Have you ever felt like you’ve hit a ceiling in your role?

Like there’s more you’d love to do, but you’re limited by the clinic you work in - or the cases you see?

If you’re nodding along at your screen right now - I’m right there with you.

I’ve definitely been there - and so has today’s guest.

In these situations, we have 3 options:

1. Leave your clinic, and find somewhere with a caseload that meets your goals,

2. Stay in that clinic and accept that this is how things are, perhaps still feeling unhappy or frustrated that there’s more you can do,

3. Look at ways you can bring those skills into your existing clinic, and work to improve the standards of care for your patients - and boost your job satisfaction whilst you’re at it.

In my case? I left and pursued a new clinic - but that’s not always the right thing for everyone. You might have been at your clinic for a long time, love your team, or feel otherwise happy there. So in this case, how can we improve things?

Today, I’m sitting down and chatting with Medical Nursing Academy member Suzanne Bruinsma. Suzanne is in this exact situation right now - and together, we’re going to explore how you can develop your skills and give better care, regardless of the clinic you work in.

Let’s meet Suzanne

It takes a lot to remain in the same practice for 25 years… but Suzanne did it. And she still loves her clinic and team now.

Suzanne began studying animal care at 17, planning to become a vet - but life soon changed.

As part of her animal care course, she did an internship at a clinic local to her hometown in the Netherlands and loved it. Whilst there, one of the veterinary assistants (similar to a VCA/ANA in the UK) fell pregnant and needed to leave.

Enter Suzanne - who ended up leaving her animal care course and working in the clinic full-time.

However, Suzanne still needed to train as a paraveterinarian (the equivalent to a veterinary nurse or technician in the Netherlands). So she began her diploma, self-studying whilst working full-time in practice.

“So I learned and worked at the same time. Never before has learning turned out to be so much fun and suddenly I found myself with my nose in school books for pleasure. And now, 25 years later, I still work in the same clinic.”

Speaking of that clinic - it’s a small, primary care clinic with a varied caseload and a team who aren’t afraid to get stuck into anything:

“We work here with 2 veterinarians and 5 paraveterinarians. Because we are a small practice, we are all true all-rounders. Everyone does (almost) everything. And I really like that.”

And then there was medicine…

Giving great inpatient care and managing varied diseases is SUCH an important part of any nurse or technician’s role, regardless of the clinics we work in.

In fact - I’ll argue that it’s even MORE important in a general practice setting because it’s these nurses seeing these patients FIRST, and more regularly, throughout the patient’s life.

So great nursing care, tailored to the individual - not just in the clinic, but at home too - is paramount.

It’s also more rewarding to see these patients flourish through our dedication and nursing care…

And that’s something Suzanne loves about it.

“I find it so amazing how extremely sick animals can improve so much. And when you see your patient improving and you see their families so happy… it’s just such rewarding work. And I think this part of our work is most evident in medical nursing.”

“It’s an area where assistants, nurses and technicians can really come into their own. I think it is a shame that we are still often underutilized - especially here in the Netherlands - but that is starting to change.”

“We see the patient. We can accurately assess how the patient feels and what he or she might need.

This really feels like a place where we can take nursing to the next level and develop ourselves enormously.”

The other thing that’s fun about medicine? How ridiculously complex - but fascinating - our bodies actually are.

“I think the body is just a wonderful thing - how everything fits together, works together, and is connected.

If there is a piece wrong somewhere in that puzzle, everything responds to it - and I love solving that puzzle.

Why does this clinical sign happen? Or why is this value so high on their bloods? What does that mean for our patient? And what can we do to make that better again?”

Learning about these conditions, and how they affect our patients, is so important. It’s not only something that allows us to learn and develop ourselves more, but it also means we feel more confident caring for our patients - and in turn, can tailor their nursing care more effectively.

And then there’s the cases that get your blood pumping.

Some of our sickest patients are medical. 

In fact, there is a TON of crossover between intensive care, emergency care and medicine… and these more critical patients provide us with even more opportunities to develop ourselves and give better care.

In Suzanne’s case, the more complex the care - and the harder her brain needs to work - the more skills she gets to use, and the happier she is:

“I love the patients who need intensive care. Now I work in a primary care clinic, so intensive care is a relative concept for us. 

But the worse the patient is, the more IVs have to be connected, the more often I have to measure the blood pressure and put my brain to work... those are the cases that make me happy.

It's like performing magic. Together with your team you really saved a life.

The splenectomies.

The extremely sick pyometra dogs.

The cats that you suddenly get to eat again.

The blocked tomcat who looks relieved once he has a catheter or the rabbit who finally has stool again. In which profession are you cheering when there are droppings again?!

But above all, the feeling when everything seems to go wrong, when it gets a little too exciting, when your adrenaline starts to flow and you still succeed... there is nothing like that feeling.”

So the next time you’re faced with a challenging emergency or more intensive case… take the pressure off yourself. Avoid the panic, and just ask yourself “How can I help this patient right now?”. And focus on that.

Believing in yourself

Confidence is something every veterinary nurse, technician, paraprofessional and even veterinary surgeon has struggled with at some point in their career.

So how can we boost this?

Suzanne’s advice from over 25 years of nursing? Remember you can do so much more than you think - and don’t compare yourself to others.

“Keep believing in yourself. Sometimes things seem difficult, but you can do so much more than you think.

And at the same time, don't be fooled by what others can do, or what they know. Everyone started from zero at some point, everyone had to learn things or do things for the first time. It's never too late to learn something new.”

Find your niche

“Find something you like, where your passion lies. Whether that is medical nursing or behaviour. Maybe orthopaedics? Or maybe you prefer client-facing or administrative roles. Our role is so diverse that there is something for everyone.

Find where your passion lies and develop in that area. And who knows, your passion may change every now and then. That's fun… because you can start learning again.

Ask for help, and be inspired by people around you. And develop yourself within your own capabilities. Everyone can grow.”

Explore different opportunities

Although Suzanne has been settled in her clinic since her career began, exploring different opportunities and seeing what’s out there is one of her top tips for boosting confidence:

“Spend time in different places and find out what suits you. Although I have enjoyed working in the same clinic for 25 years, I regret not looking around more.

If you can, investigate different disciplines within the profession. See how things are done in other clinics, etc.”

If you want to do this without committing to leaving your clinic, many larger hospitals and referral centres welcome visiting nurses. Whether your passion is medicine, ECC, anaesthesia, or you don’t know what you prefer and want to sample it all, you can always do shadow shifts in different areas!

Be prepared

Another great way to feel more confident, especially when nursing complex patients, is to prepare in advance as much as you can.

Of course, this isn’t always possible - but when you have the opportunity, grab it!

“If I know that a specific case is coming, then I dive into the books and make a plan. What else should I think about? What exactly is the condition I am dealing with? Which medications do I use or which should I not use?”

And vice versa... if there is an interesting case that feel like I don’t know much about, I'll look it up later. What was the deal with this condition again?”

Never forget the impact just BEING THERE has on your patients.

Like every academy member I’ve spoken to so far - Suzanne agrees that trusting your gut and standing up for your patients is one of the most important things we can do for them.

And whilst this can be challenging, the confidence boost you get from doing this will do so much good!

“Just be there for them (and for their owners). Observe them, and ask yourself how can you help them. Should they go outside more often or not? Should they be turned occasionally or not? Does this patient want a lot of attention or would he rather be left alone? Is additional pain relief needed? 

Stand up for them. Discuss it with your vet if you think anything needs to change. And clearly explain to owners why things are important and how to provide good aftercare at home.”

So how can you do more in your clinic?

After 25 years, Suzanne is feeling the pain of this right now.

“I have seen all the vaccinations and sterilizations. I've talked enough about worms.

I would really like more challenging cases. But as mentioned, we are a primary care clinic and if intensive care is needed, most patients are referred.

At the same time, after 25 years, you don't just leave. These people have become my family. 

Fortunately, I was able to discuss my feelings well with my employer. She fully understands it and tries to help me within the possibilities of the practice.

I now get more responsibilities - for example, spending more time in the laboratory, and doing more procedures. I personally look for challenges as much as possible.”

And learning more is one way to help you do that.

If you want to do more, then you’ll need to learn more.

Want to start using a new technique in practice? Maybe you want to start placing nasal feeding tubes in your patients, or using PICC lines in your more complex cases?

If you want to start doing this, you’ll need to not just learn that skill - but also teach your clinic how they could benefit from it. And of course, with this, your patients benefit too!

Suzanne’s passion for learning hasn’t stopped.

Suzanne still - like so many of us nurses and technicians - loves to learn, so that she can continually provide the best care for her patients. 

“I do a lot of continuous education. I visit lecturers, I watch webinars, I listen to podcasts. I did a senior anaesthesia program here in NL. I did some online training on vetmedteam.com and I own a ton of vetbooks. I’m always happy to learn new stuff!”

And that learning led her to the academy.

Suzanne joined the academy when doors last opened in August. She wanted to be part of a group of passionate nurses who could develop together:

“When I saw that there was an academy and what you did in it, I immediately became enthusiastic. I thought it would be great to have a group of passionate, like-minded people around me.

And shortly afterwards the doors of the academy opened. I looked forward to it for days.

My husband calls it my nerd club (in a very loving way) and I think he is right... it's great to nerd out a bit with each other.

And now I can regularly say to him "Sorry I can't tonight...I have my nerd club".

Seeking inspiration

As well as learning more and feeling better equipped to care for your patients, looking for inspiration and a supportive community is another way to feel more confident.

For Suzanne, it’s having a place where she feels seen and gets those reminders of the difference she’s making that gives her a boost.

“As with all CE, I think the more you know and the better you understand things, the better you can care for and advocate for your patients.

But for me personally, it is mainly a matter of inspiration. I am enormously inspired by the academy. I feel seen, understood and important. And I think it is important for all nurses to realize again how important we are. That's what the academy does for me.

And when I feel more confident, I can take better care of my patients.”

So the next time you feel like you need a boost, or feel like you’ve hit a ceiling and want to do more, remember this:

1. You make an enormous difference to your patients, clients, and team.

2. There are so many opportunities out there for you - either in the wider profession or in your own clinic. You just might need to make them, with the support of your clinic.

3. Prepare as much as you can, so you feel more confident nursing your complex patients.

4. Don’t shy away from emergencies - focus instead on how you can help them, and trust what your gut tells you.

5. And find a group of people who lift you up, inspire you, and learn with you. That might be through CPD, it might be informally in your team, or it might be through the veterinary social media community.

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