Regulations relating to Registered Veterinary Nurses in the

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Regulations relating to Registered Veterinary Nurses in the United Kingdom David Smith Edinburgh Napier

Regulations relating to Registered Veterinary Nurses in the United Kingdom David Smith Edinburgh Napier University Barbara Cooper Principal of the College of Animal Welfare

The Royal College of Veterinary Surgeons (RCVS) • The Royal College of Veterinary Surgeons

The Royal College of Veterinary Surgeons (RCVS) • The Royal College of Veterinary Surgeons exercises functions under the Veterinary Surgeons Act 1966 but was brought into being by a Royal Charter of 1844 • A Supplemental Royal Charter of 2015 makes it the regulator of registered veterinary nurses

Regulation of veterinary surgeons in the UK Current legislation based on Veterinary Other relevant

Regulation of veterinary surgeons in the UK Current legislation based on Veterinary Other relevant legislation Surgeons Act (1966) makes it: “unlawful for anyone other than a registered veterinary surgeon, or someone entered in the Supplementary Veterinary Register, to practise veterinary surgery (whether or not for payment)” “veterinary surgery” means the art and science of veterinary surgery and medicine be taken to include— (a) the diagnosis of diseases in, and injuries to, animals including tests performed on animals for diagnostic purposes; (b) the giving of advice based upon such diagnosis; (c) the medical or surgical treatment of animals; and (d) the performance of surgical operations on animals. • • • • Royal Charter of 1844 (Foundation of RCVS) Supplemental Charter of 1876 Supplemental Charter of 1879 Veterinary Surgeons Act 1881 Supplemental Charter of 1883 Supplemental Charter of 1892 Veterinary Surgeons Amendment Act 1900 Supplemental Charter of 1914 Veterinary Surgeons Act (1881) Amendment Act 1920 Supplemental Charter of 1923 Veterinary Surgeons (Irish Free State Agreement) Act 1932 Supplemental Charter of 1932 Veterinary Surgeons Act 1948 Supplemental Charter of 1967 Supplemental Charter of 2015

The role of nursing in the clinical care and recovery of animals • The

The role of nursing in the clinical care and recovery of animals • The ‘nursing’ role in clinical practice has long been recognised “strict attention to the animal’s comfort and well-being in matters of warmth, quietude, cleanliness, pure air and diet” - Steele 1888 • In the UK, official acknowledgement of the importance of the role has been slow and serpentine – In 1934 the first attempt was made to get the RCVS to recognise the title ‘Canine nurse’ failed – In 1965 the BVNA was born but had to change its name a year later because the title ‘nurse’ was protected by statute

Professionalization of Veterinary Nurses Time Line • 1961 – First RCVS approved Animal Nursing

Professionalization of Veterinary Nurses Time Line • 1961 – First RCVS approved Animal Nursing Auxiliary (ANA) training scheme • 1984 – Title ‘veterinary nurse’ first used • 1991 – Veterinary Surgeons Act 1966 amended to formally recognise the role of VN in law (schedule 3) • 1997 – RCVS accredited as awarding body for VN qualifications • 2002 – First BSc honours degree in VN awarded • 2007 – Non-statutory register of VNs • 2011 – Introduction of disciplinary system and code of professional conduct

Professionalization of veterinary nurses • Some resistance to this from within veterinary profession –

Professionalization of veterinary nurses • Some resistance to this from within veterinary profession – On inauguration of the first training scheme a Veterinary Surgeon remarked that the RCVS had "created a Frankenstein and would rue the day!" – Badger 2005 • Training veterinary nurses was seen by some veterinary surgeons as an unnecessary complication and expense

Who nursed animals before the advent of the trained veterinary nurse? • Locally employed

Who nursed animals before the advent of the trained veterinary nurse? • Locally employed people (usually women) with few relevant formal qualifications • Jack (or rather Jill) of all trades whose duties were many but not well defined – Receptionist – Kennel assistant – Administrator – Clinical assistant

This model worked for decades in the UK, why did it change? • Increased

This model worked for decades in the UK, why did it change? • Increased complexity and technical demands of veterinary medicine • Increased expectation of owners of what veterinary surgeons should do • Increased intrinsic value of animals by society • Increasing need for specialists in peri-operative care • Increased need to focus on client experience • Increasing impact of nursing expertise on survival and recovery of patients • Increasing specialisation of veterinary surgeons towards clinical expertise rather than client/practice management • Increased commercial pressures on practices to maximise return on human resource costs

Perceived threats to the role of veterinary surgeons • An erosion of statutory protected

Perceived threats to the role of veterinary surgeons • An erosion of statutory protected status • Establishment of an additional tier of animal health professionals that creates a grey area where un-suitably qualified personnel could operate • Erosions of professional standards and accountability • Undermining the viability of veterinary businesses →Cheap less qualified personnel doing the job of the professional

How are these legitimate concerns of the veterinary profession addressed? • By professionalising the

How are these legitimate concerns of the veterinary profession addressed? • By professionalising the veterinary nurse so: – Their role within practice is limited by statute – Their professional conduct is regulated by a professional body – They are trained and educated to a standard deemed appropriate and verified by the professional body

Statutory limitation of Veterinary Nursing role Schedule 3 of the Veterinary Surgeons Act 1966

Statutory limitation of Veterinary Nursing role Schedule 3 of the Veterinary Surgeons Act 1966 • 1991 amendment – Veterinary nurses are permitted to provide any medical treatment or carry out minor surgery (not involving entry into a body cavity) to a companion animal at the direction of the veterinary surgeon responsible for the care of the animal provided the veterinary surgeon was the employer, or was acting on behalf of the employer, of the veterinary nurse – A companion animal was defined as 'an animal kept as a pet or for companionship, not an equid or farm animal‘ • 2002 amendment – Appropriately trained Veterinary nurses allowed to treat all animal species

What constitutes 'medical treatment or minor surgery'? • This is largely a matter of

What constitutes 'medical treatment or minor surgery'? • This is largely a matter of professional judgement of the directing veterinary surgeon to interpret the phrase with common sense. • The following considerations should be taken into account by the directing veterinary surgeon: – How difficult is it to carry out the procedure in question competently and successfully, bearing in mind the risks inherent in the procedure? – Has the nurse who is to be asked to carry out the procedure been given training and gained experience in the performance of the procedure, been made aware of the risks associated with the procedure and is he / she now competent to carry it out? – Does the nurse not only have the expertise and general competence to carry out the procedure, but also the experience and good sense to react appropriately in the event of any problem arising? – If necessary, will a veterinarian be available to respond immediately to any request for assistance? – Does the veterinary nurse feel confident that he / she can carry out the procedure - or is he / she anxious about being asked to undertake tasks beyond his / her capabilities? )

Regulation of veterinary nurses by the RCVS • Veterinary Nurses must comply with two

Regulation of veterinary nurses by the RCVS • Veterinary Nurses must comply with two sets of regulations: – RCVS Code of Conduct for Veterinary Nurses 1. 2. 3. 4. 5. Professional competence Honesty and integrity Independence and impartiality Client confidentiality and trust Professional accountability – RCVS Veterinary Nursing byelaws • Procedures and penalties for misconduct are set out in Veterinary Nurse Conduct and Discipline Rules (2014)

Minimum requirements for registration as a veterinary nurse • Within a RCVS registered teaching

Minimum requirements for registration as a veterinary nurse • Within a RCVS registered teaching practice students must – Complete at least 2100 hrs (60 weeks) of work placement – Demonstrate competency in all RCVS day-one skills (600+) • Complete a training programme with a recognise training provider to at least Level 3 Diplomas standard either on a fulltime basis or apprenticeship-style alongside a job in veterinary practice • Be enrolled with the RCVS as a student Veterinary Nurse • Comply with RCVS Code of Conduct for Veterinary Nurses • Comply with the RCVS VN Byelaws 2011 • Work within the Veterinary Surgeons Act 1996 Schedule 3 Amendment (2002) Order

Declaration on professional registration On registration with the RCVS, and in exchange for the

Declaration on professional registration On registration with the RCVS, and in exchange for the right to practise veterinary nursing in the UK, every registered veterinary nurse makes a declaration, which, since 1 April 2012, has been: " I PROMISE AND SOLEMNLY DECLARE that I will pursue the work of my profession with integrity and accept my responsibilities to the public, my clients, the profession and the Royal College of Veterinary Surgeons, and that, ABOVE ALL, my constant endeavour will be to ensure the health and welfare of animals committed to my care. "

Market for registered veterinary nurses • 5, 069 Vet practices in the UK –

Market for registered veterinary nurses • 5, 069 Vet practices in the UK – 35% approved to train VNs – 15, 915 Vets in practice, 10, 097 VNs in practice – 0. 56 RVNs per vet • 957 VNs joined profession, 582 VN left register • Net Growth = 375 • Veterinary industry developing with larger group practices where VNs add value to the business

What Edinburgh Napier University offers • The only pre-qualification Veterinary Nursing Honours Degree programme

What Edinburgh Napier University offers • The only pre-qualification Veterinary Nursing Honours Degree programme in Scotland • A four year BSC (Hons) programme offering the opportunity to register as a VN with the RCVS on graduation • Direct accreditation • 98% employment of VN graduates • A Higher Education student experience in dynamic city setting

Trends in applicants and graduates • UCAS mean tariff score of applicants has increased

Trends in applicants and graduates • UCAS mean tariff score of applicants has increased from 368 in 2008 to 456 in 2015 • Higher entry requirements raised from CCCC to BBBC • 62% of graduates have 1 st Class and 2 (I) degrees

Programme of study Year 1 Trimester 1 Ø Foundations of Veterinary Nursing Theory Ø

Programme of study Year 1 Trimester 1 Ø Foundations of Veterinary Nursing Theory Ø Principles of Small Animal Care Ø Veterinary Anatomy and Physiology Trimester 2 Ø Veterinary Nursing Practice 1 Ø Veterinary Science in Action Trimester 3 Ø Veterinary Nursing Practice 2 Year 2 Trimester 1 Ø Veterinary Pathology Ø Diagnostics for Veterinary Nurses Ø Ethical, Legal and Professional Issues in Healthcare Trimester 2 Ø Veterinary Nursing of exotic animals Ø Theatre Veterinary Nursing and Anaesthesia Ø Application of Small Animal Nursing Care Trimester 3 Ø Veterinary Nursing Practice 3 a Year 3 Trimester 1 Ø Veterinary Nursing Practice 3 b Trimester 2 Ø Equine veterinary nursing Ø Animals in Society Ø Veterinary Nursing of wild and captive species Trimester 3 Ø Veterinary Nursing Practice 4 Year 4 Ø Veterinary Nursing Honours Project Ø Specialised Veterinary Nursing Ø Pharmacology Ø Option Module Ø Veterinary Nursing Elective Practice

Why do we want to link with external partners? • Improve the professional mobility

Why do we want to link with external partners? • Improve the professional mobility of VNs across the world • Develop leadership skills in our graduates • Improve problem solving skills is our graduates