Davina Anderson and Kit Sturgess (Figure 1). Initially the practice opened with only two nurses, but expanded rapidly and today employs over 20 nurses and 12 clinicians.

Figure 1:The practice

We currently accept referrals from all over the south of England, and these include soft tissue and orthopaedics, internal medicine and dermatology. A number of nurses, like me, have specialised, whilst others still choose to rotate between departments.

Early start

My day begins at 8am with a quick visit to the kennels to check on how the in¬patients have been overnight and to see if we have admitted any emergencies. If we have procedures booked for that day, patients may need pre-medication or blood tests taken in order to obtain results prior to ward rounds which begin at around 8.15am.

I will also check the appointments diary to see what we are expecting and will begin to set up any equipment required for the day’s procedures.

The purpose of ward rounds is to discuss each case individually. It is an opportunity for the kennel staff to voice any concerns that they may have had overnight – for example, the patient may be more subdued than previously or urine output has dropped.

Each clinician will present his or her individual cases to the rest of the team and discuss any problems or concerns that they may have. Decisions will be made about changes in medication, blood samples to be taken and procedures that are to take place, or whether the patient is fit for discharge. A nurse is then instructed to ring owners, as appropriate, to give them a progress report on their pet or to arrange discharge appointments.

Essential timetable

Once ward rounds have been completed, it is time for medical and surgical procedures to begin. A timetable will be organised with the imaging department, as generally our cases will require ultrasound or CT before they come to us for endoscopy. A time is allocated for each patient to ensure that the day runs smoothly.

On occasion, cases may potentially require surgery; in which case we will liaise with the theatre staff before beginning the procedure. Ideally a timetable will have been discussed with the relevant departments the previous evening, or earlier that morning. However, this is not always practical as often we have lab results pending, or new cases emerge that take priority over existing ones – and so flexibility is the key.

Plethora of procedures

The endoscopic procedures that are the responsibility of the internal medicine department include: bronchoscopy, colonoscopy, upper G1 endoscopy and urethroscopy (Figures 2 & 3).

Figure 2: Cystoscopy

Figure 3: Cleaning the urethroscope

We are also involved in blood sampling for insulin clearance tests and blood glucose curves; whilst other procedures include bone marrow biopsy, CSF and joint taps, and setting up halter monitors and telemetry for exercise tolerance testing.

Many of our cases present with severe anaemia and thrombocytopenia, and require transfusion. We make great use of the Pet Blood Bank that supplies us with packed red cells and fresh frozen plasma. This can save a great deal of time and transfusions can take place 24 hours a day, which means that there is little delay in beginning treatment.

In the case of cats – or situations where whole blood is more appropriate – we have a list of donors that we can call on to donate, and often find that owners of multi-cat households are happy to bring in another cat.

Flexible support

The internal medicine department has three specialist clinicians and on any one day one will be consulting, one performing procedures, and the other on administrative duty – which will include giving advice calls to local vets and seeing emergencies.

The nursing team has to support all three, firstly setting up equipment and helping with the procedures (Figures 4 & 5). The routine consultations that are admitted will generally require blood sampling for both internal and external tests and, depending on their presenting symptoms, medication including intravenous (i/v) fluid therapy. Nursing staff will take and process the bloods, place i/v catheters and instigate fluid therapy, as well as administering all required medication.

Figure 4: Preparing to take an ECG

Figure 5: Preparing for chemotherapy

Similarly, for emergencies, we will prepare equipment for patient arrival and help with diagnostic treatment, as required. On busy days we will split into two teams –   the first helping with procedures and the second supporting the consulting clinician in admitting patients.

No such thing as typical day

Lunch is usually a brief affair. The practice provides food as we are in the middle of the countryside with no shops to hand – the benefit of this is that everyone meets up in the coffee room. This provides a chance to catch up with colleagues from other departments with whom you might otherwise have little contact owing to the busy practice environment.

After a half hours break, it is back to work because procedures continue throughout the day until the list is completed. On quieter days, we may assist in other departments, such as the kennels, imaging or in the laboratory – or we may even be allowed to ‘help’ in theatre for a short time.

At the end of the day, the procedure room is cleaned from top to bottom and when this is done, I will visit the kennels and make a list of all the medical in¬patients and check the diary to see what routine appointments we have the following day.

If a patient is particularly unwell, an overnight care plan will be discussed so that night staff have a clearer idea of what to expect and what action to take if necessary. When there is time, I will have a chat with the clinician to discuss a rough plan for the following day and set up equipment for any procedures that are to take place.

As with all veterinary practices, there is no such thing as a typical day. Interestingly conditions al
ways seem to run in threes, so we will have a week of anaemic patients and multiple blood transfusions or a week of bronchoscopy or colonoscopy –   and it is precisely this that makes our job both challenging and interesting! 


Julia Anne Hurley

Grad Dip BSc(Hons) RVN

Julia has worked at Anderson Moores Veterinary Specialists for the past four years – the latter two as a senior nurse in the internal medicine department. Prior to that, she worked as a nurse in general practice. Julia lives in Alresford in Hampshire with her partner, Geoff, and Jack Russell, 'Lulu'; and her daughter works in London as a physiotherapist. When not working, she enjoys riding, walking, sailing and pilates.

To cite this article use either

DOI: 10.1111/j.2045-0648.2012.00141.x or Veterinary Nursing Journal Vol 27 pp 66-68



Veterinary Nursing Journal • VOL 27 • February 2012 •