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Is that “veterinary nurse” really a veterinary nurse?

Language and terminology is important. Our society recognises this fact, and in some walks of life, you cannot call yourself by certain terms unless you are appropriately qualified. The medical field is the area where so-called “protected titles” are most prevalent: there's a long list from “music therapist” to “dietician” to “clinical scientist” to “physiotherapist” and “paramedic”. If you read the list, you'll be surprised, and I suspect that you'll be reassured too: it's good to know that when you go to see a “hearing aid dispenser”, under law they must be properly trained and qualified. There are serious penalties for people who try to set themselves up as one of these practitioners when they are not entitled to do so: anyone using one of these titles must be registered with the Health and Care Professions Council, or they may be subject to prosecution and a fine of up to £5,000. Interestingly, not all professional titles are protected. The words “doctor” and “nurse” have been in general use for hundreds of years to describe a variety of people, and so they are not specifically protected. The title “doctor” is used far more broadly than just for medical doctors, with a number of professions (including dentists and now vets) using it as a courtesy title, as well as people who hold academic doctorates, such as PhDs. Similarly, the title “nurse” is not protected: as well as medical nurses, it's used by nursery nurses in nursery schools, and sometimes by veterinary nurses. The fact that the terms “doctor” and “nurse” are not protected can lead to issues where the public can be mislead by individuals who use the terms to their advantage (such as a person who is an academic doctor trying to pass themselves off as a medical doctor). For this reason, the terms “doctor of medicine” and “registered nurse” are protected titles, but for the public, arguably this is not sufficient to avoid confusion. There are some professions that would like to have protected titles, but for various reasons, this is not possible. Anybody can call themselves an “engineer”, a “scientist” or a “surveyor” because these terms are said to be in such widespread use. These professions have had to add prefixes to their titles to try to minimise confusion, such as “incorporated engineers”, “biomedical scientists” or “chartered surveyors”. Only properly qualified and registered vets are allowed to call themselves “veterinary surgeons”, but there is a major anomaly in the veterinary world: anybody, even without training or qualification, is allowed to call themselves “veterinary nurse”. The veterinary nursing profession has so far had to use the protected title “registered veterinary nurse” to be used exclusively by properly trained and qualified nurses, but there's a strong argument that this is not enough. Most readers, I'm sure, would agree that if they were dealing with someone calling themselves a “veterinary nurse”, they would assume that the person was qualified. Unless something changes, it's very likely that unscrupulous individuals will use this confusion to their advantage, misleading people into believing that they are qualified. What has to change? Clearly, the term “veterinary nurse” needs to be made a protected title. The Royal College of Veterinary Surgeons, the British Veterinary Association and the British Veterinary Nursing Association all believe that this is necessary. They are asking Parliament to change the law to protect the title “veterinary nurse”, and they need as much help as possible to achieve this. Please sign the official petition to register your support. The aim is to get 100,000 signatories which will trigger the issue will be considered for a formal parliamentary debate. The petition is currently at 20,594 signatures and the petition closes on 14th February 2016 so time is running out. The engineering profession tried a similar tactic to protect the word “engineer” last year, but the attempt failed after their petition only reached 6176 signatures. It makes clear sense that the term “veterinary nurse” should be trusted as the recognised name for a skilled, trained and qualified profession. If you agree, please sign this petition now, and ask as many as possible of your friends and contacts to do the same. Please follow this link to the petition. The RCVS has also produced a short animation stating the reasons behind the petition:  watch this by clicking here. Animals are the ones who will benefit from "veterinary nurse" being protected: so if you care, take action now.
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Getting ready for an anaesthetic at the vets

At one time or another we all have to face our beloved pets having an anaesthetic which can be a scary process if it’s not properly explained. Fortunately most veterinary practices have a fantastic team of nurses that can help you understand the procedure. (NB. I have used “he” in the article for continuity but this goes for all dogs a Labrador crop and cats regardless of gender). To give you a head start, here are some top tips: 1. The number one golden rule for preparing for an anaesthetic is no food after midnight (this does not apply to rabbits or guinea pigs). Also, some practices may give you an earlier time say nine or ten o’clock but the principle is still the same, basically no midnight feasts and no breakfast. The reason for this is two fold. The main reason is to stop your pet vomiting and potentially inhaling it. This can also prevent nausea on recovery. Another reason is to try and prevent any ‘accidents’ on the operating table which increases the risk of contaminating the surgical environment although to safe guard against this, some practices routinely give enemas and express bladders before surgery. So, while it breaks your heart to tuck in to steak and chips with Fido giving you the big brown eyes treatment console yourself with the knowledge that you are actually acting in his best interests to help minimise the risk of anaesthetic. 2. Give your pet the opportunity to relieve himself before coming into the surgery. Obviously this is easier with dogs but while we advise taking dogs for a walk before coming in we don’t mean a five mile hike on the beach with a swim in the sea, we mean a nice gentle walk around the block to encourage toileting. If you bring your dog in covered in dirt and sea water, you’re increasing the anaesthetic risk as we have to keep him asleep longer while we prep him. (See my previous article about how we prepare your pet for a surgical procedure). 3. Tell the nurse when she is admitting him whether you have noticed any unusual behaviour. Vomiting, diarrhoea, coughing or sneezing can all be indicators of problems and may need to be investigated prior to anaesthesia. Also tell the nurse if your pet is on any medication, when he last had it and bring it with you if you can. This way, if your pet needs to stay in after his operation, they will have everything he needs without adding extra to your bill. Harvey blanket1. Some pets get a little worried when in a new place so it may be helpful to bring in a jumper of yours or a blanket that smells like home. Be prepared for this to come home dirty! Some animals have accidents on recovery and with some of the larger practices getting through over fifteen loads of washing a day (with different people doing the laundry) it may not be possible to locate your blanket once it has disappeared into the washing room abyss. It does help tremendously if the blanket is labelled with your name. That way, if it does enter the washing room, it can be found again. Eventually. Obviously with smaller practices it’s much easier to keep track of individual items. 1. Give the practice a phone number that you can be contacted on. This is something that has surgeons and nurses tearing their hair out on a regular basis. All too often we’re given a phone number only to call it and hear a message saying that the mobile phone has been switched off or to hang on the end of a ringing phone. The reason behind this is sometimes we need to contact you during surgery because we have found something unusual or that we weren’t expecting and need to gain your consent to a change of procedure. It’s your pet and your decision and we want you to be involved every step of the way but we need to be able to speak to you to do that. I’m not saying you need to be sat by your phone from the minute you drop your pet off but please give a phone number that you or someone who can get hold of you will answer. Or at the very least, a answering machine that you check regularly. 1. Have faith in your veterinary team! If they suggest extra procedures such as intravenous fluids or blood sampling it’s because they think it would benefit your pet. I had one incident where a long haired cat was coming in to be sedated and lion clipped (shaved basically as his hair was matted). As he was over eight years old and hadn’t had a blood test I suggested a basic profile just to check what the liver and kidneys were doing. The blood tests revealed elevated kidney values which meant that there was some degree of kidney disease present. Finding this early meant that we were able to recommend a special diet to help slow the degeneration down (it’s never reversible) and the cat is now more likely to be monitored before he gets too ill. 70% of the kidney needs to be affected before clinical signs appear, wouldn’t you want to know before it gets to that point? Also, if we can see there’s an irregularity before we do the surgery, we can provide additional care to further minimise the risk. 1. Ask questions. We would much rather sit with you and explain away your concerns than have you sit at home or at work worrying. Also, if you are going to search the internet for information about the procedure your pet is having, please use reputable sources such as this one or ones written by the veterinary profession. The last thing you need to be reading is a blog by Joe Smith (fictional) about his one off experience about x, y or z and scaring yourself silly. The whole process is stressful enough, don’t torture yourself! Indie1. Bring your pet in suitably restrained. A cat needs to be in a cat carrier and a dog needs to be on a lead. A cat wrapped in a towel can easily become dinner for nervous, hungry German Shepherd. Don’t laugh, I’ve seen it happen! Yes this is a minority case but why put your pet at risk? We can’t predict how our pets will react in stressful situations (and coming to the vets certainly counts) so keep everybody safe by having control over your animal. Putting a cat in a carrier usually minimises their stress anyway as they feel safer and more secure and having your dog on a lead means that you can prevent him from bolting out of the door and on to the road. 9. That’s it! You are now fully prepared! Give your pet to the nurse to settle in and walk out the door. That’s actually easier said than done but in order to make this a smooth transition for your pet you need to be calm about it. Animals are very good at picking up stress and will become more worried about the situation the more worried you are. Obviously if your pet is aggressive the nurses may ask you to pop him in his kennel for them but the majority of veterinary professionals are more than capable of handling any type of animal and if you hand them the lead and walk out the door, nine times out of ten the dog will stare out of the door after you for a second or two then follow the nice sounding nurse who is being very enthusiastic and telling him what a good doggie he is through the door to the surgery. Don’t forget that we nurses are masters of cajoling and soothing. We have to work with vets as well after all! If you are worried about a problem with your pet, please talk to your vet or try our Interactive Symptom Guide to check how urgent the problem may be.
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