Every practice will have a clinical nurse manager, or as we used to call them a head nurse. Interestingly, that name seems to have been largely phased out now – but it all means the same. A clinical nurse manager has an important role within the nursing team. Both veterinary nurses and the clinical nurse manager have to prioritise caring for their patients, but their specific roles do differ. Whilst veterinary nurses and clinical nursing managers may both care for the patients coming into the practice, a clinical nurse manager also undertakes team leadership and admin duties.  

Team management 

It is important to any team of people that they have a leader: this is the core part of the clinical nurse manager role. She (or he) is someone that they can go to with any concerns and someone they can look up to for support.  

An important part of this leadership role would include organising rotas. Most veterinary practices will be open from early morning to late evening, meaning they need a team of people on all day. A clinical nurse manager’s role would be to organise a rota that allows for enough veterinary nurses to be on shift during the morning, afternoon and evening. Also, part of organising a rota is to also rotate nurses around the different areas of the practice – for example, a day in theatre, consults, hospital. This allows all members of the veterinary nurse team to do a bit of everything.  

Of course, running a rota also means you have to deal with staff absence and leave. When a holiday request is presented, this is usually looked at by the clinical nurse manager, they’ll either sign it off as authorised, or (if it can’t be made to work with the rota for that day or week) discuss as to why you can’t have the holiday.   

When new staff start it is usually the clinical nurse manager that mentors them. This means showing them around the practice again, introducing them to members of staff and going through health and safety. They then might pass the newest member onto another senior nurse so they can shadow them, but they are always there if they need any help.  

Another part of mentoring could be for a trainee student veterinary nurse: often clinical nurse managers are also clinical coaches which means they can demonstrate/teach and sign off any college or practical work the trainee has done.  

Another critical part of team management, that hopefully isn’t needed too often, would be to also assist/resolve any conflict within the practice and within the nurse team and ensure there is a happy team of people working.  

SOPs 

SOP stands for standard operating procedure. These are written instructions on how certain tasks should be performed. Members of the whole veterinary team should be aware of all SOP’s. SOP’s are normally written and revised by management, this being one of the clinical nurse manager tasks. It is then their job to ensure their team are up to date with any recent changes to these.  

Audits 

Clinical audits are a way of seeing if a protocol is working or failing and seeing if quality can be improved and how. Audits can be done on anything! However, typical examples would be monitoring infection control, checking that people are filling out procedure forms correctly, measuring and monitoring surgical complications, or assessing antibiotic use.  Performing audits is essential in any clinical environment because you always want to provide the best care. Audits are normally conducted by the clinical nurse manager and other members of the management team, like lead vets. Once done and a new plan is in place it is then down to the clinical nurse manager to tell their veterinary nurse team the outcome and how this can be improved – and of course this will also lead to changes in the SOPs (see above). 

Clinical standards

Clinical standards are set to ensure patients and clients are receiving the best possible care a veterinary practice can provide. To ensure these high standards are being followed, management set them out as guidelines and it would be the clinical nurse manager’s role to ensure they are being followed by their nursing team. This will of course link to the  RCVS practice standards scheme, which can tell you as owners what to expect from a practice that achieves the high clinical standards.  

Appraisals 

Most practices will do an appraisal on their staff every 6 months or yearly. I think appraisals are important within the practice, because they allow one to one time with the clinical nurse manager to discuss performance. Between them, the nurse and the clinical nurse manager can discuss the nurse’s skills and knowledge, and whether the nurse might need more training in a certain area.  They are there to discuss if any improvements can be made and how they can help and support the nurse through this. At this point also the nurse can discuss any new interests they may have to do with work and see if there are any courses they can do with this interest. During this time a scheduled meeting is arranged between the nurse and the clinical nurse manager for this discussion. It is important the clinical nurse manager does these appraisals as they know the nurse best and how they work.  

CPD 

This stands for continuing professional development. A registered veterinary nurse has to partake in 15 hours of recorded CPD in order to remain on the register. If a nurse has an interest in a certain area, they can approach their clinical nurse manager with this interest and work together to see if they can do partake in the CPD course.  

Machine Maintenance 

Within the practice there are a lot of machines that need regular maintenance, such as anaesthetic machines, X-ray machines, laboratory analysis machines, and many more bits of equipment. Regular maintenance of equipment is needed to ensure it is working correctly and  calibrated to give accurate results. It is down to the clinical nurse manager to ensure that maintenance services are arranged. Typically, if any equipment is broken it is the clinical nurse manager these breakages get reported to.  

Health and safety

Health and safety within the practice is a big thing. We have heavy dogs to lift, some weighing more than ourselves. We handle dangerous drugs which we then have to administer and we also handle animals which most are friendly but you never know. We also have equipment like X-ray machines which we need to take care around as we don’t want to be exposed to radiation. It is usually a clinical nurse managers role to ensure all health and safety advice is followed and any problems /injuries are reported. There will be health and safety protocols linked with the SOPs for our own safety. 

Budget management/stock control 

In the practice there will be budgets, unfortunately everything costs so budget management is a must. Part of a budget management is stock control. Ensuring only the necessary amount of stock is ordered and none is going to waste or expiring before its use. Clinical nurse managers don’t necessarily have to do stock control themselves, but they must make sure it happens. Sometimes, they may delegate this out to other members of the nursing team to help as more helpers the quicker and more efficient it is.  

Clinical work 

 As well as the management role it is important for the clinical nurse manager to also be on the main floor with the other nurses. This is so they can keep up with their clinical skills and knowledge and be there to support the nurses. With clinical nurse managers more than likely having more experience they can be on hand to assist with the more complex procedures that might come in.  

Conclusion 

Clinical nurse managers have an important role within the practice. They have a team to support and need to be someone that their nursing team can look up to, guide and ask for advice. They need to be the role models, the problem solvers and decision makers whilst supporting the practice also.