What is the role of a vet nurse? I chat with two nurses — Sr Cursti Potgieter and Sr Vicki Smith — who work at a busy referral practice in Kwa-Zulu Natal.
I always feel excited when I decide on the subject of a new article. It’s like decorating an empty room; the walls need colour, and images and filling the space brims with possibilities.
Before I get my paintbrush out, I would like to turn the mirrors to the wall—just for a moment. The work of a vet nurse is hard; it often includes long and poorly paid hours, it’s physically demanding, mentally and emotionally straining. And the more I learn about workplace abuse and bullying in the veterinary industry, the more I want to cast light into this space and tell you about the brighter side.
Sr Cursti Potgieter and Sr Vicki Smith work at the busy Hilton Veterinary Hospital (HVH) in Kwa-Zulu Natal —a multi-faceted practice that offers general as well as referral services. Under the direction of two specialist vets, Dr Martin de Scally (Medicine and Oncology) and Dr Sara Boyd (Surgery), the nurses in this practice really know their stuff.
Considering the years of work, skill and expertise of these two nurses, my original vision for this piece was purely educational. I imagined decorating this room with fantastic vet nurse facts about cancer in pets or surgical cases —both areas where these nurses have considerable experience.
But, what is a mind if it can’t be changed?
In preparation for our interview, I requested brief voice notes from Cursti and Vicki about their interests.
Their positive words provide beautiful images for me to decorate this room: “Work closely, so well together”, ”hand-in-hand”,” part of a structured team”,” love being part of …, “amazing nursing team”.
What struck me was love and pride. These nurses don’t want to discuss pet health issues; they want to tell me how they feel about their jobs. They want me to share their enthusiasm and to know how proud they are to be members of the Hilton team. They seem empowered, validated, appreciated and satisfied with their work and suddenly I want to paint the walls sunflower yellow.
Many people wonder about the role of a vet nurse. They ask, “What do nurses do in private practice if the vet diagnoses and treats?”
Who could help me decorate better than Cursti and Vicki?
I have always maintained (personal opinion only) that vets are like scientists. For general practice, a vet spends many years learning about body systems; how to manipulate them physically and chemically. Moreover, a specialist can spend many more focussing on a single aspect of his or her chosen field. Diagnosis and treatment — two simple words that sit politely on the tip of an iceberg; arriving at the right answers and making correct treatment decisions however takes years of study and experience.
To balance the scales, the vet nurse operates holistically. Whilst the vet is often consumed by the disease or disorder (and there are exceptions to this), the nurse is consumed by the spinoff seeming to possess outer-worldly multi-tasking skills.
Nurses execute thousands of actions daily that facilitate the diagnosis, treatment, healing and ultimate rehabilitation of the pet once the initial consultation is over. These processes require the combined efforts of both vets and nurses (not to mention all the other staff members that make up a practice).
In a busy practice like Hilton, the nurses have to be qualified to carry out numerous tests, procedures and manoeuvres to get through the day successfully. Whilst not an exhaustive list, here are some of the ‘gadgets’ that are needed to treat and heal patients in a well-functioning practice. They range from diagnostic devices and instruments to all the essential implements and machines that the nurse must not only be able to set up and operate but often calibrate, fix, maintain and clean after every use:
Blood machines, urinalysis, faecal analysis, tests for viral infections, microscope, otoscope, endoscope, gastroscope, arthroscope, hundreds of different kinds of surgical instruments, spinal drill, ultrasound, electroporation device, X-ray machine, CT scanner, ventilator, anaesthetic machine, multi-parameter anaesthetic monitor, fluid pumps, syringe drivers, tonometer, K-Laser, shockwave therapy machine, TENS machine, treadmill, balance balls, textured mats and even a swimming pool with life jackets.
Operating each one of these requires the kind of skill that comes from training, understanding and experience.
A busy practice like HVH employs a rota (Cursti and Vicki agree that working in one department for more than a week can be very taxing). Their rota is one week: hospital, one week: medicine, one week: surgery, one night a week on emergency/after-hours care and one weekend of duty in every three. On top of this, nurses perform vaccinations, emergency care and basic pet health clinics, dentistry (scaling, polishing and suturing), nursing of post-operative (orthopaedic/soft tissue) or medicine cases in the hospital, post-op recovery, bandaging and ordering stock (to name only a few extra responsibilities).
Sr Cursti qualified in 2010 and has been working at Hilton since 2018. She loves to scrub up and assist with complicated surgeries or get involved in anything that happens in the theatre (time permitting) but she also speaks passionately about how much she has learned from the medicine and oncology specialist and head vet.
On her medicine rotation, Cursti assists in consults with Dr de Scally and marvels at what an incredibly good teacher he is. Being a referral practice, they are often faced with complicated (Cursti adds exciting and interesting) medical cases. She quotes one of this specialist’s analogies: A complicated case is like running a hurdles race: To win the race, each hurdle has to be cleared starting with the most difficult one first. He explains to anxious clients that a positive outcome is not always guaranteed but 110% effort is.
Dealing with often complicated cases, Cursti and the HVH nursing team are also serious about food requirements for their recovering animals. They calculate a nutritional score and feed accordingly. A recovering patient needs high-quality nutrition to heal and the nurses have to ensure their wards receive the correct amount by way of different foods and textures, appetite stimulants, or in the case of inappetence, nasogastric or oesophageal feeding tubes.
They also have a trained physiotherapist at HVH with all the necessary tools to return their patients to good health. Sr Cursti says that owners often prefer to leave their pets at the hospital longer to receive the therapy they need to heal.
Sr Vicki Smith qualified as a nurse in 2004 and celebrates a decade with HVH this year. I ask her about her interests at the hospital and what makes her job so satisfying.
Vicki loves anything to do with anaesthetics, lab work, running and maintenance of laboratory equipment and radiology. She appreciates HVH’s level of focus on meticulous diagnoses. The accuracy of diagnostics leads to more precise treatment and ultimately a more rapid recovery. It’s easy for me to simplify these concepts with a few well-appointed words but wait… pull up a bean bag while we take a look at the bigger picture.
It is standard for a nurse to be present during the specialist consults and, once the pet has been seen, a diagnostic plan is discussed with the team who jump into action; there is little wiggle room for mistakes.
Naturally, pets can be nervous and the nurses must be able to administer tests and treatments without causing added stress. But, over the years Vicki has learned that pets are adept at reading human body language. Their owners are understandably anxious (even more so than their pets at times) and this can result in a fractious and fearful animal. She has become an expert at identifying negative situations and uses her experience to create an environment for the pet that is as stress-free as possible.
She has also learned how best to handle animals so that they remain calm. “Sometimes less is more,” she says, “If the owner is anxious and the pet is unhappy, it may be best to have as few people around as possible and exclude noise and bright light.” Less physical handling sometimes results in a more compliant patient too. The hospital also has separate wards and waiting areas for dogs and cats to reduce stress.
In the case of a terrified or aggressive pet, test or treatment which is painful or the necessity that the patient is absolutely still, manual restraint may not be possible. Vicki and the nursing team have the uncanny ability to turn stressful situations around, making the experience for staff, clients and pets as stress-free as possible. The vets also trust the team to decide on which anaesthetic or sedative will be appropriate.
Consider this: Ionic radiation (from X-rays) damages living tissue but remains one of the quickest and easiest diagnostic tools. If a patient is not completely still and positioned correctly, the need for repeated X-rays increases. The nurses take an average of 10-15 X-rays per day. Even one botched attempt per patient can lead to unnecessary exposure for both patient and handler so it is vital that their patients are adequately restrained and that their procedural techniques are 100% accurate.
From a personal perspective and having been a nurse for many years, I am noticing a decline in job satisfaction among nurses. Bullying and harassment seem more commonplace in private practice these days – it’s a disease of our time and is not exclusive to the veterinary profession.
As a member of an international vet nurse forum where nurses network and discuss work and personal issues, I have read the following two posts. These provide good examples of the disease.
“I was wondering whether any of you lovely nurses also struggle with their mental health at work. I am almost qualified and I am really struggling with the emotions of being a vet nurse. I always feel I could be doing more for our patients (when I know deep down I’m doing as much as I can) and really beat myself up about it. I worry about things that may not necessarily happen to the animals and I get myself so worked up. It’s come to the point now where I often question if I’m strong-minded enough to pursue a career that I’ve always dreamed of. I’ve been to counselling sessions in the past to help my anxiety but it didn’t seem to help. Just don’t want to feel like I’m alone. “
“I’ve lost enthusiasm/passion for nursing due to work burnout/depression etc. I still want to be able to use my nursing knowledge as otherwise I feel all these years would have been a waste but I don’t want to nurse anymore. Due to anxiety repping isn’t an option either. I was wondering if anyone else has experienced this and what they have done to overcome it OR does anyone have any ideas on other career/job options in veterinary that I could go into and the best ways of finding them (as struggling to find them on job search sites) ?”
Knowing how hard nurses work and how much physical and emotional effort they put into their jobs, it breaks my heart to read posts like this.
I listened to a Cape Talk interview (31 January 2023) called SA is facing a vet shortage—South African Veterinary Association.
I wonder about the future of vet nurses in light of a shortage of vets and practices in this country. I also wonder about the willingness of vet nurses to increase their workloads because of the shortage on top of dealing with the resulting increase in the negative and stressful working atmosphere.
And so I sit in this beautifully decorated room knowing that in the face of all the bad, Sr Vicki and Sr Cursti are a testament to a practice that values their skills immensely. These two nurses and the management of Hilton Veterinary Hospital give me hope and remind me that my profession is gold.
Co-authors: Sr Vicki Smith, Sr Cursti Potgieter
©Liz Roodt 2023
