Veterinary recruitment and retention crisis - and nurses

RE: Veterinary recruitment and retention crisis - and nurses

cairncross — Wed, 07 Dec 2022 22:04:27 GMT

Good question this sort of info is vital if we are to properly plan ahead. What percentage of our resources are spent on what percentage of cases , time and motion studies of what soaks up our limited availible time

RE: Veterinary recruitment and retention crisis - and nurses

Bob Russell — Tue, 06 Dec 2022 18:10:45 GMT

How much of the qualified vet nurse population is soaked up by referral centres?

RE: Veterinary recruitment and retention crisis - and nurses

cairncross — Sat, 03 Dec 2022 07:44:47 GMT

my understanding is that recruitment and retention of nurses isnt much better than that for vets i don't think there is a huge pool waiting out there to solve the problem. it may be quicker to train more but employing more is going to increase costs, costs which have to be extracted from a public with much less to spend for the next x? years Having more nurses to reduce pressure on vets ? the very obvious point has been made that most likely the more straightforward consults or interactions would shift to nurses leaving vets with the more intense cases the more stressful troublesome clients and take away those consults that can be moved more quickly to get a 5 min break to relax or do something pressing or catch up. the vet is still going to have to be present encase the nurse consults or procedures suddenly reveal something needing this attention or even just quick advice. vets will now be dealing with a more complex stressful list of consults whilst spontaneously being bombarded with queries questions from the 2,3,4,5 nurse consults and procedures going on at the same time. Management is not going to say yes we have employed x extra nurses that shall let the vets have lunch in peace it will be how do extract from this extra time the vets have.

i think the owners wishes is very complex and not just a matter of pandering to demands to keep a client perhaps . There are a number of academic studies in the human medical field which show that a stable doctor patient relationship has significant impact in health outcomes, i am involved in one ongoing study about the impact of these relationships and the community nature of provision on both outcomes and satisfaction. also when we have a crisis of vet time availability the continual hand over and getting up to speed with cases soaks up time even if its only 5 extra min per case this soon adds up to a few hours per week . if the average working week now for vets is 30h {averaging part time and full time} and 3h per week is spent on these hand overs thats 10 percent , 10 percent extra vets needed , thats 2900 extra vets needed in uk to accommodate flexibility .

i like your last sentence i don't mean to be combative or dismissive either we are all trying to solve the same impossible problem just with different ideas on how the deckchairs should be arranged

RE: Veterinary recruitment and retention crisis - and nurses

Alistair Graham-Evans — Wed, 30 Nov 2022 01:20:35 GMT

To help with time management I often tell my vets to report FNA results the following day or later the same day. Also if you have the results in 5 minutes it looks too easy and detracts from the professional training and expertise involved.

RE: Veterinary recruitment and retention crisis - and nurses

Stephen Courtney — Tue, 29 Nov 2022 16:28:16 GMT

I agree with Andreas. Managing expectations is key, and I need the fun consultations in between the hard ones, it takes the stress out and gives you a mini break , so delegating all that stuff to a nurse who may not want to do them / resent doing them - just so I can keep charging consult fees one after the other, is very wearing

I think clients need to be told when to expect results, especially when samples/ cases are being managed by part time staff. Obviously if something is urgent it should be delegated , but having angry clients phoning constantly for routine results when the vet involved is not at work adds to everyone's stress unnecessarily

RE: Veterinary recruitment and retention crisis - and nurses

Andreas Ege — Mon, 28 Nov 2022 09:57:32 GMT

Basically I agree with using nurses more, though there's some problems with that as well.

First, getting enough qualified nurses doesn't seem to be much easier than gettting vets. We had to keep our ops lists down and vets doing more nursing work the last few months because we have a lot of trainee nurses but not enough qualified ones. In between there were only two, putting a huge strain on them especially with ooh coverage. And as soon as we were back to three the head nurse handed in her notice and was sent on garden leave a month before her notice period ended.

The other is it often reduces a bit of breathing space for vets and personal follow ups by taking out the second vaccinations and post op checks. I find having a busy stretch with a few complicated cases or running behind for whatever reason having a probably quick and easy consult in between helps a lot by alowing me to reduce stress and to catch up.

Especially with post op checks sometimes they want/ need a vets second opinion - that usually then comes on top of ongoing vet consults and increases stress again because you almost invariably start running behind.

Another thing I think that would make sense is a change of attitude to when to do things.

I find a lot of vets want to do it (fill in your most favourite procedure) straight away. For example, I've gotten into the habit of telling owners I might not be able to report in-house blood results, urine results or fna results until the next day or even the day after. For me that takes some stress out if I can leave in the evening without worrying that somebody expects a phone call. Clients usually don't even expect same day turn-over.

Same with non-emergency ultrasound scans, xrays etc, on some days even blood sampling or other stuff I normally do straight away. Most clients seem ok with that and it takes a lot of stress out for me.

RE: Veterinary recruitment and retention crisis - and nurses

Neil Wheadon — Sun, 27 Nov 2022 17:02:27 GMT

[quote userid="2675" url="~/001/nonclinical/f/life-in-practice-discussions/30500/veterinary-recruitment-and-retention-crisis---and-nurses/240002#240002"]Actually I would take the absolute opposite view- in many practices the vets are given 7-7 shifts, the nurses were on 7.5 hours. Some organisations make things worse - the vets prepare all medication from the consults and when you did get 10 seconds or time for lunch or a break, the reception then hands you a list of repeat prescriptions, lab results and telephone calls to return, all things the powers that be have decided are outside of a nursing qualification. Some of those repeats could be 3-4 pages and included pom parasite control which if we could get Vmd and Noah to see sense about nurse qualifications, could be made much simpler. Many places are so bound and abiding the rules, you can’t get parasite treatment unless 24-48 hour notice. Don’t think the clients care one bit if their dog’s flea treatment is signed off by vet or nurse or whether it becomes easier to go elsewhere.[/quote]

Absolute beauty of a reply, this happens everywhere

I suspect and sucking my teeth here that this is historical. Nurses are traditionally a profession for women, vets for men. The result is that nurses get shorter shifts AKA more reasonable. Vets are stuck in this time warp of 08:30 - 19:00, though interestingly it wasn't like that 30 years ago where hours were 09:00-18:00 Will this change with feminisation of the profession, my guess is that it simply has to and a practice i locum at has changed to shifts

Neil

RE: Veterinary recruitment and retention crisis - and nurses

Eamon McAllister — Sun, 27 Nov 2022 11:14:54 GMT

That will be the day. These organisations seem to be working in concert and their prescriptive affect on the profession has been pernicious viz. the egregious Cascade Legislation.

RE: Veterinary recruitment and retention crisis - and nurses

Bibs — Sun, 27 Nov 2022 08:02:49 GMT

I agree vets can hardly see straight by the end of the day. Quite often when I did a normal GP job I had nausea and a blinding headache by the end of the day. Interestingly enough this doesn’t happen in other jobs. Your point is that what nurses are allowed to do should change, my point was that they’re not fully used at the moment for what they can actually do. I agree that it would be better if they could no some prescribing - half the time it’s just checking there is a recent enough exam and weight check done.

RE: Veterinary recruitment and retention crisis - and nurses

Richard Carter — Sat, 26 Nov 2022 21:34:12 GMT

Actually I would take the absolute opposite view- in many practices the vets are given 7-7 shifts, the nurses were on 7.5 hours. Some organisations make things worse - the vets prepare all medication from the consults and when you did get 10 seconds or time for lunch or a break, the reception then hands you a list of repeat prescriptions, lab results and telephone calls to return, all things the powers that be have decided are outside of a nursing qualification. Some of those repeats could be 3-4 pages and included pom parasite control which if we could get Vmd and Noah to see sense about nurse qualifications, could be made much simpler. Many places are so bound and abiding the rules, you can’t get parasite treatment unless 24-48 hour notice. Don’t think the clients care one bit if their dog’s flea treatment is signed off by vet or nurse or whether it becomes easier to go elsewhere.

So the vets can hardly see straight by the end of the day and then everyone expects it all again the next day. Really not surprised people look for alternatives.

RE: Veterinary recruitment and retention crisis - and nurses

Bibs — Sat, 26 Nov 2022 20:10:53 GMT

My impression when working for the PDSA is that they use their nurses to the maximum. My impression from working for small animal private practices is that they under use nurses. I suspect clients would need to be retrained over time to accept nurses taking full charge of certain procedures (which I’m sure they could do). The issue for me is that we put too much emphasis on vets and probably pander too much to owner's wishes when they ask to see certain people (edited to sound a bit less harsh).

RE: Veterinary recruitment and retention crisis - and nurses

Richard Carter — Sat, 26 Nov 2022 12:56:04 GMT

And how often when the first clinician formulated a plan with a reassessment planned in a couple of weeks for the client to find the next clinician trashes the plan and starts a new one

RE: Veterinary recruitment and retention crisis - and nurses

Bob Russell — Fri, 25 Nov 2022 09:33:08 GMT

Part time can be extremely inefficient. Responsibility for completion is likely to be passed to one member of staff. That person may well then not work for several days.Immediately there are delays. If responsibility is shared there is a good chance things will not be done atall unless there is someone monitoring things!

We work successfully with part-time working but it is dependent on someone carefully managing.

RE: Veterinary recruitment and retention crisis - and nurses

cairncross — Fri, 25 Nov 2022 06:36:44 GMT

On an individual or practise basis absolutely no problem with how many hours anyone does or can work as long as there are enough to go round.. there aren't enough to go round

We have a fixed but diminishing pool of workers less are training and overseas is rapidly falling. More part time workers means less fte overall.

The potential that by facilitating part time we can eventually get more overall ie the short term pain of losing some of the fixed pool to part time means we will gain in 5 of10 years is dubious.

Facilities part timevwork has also been shown to facilitate leaving all together in somecstudiescas dependence on the wage or profession is less the leap or gamble to other things is less, it leaves spare time for people to develope other jobs and interests which attract them away.

Facilitating part time in veterinary is complicated by our unique 24 7 obligation this transfers a huge obligation onto a very few and it us shutting businesses and removing welfare provision left right andvcentre

All these facilitations can be made work or at least function but not as efficiently. The communication and systems take up time and resource.

All said we are not going to stop the move to part time and the reduction in numbers overall we are going to have to accept the situation and provide different level or levels of service.

RE: Veterinary recruitment and retention crisis - and nurses

Rob Loxley — Thu, 24 Nov 2022 20:11:56 GMT

[quote userid="19228" url="~/001/nonclinical/f/life-in-practice-discussions/30500/veterinary-recruitment-and-retention-crisis---and-nurses/239993#239993"]Part time is causing something that could be sorted in one day to take months[/quote]

But is it the fact that people are working part time or that there aren’t enough FTE that is causing the issue? if you can recruit/retain more p/t workers then you have more fte workers overall. You do also need systems that adapt to part time workers, sharing cases, communicating, working collaboratively etc

RE: Veterinary recruitment and retention crisis - and nurses

cairncross — Thu, 24 Nov 2022 19:46:30 GMT

Related to my sons disability and current things going on with this i needed to contact 3 people today to get something progressed one medical,one legal and one depart of education. All 3 it turns out only work part time , it will take about 10 days to get in from one passed to other and then formulate something to send to the third then this response will have to back to the other two who will have to communicate again and form a further response. Part time is causing something that could be sorted in one day to take months.

RE: Veterinary recruitment and retention crisis - and nurses

Rob Loxley — Thu, 24 Nov 2022 15:43:06 GMT

[quote userid="2100" url="~/001/nonclinical/f/life-in-practice-discussions/30500/veterinary-recruitment-and-retention-crisis---and-nurses"] Is the recruitment crisis already causing practices to make better use of their veterinary nursing staff? Or not? [/quote]

Yes, get the nurses nursing, employ more receptionists to do the phone answering etc, employ some PCA/VNA staff to do animal care that doesn't need a Nurse, push what the nurses are doing within the scope of the rules, free the vets to spend more time vetting. Better job satisfaction, retention, easier to justify salary growth, hopefully less pressure from difficult recruitment.

RE: Veterinary recruitment and retention crisis - and nurses

Richard Carter — Thu, 24 Nov 2022 15:23:00 GMT

To become a GP you'll need to complete: a degree recognised by the General Medical Council which takes 5 years. a foundation course of general training which takes 2 years. general practice specialist training which takes 3 years.

nationalcareers.service.gov.uk › ...

GP | Explore careers - National Careers Service

RE: Veterinary recruitment and retention crisis - and nurses

Bob Russell — Thu, 24 Nov 2022 15:04:47 GMT

Almost by definition GP's are 'generalists' if there is such a word. They are not specialists and should be proud of the fact.

RE: Veterinary recruitment and retention crisis - and nurses

Richard Carter — Thu, 24 Nov 2022 14:56:47 GMT

It doesn’t help that GPs decided their job required specialist status and the nhs agreed so effectively closing the gate to ‘mere’ qualified doctors.

We have a lot of people in our profession who have tried to close gates once they through with rumblings every now and then that graduates should never aspire to rise above their station of experience etc without the magic of extra qualifications

RE: Veterinary recruitment and retention crisis - and nurses

Bob Russell — Thu, 24 Nov 2022 10:07:56 GMT

There are already 'Physician Associates' working within the NHS. These muddy the water considerably as they appear to be mini doctors without medical degrees.

This is part of the slippery slide IMO. Some 'corporate' doctors surgeries are relying heavily on them according to Panorama.

Perhaps if more doctors especially GP's worked full time they may not be needed.

taking medical histories from patients
performing physical examinations
diagnosing illnesses
seeing patients with long-term chronic conditions
performing diagnostic and therapeutic procedures
analysing test results
developing management plans
provide health promotion and disease prevention advice for patients