You know what I’m going to say about this…

Caring for patients with chronic diseases is an enormous area of potential for the veterinary nurse. 

Think about it - these patients require so much care and support from us throughout their illness, whether that’s right at the beginning when they first have clinical signs, through to their diagnosis, hospitalisation and their inpatient care.

However, one of the biggest areas we can make a difference is after they are discharged - and I’d wager it’s one of the areas where veterinary nurses are really underutilised.

By providing regular, consistent nurse support for the rest of the pet’s life, we can improve client compliance with treatments, and build a bond with both the patient and client. 

This is incredibly rewarding for us as nurses, since it allows us to develop new skills, increases our job satisfaction and allows us to pick up on subtle changes to the patient at an earlier stage because we know them well - which in turn, improves patient care!

In this post, I’m going to share my top 4 steps to run successful nurse clinics for patients with any chronic disease, allowing you to set up a chronic disease nursing service in your practice.

And if you want access to all of the tools and resources to set up clinics for any medical patient, I’m really excited to announce that doors to my new course, Conquer Your Clinics, are officially open!

In this course, I’ll walk you through an overview of all of the common conditions that we see and look at exactly what to discuss in clinics for each of them - giving you the knowledge, tools and resources to consult confidently, and pointers on how to market them in your practice.

Secure your spot here - I can’t wait to see you there!

Collect A History

Begin your consultation by collecting an updated clinical history. If you can, do this whilst allowing the patient to explore the consult room (tip: get clients to remove the door from their cat carrier and let the cat come out in their own time whilst you collect the history).

This will allow time for the patient to acclimatise to their new surroundings, and make parameters such as their heart rate, respiratory rate and blood pressure more accurate when it comes to your physical exam. 

During history collection, you can also review the patient’s pet health journal/diabetic diary etc. if they have one, and discuss any specific concerns the client has.

Examine Your Patient

Next up it’s time to examine your patient. There’s no reason we can’t perform a full clinical exam, so this should be more than just a TPR, and should include a bodyweight assessment, as well as body and muscle condition scoring. 

This will help identify trends in weight loss or gain and muscle wastage, which could be part of the patient’s disease process, or indicate a separate, concurrent disease.

For example, most of your patients coming in for medical clinics will be senior pets, so things like arthritis will also be common. So if they’ve got muscle wastage, that could be an early indicator of something like OA.

Measuring blood pressure is also recommended at this point, particularly in cats, as many chronic diseases can cause systemic hypertension - and even if it’s normal, you’ve got a baseline to compare with in future clinics.

Collect Your Samples

Most of our chronic medical patients will need some kind of sampling to monitor their condition.

Clinics are a great time for you to collect blood samples and perform any required follow-up testing (such as biochemistry, total T4 levels, ACTH stimulation tests, haematology, manual platelet counts, and urine analysis, depending on the patient) under the direction of the veterinary surgeon. 

This avoids your client having to pay for a veterinary consultation, frees the vet up to see other patients, and fully uses your skills! 

Also, as we typically have longer consultation slots, we can use these to apply topical local anaesthetics and allow for acclimatisation time, making the sampling process a nicer experience for both the patient and client.

Advise Your Client

After you’ve collected your samples, it’s time to dispense any repeat prescriptions and provide advice to your client.

The advice you give will vary depending on the patient’s disease process, and includes things like medication administration, diet, exercise, environment and lifestyle. 

Conclude and Follow Up

Before ending the consultation, review the history and points discussed with the client. Are there any concerns or ‘red flags’ which require the veterinary surgeon’s attention? If so, ensure these have been dealt with before the client leaves the clinic.

To close your clinic, summarise the discussion and any recommendations which have been made, provide written reference material to back up any recommendations, ensure the client has no further questions, and arrange a follow-up appointment at an appropriate time - ideally before they leave the clinic, to ensure one is made.

So there you have it! If you want to do more with your chronic disease patients, begin by establishing nursing support early. See patients regularly through medical nurse clinics, which you can use to gather updated clinical histories, collect diagnostic samples, and provide advice. 

The most important thing is to establish trust and build a relationship with your clients - and a simple way to do this is to make the patient and client’s experience as positive as possible. 

And if you want to learn more about exactly what to discuss with your clients, tailored exactly to their pet’s disease, along with the knowledge of their disease and lifelong accountability and support, join me for Conquer Your Clinics - doors close on Friday!