Rachel Cole RVN aka ‘The Chin Tickler’
8am: I have been allocated to work with Lorenza today, the operating vet. Whilst the vet starts her admits, I prepare the kennels, theatre and preparation area ready for use, which also involves setting up the anaesthetic and monitoring equipment.
8.30am: As patients are admitted, I familiarise myself with their notes. Two of our six patients require a blood test ahead of their surgery. I ask one our student nurses Megan to help with the sample. Toby, a DSH (domestic short hair), who is in for dental treatment turned out to be quite the character. It took two nurses to help keep him calm long enough for me to take his blood sample. The most important role of one of the restrainees’ (yes, I made that word up!) was to play the ‘distractor’. By keeping the patient’s attention on them, rather than on what I was up to, the ‘distractor’ worked wonders, and really helped Toby to feel more at ease.
8.45am: I continue to receive our patients for the day, settling them in to their beds and updating their paperwork. Frankie, a JRT (Jack Russell Terrier) in for a routine spay, came along with her own blanket, so I made sure she had that with her at all times for the familiar smells of home. Our inpatients arrive back from the out of hours care, and I receive a detailed handover of their overnight care and progress before updating Lorenza, who will be responsible for their care today as ‘operating vet’. Together we come up with a plan. Lorenza decides on the treatment plan, to include any medications needed, further tests or surgeries, and I plan the nursing care needs such as feeds, vital observations, walks, and physio-therapy as necessary, for the inpatient nurse. In Bilbo’s case, he will also need urinary catheter care and regular pain scores to assess his pain management. Bilbo, a young male cat had a blocked bladder the previous day, and will need his urinary catheter closely monitored for any further blockages.
9am – 1pm: I assist pre-medicating patients ahead of their surgeries, and organise the surgical instruments and equipment required for the next surgery. You could say that we as nurses are ‘mind-readers’, because we are very good at anticipating what the next steps of the vet will be.
By the end of the consulting morning, we have had three additional surgeries added, and the operating vet is well aware she is unlikely to get a break that day. I monitor the anaesthetics constantly to asses the depth of anaesthesia, and with permission from Lorenza, I adjust the anaesthetic gases as necessary. Boe, who has been admitted to remove a suspicious-looking lump, is a brachycephalic breed. This means she has a short nose, narrowed nostrils and an elongated soft palate, which anatomically often impairs their breathing. I imagine most people are familiar with the sound of the loud breathing and snort-like sounds of these breeds. Therefore, during her recovery from the anaesthetic, the timing to remove her airway tube had to be precise. The ease of her breathing was hugely improved with the airway tube present, which really does demonstrate how their anatomical design has impacted on their breathing.
2pm: My colleague Rachel (yes another one!) who is a fellow Registered Veterinary Nurse is monitoring Toby’s anaesthetic whilst he has his dental treatment. Our final year student Megan, has taken over from Rachel’s position as inpatient nurse whilst I was on lunch, gives me an update on our patient recoveries. Everyone is doing well. Bilbo’s urine is starting to look clearer, although he will only eat when he is being stroked at the same time. I guess that is one way to get extra fuss! Frankie loved her lunch so much so, she could not eat it quick enough. And Jenson, a beautiful DSH, was in a very loving and playful mood, completely unfazed by his earlier anaesthetic.
2.15pm: Charlotte, our consulting vet has asked for some assistance to carry out a euthanasia on a very elderly cat. Marnie had had a long and happy life, but sadly the inevitable effects of ageing had come to affect her quality of life. She was sleeping most of the time, no longer played and had no appetite. There is never an easy time to say goodbye to a pet, and as I walked into the room, tears rolled down the couples cheeks. I gave them some tissues before giving Marnie some tickles behind the ears whilst the vet explained the procedure, and I try to maintain composure. I make Marnie comfortable on her bed.
“I am doing the right thing?” The lady asks, haunted by making such a difficult decision.
“I believe so,” the vet assured. “As hard as it is, she has lost her quality of life, unable to do what she would like to. She has lost a significant amount of weight and her kidneys are failing her.”
The procedure goes peacefully, and I hope that one day soon, Marnie’s owners will be able to see that it was the last kindness they could give their beloved Marnie. I find it heart-breaking to see the distress that the families go though, just as they would for any other family member. Admittedly, the job can be emotionally exhausting at times. Each time I remember how I felt when we had to say goodbye to our family dog several years ago now, and know that I will be inconsolable when the day comes when it is time to say a ‘forever goodbye’ to my dog now.
2.30pm – 4.30pm: I take over from Rachel, whose shift has ended and is due to collect her daughter from school, and I help finish off the last of our surgical procedures with Lorenza. ‘Preparation clear-up’ is well underway out back, with Megan tackling all the used surgical equipment, tubes and drapes.
4.30pm – 5pm: With our last patient awake from surgery, and Lorenza having some belated lunch whilst writing up her clinical notes ahead of the consulting slot at 5pm, I squeeze in some clinical coach training with Megan. Clinical coach training not only involves providing support, but we also work together through an online log of skills that Megan hopes to be fully competent in by May 2018 and a variety of practical skills. Today, under exam conditions, Megan is practising drip assembly and the calculations associated with fluid rates.
5pm – 6pm: Except for Bilbo who is staying in another night, it is time for our other patients to go home. I prepare medications and paperwork ahead of their home appointment, before calling in their owners to discuss aftercare and arrange re-check appointments. The eagerness on the owners’ faces looking forward to see their pets again was evident. It is always lovely to see the reunion between owner and pet and the happiness each bring into one another’s lives.
6pm – 7pm: The vet calls me into a consultation to a Spaniel with a very tender ear. He is not keen on letting Charlotte examine it. I manage to steady Duke long enough for Charlotte to see that the ear canal looks healthy, and there was no infection present, leading to a suspicion of a potential grass seed causing acute pain. Duke had not eaten since breakfast and it is decided to sedate Duke for further exploration. Lorenza finishes her consulting slot just after 6pm, and I have already prepared the anaesthetic machine and equipment required to explore Duke’s ear. Once Duke is anaesthetised, Lorenza exams his ears with ease, spotting a grass seed. Bingo! On recovery, it is evident that Duke is instantly feeling more comfortable.
7pm: My shift was due to finish at 6.30pm, but whilst Alison our evening nurse prepares Bilbo for his overnight stay, I stay until Duke is awake and stable before leaving. Another busy day, but a rewarding one. Who knows what tomorrow will bring!