Consent, euthanasia and other professional duties Flashcards
What are the 5 principles of veterinary nursing?
- Honesty and integrity
- Professional accountability
- Professional competence
- Client confidentiality and trust
- Independence and impartiality
Define the DUTY OF CARE
A moral or legal obligation to ensure the safety and wellbeing of others
A nurse’s duty of care in order is animals, clients, employers
Define SLANDER
The action or crime of making a false spoken statement that is damaging to a person’s reputation
Define LIBEL
A published false statement that is damaging to a person’s reputation
Define LITIGATION
The process of taking legal action
Define MISCONDUCT
Unacceptable or improper behaviour
Define GROSS MISCONDUCT
Unacceptable or improper behaviour of a very serious kind, such as knowingly doing something wrong
Define MALPRACTICE
Working below accepted professional standards
What is the purpose of criminal law?
To maintain law and order via the magistrates and crown courts
What is the purpose of civil law?
To uphold the rights of the individual and to decide if there has been a breach of rights through a trial. Cases are heard in the county and high courts
Who decides the outcome in a criminal case?
A magistrate or jury
Who decides the outcome in a civil case?
A judge
What are some of the powers of redress in a criminal case?
Prison, fines, suspended sentences, probation etc
What are some of the powers of redress in a civil case?
Payment of damages, an injunction
What is the pursuer in a criminal case called?
A prosecutor
What is the pursuer in a civil case called?
A plaintiff
Define WHISTLEBLOWING
The process of a person (usually an employee) who reveals information about a company or organisation that may be deemed illegal immoral, illicit, unsafe or fraudulent
What are some examples of inappropriate behaviour that is relevant to the RCVS?
- negligence
- malpractice
- misconduct
- gross misconduct
- any criminal or civil issues
What is the name of the piece of legislation that protects whistleblowers?
The Public Disclosure Act (1998)
What are the key points of the Public Disclosure Act (1998)?
- the whistleblower does not need to be named
- the whistleblower cannot be dismissed for their statements
What are some circumstances where an animal can be given treatment without informed consent from the owner?
- emergency treatment
- in welfare cases
- where there is no available owner, e.g. strays
- for first aid (stemming bleeding, CPR, warming, provision of oxygen)
What are the key elements of consent?
- it is a formal agreement between client and practice
- it should include a fee estimate
- it should be informed
- it should involve a full explanation of possible risks and side effects
- it does not have to be written, but verbal consent should be given to two people, including ideally the treating vet
- agents of the owner can sign on their behalf but they must state they are an agent, and who they are in relation to the owner
Define INFORMED CONSENT
An essential part of any contract. It can only be given to a client who has been given the opportunity to consider a range of treatment options, with associated fee estimates, and had the significance and main risks explained to them
How old does a person have to be to give consent?
16 years old
What is a grey area in terms of consent?
16-18 year olds. A person has to be 16 to give consent but 18 to enter into a financial contract. It is up to the vet to decide if they are happy to accept consent
Who can decide if a client is legally competent to give consent to treatment?
The treating vet surgeon
How old does a person have to be to enter into a financial contract?
18 years old
How is the design of the consent form important?
It must be clearly laid out and easy to read and understand. It should include possible costs, risks associated with the procedure, and a place for the owner or agent to sign and print their name.
Ideally two copies - one for owner, one for practice
What are the two types of consent?
Express consent - the owner very much ‘opts in’ following a full explanation of the risks, costs and outcomes of the procedure. It can be verbal or written.
Implied - a behaviour or action on the part of a person which indicates their acceptance for a treatment. This is not enough for informed consent for a procedure
What should a vet check when gaining consent from someone?
- is the person able to take in and retain information about the treatment
- does this person believe or understand it
- can the person weigh up the information and make a decision?
What piece of legislation covers those who lack mental capacity?
The Mental Capacity Act (2005) - even when someone lacks the capacity they should still be treated the same way, and have all treatment options, costs etc explained to them alongside an agent
What is the minimum information a client should be informed of when consenting to a procedure?
- an associated cost estimate
- an explanation of the nature and purpose of the procedure, using correct language
- risks and benefits of the procedure
- other treatment options
- who is performing the procedure - vet? nurse?
Define an OVARIOECTOMY
The surgical removal of the ovaries
What are some potential barriers to informed consent?
- Language barriers
- Disability
- Mental capacity
- Lack of time
- Lack of training for staff members
- Emergency situations
- Distractions
Define an OVARIOHYSTERECTOMY
The surgical removal of the ovaries and the uterus
Define EMPATHY
The ability to understand and share the feelings of another.
This is particularly important for nurses and vet nurses
Define NON VERBAL COMMUNICATION
The transmission of messages or signals through a non verbal platform
What are some examples of non verbal communication?
- gestures such as waving or thumbs up
- body language and posture
- facial expressions
- eye contact and lack of (oculesics)
- clothing
- hair styles and make up
- symbols/signs
- type of speech
- haptics (touch communication)
Define COMPASSION FATIGUE
The physical, emotional and psychological impact of helping others. It is an extreme state of tension and preoccupation with those needing to be helped, and can cause secondary trauma stress to the helper
What are some examples of charities that help veterinary professionals?
Vetlife
Mind matters
The Samaritans
What does the RCVS list as the veterinary nurse’s responsibilities to their clients?
- being open and honest with clients via both verbal and non verbal communication
- providing impartial and independent advice
- responding promptly and courteously to complaints and criticism
- keeping accurate, correct clinical records
- ensuring the gaining of informed consent prior to any procedure or treatment
What should a veterinary nurse’s role be through palliative care and possible euthanasia?
A supportive role should be adopted, and the veterinary nurse should help to guide the client through
Define PALLIATIVE CARE
Care for the terminally ill and usually their families. End of life care with the assumption that the patient is not going to get better
What are some bereavement links or support charities for owners?
Blue Cross Supportline
Cats Protection
Vetlife
What should be considered during the process of euthanasia?
Decisions - these should ultimately be the owners, with veterinary professional guidance. No personal opinions should be given.
Palliative care - is the owner capable of giving palliative care? Does their home/lifestyle allow it? Will they follow the care plan effectively to manage the condition?
Follow up clinics - ideally with the same vet or nurse
Care after euthanasia - this could be through care packages, directing clients to support networks, sympathy cards etc
How should quality of life for an animal be assessed?
A combination of clinical knowledge and possibly QOL framework scales. An example is the HHHHHMM scale.
What are criteria in the HHHHHMM scale?
Hunger, hurt, hydration, hygiene, happiness, mobility, more good days than bad
Each is marked from 0-10, and a total mark of more than 35 is a good quality of life for a pet.
In what ways can grief be expressed?
Physical, behavioural, social, cognitive
It may not always be visible.
How many different types of grief are there?
15 - remember, grief is not the same for everyone and does not follow a set path.
