If you’ve been following me for a while, you’ll know - I love a good nurse clinic!

But if I’m honest, that wasn’t always the case.

Truth be told, I hated them earlier in my career - and it wasn’t until I became an internal medicine nurse that I realised more was possible with nurse clinics.

As I began learning more and more about different diseases, and truly understanding the value that veterinary nurses have in the long term care of patients, I found new ways of caring for my patients and clients - and with that, more job satisfaction.

Too often, I hear veterinary nurses tell me that they’d love to perform these clinics too, but:

• They lack the confidence

• They don’t know what to say to their clients

• They aren’t sure how to answer questions about complex diseases

• Their practices/vets won’t book these clinics in with nurses - perhaps because they too don’t realise how much we can do to help these patients!

In this post, I’m going to be getting real with you about the journey I went on from an unconfident nurse who felt she didn’t know enough, to a nurse running medical clinics confidently - and feeling empowered to ask her vet team to book more in with her. 

And because I know that we need to do more with these patients, and have more job satisfaction and confidence in our day-to-day lives, I’m bringing you a free challenge to help you do just this! I’m so excited to tell you that ‘Consult with Confidence’ will be running from the 3rd-6th May, and this is your invitation to join us for 3 days of live training, daily action steps and support to help you set up these clinics in your hospital!

To sign up, pop your email address below - all the details will be sent straight to your inbox. I can’t wait to see you there!

Let’s go back…

For context, I became an RVN quite a way back now (in 2010!). I worked in small animal first opinion practices for the first half of my career (with the exception of 2 years as an orthopaedic referral nurse). Then in 2015, I moved to a full time internal medicine nurse role in a referral centre. Since then, I’ve been a medicine RVN through-and-through.

Moving into the medicine role was a big step out of my comfort zone. In fact, 3 days in, I reached out to my old clinic about going back to GP! But I’m really glad I didn’t go back, and instead, I made a list of what I wanted to get from my new role, and what I felt I needed to do, learn more about, read up on, etc. to feel more confident in my role.

I realised that in order to deliver the level of care I wanted to, I needed to refresh my knowledge on the common diseases we saw so that I understood what we were doing and why. Now this is a very daunting task, suddenly increasing your knowledge on a ton of different diseases - so know that you’ll naturally learn more by doing, so by seeing, treating and nursing patients with different diseases, and asking your vets questions, your knowledge will increase massively without you even realising it. 

Be kind to yourself, reflect on where you started regularly, and you’ll soon realise how far you’ve come - and with that, your confidence will really begin to increase.

Where did clinics start?

In my case, clinics became quite a natural evolution. The medicine department at my hospital was small - we had 2 specialist vets, 2 nurses, and no interns or students, so our vets relied on us for a lot. 

The veterinary nurses began doing most of the discharges of our patients, and with the vet’s discharge reports, we were able to explain to clients all about their pet’s condition, and the treatment we were recommending.

Naturally, this would lead to questions we didn’t always know the answer to - leading us to speak to the vets, find out the answers, and increase our knowledge for next time, as well as getting the clients the answers they needed.

By seeing these clients and chatting to them about their pet’s newly-diagnosed disease, I saw how daunting it was for them - and this isn’t just my experience, there’s data to back this up, too!

In a study performed at the RVC, owners of diabetic pets were asked about their perception of their cat’s disease and the impact this had on their quality of life. Many clients answered that their cat’s quality of life would be a great deal better without diabetes, and when asked which factors caused them the most concern, they mentioned things like:

• Not being able to go on holiday, and concerns about boarding

• Their lifestyle needing to change to adapt to insulin injections

• The cost of treatment

• Worrying about their pet’s diabetes, and complications like hypoglycaemia

As you can see - many of these concerns are to do with the impact of the disease on the client, and these are areas we can really help with as veterinary nurses!

So as I began doing more and more discharges, I realised that actually seeing these clients back, checking in regularly, and helping them with these worries after their discharge was vital.

We spoke to our vet team and began looking at which recheck consults could be booked in with the nursing team. So for example, patients coming back for follow-up blood tests etc began being booked in with us, so we could check the patient over, grab the samples, and then the vet would contact the client with the results.

This then evolved further into more dedicated nurse clinics rather than rechecks for bloods. We began seeing patients for:

• Diabetic clinics, to do things like re-examine, answer client concerns, collect samples and apply continuous glucose sensors

• Renal clinics, to re-examine the patient, measure their blood pressure, recheck their renal values, collect urine samples, administer medications and answer client concerns

• GI clinics, to discuss diet, weigh the patient, collect samples and administer vitamin B12 injections

• Cancer clinics, to assess quality of life, provide quality and end of life care support to clients, examine our patients, check their bloods and administer chemotherapy

• Respiratory clinics, to do things like train patients to accept inhaled and nebulised medications, discuss their environment, and help the clients adapt it to help their pet

• Urinary clinics, to modify the environment of our bladder cats and promote things like weight loss, water intake, and make nutritional adjustments

And many more!

As I began seeing these patients regularly, I realised something - our clients loved having nurses they saw regularly. They had another person to talk to about their pet, someone they could ask questions they perhaps didn’t feel comfortable talking to the vet about, and they really saw the value veterinary nurses brought!

Another really important benefit to seeing these patients regularly is that I truly got to know these patients, and by seeing them regularly, I could pick up on small changes that I am sure I’d have otherwise missed. This meant we could add in extra diagnostic tests and change their treatment at an earlier stage, improving the care we delivered.

All of this hugely improved my job satisfaction, because I could see first hand the difference I was making to my patients and clients, I built closer relationships with them, and our vet team began seeing more and more the value nurses performing these clinics brought to our practice.

Getting my vets on board

I then complicated things by moving to a new hospital. 

The team I worked with were amazing, but had worked in larger hospitals previously where their support came mostly from interns and vet students and not from VNs.

This was a big difference for me, and I found myself going from a hospital where I did a lot and the vets naturally relied on nurses more, to needing to get things set up again.

I did this by chatting with the vets about what nurses can do, and finding out what they would be comfortable with us doing. I asked if there was anything they would want us to learn/understand more about and worked with them to create a structure for our clinics that everyone was happy with.

We also discussed the clinics coming in at our morning rounds, which allowed the vets to highlight anything they wanted us to ask or mention to clients specifically, and confirm any tests they wanted us to perform.

All of this allowed us to increase our vet’s confidence in us performing clinics, increase the number of clinics being booked in, and further increase our job satisfaction!

Building confidence

I’ll let you in on a secret… confidence grows through experience. 

You probably won’t feel confident or ready to start clinics to begin with, and that’s fine. It will increase over time as you learn more, gain more experience, and improve your job satisfaction.

One thing that really helped me was reminding myself that our clients don’t expect us to know everything.

Think of it this way - would your clients rather you know everything about their pet’s disease, or that you really care about them and their pet, and want to work with them to improve their pet’s quality of life?

I’ll put money on them wanting the latter - and we all know that’s an area where veterinary nurses come into their own.

So before you think you’re not ‘ready’ to start offering these clinics because you’re not confident enough or you don’t know enough - remember that you know how to care for and support your patients, and that’s enough to get started.

I am so grateful that my medicine nursing journey (almost accidentally!) included nurse clinics - it really made me see what was possible for us as nurses. It allowed me to build deeper relationships with my patients and clients, and unlocked a level of job satisfaction I didn’t think was possible.

I really want as many nurses to experience this job satisfaction as possible, too - which is why I’m running a completely free challenge, Consult with Confidence, at the beginning of May.

Consult with Confidence is a 3-day series of live video trainings with daily action steps and support and accountability in a private challenge Facebook group, designed to help you start offering these clinics in your practice. Together, we’ll increase your confidence and develop a framework for these clinics which you can tailor to any patient and any disease.

Secure your spot and get all the details by popping your email in the box below - and don’t forget to DM me on Instagram and let me know once you’ve signed up!