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Enabling nurses to take on a bigger role in the veterinary practice could help mitigate the current staff shortage crisis. By John Burfitt
There’s been little relief in recent times to the crisis of the veterinary practitioner shortage in Australia, with many vets still reporting being overworked and a lack of skilled-workers available.
But one section of the profession believes an effective workplace strategy could help relieve some of the stress many are experiencing.
“This strategy is right under our noses and those clinics already making the most of it are experiencing better outcomes,” Janet Murray, Perth veterinary nursing lecturer and editor of the Veterinary Nursing Journal, says.
“The better utilisation of veterinary nurses is highly recommended and it’s something I have been advocating for a long time. Clinics need to look at the full competencies of nurses’ skills and how they are being utilised. This format has worked well for years in the UK, and it’s something Australia needs to be considering more seriously.”
The Veterinary Nurses Council of Australia (VNCA) is about to release a new report titled ‘Better Utilisation of Veterinary Nurses’, which further explores the case for taking on more clinical duties. The council also released in 2019 The Day One Competency Standards handbook which outlined the essential clinical activities a nurse is qualified to do once they have completed the nationally-recognised Certificate IV in a Nursing TAFE course.
“The skills shortage has changed the way we all work, and it makes sense to utilise people’s skills and make the most of in-house training,” Rebecca Coventry, VNCA president, says.
Coventry believes nurses can take on such duties as blood draws, X-rays, anaesthetics, inserting cannulas and catheters, creating medication packs, offering nutritional advice, nail trimming and home care instructions, leaving the vets to attend to other duties.
“If vets understood more about what nurses have studied and trained for, I think it might assist them in realising what nurses are qualified to do,” Coventry adds.
One of the biggest issues in adapting to such a working model is the differences in nursing qualifications across Australia. The VNCA launched The Australian Veterinary Nurse and Technician (AVNAT) Registration Scheme in 2019, however the scheme is self-regulating except in Western Australia where nurses must be Certificate IV qualified.
In other states and territories, some nurses have the accredited qualifications, while others have been trained in-house. The issue of qualifications is a situation, Rebecca Coventry explains, that continues to be explored by the Veterinary Surgeons’ Board in each state.
“I think what scares some vets off is accountability, so that if a task is handed to a nurse who might be great but has no accredited qualifications, what happens if something goes wrong?” she says. “That always needs to be taken seriously, but it also highlights why continuous upskilling and in-house training, no matter what a nurse’s qualifications, are crucial to this model working effectively.”
Janet Murray says training is essential to making this model work. “It’s ensuring nurses understand the system, and knowing the policies and the procedures is a really good place to start as that will guide the nurse through,” she says.
“Also, give the nurse time to learn the way and then offer regular guidance, feedback and supervision. Then be sure to review and keep on reviewing so that the nurse feels supported, and the vet feels increasingly confident in handing over some of those duties. Putting some time in now will pay off further down the track.”
Dr Ed Bassingthwaighte of Melbourne’s Bentons Road Vet Clinic recently returned to working in a veterinary hospital after 15 years of being in private practice. “I’ve been blown away by how vet nurses are now much more highly skilled and how they are helping me do the job, taking over many tasks that I used to do,” he says.
“Nurses are now putting in cannulas and inducing anaesthetics while I oversee everything, and this is such a dramatic change to how we used to work, and far more effective.”
He believes the secret to the success of the model is the nurses he works alongside have been well trained. “Training is the key, as is being well-supported as they learn the procedures,” he says. “Everything is under the supervision of a vet and closely monitored, but it frees the vets up to get on with other things in other areas, like diagnosing and prescribing.”
Veteran Sydney practitioner Dr Lindsay Hay of the Baulkham Hill Veterinary Hospital believes a change in the mindset about the role of veterinary nurses in general, as well as the way nurses are trained, is long overdue.
“I’m sure there are still practices where nurses are treated as little more than glorified kennel assistants,” he says.
“When I started as a vet in 1974, it was in a practice run by a visionary who trained our nurses very well and gave them a lot of responsibility. As a result, we were enormously productive and able to cope with a high load. I was strongly influenced by that and believe today many practices would benefit by leveraging the skills of their nursing team better and having the vets concentrate on the things only vets can do.”
It’s not only veterinary practitioners who might require a change of perspective on this workplace model, but also the clients a practice deals with.
“A lot of people will want to see the vet, no matter what a nurse says to them,” Janet Murray says. “I have been in consults where the nurse has explained something, and the client won’t listen. The vet has then been called and repeated exactly what the nurse said, and the client is super attentive. That reaction will take time to change.”
Dr Bassingthwaighte believes it is up to the vet to position nurses as authorities and demonstrate full support in front of the clients.
“It’s about how it is framed and ensuring that the nurse is fully supported,” he says. “I have been in consultations when I have called in the nurse and handed it over, and said to the client, ‘You’re in good hands as, frankly, this nurse is the authority on this issue’. That approach can make a huge difference as the next time that client came in, having the nurse run most of the consultation was not even an issue.”