Improving practice hygiene through research
I applied for the MSD Animal Health research bursary after reading about it in Vet Record Careers and I was delighted to be the first vet nurse (VN) to receive the award.
My research involves monitoring hygiene, especially the effectiveness of decontaminating the practice environment and reusable non-invasive patient care equipment [see 'Katie's research project', below].
I have always been interested in making small changes that have an impact on improving our performance. I had never done any specific research before, but the more I looked into the subject, the more I wanted to find out.
But what got me to this point? After qualifying as a VN, I initially spent time building up my confidence within the nursing team. I enjoyed working with patients and clients and, over time, I was given more responsibility and helped with many aspects of keeping the practice running smoothly.
I liked my job and wanted to work my way up to a more senior position. I also knew that additional training would help me further my career, but was unsure what area to take it in.
My next career step was to accept a senior position in a veterinary hospital where I work today. Here, I get the chance to work with zoo animals. The practice is also a referral centre for exotic pets and offers radioiodine therapy for hyperthyroid cats and outpatient CT scanning.
My role varies widely – from inpatient care and cleaning, to supporting the vets and patients through procedures like anaesthesia, CT scans, laparoscopy and video endoscopy. It involves a wide range of animals – dogs, cats, rabbits, rodents, birds, primates, big cats, snakes, lizards and chelonians.
Typical working day
After dropping my children at school, I arrive at work just as the patients have started to be admitted. I help my colleagues to set up the theatres, prep areas, imaging suites and kennels.
Our routine procedures are scheduled for the morning; we decide on the running order for these with the duty lead vet. We ensure that all patients have been observed and the necessary preoperative procedures have been done.
Within the vet nursing team, our allocated jobs involve assisting in theatre or prep areas, or carrying out nursing consultations. A dedicated in-patient nurse takes care of the animals pre- and postsurgery.
Afternoons vary depending on the patients that we have in and any emergencies that may have arisen. I try to set aside one afternoon a week for admin and supporting the head nurse, as well as tidying and sorting my designated areas.
The aspects I enjoy most are working with zoo animals and dealing with people. Zoo work is varied and interesting. I love learning the new skills involved in treating a variety of species. From penguins to lions, and kangaroos to lemurs, each one is different.
'It’s nice to be encouraged to develop my research skills'
One of my key aims is maximising morale and team cohesion. I aim to start every shift having an enthusiastic and positive attitude. I am passionate about sharing knowledge with colleagues, especially students, and enjoy watching them apply things I’ve taught them, knowing that it will make a difference to the future of vet nursing. Sharing knowledge benefits our patients too.
What are the challenges?
Euthanasia is inevitably tough. We put so much time, care and hope into our patients that we can’t help but be affected by it.
Time management is another challenge. The hospital is busy and we never know what’s going to come through the door. We are always prepared for an emergency.
What skills have you gained?
Compassion. I pride myself on understanding how other staff members feel (and how it may affect their work), and trying, where possible, to help. This also extends to clients when they leave their pet with us for a surgical procedure or have to say a final goodbye to their pet.
Communication is key to having good working relationships with colleagues and clients.
What are your career highlights?
Moving to a hospital environment has changed my outlook on nursing. It’s a different job from working in first-opinion practice.
'I have to pinch myself to realise how lucky I am'
Whether I’m helping to treat a lion or, more recently, a tiger, or tube feeding a two-day-old penguin chick in the hospital, it’s been a dream of mine to be able to nurse such species; however, I never imagined that I would be able to do it alongside having a home and a young family in the Cotswolds! I really have to pinch myself to realise how lucky I am.
What advice would you give your younger self?
Don’t panic about not knowing everything. In my first practice, the nurses did an element of reception work. I was terrified of not knowing the answer to whatever it was the client might ask. Over time, I began to use it as a way of learning new things. Now, if I get asked a question I can’t answer, I enjoy finding out. I encourage our student nurses to do the same.
Who’s been your biggest inspiration and why?
Two people stand out. The director at my first job who took a chance on a 17-year-old who popped in off the street to ask for a job. The other was my first-ever head nurse. She inspired me to train to become the best version of myself.
They both had a positive, can-do attitude and I try to follow their lead.
How’s your work-life balance?
Although I work full time, my employers are very supportive of the fact that I have a family. I am lucky that I can drop my children off at school almost every day. The practice has a good out-of-hours and weekend rota, so I get the chance to spend most weekends with my family.
As a family, we love being outdoors – holidays, camping, theme parks and so on. I also enjoy spending time with friends. My favourite way to relax is at a spa, and I’m a keen snowboarder on winter holidays.
What would you be if you weren’t doing what you are now?
I wanted to be a midwife and, since having my children, I have toyed with the idea once or twice, but ultimately the animals always win.
Katie's research project: improving hygiene objectively
We know from human healthcare that using ATP bioluminescence meters helps to improve hospital hygiene. We wanted to demonstrate that this technique can also improve hygiene in a veterinary setting, and work out how to maximise the benefit of using it.
Currently, cleanliness in veterinary practices – even in the surgical areas – is almost always assessed by visual inspection – whether it looks clean. This is clearly not reliable. We wanted to show that it was possible to measure cleanliness objectively. To achieve this, we are comparing decontamination techniques, as well as looking at which areas of the environment and pieces of equipment are not decontaminated as effectively as others.
Bioluminescence meters measure the amount of adenosine triphospate (ATP) – organic residue – on a surface. The meter measures the light level produced by a swab placed in a solution containing a bioluminescent enzyme. The ‘relative luminosity units’ displayed indicate how much organic material is present, ie, how clean the surface is.
Improving practice hygiene should reduce the risk of nosocomial infections and surgical site infections. The objective, quantifiable measure of cleanliness provided by ATP bioluminescence meters allows us to improve hygiene, and – importantly – to know we have improved it.
Use of the meter has confirmed that our improved protocol has resulted in better hygiene, but the measurements also showed that certain areas and equipment were not cleaned as well as others. For example, the anaesthetic machine vapouriser toggles – used to adjust the flow of anaesthetic gases – seemed to be particularly poor.
2005: Auxiliary vet nurse at Tremain Veterinary Group, Witney
2006: Began vet nurse training
2008: Qualified as a registered vet nurse (RVN)
2010: Qualified as an AMTRA suitably qualified person
2018: Employed by Chipping Norton Veterinary Hospital as a senior RVN
2018-present: Clinical coach
2019-present: Deputy head vet nurse
2019: Certificate in surgical nursing (NCert [Surgical Nursing])