Veterinary Nurse Training - Examples

LECTURE EXAMPLE

The following is Lecture 8 from Part 1 Volume 1, and is a very typical lecture from NVQ Level 2. It follows a lecture in which the construction, heating, lighting, ventilation, sound-proofing and cleaning of hospitalisation kennels is described. This lecture is typical of what you will be expected to cover with the training nurse in one hour. It might look as though this is quite a lot to learn in an hour, but if you are good enough to have the basic qualifications to enter Veterinary Nurse training, you are good enough to learn these lectures in the time allocated. Trust us, we've been training student nurses for twenty years and we know you can do it!

Although they are not shown here, the lecture is accompanied by a number of diagrams to illustrate the text. Also, as you will have seen from the Study Plan Example, the lecture is accompanied by a practical task which should be performed under the supervision of the training nurse after the knowledge contained in the lecture has been learned.

HOSPITALISATION

ADVANTAGES OF HOSPITALISATION

1) Animals can be watched continually for any change in their condition.
2) Trained staff are more likely than lay people to notice significant clinical changes and respond to them.
3) Hospitalised animals always get the correct dose of any treatment at the correct time.
4) Medication can be given by repeated injections so that the medication works more quickly and is effective even if the animal is vomiting.
5) Some medication is only available in injectable form and could not be included in a home-treatment regime.
6) The animal can be nursed more intensively, eg. it can be given FLUID THERAPY.
7) The animal's environment can be controlled, eg.
it can be warmed if its body temperature falls
its diet can be controlled absolutely
you can reduce the possibility of it causing itself more damage, eg. spinal cases
8) The animal is removed from the owner's home, so they are not faced with cleaning up after the animal when it vomits or has diarrhoea, which may be distressing for them.
9) The animal is continuously available for taking samples or performing tests if these are necessary to make a diagnosis or monitor progress.
10) The animal gets more peace, quiet and rest than it would probably get at home.
11) The animal is less likely to be able to spread a contagious disease to other animals while in a controlled hospital environment rather than being exercised in a public place by its owner.

DISADVANTAGES OF HOSPITALISATION

1) Animals may be distressed when left by their owners, eg. bark continuously, become vicious.
2) Animals may refuse to eat or be very depressed when in hospital, so it may be hard to recognise that they are actually getting better.
3) Animals desperate to escape may injure noses, teeth or paws trying.
4) Animals in hospital may acquire diseases from other patients.
5) Animals get less exercise in hospital than at home. This can cause stiffness in arthritic patients.
6) Animals living in hospital kennels can be hard to keep clean and dry, especially if suffering from vomiting and diarrhoea. This can be very distressing for the animal.
7) Barking in the veterinary centre at night may lead to complaints from the neighbours.
8) Owners may not wish to be separated from their pets.
9) Other pets in the owner's household may pine if a pet is in hospital.
10) It's expensive.

WHEN AN ANIMAL IS ADMITTED
The nurse should record:-
1) Owner's name, address, telephone number and work telephone number if necessary.
2) NAME of animal, SPECIES, AGE, SEX and if neutered.
3) Label COLLARS, LEADS, CARRYING BOXES with owner's name on a tag or label.
4) DATE and TIME of ARRIVAL.
5) Details of DIET if animal has any unusual requirements.
6) Details of VACCINATION. NB. All animals coming into a boarding kennels should be vaccinated within the previous twelve months.
7) Reason for admittance if in a HOSPITALISATION KENNEL.

WHILE THE ANIMAL IS IN THE KENNELS
The nurse should record:-
1) Animal's general behaviour - BRIGHT or DULL.
2) Whether it has DEFAECATED or URINATED. What the FAECES are like and what the URINE is like.
3) Whether it has EATEN or DRUNK.
4) Any other signs of ILLNESS.
5) Any DRUGS given to the animal, the time at which they were given and the ROUTE OF ADMINISTRATION, eg. by mouth, subcutaneously, intramuscularly etc.
6) Any FLUID THERAPY given to the animal; type of fluid, when, how much and by what route.
7) Any TESTS done on the animal and their results.
8) Any COMMENTS which the vet wants to make particular note of during his ward round.

GROOMING
All animals need grooming daily. When they are well, they do this themselves.
When they are ill, they may need to have it done for them.
Grooming is necessary because:-
1) It keeps the animal clean and happy.
2) You can spot ECTOPARASITES - these are parasites living on the outside of an animal, eg. fleas, and get rid of them.
3) It stimulates sebaceous secretions which help to keep the coat healthy.
4) It stops the fur from getting matted.
Of course, long haired animals need much more grooming than short haired ones.

To groom an animal you need BRUSHES, preferably made of materials which can be sterilised in an AUTOCLAVE to prevent the spread of skin diseases which can be passed to other dogs by brushing, eg. ringworm.
You also need COMBS to remove stubborn mats and a CARD to clean the brush against to get rid of hair.
You can remove dead hair that has fallen out just by stroking the animal.

TYPES OF BRUSH AND COMB
a) BRISTLE BRUSH
This is made of natural or synthetic bristle on a wooden handle. It is useful for brushing short-coated dogs.
b) PIN BRUSH
These have straight metal pins with rounded ends on a rubber backing attached to a handle. They are useful for long, silky coats and feathers.
c) SLICKER BRUSH
These are similar to pin brushes but have bent metal pins on a rubber backing attached to a handle. The bend in the pin makes it stronger, so it can be used in heavier coats. They are useful to remove small knots, but may damage the skin if used too aggressively.
d) HOUND GLOVE
This is a material glove coated on the PALM with short bristles or plastic bumps. It is useful to remove moulted fur from short-coated dogs.
e) GROOMING COMB
This is a comb with metal teeth which have round ends set well apart to allow the comb to run freely through even thick coats. It is available in various tooth widths and lengths.
f) FLEA COMB
This is a very fine-toothed comb usually set in a plastic handle and is used to trap and remove fleas. This is a very ineffective method of flea control.
g) STRIPPING COMB
This has very short teeth and a metal cutting blade set at right angles to the teeth. It is used to remove the top coat, mainly on short wire-coated breeds, and to trim the undercoat hairs to an even length.
The cutting blade on a stripping comb is removable for sharpening or replacement.
h) DEMATTING COMB
This has teeth which are blunt on one side with a sharp cutting edge on the other. The sharp edge may be scalloped or have serrations for greater cutting effect. It is only used to cut out mats and is safer to use for this than scissors, because there is no danger of cutting the skin if the comb is used properly. It also allows the maximum of coat to be preserved after the mat has been cut up.
Dematting combs often have teeth which are removable for sharpening or replacement.
i) GROOMING AND DEMATTING RAKES
These are the same as grooming and dematting combs,with the same kinds of teeth but with rake handles rather than comb handles. It is easier to damage skin with rakes than with combs as more force can be exerted, so care must be taken when they are used.
j) TRIMMING SCISSORS
These have long, tapering points and are used to trim around ear edges etc.
k) TOE SCISSORS
These have very short blades with blunt ends and are used to trim around the toes.

When you groom an animal you should also:-
1) Clean its eyes and nose using a cotton bud soaked in warm water.
Always use a separate cotton bud for each eye or you may spread infection from one to the other.
2) Clean its ears if there is a lot of wax around the external ear canal. Always get a vet to check if the dog has got ear mites or another ear infection.
3) Clean around its anus.
In the male, clean around its preputial orifice.
You must clean away any discharges on any part of the animal's body because if they dry on, they stick and make the skin sore.

When you clean an animal, you should also check its MUCOUS MEMBRANES. These are the linings of its LIPS, VULVA or PREPUCE and its CONJUNCTIVA. They may change colour if the animal is unwell, eg. become white or blueish if it has heart failure or become yellow if it is jaundiced.

BATHING
If an animal in hospital becomes severely contaminated with body fluids, eg. urine, vomit, diarrhoea, it will need bathing.
Bathing is necessary
i) To prevent dirt and fluids scalding the skin and causing sores.
ii) To make the animal feel more comfortable.
iii) To make it more pleasant and easier for the nursing staff to handle.

EQUIPMENT FOR BATHING AN ANIMAL
Suitable shampoo
A bath of appropriate size, preferably with a shower attachment
Cotton buds
Claw clippers
Protective clothing for the staff
Towels/hair dryer
Appropriate brush/comb/card
A helper to hold the animal while it is being bathed or a grooming stand to tether it to

PREPARATIONS BEFORE BATHING AN ANIMAL
a) Groom it thoroughly to remove all dead fur and mats. Mats become 'set' when wet and are almost impossible to groom out after a bath.
b) Clean eyes, ears, anus and prepuce/vulva (see above). It is also a good idea to check the animal's anal glands before bathing it.
c) Clip any overgrown claws (see below).
d) Many grooming parlours clean or whiten the teeth with peroxide as part of their bathing procedure.

BATHING AN ANIMAL
a) Fill the bath with lukewarm water to a height about half-way up the animal's legs. Test the temperature with the skin on the inside of your elbow/forearm. If it feels hot, add cold water until it is comfortable.
b) Put the animal in the bath and wet it all over. A shower attachment can be used to wet its dorsum, but an old flannel is a more comfortable method of wetting its face. Avoid getting water in its eyes and ears. If necessary, put a cotton wool plug in each ear before you start.
c) Apply shampoo, starting on the back and working it all over, using a soft bristle brush in a circular motion to loosen dead hair and skin flakes. Apply shampoo to the animal's face on a flannel to avoid getting it in the eyes/ears.
d) Rinse well, making good use of your shower attachment. Repeat if necessary.
e) To dry a short-coated dog, you can towel it dry or use a hair dryer. Some grooming parlours have drying cabinets for smaller breeds. Once it is just damp, if you want the coat to lie flat you can pin a towel around the animal's body. This will 'iron' the coat in the right direction.
f) To dry a long-coated dog, blow-dry it with a hair-dryer while combing its fur to prevent mats. DO NOT TOWEL IT DRY, or its coat will certainly knot.

NB. When using hair-dryers, remember that they can burn the skin extremely quickly if held on the one spot for too long. Keep the dryer moving and keep your hand underneath it to monitor the temperature.

BATHING BIRDS
The procedure for bathing a bird is much the same as for bathing any other animal. Birds are usually only bathed if they have become OILED, eg. seabirds caught in an oil spill. Whe DEOILING a bird, remember:
a) Seabirds have very sharp beaks and often peck viciously. It is a good idea to bind tape, eg. ZINC OXIDE PLASTER, around the beak to help prevent injury to anyone handling the bird. It is also a good idea to wear protective goggles.
b) When removing oil, BEFORE WETTING THE COAT rub oiled areas in a suitable commercial SOLVENT, eg. SWARFEGA or DEB. Then rinse off and bath as described above in WASHING UP LIQUID (this is best at dispersing oil). Dry thoroughly and repeat if there is still any oil in the coat.

CUTTING CLAWS
The reasons for cutting claws have been discussed earlier.
If the claw is white you can see a pink core. This is a blood vessel called the 'QUICK'. If you accidentally cut this it will hurt and the dog will bleed.
You cut about 3 mm below the quick.
If the claw is black, you can't see the quick. You have to estimate how long you think the claw should be and cut there.
If there is a white claw on one toe, it can be used as a guide to the length of the quick in the black ones.
As you squeeze the clippers closed, watch for the dog's reaction. If it hurts the dog, stop and move your clippers down because you are cutting too high up and will cut into the quick.

Dew-claws particularly need cutting as they do not touch the floor so do not wear down of their own accord. They can even grow right round and penetrate the toe from which they are growing.

CATS usually don't need their claws cut unless they have become old and arthritic and don't use a scratching board or tree to remove excess claw. If the cat tries to use the furniture to sharpen its claws, the owner may want its claws clipped regularly to try to prevent this.
Their claws are RETRACTABLE unlike those of a dog.

RABBITS and other small animals sometimes need their claws clipped too if they are kept on soft bedding.

IF YOU CUT INTO THE QUICK
If you accidentally cut into the quick, you can stop it bleeding using a CAUSTIC SUBSTANCE, eg. ferric chloride, potassium permanganate or silver nitrate. These substances oxidise tissue to stop bleeding. They are sometimes called STYPTICS.
You dab this onto the end of the nail where it is bleeding, hold it on for 4 or 5 seconds; look to see if the bleeding has stopped. If it hasn't, reapply it for another 5 seconds.

After bleeding has stopped, wash the affected nail in lukewarm water to remove excess of the caustic substance, so that the animal will not burn its tongue if it licks the wound. In addition, potassium permanganate will permanently stain any fabric (such as a car seat) it comes in contact with, and the owner will not appreciate this.

CLIPPING BEAKS
BUDGERIGARS may need their claws cutting occasionally. You do this in the same way as for a dog.
They may also need their beaks trimming. A bird's beak might overgrow because of disease or lack of use. Sometimes it is due to the upper and lower parts of the beak being out of line and not wearing against each other.
You trim it using fine-pointed open ended claw clippers (NOT guillotine-type clippers). You make 2 cuts at right angles to one another to keep the beak the same shape as it was. If you can't manage this, you can make 1 cut straight across the beak. You can then use a nail file to give a better point to the beak.

You must avoid the BLOOD VESSEL which runs all the way down the beak. It is very important that you don't make a budgie bleed, because a few drops of blood is a lot of the budgie's blood volume and they can easily get very ill through losing very little blood.

You can advise the owner to put a little CUTTLEFISH BONE in the bird's cage to keep its beak worn down in future.