The personal and professional role of the RVN - EBVN

Question 1

What are some factors in the workplace that may cause stress and poor mental health for veterinary nurses?

Answer 1

• high workload
• long working hours
• unclear expectations
• challenging ethical situations

Question 2

Define COMPASSION FATIGUE

Answer 2

The physical, emotional and psychological impact of helping others, often through experiences of stress and trauma. Often experienced by caring professionals such as doctors, nurses, vets and vet nurses, and describes a point at which the individual has no more empathy left to give.

Question 3

What are some signs of compassion fatigue?

Answer 3

• feeling detached or numb
• being uninterested in the job
• lack of focus and concentration
• physical symptoms such as lethargy, tiredness and burnout

Question 4

What are some consequences of compassion fatigue?

Answer 4

• poor patient care
• negative effect on the rest of the veterinary team

Question 4

What are some important skills to develop as an SVN?

Answer 4

• time management
• self motivation
• communication, both verbal and non-verbal
• self discipline
• clinical skills

Question 5

What are some key documents that are used to help guide an SVNs and RVNs?

Answer 5

• the RCVS Code of Conduct for RVNs
• the RCVS Fitness to Practice document
• their employment contract
• their apprenticeship and college contract

Question 6

What are some examples of goals that an SVN or RVN can set for themselves in personal and professional life?

Answer 6

They may be time management related, related to mental health or wellbeing, improving personal communication, furthering clinical skills, or promotion seeking

Question 6

What is a SMART goal?

Answer 6

One that is
S - specific
M - measurable
A - achievable
R - relevant
T - time bound

Question 7

What are some examples of charities and organisations that assist with mental health and well being?

Answer 7

• Vetlife
• Mind Matters Initiative
• NHS Every Mind Matters
• Anxiety UK

Question 8

What does Vetlife do?

Answer 8

Free service for vet staff. Provides assistance on mental health support, financial assistance, information and resources

Question 9

What does the Mind Matters Initiative do?

Answer 9

Developed by the RCVS. Provides mental health awareness training and resources to support the wellbeing of veterinary staff

Question 10

What does NHS Every Matters do?

Answer 10

Provides resources and information to help individuals to manage and improve their mental health

Question 11

What does Anxiety UK do?

Answer 11

A national charity. Provides help and support for those suffering from anxiety, stress and anxiety related depression

Question 12

Define EVIDENCE BASED PRACTICE

Answer 12

A problem solving approach to clinical practice that integrates a systematic search for, and critical appraisal of, the most relevant evidence to answer a clinical question.

Question 13

What does evidence based veterinary nursing combine?

Answer 13

Clinical expertise, most relevant scientific evidence, patient circumstances and owner values

Question 14

What are the 5 steps of EVBM?

Answer 14

1. Ask - define a clinical question that can be answered
2. Acquire - find the best available evidence to answer the question
3. Appraise - assess the quality of the evidence source
4. Apply - implement the findings of the evidence into clinical practice
5. Assess - evaluate the impact of the changes

Then we must reflect on the process and decide if it was worth doing.

Question 15

Who should use EBVN?

Answer 15

Anyone in the veterinary profession - all veterinary professionals should aim to seek valid answers to clinical questions and question if ‘how its always been done’ is truly correct

Question 16

What is an actual problem in the context of EBVN?

Answer 16

Identifiable issues that are currently happening e.g. a dog present with vomiting and diarrhoea

Question 17

What are potential problems in the context of EBVN?

Answer 17

Problems that could develop from the initial, actual problem e.g. a dog presenting with vomiting and diarrhoea could become dehydrated and their electrolytes imbalances

Question 18

What is the RCVS recommended method for developing clinical questions?

Answer 18

P - Patient/population - who is the relevant population (be as specific as possible)
I - Intervention - what intervention are you interested in? Could be a diagnostic test, surgery, medical procedure, food etc
C - Comparison/control - must be the opposite of the intervention. No intervention is a valid option.
O - Outcome - what are you going to improve/measure/effect? How does it affect the patient?

Question 19

What are some examples of sources that can be used to help answer a clinical question?

Answer 19

• systematic review
• randomised controlled trial
• cohort study
• case series and case reports

Question 20

What is a systematic review?

Answer 20

An article or book published after examination of published material on a subject

Question 21

What is meta analysis?

Answer 21

Works consisting of studies that use a quantitative method to combine the results of independent studies. Helps to synthesise studies and draw conclusions

Question 22

What is a randomised controlled trial?

Answer 22

A clinical trial that involves at least one control and one test treatment. Treatments should be randomly assigned.

Question 23

What are cohort studies?

Answer 23

Studies in which a defined subset of the population are defined. Follows the cohort over a period of time, assessing the impact of factors such as exposure to a given risk factor

Question 24

What are case control studies?

Answer 24

Compares groups affected and not affected by a certain factor and examines the relationship between the attribute and the level of affectedness

Question 25

What are case reports and case series?

Answer 25

Clinical presentations that may be followed by evaluative studies. There is no comparison or control group

Question 26

What are some examples of primary sources?

Answer 26

Technical data, reports, research data. May include the authors opinion

Question 27

What are some examples of secondary sources?

Answer 27

Textbooks, review papers

Question 28

What should be considered when selecting a source?

Answer 28

• the relevance
• the reliability
• contraindications and inconsistences
• the distinction between facts and opinion
• what kind of evidence is needed and how much?

Question 29

What sort of situations can EBVN be applied to in practice?

Answer 29

• diagnosis and treatment of common conditions
• decisions on the drugs to stock in practice
• formation of clinical protocols including SOPs
• developing personal skills and knowledge base
• review of new information e.g. newly developed products
• VN care planning

Question 30

Define CLINICAL GOVERNANCE

Answer 30

A continuing process of reflection, analysis and improvement in professional practice for the benefit of the animal patient and the client owner.

Question 31

What are the main areas of clinical governance?

Answer 31

1. Animal safety - clear protocols, changes of procedure well communicated, debrief meetings for significant events
2. Clinical effectiveness - regular discussion meetings for the whole team, performance review system, implementation of CPD learnings
3. Patient and client experience - effective case handover between staff members, monitoring and taking on feedback from clients, easily accessible complaints procedure.

Question 32

Why must correct clinical records be kept?

Answer 32

Enables the practice to carry out effective and efficient service to its client and their animal patients

Question 33

What can be some consequences of poor clinical record keeping?

Answer 33

Inadequate patient care
Poor customer service
Lack of information in cases of complaint

Question 34

What are some rules surrounding the keeping of clinical client records?

Answer 34

They must be:
- be accurate, easy to follow and comprehensive
- not contain disparaging remarks
- be written up in a timely manner
- contain name or initials of the author
- be up to date with client contact information