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A day in the shoes of Becky, Registered Veterinary Nurse

In today’s blog, we step into the shoes of Becky, our Anaesthesia and Theatre Nurse and Champion of Eco-Friendliness. Becky is passionate about all things green and ensures our activities are sustainable and eco-friendly as possible. Let’s take a look at what a day in the hospital brings for Becky…

“I like to arrive early so I can start my day with a coffee and read through the day’s procedures. My role as an Anaesthesia and Theatre Nurse means I care for a wide range of patients and work with all our different services. I love the variety this brings, and how much I can learn from my colleagues – they inspire me every day! I am motivated about being the best version of myself. So I take every opportunity to learn from everyone and every situation. Once I have finished my coffee and I know more about the day ahead I change into my scrubs and go downstairs to our clinical areas.

Recording the weight of a feline patient as part of the physical examination.

I start by writing the pre-anaesthesia and sedation forms for every patient who is having a procedure that day. This involves writing the patient’s details (e.g. age, weight, breed) along with a summary of their condition. We also include any medical conditions they have or medications they take. Sadly our patients can’t talk to us (wouldn’t it be great if they could!), so I get this information from their clinical history. We prepare these forms to capture information about the patient’s ‘usual’ health. This sets a baseline for things like their temperature and pulse rate. This is useful to check against when the patient is under anaesthesia and as we track them during the procedure.

Becky performing a physical exam on a patient.

Next, I visit the patients in our Dog Ward and Cat Ward to perform a pre-anaesthesia health check and complete the pre-anaesthesia form. During this physical examination, I assess the patient’s general health. I look at several things including the colour of their gums (this is a good indicator of the patient’s circulatory health). I listen to their chest with my stethoscope and take their temperature. All this information allows us to assess the patient’s state of health, create a suitable anaesthesia plan, and minimise the risk of untoward events during their procedure. If the patients don’t yet have an intravenous cannula placed I will place one with the support of a fellow nurse. Cannulas are how we administer the anaesthetic drugs and other medications.

I then head to the Dog Induction or Cat Induction room (depending on the species of the patient) and prepare the first patient’s tray. This means gathering the required equipment and drugs for the patient’s anaesthesia and subsequent monitoring. I perform a thorough check of the anaesthesia equipment and set up the intravenous fluids (“drip”). We check the anaesthetic machine doesn’t have any leaks where the gas can escape from. We also ensure the monitoring equipment is functioning. With the equipment checked, we are ready to give the patient their pre-medication. Pre-medication keeps the patient calm and comfortable whilst we prepare them for their procedure. Our Veterinary Anaesthetists select the pre-medication used based upon the pre-anaesthesia assessment. Before the Veterinary Anaesthetists administer the anaesthesia we run through the pre-anaesthesia checklist.

I will often lead this process, which involves asking my colleagues a series of questions about the patient and procedure. We ensure everything is answered and checked by several team members before we continue. This checklist is one of many we use in our clinical activities. Although a relatively simple tool, checklists are a part of our daily practice which helps to safeguard our patients. Once the checklist is complete and we are all in agreement, the Anaesthetist administers the pre-medication to the patient.

I then start to monitor the patient and record my findings every five minutes. We record vital signs like heart rate, breathing rate, blood pressure and temperature. Once the patient is anaesthetised, I also check the amount of inhalant (anaesthetic gas) being inhaled by the patient. This is to ensure their level of anaesthesia is deep enough but not too deep throughout the procedure.

Monitoring anaesthesia during a procedure.

Depending on the procedure the patient is having, we gently move them to X-Ray, CT or MRI to capture some images before taking them through to the theatre prep room. For example, we take X-Rays, both pre- and post-operation, for our patients who undergo orthopaedic procedures to check the placement of any implants and reconstruction of their limbs. Whilst in the theatre prep room I work closely with a fellow theatre and anaesthesia nurse. So I will either monitor the patient’s anaesthetic, or I will clip the hair and clean the designated area ready for surgery.

Once in theatre, before the surgeon starts operating we perform the pre-surgery checklist. This checklist ensures, for example, that we have the right patient for the right procedure and the correct, sterilised equipment. We also check the surgical site is clean and accessible for the planned procedure. Again, once everyone is in agreement we start the procedure. During the surgery, I either monitor the patient’s anaesthesia or assist the surgeon. When the surgery is complete we conduct our ‘sign out’ checklist. This checks, for example, that the number of instruments is the same as we had at the start of the procedure, and all swabs have been counted.

When the patient is out of the theatre, I clean them and apply any bandages they may need. I then return the patient to Wards, sometimes after post-operative X-rays have been taken. I and members of the Wards nursing team recover the patient (bring them around from the anaesthesia) and settle them into their kennel. When I hand a patient over to the Wards nursing team I provide an overview of their procedure and how it went. And I let them know about the patient’s post-operative care.

After this handover, I add the anaesthetic records to the patient’s electronic record and tidy away the equipment we have used. I then repeat this process for my next patient and their procedure.

Becky installing recycling bins throughout the hospital.

I enjoy what I do, because of the difference we make to our patients. Being able to improve an animal’s quality of life is what brings me joy every day. There are sad moments when we lose a patient. This never gets any easier. Yet I feel privileged to have been a part in helping them and seek comfort from knowing we did our best for them.

When I’m not nursing my patients I am championing our eco-friendly initiatives here at The Ralph. As Champion of Eco-Friendliness I am always finding new ways for us to be that little bit more kind to our environment. From installing and checking our recycling processes to investigating ways to off-set our carbon footprint. Every little thing we can do matters. It’s great to be able to work with a team who share my passion for keeping our planet thriving.

For anyone interested in becoming a veterinary nurse, or working at a veterinary hospital my advice would be – be stubborn! It might not seem easy, but it is most definitely worth it. Just grab the opportunity to get your foot in the door, no matter what it is.”

Thank you for reading our blog. If you can’t wait for the next instalment of our “A day in the shoes of…” series, you can meet the rest of our team here.

Take care,

Team Ralph

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