How do you feel about the delegation of diagnostic imaging to RVNs?

RE: How do you feel about the delegation of diagnostic imaging to RVNs?

Judith Joyce — Tue, 14 Jan 2025 09:31:14 GMT

Very interesting. I may have unwittingly implied that vets who work for corporates aren't good at communication and behaving ethically (not the case). You are supporting and promoting the whole profession, but the impact on the independent practice owners is maybe different from those who are employed Think it probably demonstrates the emerging and increasing dichotomy between profession and industry. Even the CMA are at pains to point out that the veterinary professionals' behaviours are hardworking and driven by animal welfare, and that it is the costs, which are often out of the professionals' control that are their target.

I know a video on corporates was suggested a while back.Might one about independents attract less flack - it could enhance the professional positives (entrepreneurial spirit, prime focus on welfare rather than profit, not to mention SMEs pay most of the tax)

RE: How do you feel about the delegation of diagnostic imaging to RVNs?

Judith Joyce — Tue, 14 Jan 2025 07:33:48 GMT

[quote userid="2100" url="~/f/clinical-questions/31112/how-do-you-feel-about-the-delegation-of-diagnostic-imaging-to-rvns/246353#246353"]worth of discussion (ultrasound), so I wouldn't say it is entirely non-news. [/quote]

Absolutely, I generalised too much. Agree with the others, ultrasound definitely a discussion point. Not my area of expertise, but surely more decision making involved in obtaining the images and don't see how real time ultrasound would work.

RE: How do you feel about the delegation of diagnostic imaging to RVNs?

Arlo Guthrie — Mon, 13 Jan 2025 14:02:37 GMT

[quote userid="13891" url="~/f/clinical-questions/31112/how-do-you-feel-about-the-delegation-of-diagnostic-imaging-to-rvns/246351#246351"]All the big boys are very good at getting non-news items in the veterinary press.[/quote]

Judith Joyce LOL - I like to think I am usually pretty selective about what counts as news, in particular screening out all the 'vet treats animal' press releases that come to me from PR companies representing the big boys. I turn down much more than I publish.

This one ... well ... clearly one element of it is news and worth of discussion (ultrasound), so I wouldn't say it is entirely non-news.

[quote userid="13891" url="~/f/clinical-questions/31112/how-do-you-feel-about-the-delegation-of-diagnostic-imaging-to-rvns/246352#246352"] While excelling in one to one communication and behaving ethically, we fall down in the blowing our own trumpet department, which I guess is why Arlo needs to do the videos.[/quote]

Interesting thought. The films I've made so far have been trying to support the profession as a whole, not indies specifically. But I am keen to support a thriving independent sector, so perhaps it might be worth discussing a film about indies in the VetSurgeon Film Club.

RE: How do you feel about the delegation of diagnostic imaging to RVNs?

Judith Joyce — Mon, 13 Jan 2025 09:30:30 GMT

[quote userid="19431" url="~/f/clinical-questions/31112/how-do-you-feel-about-the-delegation-of-diagnostic-imaging-to-rvns/246333#246333"]look at us, aren't we a forward thinking and special corporate group and this sets us apart from everyone else". [/quote]

Agree,but the corporates have marketing departments so they will use them. It's where the vets fall down I think. While excelling in one to one communication and behaving ethically, we fall down in the blowing our own trumpet department, which I guess is why Arlo needs to do the videos.

RE: How do you feel about the delegation of diagnostic imaging to RVNs?

Judith Joyce — Mon, 13 Jan 2025 09:24:15 GMT

All the big boys are very good at getting non-news items in the veterinary press. Guess their marketing guys think they need to keep the profile up by having something in the press at regular intervals, and if they get lucky they will get free advertising in the national press. Agree with everyone else, there is no news here but we all fall for marketing ploys.

Totally agree would far rather well trained VNs did the imaging and associated administration than some new VS graduates (that is until the VNs have trained them up)

RE: How do you feel about the delegation of diagnostic imaging to RVNs?

Beats — Sun, 12 Jan 2025 22:11:56 GMT

[quote userid="7232" url="~/f/clinical-questions/31112/how-do-you-feel-about-the-delegation-of-diagnostic-imaging-to-rvns/246346#246346"]I would struggle with ultrasound. Static images on ultrasound machines are rarely as useful as live images and even interpreting video isn’t the same without your hand on the probe.[/quote]

Totally agree, but you can scan for the diagnostically useful information in a couple of minutes and then leave a nurse to save labelled pictures of all the boring bits you had no interest in (and in theory spend more time doing a detailed scan and let you know if they find anything additional of interest) while you phone the owner. I have one nurse who enjoys doing this and I have a nice set of saved images afterwards which I wouldn't otherwise - do I ever go back and do anything with them? No, but I guess she will get better and better with the practice and could reach a point in the future where I send her to start a scan instead and get me if anything of interest?

This of course necessitates the patient being sedated adequately that don't need a second person to hold it, but not so sedated that you are happy to leave someone who is now splitting their focus between monitoring it and scanning it (or an extra body to now be holding the animal, in which case you moving on to anything beyond a phonecall or repeat prescriptions might be put on ice if you have now run out of bodies to assist you).

I'm not sure it is much different from xrays in this respect. Yes a single xray is more useful to look at than a still ultrasound image, but unless your nurse can assess the xray then how do they know whether they need to take more or not? If I send a nurse to xray an abdomen or a chest or a hock or anything, then the classic problem I have is by the time I've caught up on consults and gone to look at the xray, it is now waking up a bit and I wanted to examine it while it was sedated, or I want some other views also now, or I think we should do the chest too now to look for mets but now have massive atelectasis for lying for 20 minutes sedated waiting for me etc. I do get nurses to do xrays, but I do think this is the limitation, and while nurses doing ultrasound has limitations, so does nurses doing xrays. I have the same problem with the less experienced vets - ask you to take a look at some xrays of a dog that is now awake and aggressive or has been sent home etc - it's not quite the same as having spoken directly to the owner, done a phyiscal exam yourself, examined sedated and then taken further views based on what you saw (or didn't see) in the first ones.

RE: How do you feel about the delegation of diagnostic imaging to RVNs?

Mark Holmes — Sun, 12 Jan 2025 17:38:40 GMT

I would struggle with ultrasound. Static images on ultrasound machines are rarely as useful as live images and even interpreting video isn’t the same without your hand on the probe.

If I’m making clinical decisions based on ultrasound I don’t even like relying on another Vet’s ultrasound.

No issue with them taking radiographs. Nor running CT.

RE: How do you feel about the delegation of diagnostic imaging to RVNs?

david kemp — Sun, 12 Jan 2025 12:51:54 GMT

Nothing new. My nurses are better,faster and slicker at getting the views requested. If only vets were quicker at coming to read the films!

RE: How do you feel about the delegation of diagnostic imaging to RVNs?

Rob Loxley — Sat, 11 Jan 2025 13:27:53 GMT

[quote userid="19431" url="~/f/clinical-questions/31112/how-do-you-feel-about-the-delegation-of-diagnostic-imaging-to-rvns/246333#246333"]Is this really new news? Nurses have always been doing radiograph positioning etc for their OSCEs[/quote]

Maybe Arlo might know, from vetnurse maybe, how many nurses are fully utilising such skills they learnt during training / for OSCEs?

RE: How do you feel about the delegation of diagnostic imaging to RVNs?

Arlo Guthrie — Fri, 10 Jan 2025 15:52:06 GMT

[quote userid="19431" url="~/f/clinical-questions/31112/how-do-you-feel-about-the-delegation-of-diagnostic-imaging-to-rvns/246333#246333"]Is this really new news? [/quote]

Steven Odell I knew nurses commonly did positioning and x-rays. Didn't realise they were doing the MRIs too, or the ultrasound.

My bad!

RE: How do you feel about the delegation of diagnostic imaging to RVNs?

Stephanie Wellings — Fri, 10 Jan 2025 15:16:55 GMT

The nurses I work with are much better at x ray positioning than I am; a lot of the time the patient is just under sedation, so they can do the entire procedure without my input, I just come and read the films.

I don’t think it would work with ultrasound because it’s really hard to interpret pictures without knowing where your hand is pointing and the views aren’t ‘standard’.

RE: How do you feel about the delegation of diagnostic imaging to RVNs?

Steven Odell — Fri, 10 Jan 2025 14:45:56 GMT

Is this really new news? Nurses have always been doing radiograph positioning etc for their OSCEs and my team are more than happy to do them for me. Only this morning, my post op TPLO rads were positioned and taken for me by my nurses while I slurped at a lukewarm cup of tea between theatre and Xray. It all strikes me as another attempt to reinvent the wheel and say "look at us, aren't we a forward thinking and special corporate group and this sets us apart from everyone else".

RE: How do you feel about the delegation of diagnostic imaging to RVNs?

Dinu Catilina — Fri, 10 Jan 2025 13:05:34 GMT

Our nurses do all our pregnancy scans, a few aa day usually and they're very good at it from about 3 weeks post mating. And I don't see how this is new. maybe new to them!

RE: How do you feel about the delegation of diagnostic imaging to RVNs?

Glen McIntosh — Fri, 10 Jan 2025 12:15:55 GMT

I thought this was already happening?

We have been doing it for years, at least for X-ray, CT and MRI. Techs or nurses take the images and interpretation done by vets or radiologists.

Not sure about u/s, since this usually requires real time interpretation.