Part B: Day One Skills for Veterinary Nurses - Small animal

Comply with Health and Safety requirements and local risk factors

Guidance
Comply with legislative requirements

Follow Standard Operating Procedures and manufacturer guidelines when using equipment and materials

Guidance
No guidance

Take appropriate action and report injury involving self or others

Guidance
Complete the accident book/record in accordance with practice protocol

Critically evaluate a risk assessment for one area of the practice and suggest appropriate action where necessary

Guidance
No guidance

Communicate effectively using a variety of different methods
Refer to and consider supporting guidance:
5. Communication between professional colleagues

Guidance
Communicate with clients, work colleagues, other veterinary professionals, and the public, considering their diverse needs and requirements.
Communication models should be considered.

Create accurate and legible written communications/documentation according to practice policy

Guidance
Records to include: patient records and reports, laboratory reports, admission and consent forms, client home care plans and instructions.

Access and store client and practice records according to practice policy and data protection laws
Refer to and consider supporting guidance: 14 client confidentiality.

Guidance
No guidance

Admit patients
Refer to and consider supporting guidance:
1. Referrals and second opinions
9. Practice information, fees and insurance
11. Communication and consent

Guidance
Obtain written and verbal informed consent; Respond appropriately to economic status of clients to include insurance and referrals; develop care plans as appropriate.

Conduct effective nursing consultations
Refer to and consider supporting guidance:
18. Delegation to veterinary nurses

Guidance
History taking and appropriate examination; Identifying patients for referral to a veterinary surgeon or veterinary nurse; Application of treatments; Programmes of preventative medicine.

Implant a microchip

Guidance
This may be completed as part of a nursing consultation.

Provide discharge information and guidance to clients

Guidance
Discuss home care plans with clients, to include advising clients on safe and correct routes of administration and potential side effects; Demonstrate to clients safe techniques for administering medication; Advise clients on the storage and disposal of medication; Wound care advice; Bandage advice; advise clients on out of hours services.

Complete appropriate documentation for referral and diagnostic services
Refer to and consider supporting guidance:
13. Clinical and client records

Guidance
To include laboratory samples, clinical histories and hereditary tests for example elbow and hip scoring, genetic testing, and blood tests.

Review and discuss evidence-based nursing

Guidance
Identify an area of practise for discussion with members of the veterinary team; Appraise literature; consider cases in accordance with reviewed literature; Discuss and disseminate findings with practice team.

Identify and collaborate on quality improvement within the practice setting
Review and consider supporting guidance:
5. Communication between professional colleagues
17. Veterinary teams and leaders

Guidance

Review definition of quality improvement and guidance provided by RCVS Knowledge, discuss unexpected medical or surgical complications with the veterinary team, examples of which may include serious complaint, accident or anaesthetic death; Consider circumstances; Ensure effective protocols are in place; Discuss proposed improvements with the practice veterinary team

Demonstrate compliance with practice protocols in regard to health and wellbeing of personnel
Refer to and consider supporting guidance:
15. Health Protocol

Guidance
Discussion of health and wellbeing concerns which may be experienced by any member of the veterinary team, and the protocols in place to prevent and mitigate them. These should include reference to mental and emotional health concerns, as well as those relating to physical safety and health.

Communicate effectively expressing appropriate empathy and sympathy
Refer to and consider supporting guidance:
8. Euthanasia of animals

Guidance
Prepare the owner for loss; Support the owner through the euthanasia process; Provide follow-up support for a bereaved owner; Maintain and adapt professional approach to the circumstances.

Evaluate behavioural and environmental factors when approaching and handling animals

Guidance
Recognition of and minimizing, fear and distress, utilising approaches which reduce stress.

Select and use appropriate personal and patient protective equipment

Guidance
No guidance

Demonstrate techniques for approaching and handling patients

Guidance
With due regard to patient needs and behaviours.

Lead and move animals using the most appropriate equipment for the species and approved manual handling and lifting procedures

Guidance
No guidance

Use appropriate restraint methods suitable for the patient and situation with due consideration for animal welfare

Guidance
Maintain patient’s emotional homeostasis and wellbeing; Recognise signs of distress and act accordingly to minimise this; Restrain for clinical examination, sample collection, administration of medicines and restrain patient for the introduction of an appropriate airway management device.

Interpret and use individualised care plans to deliver the nursing process for a range of disorders and diseases

Guidance
Interpret nursing care plans and carry out appropriate nursing intervention.
Consider cross-referencing to Section 2

Critically evaluate a care bundle

Guidance
This may be evidenced through research and a clinical discussion.

Carry out a nursing assessment ascertaining information about the patient’s normal routine

Guidance
Food and fluid intake; Urination and defecation; Behaviour (response to pain, strangers, commands etc); Mobility; Sleep and rest.
Consider cross-referencing to Section 2.

Perform a clinical examination and record findings

Guidance
To include temperature, pulse, respiration, weight, body condition score and capillary refill times/mucous membranes, non-invasive blood pressure.

Provide husbandry to patients, considering accommodation, nutrition, and excretions

Guidance
Consider age, species, condition, demeanour and enrichment. Calculate food requirements based on disease and life stage/lifestyle, manage assisted feeding to include hand feeding, oral hydration and managing and maintaining feeding tubes.

Maintain patients’ hygiene according to their needs

Guidance
Consider cross-referencing to Section 2.

Assess, monitor, manage and report the status of wounds to the appropriate member of the veterinary team

Guidance
No guidance

Apply dressings appropriate to type of wound

Guidance
Consider evidence-based techniques and materials.

Apply bandages appropriate to species and condition

Guidance
No guidance

Administer medicines prescribed by the veterinary surgeon in accordance with instructions from the manufacturer

Guidance
To include oral, topical, subcutaneous, intramuscular, and intravenous.

Monitor for side effects and adverse medication reactions and alert veterinary surgeon

Guidance
No guidance

Provide fluid therapy to in-patients

Guidance
Select appropriate fluids according to veterinary surgeon instructions; Select and prepare administration equipment; Place intravenous catheters into appropriate veins; Intravenous catheter management; Calculate amount and rate of fluid to administer; Observe and monitor patients receiving fluid therapy, reporting any concerns to an appropriate member of the veterinary team.

Identify, assess, and evaluate pain and alert the veterinary surgeon

Guidance
Score and evaluate pain using a validated system; intensity of pain and associated anxiety and behaviour.

Perform basic physical therapy techniques to aid mobilisation

Guidance
To include passive movement and active exercise.

Administer first aid for a range of situations within the limits of the law and the expertise of the student

Guidance
First aid is defined as care that can be carried out by a lay person.

Assist with a range of emergency care techniques within the limits of the student’s expertise

Guidance
Emergency care is defined as care delegated by the veterinary surgeon in an emergency scenario.

Discuss with the veterinary surgeon and prepare for an appropriate sampling strategy

Guidance
Strategy to include: personal protective equipment (PPE), clipping and preparing sample site, preparation of patient and equipment; calibration of equipment. Strategies prepared for: blood, urine, faeces, skin/hair and tissue biopsies.

Safely and effectively take appropriate samples

Guidance
Samples to include blood, urine, faeces, skin, hair pluck, bacterial swabs.

Carry out haematological analysis

Guidance
To include biochemistry, haematology, packed cell volume, total solids (protein) and smear.

Carry out urinalysis

Guidance
To include urine reagent strips, specific gravity, sediment analysis.

Carry out faecal analysis

Guidance

May include; gross visual analysis; microscopic analysis; quantitative examination; commercial test kits.

Carry out skin and hair analysis

Guidance
May include: hair pluck, skin scrapes, tape strips and coat brushings.

Use a microscope to examine laboratory samples

Guidance
To include: low magnification, high magnification and oil immersion.
Record Vernier Scale readings.

Prepare samples for external analysis

Guidance
To include: accurate completion of documentation, correct packaging and labelling, correct preservation and storage in line with current legislation.

Record laboratory test results and communicate accurately to the appropriate member of the veterinary team

Guidance
No guidance

Prepare and use radiography equipment to produce a diagnostic image

Guidance
No guidance.

Use appropriate personal protective equipment (PPE) and radiation monitoring equipment in accordance with practice local rules

Guidance
No guidance.

Position a patient to obtain a diagnostic image of the area of interest

Guidance
A variety of species and positions would be expected.

Produce images according to practice procedure

Guidance
No guidance.

Record exposures and results of images according to practice procedure

Guidance

Appraise the quality of the image.

Prepare and support animals during ultrasound investigation

Guidance
To include setting up equipment.

Ensure safe handling and management of pharmaceuticals in accordance with legislation and manufacturer guidelines

Guidance
Store, handle and dispose of medicines in line with legislative guidelines and specific requirements found in the Summary of Product Characteristics (SPC) and with reference to their drug category.

To include: Controlled drugs and hormone based medicines which require special handling and disposal.

Interpret prescriptions and prepare medicines for dispensing

Guidance
Calculate drug dosages and confirm with an appropriately qualified member of the veterinary team; Package and label in accordance with legal requirements.

Maintain appropriate records

Guidance
To include medicines records, Controlled drugs (CDs), withdrawal periods and hospital charts.

Recognise clinical signs of common zoonotic diseases and undertake strategies to prevent spread and infection

Guidance
No guidance.

Formulate and implement an appropriate infection control strategy according to practice protocol

Guidance
Constitute appropriate cleaning and disinfectant solutions; Prepare, clean and maintain patient accommodation that maximises the welfare of hospitalised patients to include isolation accommodation; Prepare, clean and maintain examination rooms, preparation area and operating theatre to include periodic deep clean and after infected cases.

Dispose of hazardous and non-hazardous waste, safely and correctly according to current legislation

Guidance
To include recycling and correct disposal of medications.

Ensure appropriate hygiene skills are followed before and after handling animals and equipment

Guidance
Comply with the World Health Organisation hand washing method; Use and dispose of PPE.

Carry out effective barrier nursing

Guidance
Taking into account accommodation, PPE, equipment and patient condition to include reverse barrier nursing.

Maintain common surgical instruments

Guidance
Identify, check, and clean common surgical instruments; Identify and report damage to equipment and instruments.

Prepare, package, and monitor the sterilisation of instruments and materials

Guidance
No guidance.

Prepare the theatre for use based on patient, equipment, and procedure

Guidance
No guidance.

Position patients appropriately on the operating table in accordance with the planned procedure considering patient condition

Guidance
No guidance.

Prepare the surgical site appropriately for the procedure in accordance with practice protocol

Guidance
Consider cross-referencing to Section 2.

Assist as circulating nurse

Guidance
Open and pass sterile materials direct to scrubbed personnel; Prepare ancillary and powered equipment; complete surgical safety checklists.

Consider cross referencing to Section 2

To include pre-surgical scrub prior to donning gown and gloves.

Prepare for surgical assistance wearing appropriate attire in accordance with practice protocol

Guidance
To include Donning of gown and gloves, using open and closed gloving method in an aseptic manner.

Assist with sterile procedures

Guidance
Maintain sterility of self and others during procedures.

Assist with draping patients maintaining sterility according to practice protocol

Guidance
No guidance.

Monitor and record materials during surgery

Guidance
No guidance.

Handle and pass instruments and equipment aseptically during surgery

Guidance
No guidance.

Assess the patient and identify the patient’s anaesthetic risks

Guidance
To include ASA guidelines, behaviour and temperament, clinical assessment, and discussion with an appropriate member of the veterinary team.

Prepare equipment for anaesthesia

Guidance
Check and prepare the anaesthetic machine in accordance with practice protocol; Select, prepare and check an appropriate breathing system/circuit and pollution control system in accordance with practice protocol; Select and prepare monitoring equipment according to the patient’s condition; Prepare materials and equipment required for induction of anaesthesia to include pharmaceutical agents (according to veterinary surgeon direction) and appropriate airway management device.

Prepare patients for anaesthesia according to practice protocol

Guidance
Administer prescribed premedicants and assess the patient’s response; Introduce airway management device (check position and secure airway management device).

Maintain and monitor the patient during the anaesthetic process

Guidance
Refer to and consider supporting guidance: 18. delegation to veterinary nurses.

Measure temperature, heart rate, central and peripheral pulse, respiratory rate, blood pressure; Evaluate depth of anaesthesia; Monitor equipment (systems/circuits and tube, gases and volatile agents, patient monitors); Interpret and report observations to the directing veterinary surgeon (Inconsistencies, patient monitors); Calculate the fresh gas flow and administer inhalation anaesthesia under veterinary direction (Change the depth or level of inhalation anaesthesia under veterinary direction), Disconnect patients from anaesthetic equipment and materials;

Complete anaesthetic monitoring records

Guidance
No guidance.

Support and assess patient recovery from anesthesia and communicate concerns to an appropriate member of the veterinary team

Guidance
Position patients for recovery; Remove airway management device at appropriate stage of recovery; Maintain accurate recovery records; Communicate post operative and/or anaesthetic recovery progress to an appropriate member of the veterinary team.