ABSTRACT: Nursing Care Plans have been used in the human medical field for a number of years and are now moving into use within the veterinary profession. Their two key benefits are, firstly, to ensure all aspects of care are addressed by the practice team and, secondly, to promote good case communication either between different nurses, vets and nurses, or even different clinics. In the author's experience, care plans are fundamental to delivering a good standard of in-patient care. This first article in a three-part series describes the author's personal approach in practice by looking at what we need to include in a care plan. It will be followed by two more dealing with how to use them and how to get started, along with case examples

It is crucial to understand at the outset that the process of planning is more important than the plan itself. The communication between different team members is vital, so that everyone involved in the case is clear about what is going on and what the goals are, as well as being able to share ideas when the care is not giving the results expected. It is a way of organising thinking and empowering the whole team to provide the necessary care.

What should be included?

There have been a number of proposed care plans based on different nursing models, but what needs to be included will, to some extent depend on the practice and the type of work that is done. A first- opinion practice, for example, would not commonly need to do a full daily neurological assessment on every patient; whilst for a referral centre doing spinal surgery this might well be an important aspect to each pet’s daily care plan.

The Process of Nursing involves assessing a patients needs, planning how it is going to be cared for, providing or implementing that care, assessing the response to that care and then planning future care and reassessment (Figure 1).

Figure 1: The process of nursing

At every stage, there can be input from the rest of the veterinary or practice team, whilst the input from the owner is especially important during the assessment stage, in order to find out what the pet normally does at home.

It also needs to be a dynamic process because a patients needs change and the speed of that change will depend on the condition from which the pet is suffering. This speed of change will, therefore, determine how often the needs are reassessed and how often the planning is re-done. It also needs to be individual for that pet and holistic, including all aspects of care so that nothing is missed.

This is important in, for example, elderly patients who have complex needs and will rarely be suffering from just one condition. It is also vital in trauma cases where there are often multiple injuries affecting more than one body system – it is all too easy to focus on, say, the fractured pelvis and forget the bladder, which may be ruptured. This will not be identified unless the whole patient is regularly evaluated.

This nursing process is more effective if guided by a Nursing Model and there are a number of examples of these. The Orpet and Jeffery Ability Model was developed from human models and looks at the ‘10 abilities’ that are considered to be the basic requirements for an animal to function.1 Ability is what the animal is able to do or not do by itself. In this way the abilities that the pet is not able to do can be identified and nursing can assist. For instance, if the animal is not able to eat by itself then it needs to be nursed to eat via, for example, a change in diet or assisted feeding.

As well as considering these abilities, each element on the care plan needs to be, in some way, dynamic – responding to the pet’s changing needs as its condition changes. For each section a current assessment of the situation needs to be followed by a plan on how to tackle that problem as needed. The key elements to include are shown in Table 1.

How long should they be?

Care plans can be as long or as short as is needed but to go over ‘one page’ makes it harder to evaluate all the information at a glance. Hence the idea of including more detail on attached pages is an attractive one (Table 1) and limiting the categories so that they can all be included on one page can also help to make them more ‘user friendly’.

Every patient or only the ‘non-routine’ or ‘long stay’ cases?

Most practices have some sort of protocol in place for dealing with routine cases and so care plans can either not be used for routine cases (day-case neutering, for example), or one general care plan is written to include all the elements above but with the same being done for each patient. Examples might be to have a generic care plan for cat neuters that is displayed in the cat ward for every case. For diet and appetite, the care plan may read ‘nil by mouth’ prior to general anaesthesia and then go on to detail the routine for re-introducing food and water on recovery and at home.

In this way, a few care plans can be put together to cover the majority of day-case surgery, so that everyone knows what is expected with these patients. They will not, however, be individual to each patient. Then the ‘non-routine’ or ‘long stay’ patients can have their own individual plans.

So how do we use care plans?

There are a number of different elements to this question and these will be the subject of Part 2 in the series.

In summary, using nursing care plans improves patient care, practice communication, and adds value to the process of veterinary nursing. 


Clare Main BVetMed MRCVS

Clare Main graduated from the RVC, London, in 1992 and spent three years in mixed practice before moving to small animal practice. She joined Hill's Pet Nutrition in 1998 and worked there for five years before setting up her own practice in 2004 as a joint venture partnership. She is currently working part time in small animal practice and volunteers at the University of Bristol, facilitating communication skills and undergraduate interviews.

To cite this article use either

DOI: 10.1111/j.2045-0648.2010.00040.x or Veterinary Nursing Journal Vol 26 pp149-151


1. ORPET, H. 12008] Advances in the Delivery of Practical Nursing Care – practical examples.

Wortd Small Animal Veterinary Association Worl
d Congress Proceedings, 2008

Further reading

ORPET & JEFFERY 12006) Moving towards a more holistic approach. VNJ 26151 May 2006.

JEFFERY 120061 Moving away from the medical model VNJ 21191 September 2006.

JOINER, T. (20001 An holistic approach to nursing. Veterinary Nursing 15141 July 2000.

JEFFERY (20081 Advances in the Delivery of Nursing Care – a new concept. World Small Animal Veterinary Association World Congress Proceedings, 2008.

Veterinary Nursing Journal• VOL 26 • May 2011 •