Human Nursing v Veterinary Nursing - Guest Blog

Guest Blog by @piranna92 - Hannah Emily Kelly

As a second year veterinary nurse and full time employee in the veterinary industry I find it extremely interesting that Veterinary medicine often replicates that of human medicine. We both deal with a very different type of patient, most Human nurses specify to deal with a certain type of patient be it paediatric, midwifery or cancer patients. Veterinary nurses however deal with a variety of different species, cases and monitor anaesthetics, so I’m guessing the real question is which value of life is more important?

Human life is almost undebatably more important and I have the upmost respect for the people that work within a hospital, I think it takes real courage to work with people when they are terminally ill or in severe pain I know I certainly could not cope with the situation. As I cut my finger open once and bandaged it for two days before admitting I needed stitches, I would not be the best person to react under that pressure.

However there have been recent studies explaining about the importance of people with the human-animal bond, this bond can be interpreted in three ways parent-child, child-parent and sibling -sibling. This “bond” has been described as an emotional tie to even loved ones that have passed or a helping hand through a difficult time of life. So therefore isn’t someone’s “child” just as important as an actual child? There have been several studies that elderly people are more likely to stay and be healthier if they have a pet to keep them company, they are also more likely to maintain a better mental state for longer and spend less time in hospital.

I recently read a article in a nursing magazine comparing the level of compassionate nursing between human and veterinary nursing, good ole Florence nightingale! She was the forefront of the article and how she is known throughout history for her caring nature towards her patients in the most disastrous circumstances. And as much as I reckon I’d look smoking in a bonnet but it’s just not surgically acceptable and there is no way I have enough time on my hands to curl my hair.............even in the old fashioned way, I still like to think that in some way every nurse steps up to her job in whatever field because they care, genuinely care about their patients. We wouldn’t keep going if we didn’t love it, patients or their owners can be aggressive and you may suffer the odd bite or two but when it really comes to it I love my job I want my patients to leave feeling more comfortable than they did when they came in. Nurses whatever kind, work very hard and no matter what every day they are there to hold someone’s hand, paw or claw. 

My patients, and other animals

Today it was suggested by a fellow professional veterinary nurse trainee colleague that I could blog about veterinary nursing v human nursing. Thankyou to @Piranna92, Hannah for this suggestion, which seems very apt as I have recently been blogging about my nursing experience over the years. Only last night on Facebook I was chatting to a friend and past colleague Nick about nursing models and excessive paperwork which prevents us from doing the job we trained for.

I had not considered the fact that nursing models may be mirrored in veterinary nursing, which proved an interesting research point today. A lot of medical research and models have been transferred from medicine to veterinary medicine. One example of this is Roper Logan and Tierneys model of nursing from the good old 1980's. It struck every student nurse with dread as we had to write care plans for patients based on these 12 elements. We all seemed to skip number 10 in our teenage naivety and embarrassing red cheeks at the thought of having to discuss this with a patient.  

Similarly veterinary nurses use nursing models of care such as Orpet and Jefferey (2007) with its 10 abilities to consider all aspects of wellbeing of an animal, not merely focus on the issue of the injury or ailment before them. 

The idea in both cases is that we as nurses are the patients advocate, delivering a personalised plan of individualised care based on all the elements. During my career I found a variety of interpretations of this. Some areas truly delivered personal care plans, involving and empowering the patient, whilst others dealt with it by having filing cabinets of pre written care plans on which you personalised it merely by adding the patients name! With animals of course it would be impossible to discuss the care plan with them, but this can still be achieved by involving the owner is possible to ensure that a routine or favourite food/dislikes are taken into account. Many of the complaints in any care profession are around lack of communication, treating individuals as just that. 

In my current role we use ICPs - Integrated care pathways, an American concept of electronic tick boxes for care delivered. Although my colleagues state this is time consuming, its is no way as long as the tedious hand written care plans of old. The downside though is that the tick boxes "yes", "no", do not allow for shifts from the norm or unexpected incidents. This results in you having to write a lengthy handwritten evaluation note, so has technology really moved us on in time? Don't even get me started on the system crashes and frozen PC screens!

Nurses in whatever job role, have always historically been hand maidens. Over my career I have dutifully trotted behind the Consultant and entourage and been left outside the curtains of the ward round fighting my way back in more times than I care to mention. I have cleared away bloody instrument covered trolleys without a second thought. This is what I trained to do wasn't it? 26 years down the line, I am a little more savvy and now lead the ward round, and woe betide any surgeon who doesn't decontaminate his hands or clean his own equipment away! I am lucky that my Consultant colleagues are in the main respectful of my standing and experience and we work together, as it is a reasonably small unit. I know my veterinary nurse colleagues will also suffer this same inferiority complex at times. We are both professional in our own right and must always strive to be seen as such, as we do respect our surgical colleagues in the main!

The training for nursing is 3 years, versus 2 for veterinary nurses. We both however never stop studying or learning and have a mandatory requirement to  provide continual professional development proof to re register on a yearly basis. This also comes with a fee - we actually pay to work and its never ending in its increase! On the nursing aspect we receive very little in reality for this (not even the old plastic registration card) apart from the protection of a legal case against us. We each have to prove our worth through post registration modules and degree pathways, length of experience no longer worth its salt.

The salary of both professions is in no way comparable. A qualified veterinary nurse can expect between £14-22,000 rising to £25,000 as a senior veterinary nurse, whereas qualified nurses can earn between £18 to £34,000. Perhaps you may argue that human life is worth more? In my eyes veterinary nursing is not just about cuddling animals. Like my nursing profession, it is not glamourous, we both take the rough with the smooth, we roll with the punches/kicks of aggressive patients/animals (and bites). We both deal with emergencies as well as the routine. We clean, decontaminate malodorous and items you don't even want to think about. We both observe, monitor, soothe, reassure, provide a safe clean environment, sterile equipment, care for pre, intra and post operative patients/animals. Both these roles matter. Personally I don't see an animal as any less important than a person in being cared for in a compassionate and thoughtful way. 

I have had aggressive, violent patients as well as easy mannered docile ones. I have had hairy patients as well as smooth. I have had mud covered patients as well as pristine. I have had quiet patients as well as those who bark orders. Nursing versus animal nursing? No difference. We both care, we both want to ease suffering. That's what we train to do every day. Equally as important to a humane society. Hannah, I take my hat off to you and all the very best in your forthcoming exams and future career. I look forward to your guest blog in the future. 

                    

Who would be a nurse? Part two

However good your initial nurse training it can never prepare you for the shifts and events that shape your career. The overwhelming memory of my last year as a student nurse was of a couple running in with a tiny baby into the A & E department, blue, not breathing, motionless. The team dutifully fired into action, faultless and robotic like in their actions. The next 15 minutes became a blur as I secretly prayed for a miracle. The dreaded words "time of death..." resounding in my head. What happened next I would never wish on anyone. I was asked to take the couple to the relatives room. Alone. Me. A mere 3rd year student nurse. A mixture of anger and choked back tears filled my head. The mother white as a sheet, clutching her yellow soft wool blanket. The father, trying to be strong but obviously falling apart. The walk to the relatives room seemed endless and dark. The chairs we sat in pale, a little tattered and worn seemed stark. The fading photography on the walls unwelcoming. As if this was not bad enough, there were two burly police officers waiting to greet us. "A sudden death... must be investigated.. just routine.. nothing to worry about..." I looked at them with disbelief. had they not tact, no common courtesy, no human compassion?

The couple now both in obvious shock, shaking from head to toe, tears falling, no tissues, until I passed them the standard NHS box. Something riled within me, and I said to the officers, "Enough, please, this is not appropriate, step outside until we are ready". I don't know where this came from, we are all prepared in training to be patients advocate, but at this moment, I truly understood what this meant.

Words came from somewhere, I managed to talk to the couple, they talked through their shock, grief, disbelief, thanks to the team, to me for my time. As they left with the police, I felt my own grief kick in. Unfortunately there was no time to discuss this, the shift was 4 hours from finishing and I was needed. The one thing that was wrong, was that no one took time to ask me if I was comfortable with how things went, did I need time out, did I need to talk. From that day on, I vowed never to leave a student or a colleague unsupported and always strive to talk through any issues that arise.

My first shift as a qualified nurse was with another more senior nurse. She hated being in charge and ended up in tears after about 2 hours. The ward in disarray, junior staff unsupervised. Although I could not hold the keys, my natural well meaning "helpful bossiness" took over and I sorted the workload, delegated tasks, and the shift passed with no one the wiser.

I have come across a multitude of leaders in my time. The born leader, who recognises when you need guidance, unclips your wings when you are ready to fly, praises and inspires. The leader who just has to be in charge, with no respect for those in their team, who squashes ideas, puts people down and is destructive but would never even recognise it. I am by no means perfect, but I have always been a hands on nurse. It comes naturally to roll up my sleeves and muck in. Emptying a commode has never been above me and never will be. I could never be "too posh to wash"

On leaving my first job a junior colleague said to me "You will always be respected as you never ask us to do anything you wouldn't do yourself" This stayed with me throughout my career. Although at times I have found the job and the people challenging, if I stopped caring I have always known I would stop nursing, simple as.

My career has covered a variety of speacialities, orthopaedic, nursing homes, medical, gene therapy, clinical investigations, infection control, and now I am a lead ward nurse on a surgical unit and site lead for infection control.

What keeps me nursing? The people who I meet who inspire me, despite their pain and suffering. The people who are not so nice, because this merely sets me a challenge to do better. The satisfaction at the end of a day when I am tired and weary that I have done some good and helped someone. Being a mentor and helping others. Despite the fact that this reminds me how long I have been nursing - now in my 26th year, it still fires my enthusiasm for my profession. I call myself an old fashioned nurse, because my standards are still what they were when I started. My trolleys are still shiny, I set high standards for patients in my care - that they are pain free, comfortable, fed and watered as far as I am able. We all have heard of recent events in the press of shortfalls in care. All I will say is that there is no excuse for poor care or turning a blind eye. We all have an equal responsibility to care for each other and shout out when there is a problem and louder still until we are heard.

Who would be a nurse?

Me. Then, now and probably until I cease to breathe. The moment the uniform goes on (in recent days, scrubs aka Nurse Jackie), I am proud of my profession. I put to one side my own problems and try to do my best for those in my care. I aim to be a happy, cheerful nurse who treats her patient as an individual with respect. I am a team player and equally work well alone. I don't get involved in too much of the gossip, as it bores me, and I merely try to get on with everyone.

I hope I am the kind of nurse someone would want to be looked after by. This would make me happy. I am glad I fought to be a nurse and that I did it just for me, achieved it for myself. My job, colleagues, and patients have helped me through some tough times and I will always be grateful for that. Like everyone I sigh at the end of a busy shift as I open my locker and get changed, but...

A Nurse's Prayer

by Teri Lynn Thompson

Let me dedicate my life today
To care of those who come my way.
Let me touch each one with healing hands
And the gentle art for which I stand.
And then tonight when the day is done,
Let me rest in peace if I've helped just one.

Who would be a nurse? Part One

My first dressing up costume was as a five year old and consisted of a nurses blue and white striped dress, white apron, plastic stethoscope and a cap with a red cross. I remember the local "old school" GP commenting on it as he came on a house visit to my Auntie with whom I lived. He asked if he could rely on me as his assistant.

My Auntie Elsie had various ailments including leg ulcers, chronic diabetes and heart issues. I remember helping the GP as he changed bandages, examined and investigated on his numerous visits. The malodorous and sights never bothered me and it seemed to come naturally to soothe and calm and provide reassurance. As a lone child, I made up many games in my childhood, including playing school. My various teddies, dolls and stuffed animals would all be propped or leaning in rows for today's lessons. They all had a variety of bandages, Elastoplasts (remember them? itchy red rash notwithstanding!) and red patches drawn onto the dressings with a red felt pen. It came naturally to want to cure and heal the sick and needy from even such an early age.

My Mothers psychiatric illness mean't I became a carer of sorts from an early age also. Her various suicide attempts and disappearances became commonplace and I spent most of my teens in psychiatric wards listening and seeing just how this affected peoples lives. It did not get picked up by any school social workers at the time, as I was always fed, clean and tidy and never skipped school - testament to my Auntie who was always supportive. My Mum could help none of it, as it was and is an illness, but it affects those close in such a deep way.

I enjoyed Latin at school and had already decided I wanted to be a nurse and was advised by my language teacher Latin would be useful. However a combination of careers advisers and my Mum did not agree on my choice of profession. This led to me taking Geography which I hated with a passion! I secretly remained passionate about nursing as my chosen career and forged ahead with studying hard. My mothers illness mean't that my concentration was poor and I needed to take some exams again which I did and finally was able to apply. The nursing interview was tough and grueling and I was surprised to be accepted. My mother was not impressed and made no attempt to cover up her displeasure. I never really discovered why it was, but I know she always wanted a career but brought me up as a single parent so perhaps there lied the reason.

My nurse training began in 1987 and I was lucky to have a great group who became known as the "whydowes" because we questioned everything constantly. The training consisted of blocks of theory in a school of nursing and placements on wards and departments within the local hospitals of a West Yorkshire town. My first placement was on a surgical ward - old Nightingale style beds with central tables on which we did our care plans and patients flowers were kept. The uniform was the same colour as my childhood costume but in blocks and a terribly itchy material, necessary black laced up shoes and tights. The best part of the uniform by far was the navy gaberdine cape with a bright red lining and straps which criss crossed over our front. We really thought we were the bees knees walking to and from placement to nursing school. They came in handy on night shifts as a blanket on the draughty old wards.

I remember my first wage slip and still have them all. It seemed so much money and after paying my mum board and lodging having so much in the bank and not knowing what to do with it. My lifestyle was not exactly fast pace and my weekly Saturday night at a local disco with friends did not really eat into it very much. This was all to change however when I got a flat nearby to nursing college with a friend. My Mum had become quite difficult to live with and I needed my own independence  The shock of bills, rent and shopping soon dawned on me and that my wage was really not that big at all!

My early memories are of strict ward sisters. One who ruled with a rod of iron on my first placement, with a starched white cap, and who amazed me as she never came out of her office but knew every last thing about the patients and us! She kindly turned a blind eye to the fact that we smoked in the sluice and there must have been so many half cigarettes hastily flushed away day and night at the sound of footsteps approaching! My sad memory here was of a boy with learning disabilities who collapsed on Boxing day and being asked to run for the cardiac arrest trolley on the next ward. I felt so stupid and slow trying to push the trolley quickly up the hill with my adrenalin pumping through my veins. The awful sight of the boy on the floor in full view of all, and attempts were futile as he must have had a long standing history of cardiac issue unbeknownst to us all. He was such a character on the ward with an infectious smile and laugh. I found it impossible to eat my Boxing Day lunch at home and burst into tears when it all sank in. The Consultants on the ward were always invited into Sisters office for a cup of tea - a full china tea service after ward rounds. They also turned up over Christmas to serve meals and one in particular was very leery to a colleague after having consumed a lot of alcohol. a good job he was not operating that day! For Christmas I received a small parcel from the infamous ward sister and it was a pack of tights. A small but very touching gesture I thought. A firm but fair leader who supported her staff and ensured the best quality care of her patients. The one thing I never understood however was why she made us butter 2 loaves of bread every single morning and offer this to patients prior to breakfast with a choice of jam or marmalade. No one ever wanted it but we did it religiously as per orders day in and day out.

Another favourite ward sister was on a gynaecology ward and would invite students to join her in a game of Trivial Pursuit. There she would be, feet aloft, fag in hand but always ready to roll up her sleeves when required. I found this placement quite alarming with patients having abortions, sad individual stories and horrific sights and memories at times - the dark side of maternity care. I did learn a lot of my technical skills on this ward including aseptic technique with the Ward sister assessing me. Trying to take sutures out whilst being assessed and my knees knocking and hands trembling, but my ward sister was so kind and patient. I passed with flying colours due to having her as one of the best mentors.

Psychiatric wards were really not for me, a little too close to home for obvious reasons. I gritted my teeth and got through it with some difficulty. We always used to joke you couldn't tell the staff from the patients.

A lot of our student nurse duties involved good old fashioned cleaning. A weekend cleaning book where we would primp, preen, shine and polish as if our lives depended on it. Woe betide a slightly smeared trolley being on your watch. We were also expected to know all our patients names, ages, and diagnoses at the drop of a hat if the dreaded Nursing Officer arrived. This was a sort of head Matron. You would have to sheepishly knock on their door when reporting back from sick or for any disciplinary issues. Their main job on nights just seemed to be the ward round. We would carefully flash our pen torches over the bed space and purport to know every last thing about the patient with flourish and all from memory. This was fine until the dreaded Nursing Officer bellowed an correction at you with gnashed teeth.

Our clinical tutors from Nursing School would arrive to teach us the main skills,like how to bed bathe a patient from top to toe. Our Jamaican tutor used to fascinate me as she was so kind and caring and left no part of a patient unwashed. The swish of her uniform was reassuring and the patient knew they were in expert hands. She taught me to treat a patient as if they were your own family. This moral stayed with me from that day forward.

Theatres was an interesting placement. Not really for me as I prefer my patients awake. But I remember a lot of tom foolery including being placed into the scrub sinks and huge buckets on our last day and water fights which ended in water flowing down the main hospital corridoor. Happy Days!