Should all CE/CPD be accredited?

Each year I record all of the continuing education or professional development that I have undertaken. As a Veterinary Technicians Specialist (VTS) in the USA, a Registered Veterinary Nurse (RVN) and as a Suitably Qualified Person (SQP) in the UK; I have to undertake very specific CPD and CE that is for the VTS and SQP have to be accredited. Requirements for the RVN currently stand as 45 hours over a 3 year period. Though as a clinical coach training students, my RVN CPD needs to be 15 hours yearly to show that I am current in my knowledge and to undertake a clinical coach update meeting yearly.

The exotic pet trade — where do veterinary professionals fit in?

Current legislation on the sale of exotic pets is out of date and is unable to regulate the trade in exotic animals as Anna Wade explains.

An extended patient care report for a canine in congestive heart failure

This article describes the nursing care provided to a patient presenting with congestive heart failure and cardiogenic pulmonary oedema. It is essential to minimise stress during diagnostic investigations and throughout the implementation of monitoring plans and nursing interventions of patients presenting in respiratory distress, to prevent decompensation and arrest. Oxygen therapy was administered immediately and drug therapy tailored to the patient's response. Monitoring techniques were selected based on those requiring minimal handling while ensuring sufficient information was obtained to allow repeat assessment of the patient's response to drug and oxygen therapy.

Recumbent patients: is turning enough?

Recumbency in patients can be challenging in veterinary practice, and further understanding of the care that these dependent patients require can be potentially further improved. Patients are seen for complex disease processes and the advances in veterinary medicine have allowed for impressive intensive care to be achieved, and the ability for gold standard nursing care which demands further research into this field. To enable care to be of the highest standard, and to ensure recumbent patients nursing care is maintained to the gold standard while hospitalised, informed, knowledgeable and trained registered veterinary nurses (RVNs) should be advised on the appropriate nursing interventions to be applied to promote quicker recovery from disease. Maintaining patent respiratory function is a necessity with recumbent patients to facilitate recovery from disease processes.

Changes in behaviour in elderly cats and dogs, part 1: causes and diagnosis

Changes in behaviour in elderly cats and dogs can occur as a result of a number of different medical conditions as well as age-related cognitive dysfunction. They may include problem behaviours such as aggression, house soiling, increasing fearfulness and waking owners at night. Early recognition of behaviour changes in elderly animals can lead to faster diagnosis and treatment of the underlying medical and/or behavioural conditions. However, owners of elderly pets do not always mention changes in their pets' behaviour during veterinary visits so veterinary nurses need to routinely ask owners of elderly pets about their pets' behaviour and to be aware of the significance of any changes reported. Targeted questionnaires or screening tests can make it easier to identify behaviour changes suggestive of cognitive dysfunction.

How to pressure check an anaesthetic machine

Pre-anaesthetic checks, including those focusing on the anaesthetic machine, form an important part of patient safety and have become an integral part of the peri-anaesthetic checklists currently being introduced into veterinary medicine. Careful testing of the anaesthetic machine involves pressure testing the various components, allowing detection of any defective workings prior to use. Implementing a step by step guide ensures that no important stages are omitted from pressure checking and prevents patient safety from being compromised. Visual checks of the gas cylinder connections, vaporiser(s), flow meters and common gas outlet should be followed by testing of the low and high pressure systems within the anaesthetic machine and then the vaporiser and its attachment to the back bar. Any leaks detected should be identified and resolved if possible or repairs organised and alternative equipment utilised.

Critical care of the small rodent: a veterinary nurse's guide

Small rodents are a popular pet choice, but their ability to conceal obvious signs of discomfort or illness, attributed to their ‘prey-like’ lifestyle, can make them challenging patients. Consequently they are regularly encountered by veterinary staff when clinical signs are apparent suggestive of chronic or advanced illnesses. Veterinary nurses are essential in the critical care of small rodent patients by appreciating correct husbandry, providing behavioural observations and administration of treatments, promoting patient welfare, minimising discomfort and preserving life where appropriate. This article aims to review the relevant characteristics of small rodents, identifying critically ill patients and nursing initiatives that can facilitate their hospitalisation, treatment and recovery.

Oral homecare regimens and products

The maintenance of the oral health of veterinary patients is fundamental to the maintenance of their overall health. Oral ill-health and untreated diseases are considered to contribute significantly to, or exacerbate, many other systemic illnesses that animal patients suffer, often due to a transient bacteraemia originating within the oral cavity, and these diseases can be painful. Anecdotally, many clients return with their animal post-dental treatment and report that they are like a puppy or a kitten again. This is simply because having cleaned away the plaque bacteria from the sulcus during the dental procedure, the animal does not then suffer this influx of bacteria from the sulcus through the breached epithelium and into the bloodstream every time it eats, closes its mouth or holds on to a toy. A persistent low-grade bacteraemia will take its toll on any animal and insidiously age it. The promotion of oral homecare and the provision of advice and guidance with regards to protocols and products is largely the responsibility of the registered veterinary nurse (RVN) or veterinary technicians in veterinary practice, and as such they should aim to promote preventative health care rather than reactive health care. This article aims to explore the different types of products available to enhance good oral homecare and examine their claims, before suggesting an optimal ‘goldstandard’ oral homecare regimen and compromises to this optimal regimen.

The euthanasia of aggressive dogs

This article will discuss the ethical issues concerned with the euthanasia of aggressive dogs in practice and where veterinary nurses (VNs) stand within this debate. Ethical theories will be discussed and, specifically, how these relate to the euthanasia of aggressive dogs in practice. The role that VNs play in the euthanasia of these patients and where VNs stand within the law when assisting with the euthanasia of aggressive dogs will also be discussed. Last, the article will look at the Code of professional Conduct for both veterinary surgeons and VNs and how it can be used to gain guidance when dealing with ethical dilemmas.

Readers' letters

In response,Dear Graham,Thank you for contacting The Veterinary Nurse and giving me the opportunity to respond to your query. You will have noted that the article is written in a veterinary nursing journal to advise veterinary nurses regarding the potential complexity of the underlying conditions motivating behaviours, the modification of which may involve desensitisation and counter-conditioning. The article specifically neglects to become involved with advice regarding to whom a practice should refer behaviour cases (although it mentions the ASAB list of accredited clinical animal behaviourists, APBC members and the ABTC register in ‘Further Advice’).Sadly, as had occurred with the veterinary nursing profession, the ‘behaviour’ profession has been unregulated. Although BSAVA and other organisations are working closely with the ABTC, who have developed a register of practitioners fulfilling mutually acceptable requirements, veterinary surgeons remain free to refer behaviour cases to whoever they wish. There are, of course, insurance and liability issues to consider in association with following professional guidelines to refer to a ‘suitable’ professional, but otherwise the selection is left to the veterinary surgeon's individual preference. As this historical problem had no relevance to the nature of the article, I did not mention it.The reference to behaviour clinicians in the early part of the article was with relevance to reminding nurses of their particularly delicate position regarding the Veterinary Surgeon's Act. Although the RCVS does not give specific guidance to their members regarding behaviour referrals, it does recognise both diplomates of the European College of Animal Welfare and Behavioural Medicine and ASAB accredited veterinary surgeons as specialists in behaviour, allowing them to use the associated post nominals between that of their first degree and their membership. By extension of this argument, it is my opinion that there must also be recognition of the competencies of other ASAB CCABs, who are assessed on exactly the same criteria as the veterinary surgeons. The relevant criteria can be found both on the ASAB website and that of the ABTC. However, as these are the minimum accredited criteria accepted as required of veterinary surgeons specialising in the detection and treatment of companion animals requiring desensitisation and counterconditioning regimens, veterinary nurses should be aiming to attain a similar level of competency if they also wish to become involved in such work.I hope that the above goes some way towards explaining the point that was touched upon, but not further developed, within the article. As mentioned, I did not even embark upon a discussion regarding the qualifications of the behaviourists to whom the veterinary team should refer as this is a matter for the individual veterinary practitioner and had no relevance to the points that I was attempting to make to the nursing readership.Yours sincerely,Claire Hargrave MSc BSc(Hons) CSci CChem MRSC CCABI read the very useful article on Lyme Disease in The Veternary Nurse (6(7): 380–7) and felt that perhaps the disease risks were under estimated with the poster reading that there is no risks to humans of transmission from dogs. Lyme disease is a serious life threatening zoonosis and the possibility of transmission via the ticks on a dog to humans is regarded as low but I would have thought higher than zero.Many thanksRichard Armour BVMS MRCVS