RVN's doing post op checks

RE: RVN's doing post op checks

Virginia Campbell — Thu, 05 Dec 2019 18:19:22 GMT

[quote user="Julian Earl"]the aim is to use nurses to their fullest potential. but it that the role of nurses and their value needs to be further explored. Make what you will of that I suppose...[/quote]

Does this mean "We'll wait till a test case is in front of the disciplinary committee, then decide where the goalposts were that the miscreant will be admonished for missing"?

RE: RVN's doing post op checks

Alistair Graham-Evans — Tue, 26 Nov 2019 21:04:03 GMT

That’s not an answer. It’s politically correct waffle. Our nurses do post-op checks for routine procedures and consult with the vet if necessary. More complex cases are checked by a vet - preferably the one who operated but this is not always possible. That seems common sense to me!

RE: RVN's doing post op checks

Julian Earl — Tue, 26 Nov 2019 12:43:12 GMT

Having attended the RCVS question Time at Nottingham last night, I raised this subject and the response is that the aim is to use nurses to their fullest potential. but it that the role of nurses and their value needs to be further explored. Make what you will of that I suppose...

RE: RVN's doing post op checks

Arlo Guthrie — Mon, 25 Nov 2019 21:57:47 GMT

Someone just shoot me.

Anthony Todd 7 posts today. I told you your limit was 3! I thought we had an understanding. I am afraid I now have to disable your account till the new site is deployed, which I believe allows me to moderate in advance of, rather than after the fact.

RE: RVN's doing post op checks

Joyce Whitehead — Mon, 25 Nov 2019 21:29:32 GMT

Arlo Guthrie

you do @ then space then start the name and it pops up

RE: RVN's doing post op checks

Nicola Cole — Mon, 25 Nov 2019 21:24:30 GMT

[quote user="Anthony Todd"]

It's not the bleeding post-op check!!! it's the "seeing out check" when the client, who has paid loads of money and been worried witless [in the vet. case] to have their beloved animal fixed, to see/thank/question/praise etc. the vet who actually did the job!!

.......

Of course a nurse could do it!!

Jeepers, the art of vet practice is dying, or already gone. Are modvets are always delegating these to nurses!??

NOTHING TO DO WITH POST-OP CARE! Very little to do with competence, skill or ability, [almost] just good manners!

[/quote]

Anthony-the deja vu is kicking in.

People have been over this time and time again in this thread. I would suggest you read the responses properly if you are actually interested in what happens in practices currently on a daily basis.

P.S. I have a relative who does a very similar thing. He has a few soap boxes he likes to get on and no matter what the starting conversation is he will end up on one of them, completely ignoring what anyone has said in the meantime. If you call him out on it he seems completely oblivious that he’s done it...but still hasn’t taken any notice of what’s been said.

Oh well.

How do I tag Arlo?!

RE: RVN's doing post op checks

Joyce Whitehead — Mon, 25 Nov 2019 21:09:55 GMT

[quote user="Anthony Todd"]

Jeepers, the art of vet practice is dying, or already gone. Are modvets are always delegating these to nurses!??

NOTHING TO DO WITH POST-OP CARE! Very little to do with competence, skill or ability, [almost] just good manners!

[/quote]

But Anthony, this thread, if you read the opening post IS about post op checks, not about discharge appointments. Which, as many many people on this thread have pointed out, are usually done by vets if a complex op, or they vet will have spoken to the owner on the phone. This is about routine op post op checks where the nurses are perfectly capable.

Please stop turbo posting and slagging off the profession.

RE: RVN's doing post op checks

Anthony Todd — Mon, 25 Nov 2019 20:43:05 GMT

Ironically, and coincidentally, we just saw the surgeon at Watford [totally wall to wall brilliant, even with a crash-cart at 2am, for a spontaneous A/F at 2am!!] only to say thank-you and the usual "what do you think etc.

Nothing actually clinical at all, well, rescan in 6 months, risks of another colonoscopy not nil etc.....

We had no need to see him at all! [BTW his father was a VS.....]

Of course a nurse could do it!!

Jeepers, the art of vet practice is dying, or already gone. Are modvets are always delegating these to nurses!??

NOTHING TO DO WITH POST-OP CARE! Very little to do with competence, skill or ability, [almost] just good manners!

RE: RVN's doing post op checks

Gillian Mostyn — Mon, 25 Nov 2019 18:26:58 GMT

The OP was talking about the RCVS view.

Most of us have very happy clients with our current systems. You don't need to defend yourself against someone who is assuming we've all got pissed off clients.

RE: RVN's doing post op checks

vetbl.locum — Mon, 25 Nov 2019 18:03:31 GMT

Instead of going round and round and round with increasing hopeless

Surely it is a matter of professional judgement on behalf of the surgeon whether to delegate any post op check to a nurse ?

Also if they cannot do check but nurse has again a matter of judgement to phone client?

Do most people not do this ?

Rgds

RE: RVN's doing post op checks

Anthony Todd — Mon, 25 Nov 2019 17:52:12 GMT

[quote user="Colin Cameron"]RCVS contradiction! [/quote]

I'm only suggesting, that after a major [ "golf ball in the gut, or KFC corn cob etc."] it would be polite/common-sense/good manners/ logical/ great PR/ great practice building/etc. for the Vet who did the major op at 2am to see out the animal rather than the nurse who has "just come on shift" and is releasing the animal!

RE: RVN's doing post op checks

Colin Cameron — Mon, 25 Nov 2019 13:28:31 GMT

[quote user="Charlotte Marshall"]An RVN could not carry out post-operative checks (aside from making a record of weight or temperature for example), as the check could risk veering into diagnosis and entering the parameters of veterinary surgery"[/quote]

RCVS contradiction! RVNs cannot do post op checks as it may veer into surgery but they can do minor operations e.g.skin suturing which is surgery!

Is it not about time the RCVS make up their minds?

Our Post op checks run very smoothly with Vets being called in to RVN checks when any 'diagnosis' is required e.g. inflammed, swollen or discharging wounds etc. Also we leave it to the Vet who does the surgery to decide how many checks required and who does them depending on the operation carried out.

Qualified RVNs are perfectly capable of examining a patient post op and deciding if is all progressing as expected or if it should be seen by a Vet.

The RCVS must not appear to devalue the RVNs, who do a sterling job!

We are meant to be in a team, where each and every member is important and has a valued place!

RE: RVN's doing post op checks

Sarah Bolt — Tue, 19 Nov 2019 14:22:54 GMT

[quote user="George Cooper"]

The very title of this "procedure" tends to trivialise it. A "post-op 'check' "??? Surely if it is to hold value for a client, to disrupt their day, consume hours (possibly) of their time, disturb a recuperating poorly pet, it has to prove to be of some benefit to someone - somewhere. If it has to be made "mandatory" far better to refer to a "post surgical assessment"?

For years - ever since a younger and large animal colleague answered the door with "Wotchu here for at this time of day? A post op check, is it? Oh well you might as well drag it on in then!" - thus encapsulating the sheer time-consuming and largely unnecessary expense of veterinary OR nursing time, I have eschewed the necessity of insisting (to the exclusion of all) of carrying any of these out. How many of all the inflicted POCs actually result in any alteration of the proscribed course of events? And my contention is that most owners would have picked up the signs themselves. That said - of course I am completely on-side with assessments that follow serious, painful, life-threatening, etc etc etc conditions.

[/quote]I agree that this is generally the case and indeed I used to advise not to come back unless they have any worries in some cases.

BUT, I have had (admittedly few) cases where there have been complications detected at the post op check that the owner seemed completely unaware of. And these cases serve as a reminder that not everyone recognises a problem. Why should they? It's not what they've trained for and some people have no idea what they're looking at, and some people just think of they leave a problem it'll go away (fear of the vet? Fear of ridicule? I don't know the reason, I just know it happens) I therefore view it that if I started a job, it is my duty of care to make sure the job is 'completed' to the best of my ability, and that includes checking for any problems at post op checks. If that means 'dragging' out 999 cases from their beds and declaring all well in order to save one animal from the pain and discomfort of an undetected infection, to me it is worth it.

RE: RVN's doing post op checks

Lucy Fleming — Tue, 19 Nov 2019 13:06:01 GMT

[quote user="Anthony Dennison"]It hasn't been my intention, however I have been growing tired of the turbo-posting and inability to accept the general consensus if he disagreed with it so decided to call him out on everything to try and make it more obvious to Tony when he is flogging a dead horse. Unfortunately my approach seems to have failed as he ignores me anyway. [/quote]

Having earlier received a reply from TT which, although courteous, suggested that he hadn't actually read my post properly, I can understand. He is always polite, and he does have years of experience that can certainly be hugely valuable. However, there are certain areas where it is clear that he is not going to change his mind, or even really listen to the experiences of others and take them into account, which can become a little wearing.

RE: RVN's doing post op checks

Anthony Dennison — Tue, 19 Nov 2019 12:38:37 GMT

[quote user="George Cooper"]Am I alone in feeing that Anthony is being just a little bit aggressive and unkind to Anthony?[/quote]

It hasn't been my intention, however I have been growing tired of the turbo-posting and inability to accept the general consensus if he disagreed with it so decided to call him out on everything to try and make it more obvious to Tony when he is flogging a dead horse. Unfortunately my approach seems to have failed as he ignores me anyway.

[quote user="George Cooper"]no matter how pointed and OTT is the criticism levelled at him.[/quote]

I wouldn't say it is OTT. It is justified to get the point across, but them my fuse is probably shorter than others at the moment.

RE: RVN's doing post op checks

Arlo Guthrie — Tue, 19 Nov 2019 12:16:45 GMT

[quote user="George Cooper"]Am I alone in feeing that Anthony is being just a little bit aggressive and unkind to Anthony? You've made it perfectly clear that Anthony and his style of contributions causes you severe pruritus - and if I may say, you're almost in danger of sounding a bit like him. Still,, they say that imitation is the greatest form of flattery.[/quote]

George Cooper You have a point.

And yes, you are right:

[quote user="George Cooper"]Anthony never seems to stoop to expressing irritation no matter how pointed and OTT is the criticism levelled at him.[/quote]

... something I very much admire about TT.

BUT

Tony's turbo posting has been a real problem for a long time, and the more time that goes by without us being able to address it, the more vocal everyone is becoming. Behind the scenes, I have tried very, very hard to come to some form of agreement with Tony, but every time we agree on a course of action to make his forum posts 'work', he just comes back and ignores what we agreed!!

For example, we agreed he wouldn't post consecutive posts, and then he did! Last week or the week before, we agreed a limit of 3 posts per day (which would help focus the mind). That didn't last long!

I am a huge believer in the value of passing knowledge and experience from one generation to another. I think it can be really helpful to have a reminder of how things were. And as you say, TT is a gent. But I have to balance that against the turbo/argumentative nature of many of the posts, and how so many others are finding it frustrating getting involved in these circular arguments where often it looks as though TT didn't read an earlier post properly.

Anthony Todd - You've had your 3 posts today! (4, as it happens).

RE: RVN's doing post op checks

Anthony Todd — Tue, 19 Nov 2019 11:44:51 GMT

[quote user="robloxley"]Absolutely. Like monitoring the animal postop and painscoring it and checking its wound and temperature then discharging it, with the vet there for Vet-input where required. [/quote]

This is where the diversion occurred and was the first mention of joining "post-op checks" and "discharge".

And the "discharge" is where, and only where, the client expects to, at least, have some contact and conversation with the operating vet, just to summarise my, and other, views finally.

RE: RVN's doing post op checks

George Cooper — Tue, 19 Nov 2019 11:26:15 GMT

Am I alone in feeing that Anthony is being just a little bit aggressive and unkind to Anthony? You've made it perfectly clear that Anthony and his style of contributions causes you severe pruritus - and if I may say, you're almost in danger of sounding a bit like him. Still,, they say that imitation is the greatest form of flattery.

Peace, guys! Although the "cross words" come only from Anthony because Anthony never seems to stoop to expressing irritation no matter how pointed and OTT is the criticism levelled at him.

RE: RVN's doing post op checks

Anthony Dennison — Tue, 19 Nov 2019 11:14:40 GMT

[quote user="Anthony Todd"]Just to be clear! I'm not talking about a POC I'm talking about a seeing-out, when the owner comes to pick up an animal with, what the owner sees is a line of sutures, cast or a bandage.[/quote]

But you weren't clear. Perhaps if you took time to read all the posts and then formulate a proper reply rather than turbo-posting your clarity would improve.

[quote user="Anthony Todd"]I'm collating replies from the few remaining dinovets I know and they all agree with me![/quote]

Well done. You sought out people with the same opinion as yourself to prove a point. How many of those that you spoke to are still in full time practice so can truly comment on the practicalities of this?

I think that after a big op the owner could expect a conversation with the surgeon. Certainly nursing staff can deal with the practicalities, and could do the discharge just as well, but that is not how the client who after all is paying the bill sees it.

(Sorry for some reason I can't quote from multiple posts anymore so had to copy and paste). This guy actually disagrees with you! We're not saying the owner will never see the vet again. At our practice vet will do the surgery and write written discharge instructions. They will speak to the owner over the phone and go through everything, then organise a discharge appointment with a nurse who can read through the written instructions. More complicated cases vets will discharge themselves, but normally with fully booked afternoon consults and nurses available to help - we will utilise them.

[quote user="Anthony Todd"]

Sorry I think I confused myself and the thread?

Am I to understand that the operating vet always, except with legitimate exceptions, does the "discharge appointment" after major procedures or, at least, telephones the owner as all dinovets used to do??

The impression I gained, confirmed by other older vets, is that now this was usually delegated to a nurse??

[/quote]

Yes, you have confused yourself. This is the problem with Turbo-posting; you're firing off shots without aiming or thinking about it. You got a bee in your bonnet about the good old days and didn't listen to what everyone else was saying. As usual.

RE: RVN's doing post op checks

Julie Innes — Mon, 18 Nov 2019 12:46:36 GMT

Like most on here, the vets discharge any non-routine surgeries, and do most post-op checks (free of charge).

The nurses discharge routine ops. They are definitely better at it than me! I got in hot water after forgetting to give out the standard post-op care sheet, as the client swore I told him it was ok for the dog to lick its wound! Had I remembered the sheet, I could have proved that our advice regarding the wound was clear, but I was too busy discussing the details of the non-routine op!! Nurses now write "post-op care sheet given, buster collar offered" on every file at discharge now- lesson learnt!

RE: RVN's doing post op checks

George Cooper — Sun, 17 Nov 2019 18:51:47 GMT

RE: RVN's doing post op checks

Evelyn Barbour-Hill — Sun, 17 Nov 2019 18:45:15 GMT

[quote user="Julian Earl"]Apologies to Evelyn if my comments are exasperating? [/quote]

No, Julian, not yours, with which I quite agree! Consider chronological order.

RE: RVN's doing post op checks

Gillian Mostyn — Sun, 17 Nov 2019 18:02:59 GMT

[quote user="Charlotte Marshall"]Rather than the original blanket statement of nurses can't do post op checks they are clarifying to say that it is fine for them to do as long as they do nothing that could stray into the realms of giving a diagnosis and refer anything that would need that back to a vet.[/quote]

Normal service can resume then.

[quote user="Julian Earl"]I was always happiestto follow my own cases through personally both for discharge and for post-op checks. One learns a huge amount about the case and the individual animal doing this. I had assumed that everyone would feel this way? [/quote]

I think you and others getting the impression that vets are now disinterested, or lazy and passing on their professional responsibilities? This is incorrect.

There is a major recruitment crisis in our industry. I am a locum so am obviously mainly seeing practices that aren't running at full staffing levels, but this is common regardless. Appointment lists are full, vets are working really hard and all of them would be happy to spend an afternoon having chats with their post op cases and discharges. They are 'easy' appointments. Unfortunately they are too busy doing things that ONLY a vet can do, meaning that utilising nurses to their full potential isn't just desirable, but necessary.

Don't get the impression that most vets aren't doing their jobs these days. They certainly are - often in very difficult situations! The concern about not allowing nurses to do post op checks isn't because vets don't want to do them - it is how the hell they would fit them in!

RE: RVN's doing post op checks

Charlotte Marshall — Sun, 17 Nov 2019 17:50:56 GMT

Okay, you will all be glad to hear that further clarification has come back from the person who sent us the original email. Rather than the original blanket statement of nurses can't do post op checks they are clarifying to say that it is fine for them to do as long as they do nothing that could stray into the realms of giving a diagnosis and refer anything that would need that back to a vet.

So basically the nurses CAN do what they have always been doing at our practice - the routine post operation checks and refer any concerns to a vet.

I wouldn't mind but it wasn't even what we were asking about, it was used as an example of tasks rvn's can and can't do.

Oh and vets in our practice will always speak to clients regarding non routine surgeries either on the phone or at a discharge appointment

RE: RVN's doing post op checks

Julian Earl — Sun, 17 Nov 2019 17:45:57 GMT

[quote user="Anthony Todd"]

[quote user="Julian Earl"]I think that it is acceptablefor nurses to do the discharge of patients but am unsure about post-operative checks.[/quote]

This is where we started!

I, and other old vets, all think it is very important, where possible, for the "operating", and usually diagnosing, vet to have a "discharge appointment" or, at least a post-op phone call with the client, end of.

Nothing to do with who does post-op care....

[/quote]

Fair enough. I was always happiestto follow my own cases through personally both for discharge and for post-op checks. One learns a huge amount about the case and the individual animal doing this. I had assumed that everyone would feel this way?

Apologies to Evelyn if my comments are exasperating? But it is a subject to discuss and I am just putting my reasons forward. As far as I'm aware my comments are as valid as any others on here?