A well-trained nursing staff is an empowered nursing staff creating increased job satisfaction that results in increased staff
retention. All the while your nursing staff is generating revenue by freeing up your time to see more patients or work on
other practice priorities while they are billing for services that you previously performed.
Develop a plan
Planning is an essential part of working efficiently to complete daily surgeries and back office procedures. It is beneficial
to have an early morning meeting with staff working in this area to plan the day and create a clear outline of how the day
needs to flow. Identify one nurse as the leader in the prep room on that day. It is that nurse's job to coordinate daily activities
and plan the work flow in order to achieve an efficient completion of all tasks. In many single veterinarian practices morning
appointments precede the day's surgeries and day-admits procedures. The nurse in charge, with the assistance of a veterinary
assistant, can be performing pre-anesthetic physical examinations on surgical patients, completing blood draws and pre-anesthetic
blood testing, placing intravenous catheters in patients, premedicating and setting up the surgery for the day's procedures
so that when the veterinarian has finished appointments they can walk into the surgery and start procedures. If all procedures
have been standardized then it is easy for the nursing staff to follow established protocols with minimal assistance from
The nursing staff is perfect to discharge pets since they are the ones providing nursing care during the pet's hospital stay.
It may also be that nurse's responsibility to admit all in-patients for that day. Our hospital uses an admitting form that
is completed prior to patients receiving an anesthetic while in our care (Figure 1). This form is completed by the nurse at
the time of admitting while obtaining consent for services to be performed. Then the back of the form is used to record the
anesthetic monitoring (Figure 2).
Once the daily procedures have been completed there are still opportunities to leverage your staff by training them on the
client education required to discharge hospitalized patients. Once again, standardization is essential so that all clients
receive the same comprehensive discharge instructions. Discharge instructions for routine procedures can be prepared ahead
on standard forms, with room to write individualized comments pertaining to the pet and any homecare instructions that are
unique to that pet. These forms should proudly display your hospital logo and contact numbers. They can be personalized with
cute pet and seasonal stickers.
Using staff effectively
The members of the nursing staff are the perfect people to perform pet discharges since they are the ones providing nursing
care during the pet's hospital stay. Train your staff on what information you want conveyed to the client, arm them with a
discharge form that they customize for each patient and watch them work their magic with the client. Once again when you empower
your staff with knowledge they are more confident to take on new responsibilities, which ultimately leads to increased job
satisfaction. It also creates an opportunity for your nursing staff to build relationships with clients, strengthening their
bond to your hospital.
Your nurses should also conduct telephone follow-ups to complete the surgical patient service cycle. Our nurses contact clients
whose pets have had a general anesthetic within two to four hours after discharge to address any immediate concerns and hopefully
avoid a panicked call to the veterinarian after hours. This call is followed by a telephone recheck two days later to ensure
the pet's well being and address any new client concerns. Not only does this avoid unnecessary calls to the veterinarian,
but it is also great client service. Your nursing team will require training on how to handle common post-anesthetic client
concerns and when these concerns warrant advice from the veterinarian.
This discussion has focused on in-hospital training, which is an essential part of efficient work flow but don't ignore outside
opportunities of staff training. Equipment companies often have very knowledgeable representatives that will educate your
staff on how to properly use and maintain surgical instruments and equipment, and they will do it for free. The results of
financial investment in your staff will often benefit the practice many times over. For instance, there are many veterinary
conferences that provide a host of support staff training sessions. We recently took two staff members to the Central Veterinary
Conference in Kansas City (we are located in Central Ontario). These nurses had the opportunity to sit in on lectures about
pain management, anesthetic monitoring and many other topics not related to surgery. Continuing education for staff at this
level validates their importance to your practice and creates renewed job excitement and rejuvenation.
Invest in training your staff and then sit back and enjoy the free time you have created for yourself because you are no longer
needed to perform technical duties within your practice. And relax knowing that your nurses are not only educating your clients
but they are providing them with excellent client service.