A veterinary nurse’s day can vary dramatically. Each day can vary depending on what area we have been allocated, but each role has the same aim. Our days can be fast paced and very hands on, but no two days are ever the same. We can have quiet and manic days but each day our goal is the same – to provide the best care we can. So let’s have a look through how a fairly typical veterinary nurse’s day goes.
The beginning of the day for the hospital nurse
A veterinary nurse’s morning usually begins around 7:30am. It’s an early start and these are usually the first people in. Each practice is different – meaning that some would keep patients in overnight whilst others will not, so depending on the practice depends on how the nurse’s day begins.
Let’s have a look at how a nurse’s day would begin if they had patients in overnight.
The day would begin with a handover from the night team. During this time the night nurse will discuss with the day nurse about the patients they have looked after throughout the night, as now the day nurse will be in charge of these patients. They will discuss any concerns they have, any improvements and just any information in general.
Once the handover is done then the day/hospital nurse, along with the hospital vet, will then examine each patient. During the examinations, they’ll be checking heart and respiration rates along with doing temperature checks and looking at other vital signs. Most patients that are kept in overnight will likely be on intravenous fluids to help keep them hydrated, so it is important their cannulas and the fluid lines are checked, ensuring that they are still patent and that they are running at the correct rate.
During these examinations, a plan between the vet and nurse should be made, which will include deciding whether the patient needs any further medication and at what dosage, if anything is needed. Often, they may need further diagnostics if they have made no improvements overnight, at which point the vet would contact the owners to discuss any further treatment, or discuss discharging the patient.
Once the patients have had their checks and a plan has been made, any discharges, medication or further diagnostics can be done. This veterinary nurse will then care for any new and existing patients till their shift ends. Their aim is to keep patients comfortable, keep up with medications and monitoring, and to keep owner updated until their next handover.
Each patient will have a hospital sheet which has all of their information on, this will include drugs administered, fluid rate, whether the patient has eaten and been taken outside. It is important to keep this up to date and be thorough and clear, so if someone looks at the sheet they can understand what is going on. Another part of their role would be to keep the kennels clean and tidy and keep up with the large amounts of washing!
If the practice doesn’t keep patients in overnight:
These nurses’ mornings will start a little different as there are no patients to look after, but they will still begin their day early. Their priority first thing in the morning is to make sure all the kennels are prepared for patients. This would be allocating which patient is going into which kennel – our patients come in all different shapes and sizes so we need to make sure they each have a comfortable space. Then they ensure there is suitable bedding in the kennel. This hospital nurse will be in charge of looking after any sick patients that come in, along with the patients recovering from a procedure.
Let the day begin!
Before patients start arriving, we need to get the prep room and the theatres set up. When getting the prep room ready, we can prepare equipment to place intravenous catheters, get some nice blankets down to keep the patients warm, and ensure the anaesthetic circuits are working.
We also need to prepare the theatres. This means we need to damp-dust all surfaces, prepare heating aids/blankets, set up the anaesthetic circuits and ensure they are not leaking, and ensure we have the correct surgical kits for the day.
So now we are all set for the day we can start admitting the patients
Most patients are admitted early morning so procedures can start. One of the main roles of the early morning nurse is to admit patients. Some patients will be coming in for routine procedures, like neutering, whilst others will be surgically (and medically) more complex. The complex patients will have already seen a vet so a nurse can usually admit these too.
During the admit process we go through a consent form, this details what the procedure is, lists the risks, talks through estimates. We also have to go through all the risks associated with this. Once the owner is happy with the estimate, procedure and understands the risks we can then get the consent form signed. The patient is then admitted and taken through to kennels.
Preoperative checks
Once the patients have been admitted, we check them over to ensure they are fit for any sedations or general anaesthetics. We perform “TPRs” which means taking their temperature, pulse and respiration. Whilst nurses can perform this, it is also a good idea to get the operating vet to have a listen to the patients heart and chest to ensure there is nothing unusual.
Once this is done we can then place an intravenous catheter. This is placed in one of the veins in the patient’s leg. This allows us to administer sedation, pre-medication and anaesthetic, or place them on intravenous fluids. If the patient requires any bloods to be take pre-operatively, then this is also done at this stage. These pre anaesthetic blood tests check the patients’ kidneys and liver function to make sure they are healthy enough to withstand an anaesthetic. Any bloods that need to be run will be done now by the nurses. If there are any concerns with the results, the operating vet would contact the owner.
As there is normally a selection of procedures it is important we have them in the correct order. So, any orthopaedic surgery will be first, then abdominal surgery, and procedures like dentals or abscess clean outs would be last, to minimise infection risks. The nurses, along with the operating vet, can organise this list and allocate who will be assisting with each procedure. It is important this is done so patients don’t get missed and we are doing everything in the correct order.
Getting the procedures underway
Now the patients have been prepared we can get underway with the procedures. Nurses will monitor the anaesthetics and monitor patients under sedation. Once a patient has had a procedure done, the nurse will then monitor the patient in recovery. This will mean sitting with the patient in the kennels, monitoring temperature, pulse and respiration, and pain scoring to ensure they are comfortable. Once the patient is nice and awake, the nurse will then call the owners to let them know they are ok and arrange a discharge time. In-between patients, another nurse will clean down the theatre for the next patient. Part of the cleaning down process means cleaning and sterilizing surgical instruments too.
Meanwhile…
Whilst it is busy in prep and theatres, there is a nurse at the other end of the building doing nurse consults. Nurse consults can be second vaccinations, flea and worm consults, weight checks, administering medication, and post operative checks.
Winding down
So once all the procedures are done, the patients can begin being discharged. This is usually by any nurse that is available at the time. At this point the kennel is also cleaned down and prepared for when another patient needs to use it. If the theatres haven’t already been cleaned then they will be cleaned from top to bottom at this point too. We need theatres as clean as possible. It is also vital we get the autoclave machines on the go, to sterilize instruments, as we will need them for the following day.
Towards the end of the day the vets are usually still consulting, so nurses are on hand to help assist with any handling or blood sampling. At the end of the day, all areas are cleaned down and prepared for the following day. Consult rooms are cleaned, syringes and needle supplies are topped up, floors are mopped, all ready to start a new day.
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