'Veterinary Nurse' protected by CoPC

RE: 'Veterinary Nurse' protected by CoPC

Evelyn Barbour-Hill — Fri, 29 Jan 2016 18:42:15 GMT

[quote user="Arlo Guthrie"]

Trying to put myself in your shoes, if I ran a practice I think in principle I'd be minded to try and squeeze every last little drop out of Schedule 3. Delegate as much as I possibly could to the nurses.

Charge the same whether someone is seeing the qualified vet or the qualified nurse, thereby either becoming more profitable, or getting to spend more time on the golf course.

I mean, what percentage of first consultations could actually be handled by a nurse, and passed on to a vet if needed? Given the difference between the staff costs of a nurse vs a veterinary surgeons, how much would it save if a practice worked on the basis that you see a nurse first, and a surgeon if it was warranted?

[/quote]

Using Registered Veterinary Nurses (RVNs) as cheap substitutes for veterinary surgeons, yes. But when I said that..... and suggested RVNs might feel a bit disillusioned when they realised it.... I got lots of abuse.

FFS. Nurses are the people who do the nursing. They are doing it in a veterinary context, so obviously they are veterinary nurses, whether one actually uses the V word or not. Registered Veterinary Nurses (RVNs) already have that title effectively protected. Not too different to the human nursing field, in fact. What is the problem?

RE: 'Veterinary Nurse' protected by CoPC

Utlendigur — Fri, 29 Jan 2016 14:49:50 GMT

[quote user="Bob Russell"]

Incompetence is not acceptable IMO. I am only talking about competent people, qualified or not. I would not want to be working with anyone without training.

If I was an employee and got into this situation, I would make very good notes to defend my position as best I could. It was the RCVS that decided it was OK for a practice to be owned and run by non-vets. They knew this would weaken their influence in a lot of situations.

I would not have allowed them to own practices but I don't have answers for those that work for non-vets. Sorry!

[/quote]

I have worked with many many unqualified staff who are great at monitoring - they may not know all the tech stuff but they really care, watch the animal like a hawk and flag any concerns asap - and I have been perfectly happy to have them monitor GAs on my own animals. But for many years there was a staff member on the OOH rota who was not competent - could not count a HR (everything was 100) and considered monitoring to consist of making crosses on a chart every 5min. This member of staff received more, and very good, training than the rest put together - but repeated discussions with the boss didn't seem to get across that training does not ensure competence. It only stopped when all the vets together refused to work with her - and the resultant fall-out (wrt nursing rota) and ill-feeling was placed firmly at our feet as if we were taking a personal issue with her.

This was a vet-owned practice!

RE: 'Veterinary Nurse' protected by CoPC

Bob Russell — Fri, 29 Jan 2016 14:39:25 GMT

Non-corporates are likely to survive because the owners get to talk about flea control with their vet. The corporate model is to make everything as efficient as possible. Smaller independents get to know their clients and patients!

It costs and hopefully enough will be willing to pay the extra to get the service they wish! At least until I retire then it can all go to the dogs!

RE: 'Veterinary Nurse' protected by CoPC

Anthony Dennison — Fri, 29 Jan 2016 14:39:03 GMT

[quote user="Arlo Guthrie"]I mean, what percentage of first consultations could actually be handled by a nurse, and passed on to a vet if needed? Given the difference between the staff costs of a nurse vs a veterinary surgeons, how much would it save if a practice worked on the basis that you see a nurse first, and a surgeon if it was warranted?[/quote]

There are nurses I would trust more than some vets to come and ask for advice or help.

RE: 'Veterinary Nurse' protected by CoPC

Bob Russell — Fri, 29 Jan 2016 14:34:50 GMT

Incompetence is not acceptable IMO. I am only talking about competent people, qualified or not. I would not want to be working with anyone without training.

I would not have allowed them to own practices but I don't have answers for those that work for non-vets. Sorry!

RE: 'Veterinary Nurse' protected by CoPC

Arlo Guthrie — Fri, 29 Jan 2016 14:28:08 GMT

[quote user="Gillian Mostyn"]Which is a shame- and is one of the reasons most veterinary nurses leave the profession. They get no respect for becoming qualified, and no understanding for what they do.[/quote]

Yes, but isn't this partly down to:

a) The limitations of the job - there is only so much a nurse can do.

b) Not helped by vets limiting what their nurses are allowed to do, even more so than the law does.

Charge the same whether someone is seeing the qualified vet or the qualified nurse, thereby either becoming more profitable, or getting to spend more time on the golf course.

David Mills was talking about the fact that the NHS will soon not be able to afford to provide end of life care for the elderly.

I ask you, with the competitive pressures from corporates, will the veterinary profession be able to continue to afford to have veterinary surgeons spending time talking to clients about fleas?

Isn't it well past time that way, way more was delegated to veterinary nurses. Especially now they are regulated and accountable?

Leaving vets to work almost exclusively on major surgery.

Just asking!

RE: 'Veterinary Nurse' protected by CoPC

Utlendigur — Fri, 29 Jan 2016 14:15:21 GMT

[quote user="Bob Russell"]You need to remember that it is the veterinary surgeon that is in charge of the patient, anaesthetic and ensuring the monitoring is adequate. I would not operate where I believed the person monitoring was not competent![/quote]

If I remember rightly, you are a boss, so you have a choice What happens when you are an employee, it's an emergency or OOH so limited staff options, and the only choice you have is working with someone who is not competent or letting the animal die? Been there more times than I want to remember (thankfully not recently), and got the grey hairs to prove it. The thing that makes me angry, is that if things go wrong, the RCVS will go after the employee who was simply trying to do their best in a bad situation not of their making, and employer who knowingly and consistently puts them in that position despite concerns being raised will likely escape unscathed.

RE: 'Veterinary Nurse' protected by CoPC

Francisco Gomez — Fri, 29 Jan 2016 14:14:42 GMT

The title is important. I agree that it implies changes for non qualified staff.
The value of the title is not only its name but what it represents.
I can write enough code to create a fully functional static website today and I don't have qualifications for it. I know things work but I don't know why.
The moment the web 'rules' change or there are improvements on how this is done, I need to re-train myself to make it work again. The moment an upgrade comes, the whole thing becomes alien to me. It takes me forever to find out how to change things to make it work again, if I manage.
Right now I can make a site go online with little effort, possibly less than a new grad. In 10 years, this new grad will be ages ahead of me.

A QVN is someone who have been trained by a set of standards rules. It means that if she/he wants to change jobs tomorrow, there is a minimum guarantee, for both the new employer and their new colleagues. This person has the tools and the knowledge to adapt and advance. Working in different practices over the years have shown me that things can be done very differently from one practice to another. A non qualified person would have a lot more difficulty to adapt to a new setup, because this person had been trained to work there and that's it.
The QVN title doesn't tell you if they are nice people or if their iv cannulas are always in at the first attempt, or if they are good or not at time keeping. But the same can be said about those not qualified. It tells you that, with this person, some bases are covered.
Even in our vet job, you could potentially train anyone to spay a cat. That's not hard. The difficulty is how to deal with the rare or the unknown when it happens. And the training you've been given serves that purpose.

For the public is also important, specially with it being more and more informed (or ill-informed), QVN do consultations and receive questions all the time. A QVN is more likely to be able to recognise if a medical term posed by a client or a vet is something to be concerned about or not, because they might have come across it in their studies. And therefore, they're more likely to know when a problem can be resolved by themselves, or it should be going up the chain to be discussed with the vet.

Anecdote alert: A 20yr non qualified nurse was questioned about a patch of alopecia in a dog skin while clipping claws, she told the owner that she 'didn't think it was mites, but the dog might
have been in contact with them'. I'd expect a QVN not to be making a diagnosis based on that, and to pass the question to me first. And if they do, I'd expect them to recognise
their liability in the matter against their qualification. But What can you tell a non qualified person? They will always have an easy escape: 'I don't 'f' know, I'm not a vet, I told
them what I thought.'

I have worked with sets of both, in several practices. If I had to choose to work between a new grad QVN and non-QVN with 20 years of experience, I would probably choose the second. At the same experience, it is QVNs 100% of the time.

RE: 'Veterinary Nurse' protected by CoPC

Robin Grimmer — Fri, 29 Jan 2016 13:58:49 GMT

I remember one practice I worked at had just taken on a particularly young looking female assistant and the clients would say "We saw the nurse last week".

RE: 'Veterinary Nurse' protected by CoPC

Gillian Mostyn — Fri, 29 Jan 2016 13:32:34 GMT

[quote user="Michael Woodhouse"]No - in that I have faith in the system[/quote]

I think this goes for the public too...they have faith in us. They assume vets are being responsible in who they allow to carry out tasks- after all, the NHS ensures everyone is appropriately trained, with adequate back-up if necessary. But...

[quote user="Michael Woodhouse"] I've happily had work experience students monitor anaesthetics [/quote]

which, in my opinion, makes my point perfectly. And Michael- be honest- do you really think this is acceptable?

[quote user="Michael Woodhouse"]If I had to pick between a VN or a capnograph - I chose the capnograph[/quote]

We'll never agree then, if you can make this comparison.

RE: 'Veterinary Nurse' protected by CoPC

Gillian Mostyn — Fri, 29 Jan 2016 13:25:09 GMT

[quote user="Arlo Guthrie"]I never forget that! It's precisely the reason why I strongly suspect the public doesn't care too much. As I said earlier, it's the vet I came to see. It's the vet who I hold responsible.[/quote]

Which is a shame- and is one of the reasons most veterinary nurses leave the profession. They get no respect for becoming qualified, and no understanding for what they do. Imagine if you held a qualification that you worked hard for and then someone tells you that the public doesn't care- they would be just as happy with anyone else doing your job. And your employer agrees! I can't blame a lot of nurses for looking elsewhere for job satisfaction.

RE: 'Veterinary Nurse' protected by CoPC

Michael Woodhouse — Fri, 29 Jan 2016 13:22:21 GMT

[quote user="Kate Richardson"]

Michael Woodhouse Would you have felt differently if you had been told prior to your appointment you would be seeing an HCA rather than a qualified nurse?

Would you have had any elements of concern prior to your appointment?

Would it depend on what procedure you were having done?

[/quote]

No - in that I have faith in the system. If I'd asked for something not in the HCAs remit I have confidence that she's have got a nurse, doctor etc. I know there were doctors on the premises at the very least.

[quote user="Gillian Mostyn"]

OK. As you say, you don't give a damn who vaccinates you. What if they were monitoring your GA a couple of weeks after leaving school with no GCSEs and no training? Your HCA may not have been a nurse, but she WILL have undergone some kind of formal training scheme.

I don't doubt that the majority of practices ensure that, qualified or not, only staff who are capable of doing a job, carry it out. However, there is scope in the current system for this not to be the case. We all charge a significant amount for the work we do, and the public have a right to assume that all staff are appropriately trained. I disagree with your opinion that they dont care- they do. Wouldn't you assume anyone you pay on a professional basis- be it mechanic, builder or dentist- have has to go through some kind of formal training? Isnt that why you're happy to pay for their services? At the moment there are VCA, VN and other animal care qualifications available. I don't understand why such a lot of vets are resistant to allowing their staff to gain these qualifications. Put another way - where is the harm in training them????

I agree that the RCVS shouldn't be spending their money on this. But if they don't champion it, who else will?

[/quote]

The overall responsibility comes down to the vet delegating the work. I've happily had work experience students monitor anaesthetics - the vet makes the calls about changing setting etc. I've been in practices where qualified VNs take over the entire anaesthetic and do what they want, and others where they run everything past the vet first. With a capnograph and ecg trace there is very little skill needed to turn the iso up from 2-2.5% on my say so.

If I had to pick between a VN or a capnograph - I chose the capnograph. Both would be lovely.

I agree that training is good - we are looking to move to a new site and recruit and train 2 VNs. I can still envisage me saying 'is there a nurse free' when they are trainees or even before they start the course. Lock me up now.

Why am I training them as VNs? Because I want them to do some things only a VN can.

RE: 'Veterinary Nurse' protected by CoPC

Arlo Guthrie — Fri, 29 Jan 2016 12:43:30 GMT

[quote user="Bob Russell"]You need to remember that it is the veterinary surgeon that is in charge of the patient, anaesthetic and ensuring the monitoring is adequate.[/quote]

I never forget that! It's precisely the reason why I strongly suspect the public doesn't care too much. As I said earlier, it's the vet I came to see. It's the vet who I hold responsible.

RE: 'Veterinary Nurse' protected by CoPC

Arlo Guthrie — Fri, 29 Jan 2016 12:41:40 GMT

[quote user="J G Wray"]

I'm still not clear what unqualified-but-formally-training-persons-who-are-present-in-veterinary-practices-and-assist-vets-in-the-care-and-treatment-of-animals should be called:

1. To their face

2. To the public

3. To colleagues

4. Down the pub

[/quote]

J G Wray This gets to the very heart of the problem. I sense (rightly or wrongly) that in the rush and enthusiasm to move the VN profession forward and protect the title, very little thought has been given to unqualified staff and the impact on them.

What we 'do' is at the heart of our very existence.

So here's a group of people who the system has allowed to call themselves veterinary nurses for eons, suddenly being told 'thou shalt not be spoken of as a veterinary nurse within the hallowed confines of practice' - with NO reasonable suggestion for an alternative.

It's been the subject of a protracted and heated debate over on vetnurse.co.uk

The options discussed so far are:

Veterinary care assistant - mouthful, will never get adopted.
Care assistant (on its own) - doesn't work outside practice
Veterinary Auxilliary - dated, requires further explanation
Veterinary Nursing assistant - doesn't cover those unqualifieds who don't assist.

The only thing I can think of that works is:

'Animal Nurse'

Keeping 'Veterinary Nurse' for those with the qualification.

Seems to have been accepted by both sides of the debate over on vetnurse.

As to how it fits with your scenarios JGW:

1. To their face - don't you just call them by name? Or just Nurse.

2. To the public (either face-to-face or on marketing materials) - Animal Nurse / Nurse.

3. To colleagues - people wouldn't understand the difference now, but if the terms got widely adopted, they would.

4. Down the pub - 'Animal Nurse' works. Succinct. Does what it says on the tin. Sounds a bit less official / qualified than 'Veterinary Nurse', which is kind of the point.

RE: 'Veterinary Nurse' protected by CoPC

Bob Russell — Fri, 29 Jan 2016 11:47:49 GMT

[quote user="Arlo Guthrie"]

[quote user="Bob Russell"]Why does this 'untrained' label keep coming up time and time again. No sensible vet is going to allow an untrained person near an anaesthetic machine except in the most dire circumstances.

Not formally qualified does not equate to untrained. Nor does qualified automatically mean competent![/quote]

I have to say, I think that is actually quite a weak argument (sorry!)

How can you justify the statement that no sensible vet would allow an untrained person near an anaesthetic machine? Any evidence for that? (or how many unsensible vets there are?!)
If by 'trained' you include in-house trained staff, the problem is the variability in the quality of training provided by one practice to the next. Formal qualifications (should) give a guarantee of a certain standard, which should be of value to you as an employer and possibly to the public.

Informally trained can mean as little as 'watching someone else (of unknown quality) do something'.

I know I wouldn't like to get on an aircraft flown by someone who'd just 'watched someone else do it'!

[/quote]

You need to remember that it is the veterinary surgeon that is in charge of the patient, anaesthetic and ensuring the monitoring is adequate. I would not operate where I believed the person monitoring was not competent!

RE: 'Veterinary Nurse' protected by CoPC

Bob Russell — Fri, 29 Jan 2016 11:26:24 GMT

I have worked in a number of practices and with qualified and unqualified but trained staff. I have to say the two I have had most concerns about have been VN's!

I would support a more basic 'nursing' course that could be supplemented with additional modules.

Veterinary Times front page suggests VN's are not used to their full potential. In many practices especially the smaller ones like ours their roles will alter from nurses to receptionists to cleaners and back again. That is what the practices need!

If today's VN's are 'overqualified' then we need to look at the training to ensure that they are right for the jobs available. The old RANA type training was close to perfect in level, despite the apparent failure rate. This may have been, in part, because it was open to a wider range of education levels.

The RCVS and nursing profession seem to be bogged down with the politics and refuse to accept that degree level training is not appropriate in many practices.

There is limited formal training available for non-VN's to complete for anaesthetic monitoring (as an example). I believe there should be and could potentially be made compulsory.

There are not enough nurses trained, those that are may well not find general practice meets their needs and there are few alternatives.

I encourage all staff to take further qualifications. We use the College of Animal Welfare courses as our starting point. We are about to get two staff to do the Level 2 courses, one for Veterinary care assistant and the other in anaesthetic monitoring.

It is good to see other options are becoming available.

RE: 'Veterinary Nurse' protected by CoPC

Gillian Mostyn — Fri, 29 Jan 2016 09:47:58 GMT

[quote user="Bob Russell"]No sensible vet is going to allow an untrained person near an anaesthetic machine except in the most dire circumstances.[/quote]

Your experience differs to mine then Bob. Many, many times.

[quote user="Bob Russell"]Not formally qualified does not equate to untrained. Nor does qualified automatically mean competent![/quote]

No. It doesn't. So does that make all formal training and qualifications pointless?

RE: 'Veterinary Nurse' protected by CoPC

Arlo Guthrie — Fri, 29 Jan 2016 09:26:00 GMT

Not formally qualified does not equate to untrained. Nor does qualified automatically mean competent![/quote]

I have to say, I think that is actually quite a weak argument (sorry!)

How can you justify the statement that no sensible vet would allow an untrained person near an anaesthetic machine? Any evidence for that? (or how many unsensible vets there are?!)
If by 'trained' you include in-house trained staff, the problem is the variability in the quality of training provided by one practice to the next. Formal qualifications (should) give a guarantee of a certain standard, which should be of value to you as an employer and possibly to the public.

Informally trained can mean as little as 'watching someone else (of unknown quality) do something'.

I know I wouldn't like to get on an aircraft flown by someone who'd just 'watched someone else do it'!

RE: 'Veterinary Nurse' protected by CoPC

Bob Russell — Fri, 29 Jan 2016 09:17:05 GMT

Why does this 'untrained' label keep coming up time and time again. No sensible vet is going to allow an untrained person near an anaesthetic machine except in the most dire circumstances.

Not formally qualified does not equate to untrained. Nor does qualified automatically mean competent!

RE: 'Veterinary Nurse' protected by CoPC

Arlo Guthrie — Fri, 29 Jan 2016 09:09:39 GMT

[quote user="Michael Woodhouse"]Honestly I couldn't give a damn. I suspect neither could the general public - as long as the animal was well looked after (the HCA vaccinated me perfectly competently).[/quote]

I suspect the same. When I go to see the vet, I go to see the, er, vet.

[quote user="Michael Woodhouse"]I think the only people seemingly bothered by all this are VNs and the RCVS.[/quote]

I think VNs have every right to be bothered by it, and you should be bothered by their bother.

All part of general job satisfaction. Passing exams, the qualifications you hold, and your job title all strengthen one's feelings of self-worth, achievement etc. If you have a qualification which entitles you to call yourself something which every Tom Dick or Harry can call themselves, it's not exactly motivational.

And it's against a background of nurses historically being often underpaid, undervalued and underused (perhaps under is the wrong word, badly would be more accurate).

So yes, I 'get' why it's important to them. And if you want motivated, fulfilled staff, I think you should be bothered by their bother!

As to the College, I don't know whether this is motivated by that kind of thinking, or by a belief that the public cares. If the latter, I am not sure what evidence exists. I suspect not much.

I'd like to commission a YouGov survey to find out. Spread the word about the new VetSurgeon Jobs section, and subscribe for local job alerts (I know you have already MW), and hopefully some time soon I will be able to afford to!

RE: 'Veterinary Nurse' protected by CoPC

Arlo Guthrie — Fri, 29 Jan 2016 08:51:28 GMT

[quote user="Clive Ansell"]

What an absolute load of bs. Who on earth dreams this garbage up.

Veterinary surgeons and nurses must not refer to unqualified nursing colleagues as 'veterinary nurses'.
Currently acceptable alternatives (for the moment at least) are 'nurse' (on its own), 'care assistant, 'auxilliary' or 'nursing assistant'.
Marketing and other materials which a regulated individual has responsibility for should be updated to reflect the change (for example, if a small practice owned by a veterinary surgeon refers to its unqualified nursing assistants as veterinary nurses on its website, that should be changed).
When asked, down the pub, what they do, unqualified nursing assistants are legally still entitled to describe themselves as 'veterinary nurses'.

[/quote]

Er, me, I'm sorry to say!

To be absolutely clear:

Bullet point 1 is exactly what the RCVS says.

On point 2, RCVS just says that you can't call unqualified staff 'veterinary nurses'. I asked what you CAN call them, and those are some examples of what they told me are OK according to the CoPC.

Point 3 is my interpretation of the new element of the code, and which I thought it would be helpful to highlight. In other words, if MsRCVs are not allowed to refer to unqualified staff as Veterinary Nurses, logically that includes marketing materials and websites. I presume that corporates, run by non-MsRCVS are not subject to the same rule.

Point 4, I couched it in those terms in order to highlight a specific (and although it may sound trivial, actually quite important point), which is how unqualified staff are supposed to describe what they do in an informal setting outside work. Clearly they can't say 'I'm a nurse' or I'm a care assistant', and the most succinct way to describe themselves remains 'veterinary nurse'. They are legally entitled to.

Perhaps my article sounds a bit like the words of some bureaucratic megalomaniac, and you might infer that those are the College's words (I did preface that para with: "the implications seem to be ..." for clarity that this was my interpretation).

RE: 'Veterinary Nurse' protected by CoPC

Gillian Mostyn — Fri, 29 Jan 2016 08:51:05 GMT

I agree that the RCVS shouldn't be spending their money on this. But if they don't champion it, who else will?

RE: 'Veterinary Nurse' protected by CoPC

J G Wray — Fri, 29 Jan 2016 08:45:42 GMT

RCVS got themselves into this. They had to do something especially when the Government (again) told them they're not in touch with real life by asking for protection of title and have launched this with as low key an announcement as they can muster.

I'm still not clear what unqualified-but-formally-training-persons-who-are-present-in-veterinary-practices-and-assist-vets-in-the-care-and-treatment-of-animals should be called:

1. To their face

2. To the public

3. To colleagues

4. Down the pub

I need to know in order not to mislead and therefore scandalise the public and also to undertake my obligation to behave in a professional manner.

RE: 'Veterinary Nurse' protected by CoPC

Kate Richardson — Fri, 29 Jan 2016 08:22:20 GMT

[quote user="Michael Woodhouse"]

Anecdote alert - I went in for a small operation this week. As part of the pre-op I needed MRSA swabbing. I rang GP to book an appointment with a nurse. Turned up, swabbed myself. Asked if I could have a flu jab, she said yes. Gave me a flu jab. I asked in passing if she was new (as I already knew the two practice nurses) and she tells me then that she's a HCA - healthcare assistant.

I booked a nurses appointment. I saw a lady in the nurses room in a blue, nurse like, uniform. She administered a vaccination. Had I not asked I'd have believed she was a qualified nurse. Was I miss-led? Do I really care?

Honestly I couldn't give a damn. I suspect neither could the general public - as long as the animal was well looked after (the HCA vaccinated me perfectly competently). I think the only people seemingly bothered by all this are VNs and the RCVS.

[/quote]

Michael Woodhouse Would you have felt differently if you had been told prior to your appointment you would be seeing an HCA rather than a qualified nurse?

Would you have had any elements of concern prior to your appointment?

Would it depend on what procedure you were having done?

[quote user="Gillian Mostyn"]

Regardless of how vets and nurses feel about titles- do you not think that the general public want transparency?

I do. I think a lot of clients would be shocked to learn that the people caring for their pets during their surgical procedures may have no relevant qualifications.

And although there are some excellent unqualified nurses out there, I think that those practices whose nurses who have put in the effort (and their bosses, who have made a significant financial contribution) should be able to market themselves differently to those practices who choose to run with unqualified staff.

[/quote]

I think some clients may be shocked, some may not give a monkeys. But what proportions? Would it cause more (possibly unnecessary) anxiety if they knew this beforehand or if they found out after their animal had been cared for?

Regarding transparency in the general public now, do they want it for everything, or more for areas where they are paying for it through taxes?

Is the primary motive mainly for marketing purposes or ego stroking?

Will it cause friction in practices that have a mix of qualified and no qualified or is that friction already there? In our practice all our VNs are qualified, but a few years ago, one wasn't but all the other nurses would have quite happily allowed her to carry the title of vet nurse.

My stance, I think qualifications should be recognised. I think non-qualified nurses should be able to apply for an honorary title of vet nurse based on experience. Will it make a significant difference in the great scheme of things, probably not.

RE: 'Veterinary Nurse' protected by CoPC

J G Wray — Fri, 29 Jan 2016 07:12:10 GMT

Alternative names etc

"Angels", capable of dancing on pinheads

Our Retention Fees pay for stuff like this and those that churn it out have no sense of irony.

Do you suppose our websites are going to be monitored now?

We have student veterinary nurses, is that acceptable?