Most of the questions received following the webinar relate to issues covered by the RCVS Code of Professional Conduct for Veterinary Nurses and its supporting guidance. In particular:
• Chapter 18, which deals with delegation to veterinary nurse
• Chapter 19, which deals with the treatment of animals by unqualified persons
• Chapter 13, which deals with clinical and client records
• Chapter 17, which deals with the veterinary team and business
• Chapter 20, which deals with whistle-blowing.
Veterinary nurses are encouraged to read the existing Code and supporting guidance in full.
For advice on employment matters, veterinary nurses are encouraged to seek advice from the British Veterinary Nurses Association (BVNA) or other relevant sources of assistance such as employment solicitors or the Citizens Advice Bureau.
Below is a selection of questions received following the webinar on which we can provide guidance:
1. “I would like to know where we stand with cat castrations, tooth removal and the giving of 2nd vaccination”
It is against the law for a veterinary nurse to castrate a cat. This is specifically excluded by Part II of Schedule 3 to the Veterinary Surgeons Act 1966.
Veterinary nurses and student veterinary nurses working under the direction of a veterinary surgeon may carry out routine dental hygiene work. The extraction of teeth using instruments may readily become complicated and should only be carried out by veterinary surgeons. The RCVS considers that the extraction of teeth using instruments is not within the meaning of “minor surgery” in Schedule 3.
A second vaccination (which is carried out some two weeks or so after the first) is usually authorised by the veterinary surgeon at the time of the first vaccination. A second vaccination would therefore be directed by the veterinary surgeon when the animal is under his or her care and when the clinical assessment is carried out, and so the administration of the second vaccination may be carried out by a veterinary nurse or student veterinary nurse at the practice, provided the veterinary surgeon is not intending to certify this vaccination.
Please see www.rcvs.org.uk/delegation for full and detailed advice on these issues.
2. “Can you clarify that the Register is still a non-statutory one?”
The Register of Veterinary Nurses is now underpinned by a new Royal Charter, which came into effect on 17 February 2015. This is not primary legislation like the Veterinary Surgeons Act 1966, but the effect is broadly the same; the RCVS is now the formal regulator of veterinary nurses.
3. “Is it acceptable for a nurse to prescribe POM drugs, e.g. advocate, without seeing a vet?”
It is not legal or appropriate for a veterinary nurse to prescribe a POM-V medicine. POM-V medicines must be prescribed by a veterinary surgeon, who must first carry out a clinical assessment of the animal under his or her care. POM-VPS medicines must be prescribed by a veterinary surgeon, pharmacist or Suitably Qualified Person (SQP). Veterinary nurses who are also SQPs should prescribe responsibly and with due regard to the health and welfare of the animal.
Please see www.rcvs.org.uk/vetmeds for further details.
4. “Can a student nurse at college but awaiting enrolment with RCVS apply flea treatment/wormer/oral meds under the direction of a vet?”
Student veterinary nurses are those enrolled with the RCVS for the purpose of training at an approved centre or practice. If a student nurse is not yet enrolled with the RCVS, they have no legal dispensation to undertake delegated medical treatments or minor surgical procedures, regardless of how well trained or experienced they are considered to be. Further information and guidance is available at www.rcvs.org.uk/delegation and in the VN Education 2014 article ‘The Importance of Enrolment’ which provides guidance on what student veterinary nurses can do.
5. “As a new locum nurse, recently left practice. I am struggling to find professional indemnity insurance for myself and have been advised that I would be covered under the practice’s indemnity policy if covered by the VDS (I am a VDS member myself) however this would not cover me in the event of a practice suing me. I would like to be sure that, as a professional, I have proper cover. I know you cannot give financial advice but have you any advice for locums regarding insurance requirements?”
Veterinary nurses must ensure that all their professional activities are covered by professional indemnity insurance or equivalent arrangements. For further guidance on this please see www.rcvs.org.uk/vetteam.
The RCVS cannot recommend insurance companies. Veterinary nurses should contact insurance companies such as the Veterinary Defence Society (VDS) for advice on obtaining cover and/or contact the British Veterinary Nursing Association for further advice.
6. “With respect to Schedule 3 you mentioned the importance of owner’s wishes, to what extent is it necessary to get explicit owner consent for a nurse to carry out procedures, especially minor surgery, in addition to normal consent to carry out the procedure.”
Our guidance in these cases is that the veterinary surgeon and/or veterinary nurse should ensure that the client is made aware of any procedures to be performed by practice staff who are not veterinary surgeons. Explaining who will carry out the procedure should form part of the discussions with the client when obtaining informed consent and the purpose of the consent form is to record the client’s agreement to treatment based on knowledge of what is involved and the likely consequences. Further guidance is available at www.rcvs.org.uk/consent.
7. “Can practices advertise for “unqualified veterinary nurses”? Surely this is against everything we are working towards?”
At the moment the title ‘veterinary nurse’ is not legally protected and so practices could, in theory, place such an advert. The phrase ‘unqualified veterinary nurse’ is misleading – if an individual does not have a veterinary nursing qualification and their name is not on the Register, then they should not be referring to themselves as a veterinary nurse. It is worth noting that the RCVS Practice Standards Scheme prohibits practices accredited as General Practice or above from using ‘veterinary nurse’ to describe staff whose names do not appear on the Register of Veterinary Nurses. In addition, the RCVS would like to increase the confidence of the public in veterinary nurses with formal statutory protection of the title.
8. “If a practice is owned by a veterinary nurse, as occasionally happens now, how does that work with Schedule 3 as the nurse is the employer, not the employee of a veterinary surgeon.”
For the Schedule 3 exemption to apply, the veterinary surgeon directing the registered or student veterinary nurses to carry out medical treatment or minor surgery (not involving entry into a body cavity) must be either the employer or acting on behalf of the employer of the veterinary nurse. In addition the veterinary surgeon must have the animal under their care and must be satisfied that the veterinary nurse is qualified to carry out the medical treatment or minor surgery.