ABSTRACT: Having worked in the same practice for our entire working careers, we have seen phenomenal changes in the veterinary profession. The make-up of our own practice, the staffing structure needed for a busy hospital, the level of commitment needed for training nurses, the standard of care and the sheer diversity of the nursing profession, client relationships and their expectations and – at long last – the banishment of the dresses just to name a few!

We both came into veterinary nursing having completed animal care courses at college and at sixth form. These gave us the foundation and determination to find a practice that would enable us to become veterinary nurses.

For the first year, Melanie attended a day-release course at the College of Animal Welfare in Huntingdon, and the second year at Milton Agricultural College Cambridge in 1995. Megan attended Easton Agricultural College – on its very first intake for animal care – and completed block-release veterinary nursing at Berkshire Agricultural College in 1997.

Apart from practice support and college attendance, CPD availability was limited. VN-focused textbooks were in short supply and there were virtually no books authored by VNs – very different from today. Jones’s Animal Nursing textbook continued to be the favourite for trainee veterinary nurses.

VNJ – known as Veterinary Nursing – was at the time produced every other month, as was Veterinary Practice Nurse which was free and funded by Pedigree Petfoods and popular for its ‘Exam Pull- out’ help. (Figure 1).

Figure 1: Veterinary Nursing and Veterinary Practice Nurse

In practice assessment was recorded in the ‘little green practical book’, with only a signature required against each item of a long list of practical tasks. Our practice devised a checklist comprising various tasks and areas of knowledge to complete to ensure levels of understanding had been reached (Figure 2).

Figure 2: Basic textbooks and the 'little green practical book'

Additionally, we each had a checklist consisting of various tasks and areas of knowledge to complete, which the surgery devised to ensure levels of understanding has been reached.

Having qualified, we settled into our new –   but differing – roles within the surgery. We were both involved in nursing clinics, but Melanie developed a strong interest in medical nursing and nursing clinics, whilst Megan fell into puppy behaviour, nursing clinics and client relations.

However, our common interest was in training and supporting the newest members of the nursing team Melanie qualified as a D32/D33 assessor for the NVQ training system as soon as it was implemented. Megan, meanwhile, began coaching and assessing the pre- veterinary nurses in preparation for the NVQ qualification.

While we moved in our specific directions, so too did other members of our nursing team. Our colleague, Jane Jakes, qualified in 1992, but decided on a career shift and took up the position of our practice administrator. Her nursing background and wealth of experience in this field have been transferable to this role (Figure 3a & 3b).

Figures 3a and 3b: Jane in her nursing days in 1990 and now in her administrative role

Raised profile

In many practices, nurses had a predominately low profile, working ‘behind the scenes’ with the vets and patients. However, it has been very noticeable of late that more practices are keen to promote their nursing team and their qualifications – using veterinary nurses as the first point of contact for their clients, both in answering the phone and face-to-face queries. This has helped the veterinary nursing profession no end.

As a practice, we have recently taken part in organising a series of client evenings, which have reached out to the local community, and as a direct result of these we have received unprecedented enthusiasm back from the public. So many clients were unaware of the VN’s many roles within the practice and what we can offer them in terms of education on the care of their pet.

We both have a very active role in providing clients with information on preventive health care by means of our regular consulting sessions, which are held in a dedicated nursing room.

Progress in practice life

Practice life has changed immensely during our time in practice. We have seen much advancement over the years, particularly in the clinical sense – and what is available to clients and the provision of treatments for their pets at home.

Such things as offering nutritional and nutraceutical therapy along with medical management of chronic arthritis cases, the home management of diabetic monitoring to allow a more accurate and reliable source of information, through to providing cancer patients with advanced and specific treatment options which in turn help to maintain as normal quality of life as possible, are all examples and areas where the VN plays a critical role in the patient’s welfare, clients’ understanding and – importantly – compliance.

The vast range of drugs we have available to us now – compared with what we had some 25 years ago – has changed immensely. We have a wider range of antibiotics, analgesic agents and many differing drug therapies. And the important issue of tailoring the individual needs of the patient and the client are more closely considered.

Our monitoring of general anaesthesia has literally come on in leaps and bounds since our early days in practice (Figures 4a & 4b). At first it was limited to oesophageal stethoscopes and eyes and fingers alone! Now it consists of pulse oximetry, blood pressure monitoring, electrocardiography and capnography, giving us a wealth of information on the patient’s vital signs and depth of anaesthesia. Of course, this is still in conjunction with what we can see, hear and touch (Figures 5a & 5b).

Figures 4a and 4b: The anaesthetic monitoring we had available in 1989 and now

Figures 5a and 5b: Our incubator in 1987 and our incubator now

Pain relief management has also advanced greatly over the years – the use of constant rate infusions is something that again we wouldn’t have imagined when we started in veterinary nursing, but it is now commonplace in our practice and a matter o
f routine with any orthopaedic or non routine abdominal surgery. Who would have thought that we would be routinely performing physiotherapy and massage techniques on patients, and actively encouraging and teaching owners to do it to their pets at home?

Another area that has seen a great change is that of diagnostic imaging, particularly automatic processing. Gone are the days of labour intensive manual film developing. We now take for granted the use of automatic developing and – even more current – the use of digital radiography. How quick and efficient it is! Ultrasound has become a diagnostic tool, which is so invaluable to us too, allowing us to perform ultrasound-guided biopsies –   patently a much less invasive way of achieving a diagnosis without having to perform a laparotomy (Figure 6).

Figure 6: Ultrasound in progress – one of our most valuable diagnostic tools

Nursing care plans are another area of huge interest, enabling documentation of the nursing process. They are an excellent tool to aid communication between nursing staff, whilst ensuring a holistic style of nursing care to the patient. Care plans are also a valuable training tool providing consistency in the level of nursing care regardless of the experience of the members of the clinical team.

The nursing uniform has seen great changes over the years as well! When we first began our nursing careers, it consisted of dresses and aprons, which unfortunately – as smart as they looked – presented practical problems when trying to restrain a 70kg Irish Wolfhound! Thankfully we moved over to tunics and trousers some 10 years ago and this has made our lives – and the retention of modesty – a lot easier.

Many of the advancements and technical improvements might not have been possible without the ever-expanding pet insurance market. This is something that clients feel is most definitely an essential part of responsible pet ownership and it has allowed us to develop higher standards of nursing care and, in turn, to improve our own understanding of the ever-changing surgical and medical treatment regimens (Figures 7a & 7b).

Figures 7a and 7b: Our old operating theatre by a proper heat bed

The future

The future of the veterinary nursing profession relies on the continuing promotion of our role within the practice. It is so important that clients are aware of who is looking after their pets while they are in our care and that we are professional people in our own right.

There are some very significant changes occurring in the world of the VN, not least those affecting the issues of registration and regulation. It is important that the role of the qualified and registered VN is strengthened within practice. The need for highly motivated and professional individuals, who are forward thinking in terms of promoting themselves, is essential in keeping the identity of the RVN in the forefront of the public’s mind.

Our careers as VNs provide us with the utmost pride in the work we do. We both credit ourselves with the skills we have worked hard to achieve over the years and looking forward to gaining new knowledge to take us into the next 25 years! 

Author(s)

Melanie Watts RVN

Melanie Watts began her training at Mill House Veterinary Hospital in 1993 as a YTS student and qualified as a VN in 1997. She became a D32/33 assessor in 2001 and also has a special interest in veterinary health care advice. Melanie regularly consults in all aspects of preventive health care.

Megan Bestbier RVN

Megan Bestbier began her training at Mill House in 1996 and qualified as a VN in 2000. She is also a veterinary health advisor and has a special interest in puppy behaviour and social development.

Veterinary Nursing Journal • VOL 25 • No10 • October 2010 •