Are RVNs allowed to perform cat castrates?

RE: Are RVNs allowed to perform cat castrates?

Richard Carter — Thu, 04 May 2023 07:40:21 GMT

The old comment- you aren’t a surgeon until you have had a bleed…(and hopefully survived!)

RE: Are RVNs allowed to perform cat castrates?

Dinu Catilina — Wed, 03 May 2023 22:41:35 GMT

[quote userid="2131" url="~/001/veterinary-clinical/small-animal/f/misc-clinical-discussions/30631/are-rvns-allowed-to-perform-cat-castrates/241469#241469"]The answer as to why veterinary surgeons shouldn't be delegating veterinary surgery to RVNs is plain.[/quote]

My advice to younger vets is to only operate when you know what the potential complications may be and how to resolve them (even if it's only theoretical). And maybe that's why nurses shouldn't operate.

RE: Are RVNs allowed to perform cat castrates?

Evelyn Barbour-Hill — Wed, 03 May 2023 18:29:15 GMT

[quote userid="8991" url="~/001/veterinary-clinical/small-animal/f/misc-clinical-discussions/30631/are-rvns-allowed-to-perform-cat-castrates/241415#241415"]

Evelyn Barbour-Hill said:
Why not let them practise nursing to a high level, instead of taking up their nursing time with a veterinary surgeon's tasks?

Maybe some nurses don't want the expense of a second degree nor the full responsibilities of a veterinary surgeon but are interested in (and have a skill in) surgical procedures?

[/quote]

I'm sure that's true for some. But, er, you haven't answered my question

[quote userid="8991" url="~/001/veterinary-clinical/small-animal/f/misc-clinical-discussions/30631/are-rvns-allowed-to-perform-cat-castrates/241415#241415"]

Michael Woodhouse said:
I'd even be happy them removing teeth with elevators/luxators and forceps.

What a wonderful time of life that was.

I wonder whether the level of veterinary dentistry has got better or worse since then, especially given the clinical education that students receive on this?

[/quote]

It's slowly but surely getting better all the time, despite the lousy instruction offered by some of the veterinary schools. Courses for young veterinary surgeons on basic veterinary dentistry are always very well attended.

[quote userid="5012" url="~/001/veterinary-clinical/small-animal/f/misc-clinical-discussions/30631/are-rvns-allowed-to-perform-cat-castrates/241425#241425"]I have never understood why we don't delegate much more to RVN's; straightforward surgeries, monitoring of chronic conditions, etc[/quote]

No surgery is invariably straightforward. (And that applies very much to tooth extraction.)

The answer as to why veterinary surgeons shouldn't be delegating veterinary surgery to RVNs is plain. Veterinary surgeons should be doing veterinary surgery (however mundane, boring, tedious or beneath their dignity) Veterinary nurses should be doing veterinary nursing, not spending nursing time on doing surgery.

We know why corporates want to delegate to nurses, of course. Nurses are cheaper.

RE: Are RVNs allowed to perform cat castrates?

Clive Ansell — Mon, 01 May 2023 09:42:50 GMT

[quote userid="8958" url="~/001/veterinary-clinical/small-animal/f/misc-clinical-discussions/30631/are-rvns-allowed-to-perform-cat-castrates/241439#241439"]In my world I'd want to do it as I would perceive it as more interesting than anaesthesia (that's why I vet)[/quote]

I've always been interested in anaesthesia, to the point I once started working towards an RCVS certificate.

My point was really that we could delegate far more to our RVN's, and free up valuable and in short supply veterinary surgeon time. It doesn't necesarily have to be surgical work, routine monitoring, and vaccinations in otherwise healthy animals for example.

At the moment I see appointments most days for nails clips, anal glands, and free of charge 6 monthly health checks in perfectly healthy animals, as part of some tinpot pet health club scheme. These are a total waste of vet's time and could esily be caried out by good RVN's. At the same time, people with sick animals cannot get an appointment and have to wait, or are turned away.

RE: Are RVNs allowed to perform cat castrates?

Clive Ansell — Mon, 01 May 2023 09:32:30 GMT

[quote userid="8958" url="~/001/veterinary-clinical/small-animal/f/misc-clinical-discussions/30631/are-rvns-allowed-to-perform-cat-castrates/241439#241439"]

Michael Woodhouse said:
Yes and no. That argument could go for anything - our nurses do far more bloods and IV cannula placement than I do, but they come to me for the difficult ones.

I go to nurses for the difficult ones, as they do so many more and are frankly better at it than I am. Just because I have 4 A levels and 2 degrees, doesn't make me great at everything

[/quote]

Me too.

Some of the nurses (Most RVN's but some untrained ones too) I work with, do far more and are far better at them than I am.

RE: Are RVNs allowed to perform cat castrates?

Clive Ansell — Mon, 01 May 2023 09:30:47 GMT

[quote userid="16672" url="~/001/veterinary-clinical/small-animal/f/misc-clinical-discussions/30631/are-rvns-allowed-to-perform-cat-castrates/241440#241440"]Just to interject, but there is the ability for nurses to specialise (I believe the only route is via North American organisations - https://navta.net/veterinary-technician-specialties/). [/quote]

RVN's here in the UK can study for a certificate or a diploma in advanced veterinary nursing. That said, after speaking with 3 RVN diplomats I have worked with, it seems other than looking good on referral centre websites it doesn't really empower them to do much or anymore than they can already.

RE: Are RVNs allowed to perform cat castrates?

Martin Hamilton — Sat, 29 Apr 2023 16:18:59 GMT

[quote userid="5012" url="~/001/veterinary-clinical/small-animal/f/misc-clinical-discussions/30631/are-rvns-allowed-to-perform-cat-castrates/241425#241425"]Why don't we have different levels of nurses, and specialist nurses as they do in human medicine?[/quote]

Just to interject, but there is the ability for nurses to specialise (I believe the only route is via North American organisations - https://navta.net/veterinary-technician-specialties/).

The VTS nurses (technicians as we call them here) are incredibly knowledgable, having gone though a rigorous exam process, and know far more about their chosen area of expertise than a general practitioner. There's a movement over here (in the process of occurring, or already has occurred depending on US state or Canadian province) whereby technicians with a VTS designation are able to do more (specialty dependant) - create a treatment plan, perform a consult, make a diagnosis etc. At least here in Ontario, surgery and the use of controlled drugs will remain under the purvue of the vet and not nurses. Technicians here will be held accoutable under our governing body to the same standard as a vet.

My fiancee is working on her emergency and critical care VTS, and I constantly blown away by the level of knowledge that has to be demonstrated to pass the final exam (with quite the extensive reading list). I would trust her to deal with a DKA cat more than a new graduate if I'm perfectly honest. She has no interest in performing surgery etc, but does look forward to having more autonomy once legislation changes, allowing her to adjust fluid rates, administer medications etc without having to defer to someone less knowledgable.

RE: Are RVNs allowed to perform cat castrates?

Neil Wheadon — Sat, 29 Apr 2023 09:14:56 GMT

[quote userid="5012" url="~/001/veterinary-clinical/small-animal/f/misc-clinical-discussions/30631/are-rvns-allowed-to-perform-cat-castrates/241437#241437"]

Neil Wheadon said:
I've asked maybe 40 nurses as I spay a bitch 'would you like to swap places?' Not one has said yes. This is a serious question as in their position, I'd be itching to do it, but they genuinely don't want to.

A bitch spay is a major abdominal surgical procedure, not one that could safely be delegate to nurses.

[/quote]

No this isn't the point I'm making

The point I'm making is that nurses don't want to operate, they want to nurse. The question I ask is "Would you ever like to do a bitch spay' always asked as I'm elbow deep pulling an ovary. In my world I'd want to do it as I would perceive it as more interesting than anaesthesia (that's why I vet), but there is a genuine and constant desire to nurse, not operate.

[quote userid="3169" url="~/001/veterinary-clinical/small-animal/f/misc-clinical-discussions/30631/are-rvns-allowed-to-perform-cat-castrates/241438#241438"]Yes and no. That argument could go for anything - our nurses do far more bloods and IV cannula placement than I do, but they come to me for the difficult ones. [/quote]

I go to nurses for the difficult ones, as they do so many more and are frankly better at it than I am. Just because I have 4 A levels and 2 degrees, doesn't make me great at everything, you've obviously got the touch

Neil

RE: Are RVNs allowed to perform cat castrates?

Michael Woodhouse — Sat, 29 Apr 2023 08:53:38 GMT

[quote userid="8958" url="~/001/veterinary-clinical/small-animal/f/misc-clinical-discussions/30631/are-rvns-allowed-to-perform-cat-castrates/241433#241433"]

So, all the nurses do the castrates, lump removals, all the things that give a vet a feeling for surgery. So where exactly does the experienced vet who can save the day come from in 20 years time?

[/quote]

Yes and no. That argument could go for anything - our nurses do far more bloods and IV cannula placement than I do, but they come to me for the difficult ones. Just because there is overlap in skills doesn't mean it's a bad idea to have some nurses doing more surgery. There was talk in the media about surgical training for human nurses to do some surgeries. This is why I do think the current rule that we can delegate what we think is appropriate to nurses is correct.

[quote userid="5012" url="~/001/veterinary-clinical/small-animal/f/misc-clinical-discussions/30631/are-rvns-allowed-to-perform-cat-castrates/241437#241437"]A bitch spay is a major abdominal surgical procedure, not one that could safely be delegate to nurses.[/quote]

I would disagree. I'd bet good money if I had 2 weeks and 20 bitch spays I could have one of our RVNs spaying bitches as well as any recent graduate vet.

I'm not saying it is desirable, but very, very possible. The undergraduate training for vets in surgery can be, at best, described as sporadic. We've had 2 new grads over the years who'd never spayed a bitch and had a vet degree. Something is wrong somewhere.

RE: Are RVNs allowed to perform cat castrates?

Clive Ansell — Sat, 29 Apr 2023 08:38:00 GMT

[quote userid="8958" url="~/001/veterinary-clinical/small-animal/f/misc-clinical-discussions/30631/are-rvns-allowed-to-perform-cat-castrates/241433#241433"]I've asked maybe 40 nurses as I spay a bitch 'would you like to swap places?' Not one has said yes. This is a serious question as in their position, I'd be itching to do it, but they genuinely don't want to.[/quote]

A bitch spay is a major abdominal surgical procedure, not one that could safely be delegate to nurses.

I'm working with 2 RVN's at the moment, and both would like to do more and be given more responsibility. One is very practical and is fantastic at i/v working, setting up and monitoring drips, blood sampling etc, she would fine carrying out simple surgical procedures under veterinary supervision. The other enjoys interaction with the clients, and has an interest in canine behaviour, weigth clinics and wellness clinics for older pets; there is no reason I can think of that her role couldn't be extended to include routine vaccinations and monitoring patients on long term treatments.

Where I am working Vets time is in very short supply, only 5 of 11 clinics are currently open, and wait times for routine appoinments or surgeries is in excess of a month. I think we have an under utilised resource in our RVN's and that they could be doing far more than they do, although I accept we are short of good RVN's too.

RE: Are RVNs allowed to perform cat castrates?

Neil Wheadon — Fri, 28 Apr 2023 22:03:29 GMT

[quote userid="4256" url="~/001/veterinary-clinical/small-animal/f/misc-clinical-discussions/30631/are-rvns-allowed-to-perform-cat-castrates/241419#241419"]This level of surgery , and frankly many others - are technical skills that can be taught and performed safely by anyone with the right manual skills/ dexterity etc and in many countries that's exactly what happens. there are no issues with the surgery, analgesia and adverse outcome management are another story, but that should never be an issue in a vet clinic in the UK[/quote]

Anyone can castrate a cat, only a good surgeon knows what to do when things go wrong, as they do to anyone.

Where does one draw the line?

So, all the nurses do the castrates, lump removals, all the things that give a vet a feeling for surgery. So where exactly does the experienced vet who can save the day come from in 20 years time?

I've asked maybe 40 nurses as I spay a bitch 'would you like to swap places?' Not one has said yes. This is a serious question as in their position, I'd be itching to do it, but they genuinely don't want to.

Neil

RE: Are RVNs allowed to perform cat castrates?

Clive Ansell — Fri, 28 Apr 2023 08:48:26 GMT

[quote userid="4256" url="~/001/veterinary-clinical/small-animal/f/misc-clinical-discussions/30631/are-rvns-allowed-to-perform-cat-castrates/241419#241419"]Every blood test, asthma review, vaccinationI have had in the last 20 years was done by a nurse. We need to be less protectionist and more welcoming [/quote]

We are a backward and stick in the mud profession in some ways.

I have never understood why we don't delegate much more to RVN's; straightforward surgeries, monitoring of chronic conditions, etc

Why don't we have different levels of nurses, and specialist nurses as they do in human medicine?

When I first had issues with my spine, and was referred by my GP, I initially saw a senior specialist physiotherapist. He was very thorough, and able to examine me in detail, interpret and discuss MRI images, and discuss surgery vs conservative management.

RE: Are RVNs allowed to perform cat castrates?

Stephen Courtney — Tue, 25 Apr 2023 21:26:31 GMT

This level of surgery , and frankly many others - are technical skills that can be taught and performed safely by anyone with the right manual skills/ dexterity etc and in many countries that's exactly what happens. there are no issues with the surgery, analgesia and adverse outcome management are another story, but that should never be an issue in a vet clinic in the UK

Eg laboratory rodents being spayed by technicians who do thousands of these procedures - and nothing else - far better than I could . Or most of us.

Farm workers castrating cattle/ pigs/ sheep

Just because they can, should they?

But I do think having nurses do things like cat castrates and similar procedures is useful and providing they want to do it, rewarding for them.

Saying they aren't competent / qualified to do so is as silly as saying RSPCA kennel staff are incapable of vaccinating dogs and cats ....oh wait....

Sure things might go wrong, and for that a vet should be at hand / in charge

Every blood test, asthma review, vaccinationI have had in the last 20 years was done by a nurse. We need to be less protectionist and more welcoming

RE: Are RVNs allowed to perform cat castrates?

David Mills — Tue, 25 Apr 2023 13:48:55 GMT

[quote userid="3169" url="~/001/veterinary-clinical/small-animal/f/misc-clinical-discussions/30631/are-rvns-allowed-to-perform-cat-castrates/241400#241400"]I'd even be happy them removing teeth with elevators/luxators and forceps.[/quote]

What a wonderful time of life that was.

I wonder whether the level of veterinary dentistry has got better or worse since then, especially given the clinical education that students receive on this?

[quote userid="2131" url="~/001/veterinary-clinical/small-animal/f/misc-clinical-discussions/30631/are-rvns-allowed-to-perform-cat-castrates/241402#241402"]Why not let them practise nursing to a high level, instead of taking up their nursing time with a veterinary surgeon's tasks?[/quote]

Maybe some nurses don't want the expense of a second degree nor the full responsibilities of a veterinary surgeon but are interested in (and have a skill in) surgical procedures?

RE: Are RVNs allowed to perform cat castrates?

Clive Ansell — Sat, 22 Apr 2023 07:29:23 GMT

I have mixed feelings.

In my first job, 1996-2001, trained and untrained nurses carried out almost all cat castrations. I don't recall a single one every going wrong (in 5 years n = approx 2500). Always under veterinary surgeon supervision of course. Double/triple combo GA, Metacam, job done. These, 2 or 3 most days, would usually be done by about 0915, freeing up a vet and theatre nurse to crack on with a full op list. Worked very well.

I'm all for empower our nurses to do more and be able to delegate to them. Where I am working at the moment, veterinary surgeon time is in short supply, so if RVN's can take some of the workload, it has to be of benefit all round. Nurses like it too.

My only reservation, is that in a corporate dominated profession it could be the thin end of the wedge of being able to use RVN's more and for a wider range of proceedures. If they could employ more RVN's and fewer veterinary surgeons, it would be a means of reducing costs and maximising financial returns for shareholders (Which in company law they are obligated to do). Watch this space as they say.

RE: Are RVNs allowed to perform cat castrates?

Evelyn Barbour-Hill — Fri, 21 Apr 2023 15:59:43 GMT

[quote userid="3169" url="~/001/veterinary-clinical/small-animal/f/misc-clinical-discussions/30631/are-rvns-allowed-to-perform-cat-castrates/241400#241400"]To see if you can actually spit your coffee out onto your keyboard, I'd even be happy them removing teeth with elevators/luxators and forceps.[/quote]

It's a good job I never drink coffee and indulge in keyboard activities at the same time!

[quote userid="3169" url="~/001/veterinary-clinical/small-animal/f/misc-clinical-discussions/30631/are-rvns-allowed-to-perform-cat-castrates/241400#241400"] If they can amputate a tail, remove a mass etc then they can castrate a cat.[/quote]

Well, I certainly don't think an RVN should be amputating a tail. I don't think they should be excising skin tumours either. Why? Why would you want them to? This is not a rhetorical question.

[quote userid="3169" url="~/001/veterinary-clinical/small-animal/f/misc-clinical-discussions/30631/are-rvns-allowed-to-perform-cat-castrates/241400#241400"]In human medicine one of the things they have done is to safely upskill members of staff. [/quote]

Registered Nurses are not permitted to amputate digits (The English Patient notwithstanding ) or excise skin tumours.

[quote userid="3169" url="~/001/veterinary-clinical/small-animal/f/misc-clinical-discussions/30631/are-rvns-allowed-to-perform-cat-castrates/241400#241400"]Why not let a fellow professional develop their skills and range of tasks?[/quote]

I'd be all in favour of fast-tracking RVNs on a veterinary degree course leading to MRCVS, yes.

Otherwise: a RVN has advanced knowledge and a wide range of very special skills (don't reference Liam Neeson's character in Taken ) , some of which are not well developed in veterinary surgeons. Why not let them practise nursing to a high level, instead of taking up their nursing time with a veterinary surgeon's tasks?

RE: Are RVNs allowed to perform cat castrates?

Michael Woodhouse — Fri, 21 Apr 2023 14:54:03 GMT

[quote userid="2131" url="~/001/veterinary-clinical/small-animal/f/misc-clinical-discussions/30631/are-rvns-allowed-to-perform-cat-castrates/241398#241398"]Why would anyone, nurse, veterinary surgeon, the public, want a RVN to castrate cats?[/quote]

Because it's technically much easier than many other things in their surgical skill set?

I appreciate not all nurses want to do surgery, but I think we should encourage those that do. If they can amputate a tail, remove a mass etc then they can castrate a cat.

To see if you can actually spit your coffee out onto your keyboard, I'd even be happy them removing teeth with elevators/luxators and forceps.

In human medicine one of the things they have done is to safely upskill members of staff. We have advanced paramedics and nurses working in doctors surgeries with full prescribing qualification and seeing a full range of patients. Critical care paramedics are trained in ultrasound, finger thoracostomy and various other advanced procedures that were once doctor only. Most bloods in hospitals are taken by phlebotomists with a very short training course. Sutures are removed and dressings changed by healthcare assistants.

Why not let a fellow professional develop their skills and range of tasks?

RE: Are RVNs allowed to perform cat castrates?

Evelyn Barbour-Hill — Fri, 21 Apr 2023 14:14:22 GMT

Why would anyone, nurse, veterinary surgeon, the public, want a RVN to castrate cats?

RE: Are RVNs allowed to perform cat castrates?

Beats — Mon, 17 Apr 2023 20:23:51 GMT

Nothing in section 19(4)(b) of this Act shall authorise—

(a)the castration of a male animal being—

(i)a horse, pony, ass or mule,

(ii)a bull, boar or goat which has reached the age of two months,

(iii)a ram which has reached the age of three months, or

(iv)a cat or dog;"

Veterinary Surgeons Act 1966 (legislation.gov.uk)

Last updated in 2021, although apparently the Government's site of legislation may not be up-to-date:

Changes to Legislation

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RE: Are RVNs allowed to perform cat castrates?

Gillian Mostyn — Mon, 17 Apr 2023 13:25:14 GMT

Currently still under consultation, as far as I'm aware.

https://www.rcvs.org.uk/news-and-views/our-consultations/legislation-working-party-report/part-2-enhancing-the-vn-role/?&&type=rfst&set=true#cookie-widget

RE: Are RVNs allowed to perform cat castrates?

Arlo Guthrie — Mon, 17 Apr 2023 11:44:24 GMT

Not sure why this is an anon question? But I'll let it go!