References
Comparison of expectations between veterinarians and veterinary nurses in tasks and responsibilities in clinical practice
Abstract
Background:
It is reported that expectations from veterinary nurses and veterinarians on the clinical tasks veterinary nurses undertake in practice vary widely.
Aims:
To understand the difference in tasks and responsibilities reported by veterinary nurses in comparison to veterinarian expectations.
Methods:
Using an online survey, expectations regarding the capability of veterinary nurses undertaking clinical tasks in New Zealand veterinary clinics, were measured. Respondents were provided with a list of clinical tasks veterinary nurses are routinely trained to perform as part of formal veterinary nursing education, and two tasks veterinary nurses legally are currently not able to perform (cat neuters and dental extractions).
Results:
There were 288 responses from a veterinary nurse population of 1479 (19%), and 37 responses from a veterinarian population of 2425 (1.5%). Of respondents, 80% took blood samples, 78% placed intravenous (IV) catheters, 95% set-up of IV fluids, 72% carried out veterinary nurse consultations, 62% carried out clinical examinations, many carried out diagnostic testing (e.g. iDEXX/Vetscan (86%), urinalysis (88%), microscopy (51%), taking radiographs (81%)), 54% carried out dental scale and polish, 86% assisted with surgery, and 97% monitored anaesthetics. Veterinary nurses in New Zealand legally are currently not able to perform cat neuters and dental extractions — of these tasks, 25% and 26% of veterinary nurses reported having had training (either formal or informal) on performing cat neuters and dental extractions, with 12% and 16% of veterinary nurses reporting that they undertake this clinical procedure in practice.
Conclusions:
When looking at a selection of these tasks, comparing how many veterinarians report that veterinary nurses should be undertaking them, results show support for veterinary nurses undertaking these tasks. 100% of veterinarians support veterinary nurses placing IV catheters, with only 78% of veterinary nurses reporting completing this task, and 96% of veterinarians support veterinary nurses undertaking microscopy. In conclusion, veterinary nurses are trained in tasks they are not performing in clinical practice. The justification for this discrepancy is the subject of a future study with the aim of designing practical support for veterinary clinics to utilise the skills of veterinary nurses.
Anecdotally veterinary nurses are not being utilised to their full capacity in clinical practice. Veterinary nurses are trained and assessed for competency in admission and discharge of patients, pre-operative checks, using clinical equipment, and medical and surgical care, as per the New Zealand Qualifications Authority (n.d.). This list is not exhaustive but indicates the scope of tasks for which veterinary nurses are trained. In many clinics, however, veterinary nurses have reported that the veterinarian is completing these tasks instead of veterinary nurses.
Discussion of the role of the veterinary nurse, and the execution of specific tasks in practice is not a new issue. Molyneux (1998) listed the skills veterinary nurses in practice should be undertaking which included sample collection, processing and analysing, intravenous (IV) catheter placement, and urinary catheter placement. Following this, at a presentation at the 3rd AVA/NZVA Pan Pacific Veterinary Conference, veterinarian Dr Karen Koks (2010) talked about the under-utilisation of veterinary nurses in practice, and how to make better use of veterinary nurses. Her suggestions for utilising veterinary nurses better included organising practice areas into ‘zones’ whereby veterinary nurses would perform all the clinical tasks in that zone, except for diagnosis, surgery, and prescribing. This would include placing IV catheters, running blood tests, and monitoring anaesthetics. This topic was addressed in 2012 at the New Zealand Veterinary Nursing Association annual conference by veterinarian Dr Linda Sorensen (2012), who stated in her address that ‘the goal of the nurse-centred clinic is to fully utilise the nursing staff within legal limits’. Dr Sorensen stated that this requires a shift in perspective from veterinarians, who need to be willing to delegate clinical tasks to their veterinary nurses. Veterinary nurses also need to be willing to take on the added responsibilities.
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