Education

Legal implications of euthanasia without owner consent

A veterinary surgeon and registered veterinary nurse must act in accordance with an animal owner's wishes and should respect their confidentiality. This can cause conflict as animal welfare should also be considered as a priority. Contradictory messages from legislation and the Royal College of Veterinary Surgeons Code of Professional Conduct for Veterinary Nurses are confusing, however, guidance from these suggests that animal welfare overrides all. To practice clinical governance, veterinary...

Clinical governance: quality improvement and clinical audits in practice

Quality improvement (QI) has been employed successfully across various industries, including human healthcare, as well as the aviation and automotive industries. In the veterinary sector, practices are starting to see the many benefits that QI can offer — particularly those that come from conducting clinical audits. Clinical audits are a part of QI and aim to look at how closely clinical practice is carried out when compared with set guidelines or protocols. This article looks at the steps of...

Quality improvement, checklists and systems of work: why do we need them?

Missing out one small step in a complex procedure can lead to an error. A checklist is a list of actions that can identify the small but crucial steps which may be missed out. Checklists are just one of the tools used to form a culture of continuous quality improvement (QI) in veterinary practice. QI is about understanding the level of care practices provide and implementing interventions to try to improve it. Checklists have been used in aviation and in human healthcare to reduce errors. The...

Nursing advice for owners of a visually impaired dog

Dogs are often presented in first opinion practice with visual impairment resulting from a variety of acute and progressive diseases or trauma. Visual impairment and blindness in dogs can be distressing for both the patient and the owner, and registered veterinary nurses can provide guidance and support on the adjustments needed to allow the patient to have a good quality of life. This article will discuss the disease processes, treatment options and client education for canine blindness.

Euthanasia: not an every day experience

Euthanasia can be a very personal and often dreaded time for veterinary clients. As veterinary professionals we carry out euthanasias on a weekly or even daily basis and are therefore liable to suffer from compassion fatigue, potentially leading to burnout or apathetic behaviour. Behaviours such as these could have a negative effect on the care given during euthanasia visits. The aim is to make the 30–40 minute appointment that is a regular occurrence for veterinary professionals truly memorable...

Taking back control

At a time when our world is rapidly changing, in ways that we cannot control, it is more important than ever to lean in and be there for each other and for ourselves. Taking back control requires recognising what is under our control, what we can influence and what is outside our sphere of influence, followed by taking action to control what we can, and learning not to waste mental, physical or emotional energy fighting what we cannot control.

Creating a just and learning culture through staff support

A just and learning culture consists of a balance of fairness, justice, learning and taking responsibility for actions. It is not about seeking to blame an individual when care falls short of expectations or goes wrong. A recently published report from NHS Resolution, Being fair, sets out the argument for organisations to adopt a more reflective approach to learning from incidents and supporting staff. Instead of asking ‘who is to blame?’ or ‘what did you do?’, try asking ‘what happened?’ and...

How to conduct an effective patient handover

Within a busy veterinary practice, it can feel at times as if there is simply no time to stop. There is always a set of test results ready, medication to be administered, clients to call and so on. However, taking the time to properly hand over details of your patients to the next staff member is vital in providing continuity of care. British Medical Association (BMA) et al (2005) suggested that handover of care is one of the most perilous procedures in healthcare; when carried out improperly...

An overview of decision making in veterinary nursing

Decision making takes place in all aspects of veterinary care. Throughout any consultation, work up, hospitalisation or ongoing home care, decisions need to be made about the next step to be taken. Clinical decision making is influenced by many different factors including past experience, emotions, owner wishes, financial concerns and communication skills. Within the veterinary team, it is important that everyone understands the factors influencing decisions. Decision making can follow a...

Looking after the end-of-life patient: four case studies

Patients that are in the fifth life stage (end-of-life) often present with multiple problems, which makes them challenging cases. Often, these patients are very vulnerable, and this is sometimes overlooked. This article aims to provide a brief and basic overview of looking after the end-of-life patient, whether at home or in hospital, by utilising a framework adapted from the 2016 International Association of Animal Hospice and Palliative Care, and American Animal Hospital Association Guidelines...

Managing pain in common end-of-life conditions

Pain is an under-recognised, under-diagnosed and under-treated condition in animals. Chronic pain is a significant welfare concern in our fifth life stage (or end-of-life) veterinary patients. This article aims to look at three common conditions that can adversely affect end-of-life patients: osteoarthritis, dental disease, and cancer. It will then look at how the pain in these conditions can be effectively addressed and managed.

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