L2 Cert in Assisting VS with Anaesthesia.....

Re: L2 Cert in Assisting VS with Anaesthesia.....

Julie-Anne Harrison — Sat, 02 Jun 2012 15:15:55 GMT

As an RVN, I feel that we don't get taught a lot of theory on anaesthetics - at least I didn't when I was training a few years ago. A lot of what we learn about anaesthetics is taught to us in practice and I feel that non RVNs can learn this just as easy.

That being said, I wouldn't fully trust just anyone to monitor an anaesthesia. I think ANAs and SVNs (depending on how far into their training they are) should be capable of monitoring anaesthetics. If they feel they are not, they should ask and RVN to supervise them until they are competent.

[quote user="Anthony Todd"]

[quote user="Bob Russell"]Sadly I have known RVN's that I would not trust to watch an anaesthetic on a teddy bear! I have (and do) employ nurses and trained nursing assistants that I would trust implicitly to monitor an anaesthetic.[/quote]

Me too, and the psychopathic emphasis now on the oesophageal stethoscope, when the animal hasn't breathed for some time, is worrying....

Doesn't anyone use Apalerts anymore?? And I know the purists say "observe the respiration".

Why do you think pilots have audible alarms??

[/quote]

And once again I feel I must say that oesophageal stethoscopes can be used to monitor respiration just as well as heart rate. Why do you think we nurses like using them so much? They are a lot easier to use when an animal is fully draped up than a normal stethoscope. I don't know why you have such a low opinion of oesophageal stethoscopes and it does lead me to believe that you haven't ever seen one be used properly.

Re: L2 Cert in Assisting VS with Anaesthesia.....

Mark Hedberg — Fri, 17 Feb 2012 07:36:29 GMT

[quote user="Clive Ansell"]

Short answer is no.

However, I agree with others in that I have worked with some very good and competent non VN's who I would trust 100%, and with some VN's who are incapable - having a piece of paper does not immediately mean a good nurse. In fact, the worst anaesthetic nurse I know by far is a qualified VN, so it has to call in to question the quality and standard of modern VN training (subject for another debate perhaps?)

[/quote]

Well, I was going to say that everyone probably knows a vet surgeon somewhere that isn't very good either, so we should review VS training, but I then realized that reviewing VS training periodically is a good idea anyway, meaning I wasn't really making a point. Oh well. :p

Re: L2 Cert in Assisting VS with Anaesthesia.....

Michael Woodhouse — Thu, 16 Feb 2012 23:55:40 GMT

Not everyone has the luxury of working in a fully staffed small animal hospital full of nurses etc. We are a mixed practice with most of our work being large animal. We may do half a dozen GAs one week and none the next. We could never justify employing a VN and if we did she'd be bored stiff!

We use lay staff and they do what is required, whether raising a vein, dispensing drugs, mopping the floor, answering the phone or anaesthetic monitoring. They are perfectly capable. Recently we bought an oesophageal stethoscope amplifier from JAK marketing and it is the best £100 I've ever spent. So easy to hear changes in heart rate, each breath etc.

The vet is in charge of the anaesthetic whether it;s a nurse, lay staff or they are monitoring things themselves.

Re: L2 Cert in Assisting VS with Anaesthesia.....

Anthony Todd — Thu, 16 Feb 2012 23:33:37 GMT

Me too, and the psychopathic emphasis now on the oesophageal stethoscope, when the animal hasn't breathed for some time, is worrying....

Doesn't anyone use Apalerts anymore?? And I know the purists say "observe the respiration".

Why do you think pilots have audible alarms??

Re: L2 Cert in Assisting VS with Anaesthesia.....

plantagenet — Thu, 16 Feb 2012 17:44:18 GMT

[quote user="Zeke"]a wealth of knowledge about the whole patient, diseases and conditions aswell as training covering anaesthetic drugs, equipment and an understanding of how different conditions may affect the anaesthesia.[/quote]

The trouble is, and I have my tin hat on here, that sometimes the knowledge is less than the possessor of the knowledge thinks it is. I have found this can make some RVNs a rather dangerous commodity.

I want someone who does what they are told and monitors the anaesthetic and tells me if something is not right. I don't want someone who thinks they are very almost a vet.

Re: L2 Cert in Assisting VS with Anaesthesia.....

Clive Ansell — Thu, 16 Feb 2012 16:59:42 GMT

[quote user="Malcolm Ness"]

[quote user="Richard Holborow"]If you are one of the lucky practices with enough VNs for all occasions you have no need to be involved [/quote]

Now we have the wonderful new apprentice scheme paying prospective VNs £2=60 an hour, surely we will be absolutely inundated with nurses!!

[/quote]

Madness. I didn't realise pay rates were so much lower for apprentices - an 18 year old non apprentice could earn almost double that of an apprentice peer ???????

One could put forward the argument - is someone who is willing to work for £2.50/hour worth employing?

Current NMW rates

£6.08 - the main rate for workers aged 21 and over

£4.98 - the 18-20 rate

£3.68 - the 16-17 rate for workers above school leaving age but under 18

£2.60 - the apprentice rate, for apprentices under 19 or 19 or over and in the first year of their apprenticeship

Re: L2 Cert in Assisting VS with Anaesthesia.....

Clive Ansell — Thu, 16 Feb 2012 16:49:27 GMT

[quote user="Richard Holborow"]

I share the aspiration for anaesthetic monitoring to be reserved only for VNs.

The Certificate will not be a trivial achievement and will require considerable commitment.

Entrants must already have been working or volunteering within a veterinary practice for six months and the application must be endorsed by a veterinary surgeon. Students will have to record 200 hours of practical experience of supervised monitoring etc. and will submit a number of detailed case reports. It will require significant study time (class based or distance learning) and students will be assessed on their knowledge of a syllabus designed to cover the range of knowledge needed for the role. Completion of the certificate is expected to take a year or more. Hopefully, some of the successful candidates will be encouraged to continue their education and progress to the level 3 VN Diploma.

[/quote]

As it involves what seems a fair amount of commitment and study, why not just enrol and do the VN training?

Re: L2 Cert in Assisting VS with Anaesthesia.....

plantagenet — Thu, 16 Feb 2012 15:52:52 GMT

My best nurse (and I will call her that, because that is what she does for me) is an ANA with 15 years experience, her experience, acquired expertise and supportive personality make her outshine my RVNs. She is not very good at passing exams though.

Re: L2 Cert in Assisting VS with Anaesthesia.....

Malcolm Ness — Thu, 16 Feb 2012 15:43:09 GMT

[quote user="Richard Holborow"]If you are one of the lucky practices with enough VNs for all occasions you have no need to be involved [/quote]

Now we have the wonderful new apprentice scheme paying prospective VNs £2=60 an hour, surely we will be absolutely inundated with nurses!!

Re: L2 Cert in Assisting VS with Anaesthesia.....

Mark Holmes — Thu, 16 Feb 2012 15:20:59 GMT

[quote user="Richard Holborow"]

If you are one of the lucky practices with enough VNs for all occasions you have no need to be involved with the new certificate. But if yours is one of the many practices where non-VN help is a necessity, we hope that you will find the new certificate a helpful aid to raising standards and increasing patient safety.

[/quote]

Whilst agree with alot of the sentiments in htis post I htink there are some practical issues which will make it difficult for this to take off. As pointed out its a lot of work which may be considered leading to no-where if non certificated assistants can monitor GA as well. Secondly the costs of training, my experience is that economics result in "cheaper" assistant VNs being employed. Would a practice relying on avns feel they could fund the costs of the certificates. I wonder if it is something that everyone will consider to be a worthwhile idea and I'm sure somebody ELSE will be interested. The motivation is good though, and if it could include practical training on venepuncture and the administration of injections (under instruction) which really DO NOT need full RVN training then I think uptake would be imrpoved.

Re: L2 Cert in Assisting VS with Anaesthesia.....

Zeke — Thu, 16 Feb 2012 14:57:12 GMT

Perhaps it would be better to incorporate into a qualification which would produce a more all round assistant such as L2 Diploma for ANAs - what else would these 'monitors' do when there are no anaesthetics?

Re: L2 Cert in Assisting VS with Anaesthesia.....

Rob Loxley — Thu, 16 Feb 2012 14:49:54 GMT

I think Bob makes a good point, that as it currently is with an RVN monitoring, the vet is in charge of and responsible for the anaesthetic (as per RCVS advice note 19).

I can see the point that is made re the lack of VNs, so why aren't we recruiting these potential 'anaesthetic monitors' into VN training??

Re: L2 Cert in Assisting VS with Anaesthesia.....

Clive Ansell — Thu, 16 Feb 2012 14:36:29 GMT

Short answer is no.

I still think having trained vn's/rvn's to monitor anaesthesia is the right way to go, and not a stand alone certificate to enable non vn's to do a vn's job.

Re: L2 Cert in Assisting VS with Anaesthesia.....

Richard Holborow — Thu, 16 Feb 2012 14:23:15 GMT

As one of the SPVS working party that helped to instigate and design the Monitoring Certificate I share the aspiration for anaesthetic monitoring to be reserved only for VNs. In the long term I hope that there will be enough VNs to fill the role. However 100% VN-only monitoring of anaesthetised veterinary patients is an aim that cannot be achieved for years to come, however much we might desire it. There are simply not enough VNs to monitor all anaesthetised animals. About two thirds or more of practices use non-VNs to monitor anaesthetised patients at least some of the time and a significant number have no VNs at all. Many practices report difficulties in recruitment and it seems very unlikely that numbers will increase quickly enough to change this for years to come, despite the recent improvements. The earlier quote in this thread about VDS advice is mistaken. Practices are entitled to use non-VN monitors and they will continue to do so for as long as there are too few VNs. It is likely that at least a third, possibly many more, UK small animal anaesthetics will be monitored by non-VNs in the short to medium term future. Until now they have had no opportunities for nationally recognised, quality controlled training.

The SPVS working group believes that it is morally wrong for the profession to allow this situation to continue. For the first time, support staff expected to monitor anaesthetised patients will have access to a well designed, recognised qualification that demonstrates basic understanding of the issues that impact on the safety of anaesthetised animals. The Certificate is only to level 2. They will be monitors and assistants, neither anaesthetists nor VNs, but a well informed Level 2 monitor is a much safer assistant than one with haphazard informal training. Who could doubt that the public would agree?

The Certificate will not be a trivial achievement and will require considerable commitment. Entrants must already have been working or volunteering within a veterinary practice for six months and the application must be endorsed by a veterinary surgeon. Students will have to record 200 hours of practical experience of supervised monitoring etc. and will submit a number of detailed case reports. It will require significant study time (class based or distance learning) and students will be assessed on their knowledge of a syllabus designed to cover the range of knowledge needed for the role. Completion of the certificate is expected to take a year or more. Hopefully, some of the successful candidates will be encouraged to continue their education and progress to the level 3 VN Diploma.

Re: L2 Cert in Assisting VS with Anaesthesia.....

Bob Russell — Thu, 16 Feb 2012 13:02:01 GMT

Sadly I have known RVN's that I would not trust to watch an anaesthetic on a teddy bear! I have (and do) employ nurses and trained nursing assistants that I would trust implicitly to monitor an anaesthetic.

I am not sure about the VDS comment. It is the veterinary surgeon that is responsible for the anaesthetic and the purpose of the person monitoring is to pick up any changes in the animals condition so the vet can take appropriate action. I would very much doubt that anyone would 'not have a leg to stand on' if something went wrong.

Re: L2 Cert in Assisting VS with Anaesthesia.....

Holly Norman — Thu, 16 Feb 2012 12:43:51 GMT

Nope.

The group I work for already employs many "nursing assistants" (mainly because they are cheaper and easier to find than RVNs) and I've since put my foot down and refused to have anyone other than an RVN with me at my branch. Being fairly inexperienced I need to have complete trust in my nurse and their support is invaluable (especially when I'm attempting to fix my first bitch spay bleeder).

Although I do know some very experienced lay people, when I spoke to the VDS about this, apparently I wouldn't have a leg to stand on if something went wrong whilst the animal was under anaesthetic and it wasn't a RVN monitoring.

Re: L2 Cert in Assisting VS with Anaesthesia.....

Mark Holmes — Thu, 16 Feb 2012 11:09:05 GMT

I have worked in several practices where GA's are monitored by people with nothing more than experience and they have all been excellent and would trust them entirely. Equally I had one VN some years ago who did not notice I had euthanased a dog for 10 minutes.

In my opinion the VS needs confidence in his support staff and paperwork should only play a part in that.

Re: L2 Cert in Assisting VS with Anaesthesia.....

Hannah Wynne Richards — Thu, 16 Feb 2012 10:56:02 GMT

Wynne