What is the SIII Survey?
As if we RVNs need reminding, but let’s start at the very beginning, a very good place to start. SIII is an amendment to the VSA 1966 and it bestows:
‘the privilege of giving any medical treatment or carrying out minor surgery, not involving entry into a body cavity’ to RVNs, and SVNs with certain caveats for supervision.
All good so far… As these guidelines have been around for some time, why has there been a survey and why now?
Why the SIII survey?
The questions that the delegation of treatment to RVN’s has raised include:
- What is minor surgery?
- What is a body cavity?
- Who can answer these questions definitively?
- Should vets and RVNs be allowed to use their own discretion in delegating treatment
- Who is best placed to support training for vets and RVNs in these skills and the art of delegation?
As you can see there are quite a few questions that cannot be answered easily. This has led to a situation where there is confusion over what is covered by SIII and what isn’t. The result of this confusion is in the utilisation of vet nurses in practice.
What’s the latest?
The RCVS have released some headline figures about the response to the survey. I picked up a leaflet at BVNA and here’s the news:
- More people responded than to any other consultations – good work #planetrvn
- 34.9% of RVNS responded
- Of that 94 % were in clinical practice
- 21.3% of vets responded
This makes for interesting reading. Clearly, people are interested in this aspect of their role and a consultation is only as good as the information the respondents share. Well done everyone who responded.
What could the SIII Survey do for us?
My personal view is that we need to have this discussion. I have worked with great vets who understand how delegation works over the years, I have carried out a number of SIII procedures from the daily placement of IV catheters to stitch up wounds and lump removals.
However, I have also had the boundaries pushed by vets. I had one vet say my suturing and tissue handling was great, so he wouldn’t mind if a did a leg amputation. Clearly, he hadn’t read SIII and seemed surprised when I said that a leg amp was major surgery.
I’ve also had a vet ask me to see all his Sat morning consults as they were 2nd vaccines. Now, I hear some of you cry, that is allowable under SIII! Ah, yes, but in this situation, I was a locum nurse working with a locum vet I’d never met before. It’s great that my RVN status means he’s confident to delegate to me but in that situation all clients had booked vet appointments, he doesn’t know my skills or experience and as I rarely worked at the practice I felt a 2nd vaccine appointment is an important bonding experience for new pet owners that it should be the person they are more likely to see again they should see.
In both situations, I used my knowledge of SIII and applied it to the situation. It worked out well in both instances.
However, if the vets did not have a working knowledge of SIII or if I wasn’t confident enough to say ‘No’ what could have happened?
This is why we need this discussion. For every vet nurse to feel that they have the option to work within the guidelines we need our employers and the delegator to understand what the schedule means and how it can be implemented into their practice to be fit staff and patients.
Here is a great table from Wendy Sneddon, showing the breakdown of finance in a vet practice.
It’s a good learning tool for staff to understand the breakdown of practice costs but please focus on the top line – the sales line. This isn’t just selling bags of food, this is all income generated, and here are the magic words – Allow RVNs to do more and you can increase practice income by 25%.
I know some people don’t like talking about money, but every practice is a business and needs to be successful to survive and here are the figures, to support that utilising RVNs fully under current legislation will increase income.
It’s that basic. Having the conversation about SIII, getting vets to realise just how much we can do with the patients and apportioning income to the vet nurse role to show income generated are all key to a successful business and staff retention.