References
Do ‘CARE’ labelled canine patients get a lower standard of nursing care?
Abstract
Aggressive patients are labelled as ‘CARE’ within their clinical history and the quality of nursing care they receive may be compromised because of concerns for staff safety. The aim of this study was to investigate if a difference in the quality of nursing care exists between aggressive patients labelled as CARE and other patients not labelled as CARE, hoping to identify whether this suggested a breach of patient welfare. This study used a cross-sectional, observational survey distributed online via social media veterinary nursing community pages. Open invitations were also emailed to the first author's own practice, and the RVC's Queen Mother Hospital for Animals. UK-based registered veterinary nurses who had been in practice within the last 12 months participated. Likert response categories of 1-5 were used to question registered veterinary nurses about how likely they were to undertake certain nursing activities for both CARE and non-CARE canine patients. In total, 390 registered veterinary nurses completed the questionnaire. Pearson's chi-squared test was used to statistically analyse the data. An association was discovered between level of nursing care and CARE or non-CARE labelled patients. Statistically significant differences (P=0.05) in nursing care were found under every nursing category for CARE patients. The key categories identified were patient hygiene, feeding, pain scoring, exercise and restraint. The current study provides evidence that aggressive canine patients do get a lower standard of nursing care compared to other canine patients. Areas of concern are highlighted when these differences are discussed in the context of animal welfare. The authors hope these findings serve as a prompt for practices to examine their performance towards aggressive patients to ensure adequate standards of nursing care and patient welfare are sustained.
Aggressive canine patients are not rarely encountered in practice, as current surveys show that 7% of UK owners' dogs demonstrate aggressive behaviour towards strangers (Casey et al, 2014), with human-directed aggression the main presentation of canine aggression reported to veterinary behaviourists (Bamberger and Houpt, 2006). Veterinary staff come into close contact with canine patients and so are more likely targets of aggression (Fatjo, 2007). However, despite the risk aggressive behaviour brings to veterinary personnel, the registered veterinary nurse must ensure the patient receives adequate care. The Animal Welfare Act 2006 ensures animal needs are met by the person responsible for their care, therefore this responsibility extends to registered veterinary nurses during their hospitalisation. Under the Royal College of Veterinary Surgeons (2017) code of professional conduct, the duty of registered veterinary nurses is to make animal health and welfare their first consideration by providing appropriate and adequate nursing care. However, the Royal College of Veterinary Surgeons code also states ‘Veterinary surgeons are not expected to tolerate threatening, aggressive, or violent behaviour or to compromise their personal safety when attending to animals’. This opens up an interesting discussion as canine human-directed aggression is a significant welfare consideration, as it can subsequently make clinical treatment of patients difficult (Odore et al, 2020). This queries if a balance between patient welfare and personal safety is possible if there is a considerable compromise to personal health and safety.
Register now to continue reading
Thank you for visiting The Veterinary Nurse and reading some of our peer-reviewed content for veterinary professionals. To continue reading this article, please register today.