INTRODUCTION ................................................................................................................................................ 1 OUR STANDARDS ................................................................................................................................................ 1 OUR OBJECTIVES ................................................................................................................................................. 1 OUR PRACTICE IN GENERAL ....................................................................................................................... 2 HISTORY OF ANRICH ........................................................................................................................................... 2 THE STAFF........................................................................................................................................................... 3 Principal ......................................................................................................................................................... 3 Assistants ........................................................................................................................................................ 3 Nursing Staff.................................................................................................................................................. 3 Dog Grooming ............................................................................................................................................... 4 Administrative Staff ....................................................................................................................................... 4 CONTACT TELEPHONE NUMBERS ........................................................................................................................ 4 EMERGENCY TELEPHONE NUMBERS ................................................................................................................... 4 FACILITIES........................................................................................................................................................... 5 24-hour Cover ................................................................................................................................................ 5 On-site Blood Testing .................................................................................................................................... 5 Microbiology .................................................................................................................................................. 5 E.C.G’s ........................................................................................................................................................... 6 Ultrasound ..................................................................................................................................................... 6 MRI ................................................................................................................................................................ 6 X-Rays ............................................................................................................................................................ 6 Isolation Ward ............................................................................................................................................... 6 PRACTICE POLICY ........................................................................................................................................... 6 BAD DEBTS ......................................................................................................................................................... 6 CLIENT CARE ...................................................................................................................................................... 7 COMPLAINTS HANDLING ..................................................................................................................................... 7 DISCIPLINARY AND GRIEVANCE PROCEDURE ...................................................................................................... 8 Disciplinary Procedure .................................................................................................................................. 8 CAPABILITY PROCEDURE ............................................................................................................................. 8 STAGE 2: FORMAL DISCUSSION ......................................................................................................................... 9 DISCIPLINARY PROCEDURE ......................................................................................................................... 9 SCOPE ................................................................................................................................................................... 9 INVESTIGATIONS ............................................................................................................................................... 10 Examples of misconduct .............................................................................................................................. 10 Grievance Procedure ................................................................................................................................... 12 PURPOSE AND SCOPE .................................................................................................................................... 12 GENERAL GRIEVANCE PROCEDURE ....................................................................................................... 13 STAGE 1: INFORMAL DISCUSSION ............................................................................................................ 13 STAGE 2: FORMAL DISCUSSION ................................................................................................................ 13 STAGE 3: RIGHT OF APPEAL ....................................................................................................................... 13 EMPLOYEES ....................................................................................................................................................... 13 Contract of Employment.............................................................................................................................. 13 Appraisals..................................................................................................................................................... 14 Continual Professional Development (CPD) .............................................................................................. 14 Time Keeping / Overtime ............................................................................................................................. 14 Nurses Bedsit ............................................................................................................................................... 15 Dress and Demeanour ................................................................................................................................. 15 VETERINARY NURSES ..................................................................................................................................................... 15 RECEPTIONISTS ............................................................................................................................................................. 16
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VETERINARY SURGEONS ................................................................................................................................................. 16 OFFICE STAFF .............................................................................................................................................................. 16
Confidentiality ............................................................................................................................................. 16 Behaviour ..................................................................................................................................................... 17 Smoking ....................................................................................................................................................... 17 Mobile Phones ............................................................................................................................................. 17 Alcohol ......................................................................................................................................................... 17 Accuracy and Honesty ................................................................................................................................. 17 Termination of Employment ....................................................................................................................... 17 EQUAL OPPORTUNITIES ..................................................................................................................................... 18 HOLIDAYS & SICKNESS ..................................................................................................................................... 18 Holidays ....................................................................................................................................................... 18 Absence ........................................................................................................................................................ 19 ABSENCE THROUGH SICKNESS ........................................................................................................................................ 19 ABSENCE THROUGH OFFICIAL REASONS ......................................................................................................................... 19 ABSENCE ON COMPASSIONATE GROUNDS........................................................................................................................ 19
MOTOR VEHICLES ............................................................................................................................................. 20 PAY GRADES ..................................................................................................................................................... 20 PENSIONS .......................................................................................................................................................... 21 PRACTICE MEETINGS ......................................................................................................................................... 21 PROFESSIONAL NEGLIGENCE ............................................................................................................................. 21 STAFF BENEFITS ................................................................................................................................................ 22 SUGGESTED IMPROVEMENTS ............................................................................................................................. 22 TRAINING .......................................................................................................................................................... 22 New Staff Induction ..................................................................................................................................... 22 All Staff ........................................................................................................................................................ 22 Veterinary Nurses ........................................................................................................................................ 23 UNWELCOME CLIENTS ...................................................................................................................................... 23 PRACTICE PROCEDURES ............................................................................................................................. 23 ADMITTING/DISCHARGING ANIMALS ................................................................................................................ 23 Admitting ...................................................................................................................................................... 23 Discharging .................................................................................................................................................. 24 ADVICE ............................................................................................................................................................. 25 Dog Grooming ............................................................................................................................................. 25 Drug Regulations ......................................................................................................................................... 25 Estimates ...................................................................................................................................................... 25 First Aid ....................................................................................................................................................... 26 BLEEDING................................................................................................................................................................. 26 RESPIRATORY DIFFICULTY.................................................................................................................................... 26 ROAD TRAFFIC ACCIDENT / SHOCK ..................................................................................................................... 27 HEATSTROKE ........................................................................................................................................................... 27 FITTING ..................................................................................................................................................................... 27 FRACTURES .............................................................................................................................................................. 28 BURNS ....................................................................................................................................................................... 28 ELECTRIC SHOCKS .................................................................................................................................................. 28 WHELPING AND KITTENING .................................................................................................................................. 28 STINGS ....................................................................................................................................................................... 29 POISONS .................................................................................................................................................................... 29 EYE INJURIES ........................................................................................................................................................... 30 DROWNING ............................................................................................................................................................... 30 MOUTH WOUNDS .................................................................................................................................................... 30
Fleas ............................................................................................................................................................. 30 ADVANTAGE.................................................................................................................................................................. 31 FRONTLINE SPRAY ......................................................................................................................................................... 31 NUVAN TOP .................................................................................................................................................................. 31 STONGHOLD ................................................................................................................................................................. 31 PROGRAM ..................................................................................................................................................................... 31
Tracer ........................................................................................................................................................... 31 Insurance ..................................................................................................................................................... 32 Kennels / Catteries ....................................................................................................................................... 32 Loyalty Vouchers ......................................................................................................................................... 32 Misalliance ................................................................................................................................................... 33
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Neutering ..................................................................................................................................................... 33 Pet Shop ....................................................................................................................................................... 33 Pet Travel Scheme ....................................................................................................................................... 33 Puppy/Kitten Checks .................................................................................................................................... 34 Puppy/Kitten Lectures ................................................................................................................................. 34 Vaccinations................................................................................................................................................. 34 PUPPIES ....................................................................................................................................................................... 34 CATS ............................................................................................................................................................................ 34 RABBITS ....................................................................................................................................................................... 35
Monthly Healthcare Lectures ...................................................................................................................... 35 Worming....................................................................................................................................................... 35 ANRICH RESCUE FUND ...................................................................................................................................... 35 ANRICH BENEFIT SCHEME ................................................................................................................................. 35 APPOINTMENTS ................................................................................................................................................. 35 CHARITIES ......................................................................................................................................................... 36 Cats Protection League (CPL) .................................................................................................................... 36 Guide Dogs for the Blind (GDBA) .............................................................................................................. 36 Dogs Trust (formerly NCDL) ...................................................................................................................... 36 Royal Society for the Protection of Cruelty to Animals (RSPCA).............................................................. 36 CLIENT MANAGEMENT ...................................................................................................................................... 37 END OF DAY ROUTINE....................................................................................................................................... 37 NURSE CLINICS ................................................................................................................................................. 37 NURSE DUTIES .................................................................................................................................................. 38 Cleaning Room ............................................................................................................................................ 38 X-Ray Room ................................................................................................................................................. 38 Operating Theatre ........................................................................................................................................ 39 Prep Room.................................................................................................................................................... 39 Laboratory .................................................................................................................................................... 40 Dispensary .................................................................................................................................................... 40 Consulting Room ......................................................................................................................................... 41 General ......................................................................................................................................................... 41 Nights ........................................................................................................................................................... 42 Shifts ............................................................................................................................................................ 42 Weekend and Night Duties .......................................................................................................................... 43 Specific Night Duties ................................................................................................................................... 43 CASE HAND OVER ......................................................................................................................................................... 43 PROBLEMS .................................................................................................................................................................... 43 SECURITY ..................................................................................................................................................................... 43 TILL ............................................................................................................................................................................. 44 BODIES AND GASES ...................................................................................................................................................... 44 TELEPHONE .................................................................................................................................................................. 44 ALARM ......................................................................................................................................................................... 45 DUTIES ........................................................................................................................................................................ 45
PAYMENTS ........................................................................................................................................................ 45 PET SHOP DUTIES .............................................................................................................................................. 46 Checkout/rear reception .............................................................................................................................. 46 Shop Floor ................................................................................................................................................... 47 Deliveries ...................................................................................................................................................... 47 Livestock....................................................................................................................................................... 47 FEEDING ...................................................................................................................................................................... 47 CLEANING .................................................................................................................................................................... 47
PET SHOP MANAGEMENT .................................................................................................................................. 48 Code of Practice for Retailers ..................................................................................................................... 48 The Livestock Code ...................................................................................................................................... 48 ACCOMMODATION......................................................................................................................................................... 48 EXERCISE FACILITIES .................................................................................................................................................... 48 REGISTER OF ANIMALS .................................................................................................................................................. 49 STOCKING NUMBERS AND DENSITIES .............................................................................................................................. 49 HEALTH, DISEASE AND ACCLIMATISATION ....................................................................................................................... 49 FOOD AND DRINK ......................................................................................................................................................... 50 FOOD STORAGE ............................................................................................................................................................ 50 OBSERVATION ............................................................................................................................................................... 50
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EXCRETA AND SOILED BEDDING..................................................................................................................................... 50 TRANSPORTATION .......................................................................................................................................................... 50 TRANSPORTATION CONTAINERS ...................................................................................................................................... 50 SALE OF LIVESTOCK ...................................................................................................................................................... 50 DANGEROUS WILD ANIMALS .......................................................................................................................................... 51 PET CARE ADVICE ........................................................................................................................................................ 51 STAFF TRAINING AND LIVESTOCK KNOWLEDGE ............................................................................................................... 51 CITY AND GUILDS ......................................................................................................................................................... 51 BOARDING OF ANIMALS ................................................................................................................................................. 51 FIRE AND OTHER EMERGENCY PRECAUTIONS ................................................................................................................. 52 SALE OF GOODS ACT AND SUPPLY OF GOODS AND SERVICES ACT 1982 AND OTHER RELATED LEGISLATION ....................... 52 PRICING ....................................................................................................................................................................... 52 COMPLAINTS................................................................................................................................................................. 52
Stocking Densities ........................................................................................................................................ 53 POLICE .............................................................................................................................................................. 56 PRE-OPERATIVE PROCEDURES .......................................................................................................................... 56 PREP ROOM CHECKS .................................................................................................................................................... 56 THEATRE CHECKS ......................................................................................................................................................... 57 PATIENT CHECKS .......................................................................................................................................................... 57 VET SUPPORT ............................................................................................................................................................... 57
POST-OPERATIVE EXAMINATIONS ..................................................................................................................... 57 RECEPTION/WAITING ROOM ............................................................................................................................. 58 ROAD TRAFFIC ACCIDENTS (RTA’S) ................................................................................................................ 59 SHOPLIFTERS ..................................................................................................................................................... 59 STOCK ORDERING ............................................................................................................................................. 59 Drugs ............................................................................................................................................................ 59 Instruments .................................................................................................................................................. 60 Pet Food ....................................................................................................................................................... 60 Pet Shop ....................................................................................................................................................... 60 Livestock....................................................................................................................................................... 60 STRAY ANIMALS ............................................................................................................................................... 60 TELEPHONE TECHNIQUES .................................................................................................................................. 60 VOUCHERS ........................................................................................................................................................ 62 WILDLIFE .......................................................................................................................................................... 62 GOVERNMENT LEGISLATION ............................................................................................................................. 62 PETS TRAVELLING ABROAD .............................................................................................................................. 62 Summary ...................................................................................................................................................... 62 PETS Pilot Scheme – Interim Advice ......................................................................................................... 63 INTRODUCTION ............................................................................................................................................................. 63 CONDITIONS OF THE PET TRAVEL SCHEME ..................................................................................................................... 63 PILOT SCHEME ROUTES ................................................................................................................................................. 63 PETS PILOT IN OPERATION............................................................................................................................................ 63 QUALIFYING COUNTRIES ............................................................................................................................................... 64 GUIDE DOGS AND HEARING DOGS ................................................................................................................................. 64 DOCUMENTATION ......................................................................................................................................................... 64 WHAT PET OWNERS CAN DO NOW ................................................................................................................................... 64 MICROCHIP IDENTIFICATION ......................................................................................................................................... 64 VACCINATION ............................................................................................................................................................... 65 BLOOD TESTING............................................................................................................................................................ 65 BLOOD TESTING LABORATORIES (UK) ............................................................................................................................ 66 BLOOD TESTING LABORATORIES (OVERSEAS) .................................................................................................................. 66 FURTHER INFORMATION ................................................................................................................................................ 67
HEALTH & SAFETY / SOP’S .......................................................................................................................... 67 CLEANING ROOM .............................................................................................................................................. 67 CLINICAL WASTE .............................................................................................................................................. 68 CONSULTING ROOM .......................................................................................................................................... 68 DISPENSARY ...................................................................................................................................................... 68 FREEZER ROOM ................................................................................................................................................. 69 GASES ............................................................................................................................................................... 69 LABORATORY .................................................................................................................................................... 69 OPERATING THEATRES ...................................................................................................................................... 69 PREP ROOM / KENNELS ..................................................................................................................................... 70
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SECURITY ......................................................................................................................................................... 70 FIRE PRECAUTIONS ....................................................................................................................................... 72 FIRE PREVENTION ......................................................................................................................................... 73 ACTION ON DISCOVERY OF A FIRE: ................................................................................................................................. 73 ACTION ON HEARING THE FIRE - ALARM:........................................................................................................................ 73 RECEPTION OF THE FIRE BRIGADE: ................................................................................................................................ 73 FIRE DRILLS: ................................................................................................................................................................ 73
GENERAL FIRE PROCEDURE .............................................................................................................................. 74 IF YOU DISCOVER A FIRE: ...................................................................................................................................... 74 IF YOU HEAR THE FIRE ALARM: ............................................................................................................................ 74 DO NOT: .................................................................................................................................................................... 74 THE ASSEMBLY POINT IS: ....................................................................................................................................... 74
FIRE OFFICER’S RESPONSIBILITIES ......................................................................................................... 75 FIRE OFFICER: LYDIA SAGAR ............................................................................................................................... 75 DEPUTY: ANJI WESTON ......................................................................................................................................... 75
FIRE DRILLS AND ALARM TESTS .............................................................................................................. 75 USEFUL CONTACTS ....................................................................................................................................... 76 DANGEROUS ITEMS ....................................................................................................................................... 76 COMPUTER SYSTEM ..................................................................................................................................... 76 Templates ..................................................................................................................................................... 77 ADDITIONS TO MANUAL .............................................................................................................................. 78
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INTRODUCTION This manual has been compiled to help practice members familiarise themselves with working practices at Anrich Veterinary Hospital, Pets by Vets and Dog Grooming at Anrich. It is an attempt to provide an insight into the philosophy of the practice and details some of the protocols that have been established as the practice has developed. It is by no means an exhaustive listing of all aspects of practice life and has been compiled to assist new members of staff at the practice. All staff at every level have an important part to play in the practice. The success of the business depends on the quality of the service we provide and that quality depends on each member of staff doing their best. This Manual is designed to help you do that. A copy of the Manual is available to all members of staff. It is the responsibility of each person to keep himself or herself updated on any revisions made. This Manual is a supplement to the contract of employment between the practice and its employees. The provisions and regulations it contains may be referred to in any discussions between the parties as regards the standards required. Your contract or particulars of employment may make reference to the Practice Manual and in such case that section of the Manual will be considered as part of your contract or particulars of employment. All references to conditions of employment referred to in the manual and deemed to be accepted by the employee when the employee accepts the manual and then continues to work within the practice and accept their first monthly salary payment. You will therefore be requested to sign a document confirming you have read the Manual and agree to abide by its contents. Suggestions for inclusion in future editions of this document would be appreciated in order to maintain this document as an up to date working Manual. This document is confidential and circulation is restricted to Anrich Veterinary Hospital staff only. The contents may not be reproduced in any form without the express permission of the Principal.
Our Standards We aim to provide a professional, prompt, caring and efficient service to all our clients. This service must be friendly and encourage clients to return to us. It is not our intention to provide the cheapest service, but one which gives value for money for top quality work at a price that is fair to both clients and staff of the practice. The welfare of all that work in the practice is important to us and we welcome discussions on any aspect of practice life.
Our Objectives To provide the highest level of care to owners and pets with the highest level of professionalism, whilst maintaining a level of enjoyment and helping owners understand health care through education. To provide this as a “one stop� complete Pet Healthcare Centre Our approach to clients should be friendly and efficient. Clients should be made to feel welcome but also confident that his or her veterinary problem will be dealt with in a caring and competent manner. Many of the standards and procedures referred to in this Manual (e.g. Punctuality, etc.) have the same objectives, namely to create the right impression with the client and the public generally, and to ensure the efficient operation of our practice. We market ourselves by delivering our service to our clients in the most efficient cost-effective way,
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while being approachable and available. Marketing is the responsibility of every member of staff. From the moment the client sets foot in the practice or speaks on the telephone, the impression formed by whoever he or she speaks to will be the image the client adopts of the practice as a whole. Marketing is not just advertising, it is the everyday dealing with clients: our efficiency, quality of work, our skill and ability to demonstrate to each client that we care about them and their animal. Every member of the public entering our premises should be approached within one minute of entering the building and offered help. They should not, however, be hounded if they just wish to browse. Telephones should be answered within four rings.
OUR PRACTICE IN GENERAL
History of Anrich The original practice was established in 1967 by Enid Moody in Bolton Road, Ashton-inMakerfield and was moved to its betterremembered site in Wigan Road, Hindley in 1971. It was bought by Richard Weston on 8th October 1981 and was renamed “Anrich” (derived from Angela and Richard). During the following years the practice was 206 Wigan Road, Hindley. modernised and extensively rebuilt. During the modernisation phase branches were set up: back to Bolton Road, Ashton in 1982, Ormskirk Road, Pemberton in 1983 and High Street, Standish in 1985. Each of the branch surgeries were equipped for consultations only, all surgery was done at Hindley. In 1988 Anrich was a large four Vet, four Surgery practice. However, Vets were becoming harder to employ, especially in the North, and it was felt that quality of care had declined slightly with the increase in size. In October 1988 the Ashton and Standish surgeries were closed and the number of Vets employed reduced to two. The Hindley surgery was upgraded to pass the Royal College of Veterinary Surgeons Hospital Board inspectorate. The award of Hospital Status guarantees the client that the surgery conforms to very high standards. Unlike other practices we are inspected by governing bodies every four years but can also be subjected to spot checks at any time. From 1988 to 1995 the Hospital maintained its commitment to quality care as a two Vet Hospital practice. There was continued investment in equipment, skills and staff. During the 1990’s the Americans changed the face of Veterinary Practice by incorporating practices into Pet Superstores. Seeing this would soon follow in Britain, in 1995 it was decided to move the Veterinary Hospital to a more central site and open our own Pet Superstore; Peoples Pets. This was the first Veterinary owned Pet Superstore in Britain. The new purpose built Veterinary Hospital in Caroline Street was a great success; so much so it rapidly began to outgrow the building it was in. However, despite the success of the Hospital, competition from Petsmart and Pets At Home opening in Wigan in December 1996 caused Peoples Pets to close in May 1997. The lessons learned from the venture allowed the shop to re-open in January 1998 under the new name of Pets By Vets, reflecting the major difference this shop has to offer. No longer would the shop be manned by “lay” staff but by fully trained Veterinary Nurses ensuring professional advice would be given at all times. This is something no other pet shop in the world offers.
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The shop, whilst called a different name to attract non-veterinary customers, is very much a part of Anrich and plays an important role in the overall income to the Hospital. In 1999 the Hospital was moved across the car park to unite with Pets By Vets. The facilities have been expanded to include: Dog Grooming Salon Observation Window for Trainees 100 seater Tiered Lecture Theatre 50 seater flat all purpose Lecture Theatre IT training room Hydro-Therapy Pool
The Staff All staff members should be working together as a team. Every member of the team is responsible for the smooth running of the practice. It is important to allow clients to see that you are working as a team. Every member of the team is responsible for answering the telephone within four rings; so if the person on Reception is busy another member of the team should step in to help. All staff should wear name badges whenever possible.
Principal Richard Weston was born in Scotland and qualified from Glasgow University in 1978. His first position was as an Assistant in a large animal practice and having decided this was not for him joined a mixed practice to further his skills in small animal work. It was during working at a practice in Nottingham that he met and, later, married Anji. They have two sons, Barry and James. He is the first to admit he has a fiery temper (which has mellowed over the years!) but he never holds a grudge. To prove he is human he rescued Tessa, a black Labrador from a farm in Wales. She was frightened of guns and therefore no use as a gun dog. Libby and Lottie, two moggies, were acquired somewhere along the way and Tilly, a chocolate Labrador, was home bred and lovingly cared for but repaid her “humans” by continuously destroying their house – and she’s still there! Richard prides himself on his surgical abilities and has a special interest in orthopaedics. Local practices have been known to refer difficult cases to us.
Assistants Becky Frost
Nursing Staff Lydia Sagar (Head Nurse) Michelle Wilson VN Yvette Patton Naome Jackson Leanne Frodsham
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Chris Gee
Dog Grooming Sarah Lowe Head groomer Yvette Whittle Christine
Administrative Staff Anji Weston. Well, what can I say? Must have the patience of a saint, the skin of an elephant and deserves a prize for service beyond the call of duty; that’s just for being married to Richard! Works, reluctantly, on Reception, handles all the banking and deals with bad debts. Lisa Hessian
Contact TelephoneNumbers Clients Call:
Staff Call:
ANRICH Caroline Street, Wigan. WN3 4EL.
Tel: Fax: e-mail
(0871) 223 2040 (0871) 223 2070 enquiries@anrichvets.co.uk
Tel: Fax:
(01942) 760750 (01942) 770205
PETS BY VETS Caroline Street, Wigan. WN3 4EL.
Tel: Fax: e-mail
(0871) 223 2060 (0871) 223 2070 enquiries@anrichvets.co.uk
Tel: Fax:
(01942) 760750 (01942) 770205
Emergency Telephone Numbers These telephone numbers are for use in emergency only and under no circumstances given out to clients without the authority of the person concerned. EMPLOYEE Richard Weston Anji Weston Beccy Frost Lydia Sagar Michelle Merritt Yvette Patton Naome Jackson Leanne Frodsham Lisa Hessian Sarah Lowe Yvette Whittle Chris Gee
HOME 01942 831061 01942 831061 01942 770204 01254394670 01942 713417 01257 423598 01942 517891 01942 707199 01942 706732 01942 601550 01204 694768 01744 892154
MOBILE 07766 515005 07971 234403 07752 887047 07801 536668 07903 728113 07719 643667 07812 806558 07958 513281 07761 147192 07810 482548 07747 742744 07843 778096
OTHER 01942 830278 01942 830278
01942 708580
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Christine Foster
01695 624005
Facilities We are a Small Animal Practice and pride ourselves on the wide range of facilities available to our clients:
24-hour Cover The practice provides a full 24-hour all year round service to ensure that animals receive medical attention to relieve pain or suffering. This cover is shared equally between the Veterinary Surgeons employed within Anrich. The vets rota system is on the spreadsheet which is an icon on each desktop.
On-site Blood Testing The Idexx laboratory equipment allows us to perform in-house blood testing. The major advantage of this is that we can provide on the spot results for our clients. There are varying levels of tests available and all staff should be aware what is on offer: Pre-anaesthetic: For animals between 12 months and eight years anaesthetics will have this mini profile. The client must be recommended to have this and must sign a refusal if it is not done. GHP:
All animals over eight years old must have a general health profile plus haematology test. This should be carried out routinely prior to anaesthesia and forms part of the Anaesthetic Consent Form but should also be offered during consultations to check the general well being of the animal. This will allow us to pick up clinical problems at an early, treatable stage. If clients refuse this they must sign the form refusing this
T4:
Any suspicion of hypothyroidism should be brought to the Vets attention.
Cortisol
We are able to do our own high and low dexamethasone suppression tests and ACTH tests for Cushing’s Syndrome on site.
FELV/FIV:
This test should be offered prior to the vaccination of cats/kittens. A leaflet entitled “Will your cat pass this test?” is available from Idexx and should be given to clients to help explain the importance of testing/vaccination.
Remember –
be positive when recommending blood tests. Wouldn’t you like to know everything possible has been done prior to your pet undergoing anaesthesia? If a client is given the opportunity to understand the importance of blood testing the costs involved become negligible. It is possible we could be accused of negligence if these tests are not offered.
Microbiology Using the incubator, bacteria can be grown on agar plates and sensitivity tests can be performed to determine the correct antibiotic therapy. The Vet will require the Nurse to be able to plate up swabs taken from animals onto the agar plates and perform and read the sensitivity tests. Whilst this is not regularly done on site, the fact we have the equipment means we can develop the skill to offer this service. Part of the nurse training means being able to do and understand this procedure.
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We should make clients aware of this facility, pointing out the incubator when showing clients around the surgery.
E.C.G’s An ECG can be taken using the Silogic machine. The results of this ECG are downloaded into the computer system and the findings faxed directly to Andrew Carmichael at Cardiophone for his diagnosis. This is normally carried out by the Vet but the Nurse should know how to operate the system and how to save the ECG if necessary. If an ECG is taken early in the morning it is sometimes possible to get the results the same day.
Ultrasound We have an Imotek ultrasound machine which has colour dopplar. It can be used to diagnose abdominal detail, blood flow throw the cardio-vascular system. It can also be used to measure muscle depth.
MRI The Imotek Vet –MR is being installed in July 2005. Further information will be added after its installation.
X-Rays We have one of the most powerful X-ray machines in the area allowing us to cater for even the giant breeds of dog. The clarity of x-ray allows us to make informed diagnosis of problems to aid our surgical procedures. Recently a CR machine was installed which has removed the requirement to develop x rays in normal developer. The plates are developed onto computer and the image stored there where they can be manipulated and if required, e-mailed for referral opinion. These images can be viewed on other PC’s throughout the practice
Isolation Ward The Isolation Ward will have its own separate external entrance at some point in the future. For now the entrance is opposite the rear checkout reception.. This means any cases that are thought to be infectious can be admitted directly into Isolation without the need for entering the normal practice waiting area. This in turn will help reduce the risk of infection of other animals at the surgery. At no time should known infectious cases be admitted to ANY part of the hospital other than the Isolation Ward. No clients or members of the public are allowed to enter isolation under any circumstances.
PRACTICE POLICY
Bad Debts Always politely establish how a new client wishes to pay (cash, Cheque with bankers card, credit card or switch) to avoid embarrassment later.
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Look up client details on computer to check for outstanding debts before they are seen. Discuss pet insurance with all new and uninsured clients. Medicines are only handed out after payment is received. Clients not paying on departure must sign a debt letter agreeing to payment terms before leaving the building. A debt letter can only be given on authority from Richard or Anji, and in their absence, Lydia Clients must settle their debt with us prior to completing and sending off any insurance claim on their behalf. This is because most insurance companies will send their cheque to the client, not to us. In particularly large bills this may by be varied to claim directly from the insurance company, but only by direct instruction from Richard. Clients may be offered the opportunity to pay their annualised preventative care costs by standing order. Clients may be offered interest free credit for bills over £200 payable over 10 months Bad debts usually occur by UNDER-ESTIMATION of a client’s ability or willingness to pay, and most are incurred because of poor communication of the practice fee policy to the client, especially in the case of “out of hours” or night calls. To minimise misunderstanding estimates for non-routine procedures should only be given by the Vet and recorded on the clients’ records. A copy should be given to the client. Quotations for routine procedures should be stressed that they are approximate and not a guarantee of the overall price. Always remember to add £30-£50 to the computer procedure estimate to allow for drugs used. The practice has a cash policy with no accounts for small animals unless previously agreed by Richard and written on the client’s record.
Client Care
The following is a list of basic standards common to all who work in the practice. It is likely that the list will expand over the years. 1.
All clients must be treated with courtesy and respect
2.
Telephone calls must be answered within four rings.
3.
Telephone calls from clients are to be returned the same day.
4.
Correspondence of any sort is generally to be dealt with on the day that it is received.
5.
Appointments are to be given to clients without any undue delay.
6.
All new Puppy/Kitten owners are to be given a Puppy/Kitten pack.
7.
All new clients are to be sent a welcome letter and practice brochure on the day of registering.
8.
All clients leaving the Practice are to receive a leaving letter immediately we are informed.
9.
Letters are to be signed by Richard
Complaints Handling As advised by the RCVS, we have a procedure for dealing with complaints from clients, so that we can resolve as many as possible within the practice, thus preventing complaints to the RCVS and preserve the goodwill of the client, even if things have gone wrong. Some of the complaints about us may be well founded. We all make mistakes and Richard expects honesty and realism from any member of the clinical, reception or office staff when they have done so. The practice member will in turn receive support from Richard.
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Such complaints must be dealt with sympathetically and quickly. Our reputation depends on this, as it is all part of our “Quality Service”.
Disciplinary and GrievanceProcedure OBJECTIVES:
To take disciplinary action only after careful investigation of the facts and after the employee has had the opportunity to present their case. To take disciplinary action with the aim of correcting the employee’s behaviour wherever possible, rather than simply punishing the employee. To take into account the circumstances of each case, giving consideration to any employees whose past record demonstrates a willingness to abide by accepted standards of conduct and fulfil the terms of employment. To apply progressively more severe penalties to those employees who show that previous disciplinary action has been ineffective in producing the desired improvement. To deal sufficiently and effectively with cases of serious misconduct. To provide employees with a right of appeal against all disciplinary actions taken by the Practice.
Disciplinary Procedure CAPABILITY PROCEDURE Purpose and Scope This policy and its procedures are designed to: Provide a fair and consistent method of dealing with problems of capability at work, work performance, attendance and ill health. To help and encourage all employees to achieve and maintain high standards of work performance or to secure good attendance. If an employee’s work performance or attendance does not reach or falls below the required standard, the following procedure should be followed: Procedure
Stage 1: Informal Discussion If the Practice Principal considers that the work performance/attendance of an employee may be failing to reach the required standard then action should be taken to encourage improvement, by conducting an informal discussion with the employee. The manager is not required to give the employee prior notice of the discussion at this stage in the procedure.
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Stage2: Formal Discussion
If, after allowing a reasonable time for improvement, it is considered by the Practice Principal that the employee has failed to achieve a satisfactory level of performance or attendance, the employee will be required to attend a formal interview to discuss the matter. He/she will normally be given 24 hours notice of the time and date of the interview, informed of the reason for the interview and be told that he/she may bring an internal work colleague to be a witness, or as determined by statutory regulations. If no acceptable explanation is given by the employee, he/she will be liable to be told that a formal written warning will be issued as soon after the meeting as possible. Such a warning should inform the employee that his/her continued employment may be at risk if satisfactory performance or attendance is not achieved and sustained, and of their right of appeal.
Stage 3: Final Discussion If, after a reasonable time has been allowed for improvement, it is still considered that the employee’s performance or attendance remains less than satisfactory, a further formal interview will be convened and conducted as above, before a decision is taken whether or not to allow more time for improvement. If more time is to be given, a final formal written warning should be issued, and informed of their right of appeal. Alternatively, it may be decided that improvement is unlikely in which case dismissal will be the only course of action. If dismissal is decided upon, the employee will be dismissed with notice or pay in lieu of notice.
DISCIPLINARY PROCEDURE
In any organisation it is essential that certain standards and performance must be maintained to protect the smooth running of the company and the well being of its employees. The disciplinary procedure is designed to ensure fair treatment for those whose job performance is below requirements and those involved in breaches of discipline. Depending upon the seriousness of the case the disciplinary procedure may be entered into at any of the stages outlined below. Except for those instances of gross misconduct, dismissal will not normally be the first step. In general, particular shortcomings on the part of an employee in meeting job requirements or standards will be initially brought to his/her attention by the Practice Principal or Head Nurse in informal conversations accompanied by the offer of assistance towards achieving improvement.
SCOPE
This procedure is designed to: Provide a fair and consistent method of dealing with problems of conduct at work.
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Help and encourage all employees to achieve and maintain high standards of conduct at all times. Apply to all employees.
Investigations
The Company will take no action before a proper investigation has been undertaken by the Company relating to the circumstances of the matter complained of. If appropriate, the Company may, suspend you from work for a specified period during which time such an investigation will be undertaken. If you are suspended, your contract of employment will be deemed to continue together with all your rights, including the payment of wages. During the period of suspension, however, you will not be entitled to access to the Company’s premises. Except with the prior consent of the company and subject to such conditions as the Company may impose. Guidelines for the Conduct of Disciplinary Meetings At least 24 hours notice will be given when inviting an employee to a Disciplinary Meeting. The employee will be advised of the full disciplinary procedure prior to the meeting. Employees have the right to be accompanied by a fellow employee if they so wish, at any meeting held under the disciplinary procedure. The Practice Principal will state the reasons for invoking the disciplinary procedure, Full opportunity will be given for the employee to state his/her case and explain the circumstances surrounding any breach or alleged breach of Company rules. After an adjournment the manager will state the disciplinary action to be taken and the corrective action required from the employee, together, where appropriate, with a specified date by which acceptable improvement should be made. Disciplinary proceedings, witness statements and records will normally be kept confidential and will conform to the Data Protection Act. The level of disciplinary warning deemed appropriate will be implemented at any time if the employee’s misconduct warrants such action.
Examples of misconduct This list is not exhaustive or exclusive and offences deemed of a similar nature or severity will be dealt with in a similar manner. Poor time keeping which means arriving for work more than 3 minutes after your designated start time and taking breaks longer than authorised. Unreasonable, unexplained, persistent or irregular absence or failure to follow the absence procedure. Minor damage or misuse of the Company’s property or defacing the Company property such as notice boards. Use of obscene or offensive language. Job performance issues.
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Abuse of staff facilities, Company gifts or hospitality procedures. Failure to comply with Company or Government rules, policies or procedures. Depending on the seriousness of the failure this could be deemed as Gross Misconduct. Serious insubordination Stages of the Disciplinary Procedure Stage 1: Oral warning Should an employee’s conduct or performance remain less than satisfactory after counselling, the situation will be formally reviewed with his/her immediate supervisor who will talk to him/her about his/her shortcomings and suggest ways in which he/she might put these to right. The supervisor will keep a written record of this meeting on the employee’s file and the employee will receive a copy of the record. Stage 2: Written warning If the employee’s conduct or performance remains less than satisfactory in relation to the agreed improvement plan made at Stage 1, or in more serious cases, the Practice Principal will formally review the situation with him/her. Following this meeting the employee will receive, from the Practice Principal, a letter recording the nature and outcome of the disciplinary meeting. The employee will be asked to sign a copy of the warning letter to confirm understanding of the terms of the letter. The letter will clearly state a plan of improvement and deadline dates for achievement, or the duration of the warning as appropriate. A copy will be held on the employee’s personal file. Stage 3: Final written warning If the employee’s conduct or performance fails to meet the standards established at Stage 2, or in more serious cases, the Practice Principal will review the situation with the employee. Following this meeting the employee will receive a letter from the Practice Principal recording the nature and outcome of the disciplinary meeting. The employee will be asked to sign a copy of the warning letter to confirm understanding of the terms of the letter. The letter will clearly state a plan of improvement and deadline dates for achievement, or the duration of the warning and indicate that if no improvement is forthcoming, or if there is further misconduct, the company will take steps to dismiss the employee concerned. Stage 4: Dismissal If the employee’s conduct or performance, despite warnings, is still unacceptable or in very serious cases, the situation will be reviewed with the employee. The decision to dismiss an employee will be made by the Practice Principal. The decision will be confirmed to the employee in writing and this letter will also confirm to whom any appeal should be made and details of the procedure to be followed. Summary Dismissal In cases of gross misconduct, summary dismissal may be the only reasonable course of action for the company. The following list provides examples of offences normally regarded as Gross Misconduct. This list is neither exclusive nor exhaustive: Fighting at work or striking a colleague or supervisor. Failure to maintain records as required by Veterinary standards or falsification of any Company records. Sale and/or consumption of alcohol or illegal drugs on Company premises or believed to be under the influence of alcohol or illegal drugs at work. Eating, drinking, spitting, chewing and smoking in non-designated areas.
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Using a mobile phone whilst driving a vehicle or operating machinery. Theft. Unsafe behaviour, which could endanger self or others or a serious breach of the Health and Safety rules or procedures. Acts of bullying or harassment on grounds of sex, race, national or ethnic origin, colour or disability. Breach of the duty of confidentiality. Making false or fraudulent claims against the Company (including claims for sick pay under the Company’s sick pay scheme). Failure to disclose any criminal convictions (other than spent convictions). Failure to comply with lawful and reasonable instructions (gross insubordination). This list is not exhaustive. If the investigation has upheld the case of gross misconduct, the employee will be summarily dismissed without notice or pay in lieu. The decision will be confirmed to the employee in writing and this letter will also confirm details of the appeal procedure. Appeals against Disciplinary Action Any appeal against disciplinary action must be made in writing within 5 working days of the disciplinary action. An appeal against a written warning should be made to the Practice Principal stating the reasons for nonacceptance of the warning. He will carry out a full review of the facts, which may include further meeting with the employee and management. Following this review, she/he will reply in writing to the employee’s comments. An appeal against dismissal should be made to the Practice Principal. He or a nominee will carry out a full review of the facts and will reply in writing to the employee within 5 working days. Records Unless otherwise specified warnings will stay in force for 12 months and will remain on file and may be referred to for up to three years.
Grievance Procedure PURPOSE AND SCOPE
All employees have a right to seek redress for grievances relating to their employment. It is company policy to resolve any problems you may have relating to your employment as quickly as possible. Set out below is the procedure you should follow. If your complaint is about a particular person, no decision will be made until that person has had the opportunity to state his or her case.
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GENERAL GRIEVANCE PROCEDURE
STAGE 1: INFORMAL DISCUSSION Initially, please discuss your grievance with your immediate superior. If this fails to satisfy you, initiate the next stage of the grievance procedure.
STAGE 2: FORMAL DISCUSSION Refer your grievance in writing to the person to whom your immediate superior reports. This should be done within ten working days following the first discussion. Your grievances will be fully investigated. If your grievance is contested it may be decided to invite you to attend a hearing in order to discuss the grievance. You will have the right to be accompanied by a work colleague. The decision made will be notified to in writing, normally within 10 working days of receiving your written grievance or a grievance hearing. If it is not possible to respond to you within ten days then the delay will be explained to your and your will be told when a response can be expected.
STAGE 3: RIGHT OF APPEAL If the above fails to satisfy you, send a written statement to the Practice Principal within ten working days of the date on the letter confirming the decision. Your grievance will be fully investigated and a hearing arranged, normally within ten working days of the date on your statement. You will have the right to be accompanied by a work colleague. The decision made will be notified to you in writing, normally within 10 working days of receiving your written grievance or a grievance hearing. If it is not possible to respond to you within ten days then the delay will be explained to you and you will be told when a response can be expected. The Practice Principal’s decision is final. TRAINEE NURSE TRAINING GRIEVANCES Should there be any cause for concern regarding a trainees training, the trainee will have recourse to complain in the first instance to the hospital principal, Richard Weston. In the event of the problem not being satisfactorily settled, the trainee will then pass their problem to AC Training and finally if the problem is unresolved the trainee may make an application to the Royal College of Veterinary Surgeons, either directly or through the BVNA for arbitration.
Employees
Contract of Employment All employees will be issued with a contract of employment. One copy should be signed and returned to Personnel, the other should be retained by the employee. If you are unable to sign the contract this should be discussed with your immediate supervisor or the practice Principal. As indicated at interview, the Practice Manual forms an integral part of the employees contract of employment. Acceptance of the position offered is acceptance of the contents of this manual. Failure to adhere to the contents of this manual will result in immediate disciplinary action. A probationary period of three month is granted to new employees while under training to give them time to read and understand the contents of the manual.
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Your letter of appointment and your acceptance of the post serve as an agreement between you and the practice until your Contract of Employment is completed and signed. Your employment will be subject to a probationary period of six months. Accommodation: If you occupy accommodation provided by the practice, specific details will be set out in your contract of employment. All services, (gas, electricity, etc.) unless otherwise stated in your Contract, should be in your own name and you must be responsible for settling any outstanding accounts. This is particularly important at the termination of your employment. Any bills will be forwarded to you for settlement.
Appraisals We recognise that the people in the practice are our most valuable assets and the appraisal is intended to help you achieve your full potential and us to continue to improve the quality of service we provide. It is an opportunity to take an overall look at work content and volume, look back at what has been achieved and agree objectives for the future. Staff appraisals will be held on a regular basis.
Continual Professional Development (CPD) It is mandatory for ALL members of staff do at least 50 hours per year of CPD. This may take the form of formal training for a specific qualification or informal research using CD-ROMS (e.g. CD-Felis/Canis/Lapis), educational videos or veterinary journals. Staff meetings are included in this. All staff are responsible for keeping their own record of CPD up to date, which can be accessed from any computer by activating the CPD spreadsheet.
Time Keeping / Overtime Normal working hours are 8.00am to 7.00pm with one hour for lunch dependent upon your shift. Due to the nature of our work sometimes you may be requested to stay longer than your defined shift. Any extra hours worked should be logged in the Nurses file and reclaimed as directed by your Head Nurse. Good time keeping is of considerable importance and a matter of courtesy to the clients who expect us to be available. We expect everyone to clock in and out of work using Hapiclock. Pay is calculated on the hapiclock report so failure to clock in and out may result in loss of pay. No member of staff will clock in another member. The weekly rota is displayed in the Hospital and it is the individual’s responsibility to ensure they know which shift they are on. We expect prompt time keeping at the beginning of each period of working, this is particularly important where telephone answering is involved. Consistent poor time keeping will not be tolerated and may lead to a formal warning and/or dismissal in extreme instances. There are three shifts to cover all aspects of our twenty four hour cover, seven days a week. They will be as follows; Early
8am to 5pm with one hour for lunch
Late
10am to 7pm with one hour for lunch
Early pre nights week
Monday to Wednesday 8am to 5pm then Thursday 8am to 4pm. Total 31 hours.
Night
Friday 7pm to Monday 8am Monday to Thursday 7pm to 8am
The night shift is based on the following hours:
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Friday Saturday Sunday Monday Tuesday Wednesday Thursday
7pm to midnight 10am to 5pm 11am to 4pm 7pm to midnight 7pm to midnight 7pm to midnight 7pm to midnight Total
5 hours 7 hours 5 hours 5 hours 5 hours 5 hours 5 hours Work: 37 hours
Sleep 7 hours Sleep 7 hours Sleep 7 hours Sleep 7 hours Sleep 7 hours Sleep 7 hours Sleep 7 hours Sleep: 49 hours
Rest: 25 hours
Average for the two weeks is 40 hours worked. Salary is therefore based on an average of 40 hours per week throughout the year. The night shift nurse must keep the week prior to her week on nights free of commitments because if a staff member does not report for their duty shift, the nurse on the following shift will be called in to work this shift. Therefore, it is the interests of all members of staff that commitment to the nursing profession is such that only the most serious of illnesses will prevent a nurse from working her night shift. It is expected that nurses will have respect for each other’s feelings and their commitments.
Nurses Bedsit During the week of the nightshift, the duty nurse is supplied with a bed sit. The accommodation comprises of a large bed/sitting room with a kitchenette. There is a double bed. The duty nurse is responsible for supplying her own bed linen. There is a CCTV monitor connected to three cameras outside the building and one in the kennels. It is the duty nurses responsibility to ensure this is working at all times or to report problems to the Head Nurse or Richard. There is a television supplied for staff use. The kitchenette has a fridge, hob and combination oven/microwave. There is a bathroom with WC, bath, shower and wash basin. It is the duty nurses responsibility to ensure the flat is kept clean and all items are in working order. No animals will be allowed in the flat, or anywhere upstairs, under any circumstances. Nurses finishing their week on nights will clean and hoover the bed sit, including the bathroom. All dishes will be washed and put away. Food and bedding will be removed from the flat so the next nurse will be able to occupy it on the Friday night.
Dress and Demeanour You should dress appropriately to the post you hold. People working at the reception desk create the first impression to a client. The standard of dress you adopted for your interview should be reflected in the way you dress for work daily. First impressions are easily created and are difficult to change once established. Your appearance, dress and attitude all influence that first impression. The appearance of all staff is considered by Richard to be extremely important in terms of meeting with our clients’ expectations. Staff are expected to appear neat, clean and tidy with appropriate dress as detailed below. Staff who have a name badge should wear them at all times.
Veterinary Nurses Bottle Green VN Dress of appropriate size, design and length. All fastenings should be intact and the dresses ironed. Bottle Green Belt with buckle. Black tights or stockings in winter. Sensible, comfortable, flat, enclosed black shoes in winter. Sensible sandals may be worn in summer. Boots, flip-flops and other forms of footwear are not acceptable. Bottle Green Sweatshirt or Cardigan. VN badge on collar, if appropriate.
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Bottle Green Trousers. These uniforms should be worn with pride at all times as they reflect the practice and our nursing standards. Personal attention to hygiene and detail are essential. Hair must always be clean and tidy. Long hair should be worn off the face, and tied back at all times. Hair colourings should compliment natural shades (i.e. not purple or green!). Fingernails must always be clean. Coloured nail varnish is not allowed. For theatre, nails should be trimmed evenly, level with the fingertips. Jewellery may be worn, but only stud earrings, wedding rings and watches. No other jewellery is acceptable. Facial jewellery is not permitted. Make-up, if worn, should be tasteful and in keeping with a professional image. Tattoos are not encouraged. As a sweatshirt or cardigan is supplied and the premises are heated, staff are only permitted to wear uniforms as detailed above. Alternative body warmers are not permitted. During dirty jobs out of sight of the public, uniforms will be protected by wearing plastic aprons supplied. These will NOT be worn in the front public view.
Receptionists Receptionists must be well groomed with a very smart general appearance. Name badge, if supplied, must be worn at all times. Jewellery is to be kept to a minimum. Facial jewellery is not permitted. Make-up, if worn, should be tasteful and in keeping with a professional image. Tattoos are not encouraged.
Veterinary Surgeons Vets should wear smart casual, practical clothes in keeping with the public’s image of a professional person. Smart jeans are acceptable; T-shirts are not permitted. A clean, smart consulting coat (as supplied) should be worn during consultations, displaying your name at all times. Hair must always be clean and tidy. Long hair should be worn off the face, and tied back during theatre procedures. Hair colourings should compliment natural shades. Moustaches and beards are to be kept neat and trim. Fingernails must always be clean. For theatre, nails should be trimmed evenly, level with the fingertips. Jewellery should be kept to a minimum. Facial jewellery is not permitted. Make-up, if worn, should be tasteful and in keeping with a professional image. Tattoos are not encouraged.
Office Staff All office staff should wear smart clothing in keeping with the image of the practice. Neither jeans nor T-shirts are acceptable. A clean well-groomed appearance is expected. Make-up, if worn, should be tasteful and in keeping with a professional image. Tattoos are not encouraged. Any staff being inappropriately dressed will initially be informally warned. The need to repeat a warning will result in formal warnings and that member being immediately sent home to change, without pay.
Confidentiality Confidentiality applies to every item of information concerning our clients, their business, or indeed the practice’s business. Breach of this essential requirement will always be dealt with as a disciplinary procedure. If you have seen or heard any information about or concerning the practice or its clients, you should not speak about it to third parties even within the practice (unless in a professional conversation about your job) and under no circumstances to anyone outside the practice. In the course of day to day work you will acquire detailed knowledge of clients’ clinical and financial information. This information is confidential and disclosure to anyone outside the practice may lead to the client taking action against the practice. Remember that your family and friends are not bound by any confidentiality contract in respect of anything you innocently disclose to them. Accordingly you should not disclose confidential information to anyone outside the practice. Breach of confidentiality is considered a very serious offence.
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Behaviour Any behaviour which reflects badly on the practice or profession should be avoided. In particular you should avoid giving offence to a client or potential client. Dealing with an angry or aggressive client can be difficult and you should ask a senior member of the practice or Richard for help. You should never argue with, or be rude or offensive to a client. Rather refer them to Richard, a Vet or Practice Manager in the knowledge that if you have carried out your task to the best of your ability, we will always back you up. Some specific aspects of personal behaviour need particular mention. The illegal use of prohibited substances at any time is incompatible with employment in the practice. The presence on our premises of dangerous and controlled drugs makes this provision mandatory. If such misuse is discovered or suspected, you may be dismissed without further warning. This document is formal warning of our policy.
Smoking This is a non-smoking site. Smoking will not be permitted anywhere on the Practice premises, including in or around your car within the grounds.
Mobile Phones Staff will switch personal mobile phones off at all times during working hours whilst they are in the Hospital. No phone calls or texts will be made or received during working hours. No private phone calls will be made or received on the Hospital phone unless permission is granted by Richard, Anji or the Head Nurse, with the exception of serious personal emergencies.
Alcohol Alcohol consumption during working or duty hours is not permitted. If you have to deal with clients soon after drinking alcohol, your competence or capabilities may be wrongly judged even though you are sober.
Accuracy and Honesty Clients who ask for a visit or who place orders for Food or repeat prescriptions get very irate if they are missed out because someone forgot or recorded an inaccurate message. This makes the practice appear inefficient and slack. Make certain that messages are recorded accurately in the appropriate place immediately. When dose rates of drugs/drug use are involved, accuracy is paramount. If you are not absolutely sure of doses or instructions, ask for confirmation by the Vet. For example the difference between milligrams and micrograms is 1000 times. Honesty is expected in all aspects of your work. This includes the admission of a mistake or error, of which everyone is guilty at some time. It is far better to admit a mistake immediately, than to wait for the error to be discovered at a later date.
Termination of Employment The notice required by each side is as set out in your Contract of Employment. It is accepted that irrespective of contractual notice (normally two months) the employee will work no less than one months notice. Failure to give one months notice will result in the employee being liable to pay the employer one month’s salary. On the day you finish work you must return all practice property, including all keys to property and/or vehicles,
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uniforms issued, etc. The final payment of wages will be retained until all practice property has been returned. Any costs to the hospital or its principal in time and/or money resulting from the means by which termination of employment occurred will be charged to the employee and deducted from the employee’s final wage. If there is any shortfall, the employee will be asked to reimburse the employer within one month of the leaving date. Nurses who have had training paid for, and who leave before the end of completing their course will be required to reimburse the employer for the costs incurred by the practice for fees, books and equipment supplied by the practice and for salary paid to the employee whilst away at college on day release. If you occupy practice accommodation, you must vacate the accommodation on (or before) the date of termination of employment and you must inform the relevant services to prepare an account to the date of your leaving.
Equal Opportunities The Company is an equal opportunities employer. This means that it is the Company’s policy, and it will make every effort to ensure, that there is no discrimination or harassment on the grounds of colour, race, nationality, religion, ethnic origin, disability, age, gender or marital status or sexual orientation in the way that the Company treats its employees, job applicants and visitors. In issuing the policy, the Company has three main objectives. Firstly to encourage its employees to take an active role against all forms of harassment and discrimination; secondly to deter employees from participating in harassment or discriminatory behaviour and thirdly to demonstrate to all employees that they can rely upon the Company’s support in cases of harassment or discrimination at work. The Company is committed to a working environment that offers equal treatment and equal opportunities for all its employees, so that every employee is able to progress to their true potential. The policy applies to all aspects of the Company’s working practices and therefore applies to the recruitment and selection of employees, terms and conditions of employment, training, salary, work allocation, promotion and disciplinary procedures. The Company’s recruitment, selection, promotion procedures and general policies and practices will be periodically reviewed to ensure that the equal opportunities policy is being implemented. All employees are required to follow and implement the Company’s equal opportunity policy and to undergo any training and development activities to ensure that they can carry out their duties and responsibilities in terms of promoting, developing, implementing and reviewing the policy arrangements in the course of their work. MATERNITY & PATERNITY POLICY The Company offers benefits, which are in line with the statutory maternity benefits scheme. Employees who become pregnant are requested to inform the Practice Principal as soon as possible to discuss their future intentions so that appropriate arrangements can be made.
Holidays & Sickness
Holidays Your holiday entitlement is set out in your Contract of Employment. The holiday year commences on 1 st January. No holiday entitlement can be carried into the next year except in special circumstances and with prior agreement of the Practice Principal. In any year that you work less than a full year, (starting or leaving years for example) holidays will be on a pro-rata basis. If you are dismissed for misconduct, however, any due holiday accrual will be paid at the total sum of £1. Holiday dates must be arranged to avoid staffing difficulties in any department of the practice. Holiday requests should be given to the Head Nurse who will make any changes as necessary to the rota. Holidays are granted
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strictly on a “first come, first served basis”. No firm arrangements should be made without first having obtained written authorisation. Holidays should be requested at least 4 weeks in advance in writing. Holidays will not be granted if asked for within 4 weeks unless in exceptional circumstances and at the discretion of the Principal. Bank Holidays are worked on a rota basis and are included in the employee’s holiday entitlement. Before going away on holiday you must ensure that the practice continues to run smoothly by making certain that: all paperwork and case histories are up to date and current cases handed on; all messages are recorded or passed to someone; all equipment is left at the practice.
Absence Absence through Sickness 1.
It is the responsibility of all members of staff absent through sickness or injury to inform Richard Anji or the Head Nurse by 8.00am on the first day of absence, and thereafter to inform them not less than every other day as to progress and anticipated return to work. Other members of staff receiving the above information first are to pass this on to the appropriate person without delay. Members of staff informing anyone other than Richard, Anji or the Head Nurse their illness and progress will be disciplined
2.
For absences up to seven days, staff are required to complete and sign a Statutory Sick Pay Certificate form countersigned by the Practice Manager/Head Nurse. Forms are obtained from the Practice Manager.
3.
For absences over seven days, a certificate signed by a registered medical practitioner is to be sent to the Practice Manager/Head Nurse as soon as possible, and in any case within 72 hours. Without this certificate you cannot be paid under the Statutory Sick Pay scheme and may therefore lose income for the period of sickness.
4.
Any employee off sick during a holiday period will be paid under the terms of the Statutory Sick Pay scheme, the days of holiday when the employee was ill will be credited as holiday entitlement to be taken at a later date agreed in the normal way.
5.
Pregnancy and Maternity Leave. You should inform either the Practice Manager or Head Nurse as soon as your pregnancy is confirmed, so that we can ensure you avoid any unnecessary risks to you or your baby (i.e. X-rays, animal tissues or waste products, or certain drugs). It is most important that you wash your hands frequently using the disinfectant provided.
6.
Where sickness occurs at or near an official holiday, the staff member will be expected to bring in a doctors note immediately on their return. Staff who appear to have regular short periods off work will be investigated and expected to produce documentary evidence of the illness or illnesses from which they are suffering. Staff are reminded that this is a small business employing few staff. Absence has a serious effect on the efficient running of the business and the moral of the other staff that have to cover the absence.
Absence through Official Reasons If you are required to be absent for official reasons e.g. jury service, it is essential you give as much notice to the Practice Manager / Head Nurse as is possible.
Absence on Compassionate Grounds In certain circumstances, additional leave may be given on compassionate grounds on the authority of the Practice Principal. Everyone occasionally needs to take time off for family or personal emergencies. In the case of bereavement, births or emergency illness involving immediate family members, you may be allowed
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compassionate leave on application to Richard. At Richard’s discretion, you may be required to make up the time at a later date.
Motor Vehicles The practice ambulance is insured for any driver over 25 only. Richard and Anji’s cars are not insured for any other drivers. Anyone driving a practice vehicle must hold a current driving licence. The driver is responsible for checking and maintaining fuel, oil and water levels and tyre pressures at regular intervals. Any items needing replacement (such as tyres or brake pads) should be reported promptly to Richard. Any accident involving a practice vehicle must be reported as soon as possible to Richard or the Practice Manager. Any impending motoring offences must also be reported in writing. Speeding/Parking tickets are the employee’s responsibility. For your information the practice insures its vehicles through: Kerwin Smith Ltd.
Tel: 01942 610031
Staff vehicles should be parked backed onto the fence dividing our premises from Fir Tree Farms premises. The practice cannot accept any liability for damage or loss to a vehicle or its contents whilst parked on practice property.
Pay Grades A structure is in place whereby staff meet annually with Richard to discuss their performance and to set objectives for the following year. The appraisal is made up of various elements: a)
Attendance and punctuality Lateness for work / earliness for work Abusing sick pay scheme Extended dinner hours Time taken during working hours for personal non-essential appointments General time keeping and punctuality Ability to perform jobs in allotted time Apathy –v- enthusiasm
b)
Reception skills Understanding of practice routines Ability to convey factual information from clients to colleagues and vice versa Keyboard skills – invoices/payments/appointments etc. Ability to interact with other with courtesy and diplomacy Handling of routine enquiries Listening skills and responsiveness to requests Cashing up / locking up procedure adherence and accuracy Organisation of reception tasks Ambassadorial / representative skills Client communication and counselling skills Telephone abilities / manner Technical knowledge and ability to give advice Dealing with stressful situations and when practice overloaded (emergency handling) Ability to deal with sensitive issues Prioritisation of reception duties
c)
Nursing skills Ability to carry out job description methodically, trustworthy and safely
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Observation skills and ability to assess and report on patient progress Diligence and level of care applied Meeting of training objectives Learning abilities and interest displayed Attention to detail Tidiness / cleanliness and hygiene levels Consistency in carrying out abilities Ability to cope under stress / during emergencies Ability to operate under own initiative d)
Responsibilities and social skills Ability to communicate and work with others as a team Ability to work on own Portrayal of appropriate practice image to public Communication skills with clients Ability to motivate and supervise other staff Ability to carry out set projects and assigned duties/responsibilities in a satisfactory manner
e)
Personal projection Appearance and dress General motivation Ability to work harmoniously and without causing disruption General helpfulness, dealing with inconveniences Willingness and availability in promoting smooth running of practice Contribution to practice morale etc.
These lists are not exhaustive but provide some general pointers to the issues that may be evaluated and discussed at appraisals. It is hoped that these appraisals will allow strengths and weaknesses to be identified allowing them to be developed positively allowing staff to progress their career further. Individual salaries will be reviewed annually as defined in the Contract of Employment. Salary increases will depend on: The budget available (Practice Profitability) Inflation Appraisal
Pensions The Practice operates a company pension scheme with Scottish Amicable. Stakeholder Pension is available to staff through Standard Life. To join Standard Life phone 0845 6060087 and quote reference number JA7258 when asking for a pack. Both pension are contributory schemes. The practise does not contribute to staff pensions
PracticeMeetings Practice Meetings take place every two weeks on a week day afternoon to be arranged by notice, two weeks in advance. It is expected that all staff attend. Any issues that you would like to raise at the meeting should be submitted in writing to the Head Nurse, Practice Manager or Principal for inclusion into the Agenda. Any meetings held outside normal hours will also be attended by all staff, without pay.
Professional Negligence Any person who becomes aware of circumstances giving rise to any possibility, however remote, that a claim for negligence might be made against the practice must immediately give notice thereof to Richard with written details of the facts and circumstances. Under no circumstances are you to admit liability for anything that goes
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wrong with a case. This would immediately nullify our Professional Indemnity. Of course sympathy must be extended to the client; this is not an admission of negligence.
Staff Benefits Staff may have one of their own pets vaccinated free of charge per year. Staff will be entitled to £500 worth of consultations and surgery free of charge per year. There after they will pay half of these fees. Drugs and shop goods will be allowed a 30% discount. These products, if not paid for at the time will be deducted from the employees salary at the next pay day. Vets will charge all procedures as they are done to employee’s pets and Anji will calculate discounts before deducting from wages. Vets found not to be charging staff will become liable for the costs allowed to the employee, which will be deducted from their next salary. Any or all of these benefits are entirely at the discretion of the practise principal and can be varied or withdrawn without notice. Books are provided in the Library for reference purposes. If you wish to take a book home, please let the Head Nurse know. A log will be kept until the book is returned. Any losses are the staff’s responsibility.
Suggested Improvements Any member of staff is welcome to make constructive suggestions for the better running of the Practice or for ways of reducing costs. Written and signed suggestions may be included in the Agenda for the next Practice Meeting or passed to the Practice Manager for consideration.
Training
New Staff Induction It is important that new members of staff learn our practices and procedures as quickly as possible, so that they become part of the team in the shortest possible time. The induction programme also reduces anxiety naturally felt by a new employee. The Manual does not detail the induction programme for all new staff, as this will be different for each person. The induction starts on the employee’s first day in the practice and comprises: 1.
Welcome and introductions together with a tour of the practice.
2.
Formalities e.g. Job Description/Contract of Employment, Personnel Records, The Practice Manual.
3.
Salary payment details, holiday and sickness procedures, health and safety procedures.
4.
Schedule of training.
5.
Basic computer and telephone system training.
All Staff On-going training is encouraged in all areas of the Practice. Any information regarding forthcoming courses will be placed on the Notice Board for all staff to see. If you find a particular course to be of interest discuss its suitability with your immediate Supervisor. Training evenings take place regularly every 6 weeks and suggestions for courses are always welcomed. Trainees under the age of 17 can receive funding via Metrotec. All other training is funded by the employee.
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Veterinary Nurses Student nurses gain practical experience in the Practice while attending college on a block/day release basis. Learning within the Practice is achieved in several ways: 1.
Trainee nurses must learn a great deal by observation and questioning of the veterinary nurses and vets that they work with. Experienced staff are happy to help with any difficulties. Please ask questions to gain knowledge and benefit from their experience.
2.
It is essential that trainee nurses learn to study on their own and follow a programme of learning for appropriate texts (e.g. The Veterinary Nursing Handbook) throughout their time with the practice. Spare time at work should be used for study purposes.
3.
The college is responsible for formal lectures, further practical training and examination preparation.
Unwelcome Clients
For various reasons it may be necessary to refuse to treat (except in an emergency) animals of the following clients:
PRACTICE PROCEDURES
Admitting/Discharging Animals
Admitting Admissions take place between 8am and 9am. It is important to space the admissions at least at ten minute, but preferably fifteen minute, appointments. Additionally, when making an appointment for an admission a second appointment for collection during evening surgery must also be made with the Nurse responsible for Discharges. The client should be informed that a nurse will telephone them after the operation to report on the progress of the procedure. At this time the appointment time should be confirmed. It is most important to re-assure the client about the operation and that the client understands what is going to happen to their pet. A full examination should be given to the animal being admitted. 1.
At Reception, fill in the Consent Form whilst the owner is present, explaining the choices available as you do so, with particular emphasis on the importance of pre-anaesthetic blood profiles. Print and Save a copy of the form to the client’s record. Double check that the consent form has been filled in correctly, that you are examining the animal stated on that form and that the operation to be performed is the correct one. In particular identify which limb, if a limb problem, and where lumps are located by getting the owner to point them out and clip the hair to mark the site.
2.
Weigh and record the animal’s weight on the consent form. If it is a cat or small animal in a carrier, weigh the carrier with the animal in it; when the animal has been transferred into the kennel re-weigh the carrier and subtract this weight to achieve a correct weight of the animal. This should ensure that we never lose our patients. Always have dogs on a lead when out of the kennels.
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3.
Take the client into the Admission Room. Check with the owner that the animal has been in good health, if in for a routine operation. Ask if there has been any diarrhoea/vomiting within the last 48 hours, or if the animal has appeared unwell in any way.
4.
Check and record on the consent form the temperature, heart rate, pulse rate, respiration rate, CRT and colour of mucous membranes. If you find a problem with any of these the vet must check the animal.
5.
Check if the animal is on any treatment; if so did it receive its medication on the morning of the operation?
6.
Check that the animal has not eaten since 8pm the night before or had anything to eat or drink on the morning of the operation.
7.
Explain to the client the full details of the operation, what will actually be happening to their pet.
8.
When examining the animal make sure everything is covered. Check that the animal does not require any extras such as a dental or ear clean whilst under the anaesthetic.
9.
Give the Consent Form to the owner to read and sign.
10. If the animal is well and does not require a blood profile, sedate the animal with the client holding the pet. 11. Admit the animal to hospital both physically and on the computer. Write the details on the Op Board in the Kennel area. 12. Give any leads, collars or pet carriers back to the owner and ask them to contact us between 2pm-3pm to arrange a time to collect their animal. Any owner’s goods that are lost are the responsibility of the Admissions Nurse
Discharging Most animals will be able to go home between 4.30pm and 6.30pm. Again all discharges are by appointment, which should be spaced evenly between the number of animals going home that evening. The animal is not discharged from the hospital records until the owner arrives at the surgery. No animal must be discharged without the correct paperwork to hand. When the owner arrives at the surgery: 1.
The Receptionist will collect the paperwork from the relevant kennel, check that all the procedures, materials, drugs and dispensed medication are correctly entered on the computer, make an appointment for an Op-Check as necessary, print a Post-operative sheet and take payment from the client. ALL operations apart from cat castrations are checked at 5 days unless otherwise stated by the vet.
2.
If the client cannot pay, check the record for any payment terms agreed. If no payment terms agreed the client will have to wait to speak to the Head Nurse or Richard. If the client becomes abusive in any way see section “How to handle complaints”.
3.
Once payment is received, all documentation is passed to the Nurse responsible for discharges. It is the Discharge Nurse’s responsibility to ensure that all case details have been passed on and understood correctly, and that he/she is fully aware of the operation carried out, together with any complications encountered.
4.
Before speaking to the owner the animal must be checked to ensure that the operation site is clean and has not been tampered with. Any animal seen to be interfering with sutures must be sent home with a buster collar that must be paid for by the client. Animals must be dry and not have any urine or faeces present on its coat.
5.
Call the owner into the Discharge Room. The owner and animal record must be brought up on the computer and referred to during the discharge. Check for instructions that may be relevant in earlier history. The operation site and any hair loss due to clipping – for example legs/neck for blood sampling or
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the administration of anaesthetic – must be shown to the owner. A full explanation of the operation must be given, together with any blood results. If necessary ask a vet to explain these if you are unsure. The vet must discharge all animals that have had x-rays. Check that the vet does not need to see client in all other cases. 6.
All owners must be given the Post-operative sheet and all points must have been explained or, if not relevant, deleted to avoid confusion. Ensure that the owner fully understands the level of post operative care required prior to leaving the consulting room.
7.
Reassure the client that they can contact us at any time if they have any concerns.
8.
Check that an Op-check appointment has been made if necessary.
Advice All advice is given free of charge. If a detailed explanation is required, e.g. for a new puppy or kitten owner, then it may be better to advise a Puppy or Kitten check either with a Vet or Nurse. For non-clients, still give advice if possible but advise them that records would need to be transferred if they wish the animal to be seen. Regular Puppy & Kitten talks are held as are Puppy Parties which should be positively promoted to all clients.
Dog Grooming There is a range of grooming products available in the shop if people wish to groom their own pet. Alternatively we recommend our own in-store Groomer for professional advice.
Drug Regulations POM - Prescription Only Medicines mean that they can only be prescribed by a Veterinary Surgeon. The Vet must have seen the animal within the last six months for such medications to be dispensed. Any animal not seen within the last six months will have to be referred to the Vet before medication can be dispensed. The only exception to this is flea treatment, which is 12 months. PML - Pharmaceutical Medical Licence can only be given out with the permission of a Veterinary Surgeon to registered clients who have been seen in the last 12 months. If the practice has a current Pharmaceutical Licence it can dispense to non clients. Anrich does not have a licence. GSL -
General Sales Licence means that these products can be sold over the counter or via the pet shop to clients and non-clients alike. The animal does not have to have been seen by us to dispense this type of medication.
There are discussions in parliament currently to make changes to this classification. Be aware these may change in the future
Estimates Many clients will “ring round” practices to ask prices. It is essential therefore that you give some advice and explanation of what a client will get for their money. For example, all Consultations include a full health check, we have manned 24 hour cover every day of the year, cat vaccinations include Leukaemia, etc. Fees that you may quote include:
Consultations Vaccinations Nail Clips Neutering
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Fees not to quote are:
Non-routine operations Dentals
First Aid Aim of First Aid is to assess a problem, its urgency and to stabilise until the problem can be professionally dealt with.
BLEEDING Arterial
can be recognised by the fact that the blood spurts under pressure and is bright red.
In the case of Arterial bleeding it may be necessary to apply a tornique above the site of haemorrhage. Any rope, cloth or bandage may be used to tie round a limb and is tightened by twisting with an object like a stick. The tornique should remain on for no longer than 15 minutes before being released.
Venus
flows quickly but without spurting and is darker red in colour.
Bleeding from smaller arteries, veins and capillaries may be arrested by external pressure to the wound.
Capillary
is general oozing of blood from a surface.
In all cases of bleeding the object is to arrest bleeding as quickly as possible. If there is a penetrating object this should not be removed but pressure should be applied around the object. If bleeding persists through the pressure bandage DO NOT remove but apply further dressings. Should ice be available this may also be applied to encourage contraction of blood vessels.
RESPIRATORY DIFFICULTY History is of vital importance in an animal presented with respiratory signs. Firstly identify speed of onset and duration of the symptoms.
Is it possible for a foreign body to be present? always ensure patency of the airway.
Remove any obstruction and ensure the tongue is not choking the pet. If there is access to oxygen immediately oxygenate the animal with a mask.
Check the heart rate and rhythm
If the animal stops breathing then extend the animals head and neck in lateral recumbency and gently press the chest wall once every ten seconds. If the heart stops apply increased pressure to the ventral area of ribs 3,4 and 5 ten times and reassess. Repeat the procedures until professional help arrives. If there is more than one person available and the animal has stopped breathing then an endotracheal tube may be introduced which will facilitate positive pressure ventilation.
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ROAD TRAFFIC ACCIDENT / SHOCK It is most important to keep calm and have an organised approach to the road traffic accident (RTA). Approach the animal slowly and quietly and lay a hand on its back (if uninjured) to let it know you are present. Speak to the animal calmly. Visually assess external injuries to the animal. If in the street assess the dangers to yourself and others Ascertain if possible exactly what happened and if an owner is present. Identify if there is any external bleeding, respiratory difficulty or broken bones.
Initially control bleeding and respiration and stabilise if possible any fractured limbs.
Before moving the animal apply a muzzle for safety. Cover the animal to keep it warm but do not offer any fluids by mouth In every case the animal will be suffering from shock and therefore needs urgent medical attention. After bringing to the Hospital the shocked patient is likely to be put on fluids so whilst waiting for the Vet to attend a Hartmans Drip should be warmed up and be ready to apply. All shocked cases will be given steroid, usually Dexadreson, so it would be appropriate to have this ready for when the Vet attends.
HEATSTROKE During the Summer, in hot weather, this can be very common especially in cases of pets left in confined spaces (eg cars) or dogs that have exercised excessively. The main priority is to reduce the body temperature as quickly as possible. This may commonly be in excess of 42°C to start with. Temperatures higher than 43°C seriously jeopardise the animals life due to damage of the temperature regulating mechanism. Soak the animal in cold water and if possible cover with a wet sheet monitoring the temperature every ten minutes until 39°C is achieved. At this point dry the animal off to stop the temperature dropping any further.
FITTING Uncontrolled shivering and muscle contractions are indicative of epileptiform fits. These may vary from mild tremors to full lateral recumbency with all limbs rigid and twitching, the mouth opening and shutting with hypersalivation causing frothing at the mouth. Obtain a history from the owner as to whether this has happened previously, if so identify when, frequency and duration of fits and treatment (if any). Identify, if a bitch, if she is entire and if so has she recently had puppies. If she has, and more importantly if she is a Yorkshire Terrier, then eclampsia needs to be considered for which the treatment would be administration of calcium intravenously by the Vet. Under no circumstances try to restrain the animal as it is possible to be bitten during the animal’s convulsion. Clear all obstacles from around the animal and allow the fit to pass. Under Veterinary supervision a sedative may be given to alleviate fits lasting longer than five minutes.
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FRACTURES Simple, compound or
These simply require stabilisation with external splints until x-ray and fixation can take place.
open
In open fractures there may be dirt and debris in the open wound and bone. The wound should be covered with gauze soaked at least in water but preferably Pevidine. The fracture should then be stabilised.
In all cases of fractures shock will also be involved. See RTA. Due to the problems of clot emboli it is important not to move and manipulate the fracture site any more than necessary. Emboli can kill. In the case of spinal injuries the animal should not be moved unless on a fixed board stretcher.
BURNS Remove any hot substances or objects still in contact with the skin, DO NOT apply any creams or ointments. Soak the affected area in, if possible, a constant stream of cold water. When transporting the animal apply a cold wet compress to the affected area.
ELECTRIC SHOCKS Low voltage eg at home
DO NOT touch the animal until the source of the electric shock is removed. Where possible turn the power off at the mains and remove the plug. In cases of unconsciousness follow the steps described in Respiratory Difficulty. Treat other injuries in order of priority: bleeding, burns, fractures.
High voltage eg power lines
Under no circumstances try to approach or rescue the animal. Call the Police on 999 and keep onlookers away. Once informed by an official person that the power has been cut off the animal may be approached a resuscitation attempted as previous described again treating injuries in order of importance.
WHELPING AND KITTENING Cats and dogs will start parturition anywhere from 59 to 70 days after mating. If is essential to gain a complete history of the pregnancy. The answers to these questions will allow you to advise the client on whether there is a problem or not.
When was the animal first mated? When was the animal last mated?
From that calculate 59 days from the first mating to 70 days from the last mating which will give you the parturition window.
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Has there been any discharge during pregnancy? Have there been any infections or treatments during the pregnancy? How long has she been bed making (first stage labour)?
First stage labour will last from anything up to 48 hours.
Has she started any abdominal contractions?
Second stage labour i.e. when contractions start will last anywhere from a few minutes to twenty minutes.
How long has she been contracting without producing?
If no puppy/kitten is forthcoming within twenty minutes there is a problem which needs immediate Veterinary attention. At this stage prepare the Theatre for a Caesarian.
Has she produced any puppies/kittens? How long between?
The interval between puppies/kittens may be a few minutes or several hours. Provided there are no contractions there is no worry. Should a foetus be partially produced then gentle external pressure may be necessary to help pull the foetus out. If this fails Veterinary attention is essential.
STINGS Plants
Plants seldom cause problems due to the fact that the animal’s coat protects it. Alopaecic animals may be subject to plant stings.
Wasps
A Wasp sting may be neutralised by Vinegar.
Bees
A Bee sting by Bicarbonate of Soda. In all cases clean the area with an antiseptic wash, if you see the sting pull it out.
Ticks
In the case of ticks DO NOT remove, instead spray the tick with Nuvan Top and allow it to die off.
In all cases of stings the Veterinary Surgeon will treat with a steroid.
POISONS Where a known poisoning has occurred it is vital to identify the nature of the poison and identify the antidote. DO NOT make the animal vomit. Contact the Vet immediately and admit the animal to the Hospital gaining as much history as possible surrounding the circumstances of the poisoning to pass on to the Vet. Where possible milk should be given to absorb the poison as much as possible until a specific antidote can be given.
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EYE INJURIES Prolapsed eyeball should not be replaced.
Gently apply a cold compress to keep the eye moist until a Veterinary Surgeon can attend to it.
Foreign bodies and irritants
Gently flush the eye but do not attempt to remove the foreign body. Having flushed the eye gently apply a cold compress and put a buster collar on to stop the animal from interfering with it. In the case of an irritant identify exactly what the irritant is.
DROWNING After rescue hold the animal by its hind legs and swing gently to drain water from the animals lungs. If the animal is not breathing resuscitate and previously described or by mouth/nose resuscitation if in the field. Once the animal starts breathing dry and keep warm until Veterinary attention arrives.
MOUTH WOUNDS Sticks
In the course of throwing sticks for pets they sometimes get the stick impaled in the back of the throat. If still present this should be removed and Veterinary attention sought immediately.
Bones
Bones being chewed often get lodged between the teeth across the hard palate causing the animal some distress. Using a pair of artery forceps this can usually be removed without a General Anaesthetic but if the animal is fractious then sedation with Rompun or possibly a GA may be necessary which requires Veterinary attendance.
Fleas One of the most frequent enquiries you will receive will be regarding fleas. There are leaflets available for each product sold through the practice or pet shop and these should be handed to the client as each product is explained. Firstly, you must begin by explaining the life cycle of the flea so that the client understands why there are products available for the environment as well as the pet. If the pet is with them you may offer a free flea examination or alternatively make an appointment for one of the Nurse Clinics. After explaining the life cycle of the flea and hence where the challenge comes from you can advise Vetchem Acclaim or Defest II which they can purchase straight away to begin treatment of their home. You must advise them that as the best flea products available are POM’s the animal will have to be seen prior to any medication begin dispensed. If a client is unwilling to return with the animal then you can advise Sherley’s Big Red Flea Spray available from the pet shop. Make sure that any product sold is correctly labelled and that the client is aware how to use it. The main products sold through the practice are Advantage, Frontline, Program, Capstar and Stronghold. Explain each product to the client so they can make an informed decision.
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Advantage This drop-on solution is for the control of fleas in cats and dogs. Advantage 40 is for cats, small dogs and rabbits over the age of 8 weeks weighing up to 4kg. Advantage 80 is for cats over the age of 8 weeks weighing over 4kg Advantage 100 is for dogs over the age of 8 weeks weighing between 4kg and 10kg. Advantage 250 is for dogs over the age of 8 weeks weighing between 10kg and 25kg. Advantage 400 is for dogs over the age of 8 week weighing over 25kg. Advantage comes in boxes of 4 pipettes. Each treatment lasts for approximately 1 month and is applied between the shoulder blades onto the skin after parting the pet’s hair. Advantage is licensed for use on pregnant or lactating bitches or queens. If clients have a large number of pets you may refer them to Richard who may sanction the use of 250 or 400 to be shared between the pets. Telephone number for Bayer is 01284 763200.
Frontline Spray This product is available in 100ml and 250ml pump action sprays. It will rapidly kill fleas/ticks and can be used on cats and dogs. As it is a non-aerosol spray nervous animals, especially cats, tolerate it well. Frontline protects against fleas for 3 months in dogs and 2 months in cats, and also protects dogs against ticks for 1 month. Puppies can be treated with Frontline at 2 days old. Kittens can be treated at 7 weeks old. It is also licensed for use in pregnant and lactating bitches. Telephone number for Merial is 01279 775858.
Nuvan Top This product is now out of production
Stonghold Stronghold not only kills fleas but also kills roundworm. In cases where an owner cannot give oral medication, suggest Stronghold for fleas and roundworm and Droncit spot on for tapeworm.
Program Most clients who have experienced a flea infestation are keen to prevent it from re-occurring. Program works in a unique way to break the life cycle of the flea by effectively making the flea infertile. As the product is weight dependent, each animal needs to be weighed. Each box lasts for a six-month period, so it is important that weights are checked for growing puppies to ensure that the correct dose is given for the next six months. It is an oral treatment available for both dogs and cats and should be mixed with the animal’s main meal on the same date each month throughout the year. Cats can be given an injection that lasts for six months. The best time to start an animal on Program is when the pet does not have any fleas. It is safe to use in puppies and kittens at weaning. Generally though, if there is a choice advise the client to stick to Advantage. Telephone number for Novartis is 0800 854100.
Tracer An animal can be chipped with a Tracer at any age. There is an example of what a chip looks like at Reception, and a reader is always available to show how it works. Once a chip has been implanted, a form is completed
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(which the owner must check is correct or there is a £3 charge to change it afterwards) and a copy sent to Petlog who hold the National Pet Register. Any organisation finding this animal will contact Petog and be given the owners, or their Vets, details. Animalcare now produce a Thermal Identichip which shows the animals temperature also. This requires a special reader. The chip is more expensive but can be offered as an alternative to clients Make sure the animal’s Identichip code is entered on its record – this is our quickest way to search if we find a stray animal. Petlog can be contacted on 0207 629 3267 or Bayer on 01284 763200.
Insurance As a practice we recommend Pet Plan Insurance. New FSA regulations have meant much more stringent rules for selling and discussing insurance with pet owners. All members of staff MUST be Authorised Representatives (AR). Details about the various policies available are available within the practice and you should familiarise yourself with them. All puppies and kittens receive free insurance at their first vaccination if they are under 16 weeks old. This insurance covers them against accident or illness for 1 month. Pet Plan will send details directly to the client asking if they would like to continue with the cover, there are no penalties if cover is not continued. If the animal is over 16 weeks old, recommend the use of Easy Application Form to start the client’s insurance. With this they also get the first month free. Additionally if they sign up they get the second month free. Advise the client the benefit of Pet Plan being cover for life. This means that when the pet reaches 10 years old the premium and excess will be the same but only 75% of any claim will be paid. Read the leaflets to ensure you are aware of the terms. Don't forget that Rabbits can also be insured. Even if an animal is insured, clients must pay for their treatment in full unless Richard has given specific authorisation that we will claim directly. As soon as a case becomes an insurance claim we need a signed claim form. If the pet is insured through Pet Plan we have claim forms available within the surgery. Any other insurance company, the owner will have to provide their own claim form. Please check that the form has the client’s name, address and pet details completed and that the form has been signed by the Policyholder. When you are happy the claim form has the correct details establish which Vet is dealing with the case and put the claim form in their file. At the end of treatment a full claim will be made which will be settled directly to the client. Pet Plan can be contacted on 0800 282009. Our practice ID is 5318.
Kennels / Catteries As a profession we are not allowed to recommend Kennels or Catteries. However, we are allowed to give a personal recommendation but it must be stated as such. Organisations that have been used in the past by colleagues or recommended by clients are: Dukes Barn Farm Holly Bank Dam Lane
Loyalty Vouchers Clients register on our Customer Loyalty Scheme that is administered through the Pet Shop. For every 50p they spend in either the practice or pet shop they receive 1 point. The Customer Loyalty Card should be presented to the cashier at the till prior to a purchase being made. This will allow points to be automatically added to the client’s record when a purchase is completed. Receipts from Veterinary purchases need to be manually added and, once done, the back of the receipt must be signed so that these points are not added again. Once points
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have accumulated they can be exchanged for vouchers which can be used in the practice or shop. Points accumulate as follows: No. of points Voucher
200 £2
400 £4
600 £8
800 £10
1000 £15
Recommend to client our Gold Silver and Bronze cards that are now available. Platignum £1000 15% discount Gold £ 500 10% discount Silver £ 250 5% discount Bronze £ 50 2.5% discount
Misalliance If a bitch has been mated and the pregnancy is not wanted a misalliance injection can be given: 1st injection 2nd injection
3 days after mating 5 days after mating
priced as misalliance plus mesalin ½ml/10kg priced as injection fee plus mesalin ½ml/10kg
Neutering We advise all pets to be neutered when they are six months old unless the owner specifically wishes to breed from them. When the pet reaches six months of age the owner may telephone to make arrangements for the operation to be carried out. If a bitch has been in season we need to wait a month from the end of the season before spaying can proceed. For Neutering Schemes see section headed Charities. If cost is a problem we will allow a client to pay in instalments in advance. When the cost of the operation has been reached it can then be booked in. Remember males and females of dogs, cats and rabbits must be neutered.
Pet Shop The advice given at the pet shop must never conflict with the advice given from the practice. Products are available through the shop, which we may not necessarily agree with in the practice. They are there to give people a choice. It is your job to sell products with advice on the hope that the client will be a little more informed the next time the same problem arises. We want clients to feel comfortable when visiting the shop and not to feel “bull-dozed” into taking the best product. Remember unhappy clients will not return. You will commonly be asked if it is possible to supply ear drops over the counter. The only ear solution to be supplied over the counter should be a GSL ear cleaner such as Leo’s ear cleaner for dogs and cats. Explain to clients that we would not be doing our job properly if we supplied drops without checking the animal’s ears first. There are many different ear solutions to treat different ear problems, and often a course of antibiotics is also required. The best way to treat an ear infection is to swab the ears first, grow the bacteria and treat with the treatment we know will work after performing a sensitivity test. This procedure should be carried out by a Vet.
Pet Travel Scheme Please refer to section “Government Legislation” for full details.
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Puppy/Kitten Checks For new owners we recommend a Puppy/Kitten check at a reduced consultation rate. See Clinics for more details.
Puppy/Kitten Lectures On the first Thursday of each month Richard will do a lecture in the lecture theatre from 7pm to 8pm. All puppy and kitten vaccinations must be booked in for this lecture and it must be promoted as part of the vaccine course. All new clients and any one else interested can be invited to the lecture. People coming to the lecture must be booked in.
Vaccinations Puppies We recommend that the puppy vaccination course commence at 8 weeks of age. At this time the puppy will be given Duramune dhppil. The second vaccination needs to be given two weeks later and this will also be Duramune dhppil. The puppy can be taken out one week later. All dogs need an annual booster to maintain protection. If a booster injection is more than five months late then we would recommend that the course is restarted. For animals going into kennels, attending show or training classes we recommend vaccinating against Kennel Cough. This should be given at least 1 week before needed to ensure it has time to take effect. Always ask clients requesting boosters if the dog is going into kennels. If so then recommend Kennel Cough advising this will save ÂŁ12 if done with the booster. It is company policy that all dogs are sold worming tablets at the same time as the vaccination and every 3 months after that. We can now remind via Wormfree.co.uk by e-mail and text so offer one years supply at 20% discount.
Cats We recommend that the kitten vaccination course commence at 9 weeks of age. At this time the kitten will be vaccinated against Flu, Enteritis, Leukaemia and Chlamydia in a combined vaccine. Three weeks later the injection will be repeated to complete the course. All cats need an annual booster to maintain protection. If a booster injection is more than five months late then we would recommend that the course is restarted. The vaccination against Leukaemia can be given at any age, even if the cat has never been vaccinated against it previously. The normal booster injection will be given including the Leukaemia part and three weeks later the cat will return for a single Leukaemia injection to complete that part of the course. Additionally there is a test that can be offered to test if a cat has been exposed to the disease. Unfortunately, if it has, there is no cure. Cats can be carriers of the disease, passing it on to other cats, but never becoming ill themselves. It is to stop the disease from passing through the cat population that we must stress the importance of vaccination. It is company policy that all cats are sold worming tablets at the same time as the vaccination and every 3 months thereafter. We can now remind via Wormfree.co.uk by e-mail and text so offer one years supply at 20% discount.
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Rabbits Rabbits can be vaccinated against two killer diseases, Myxamatosis and HVD, when they are 8 weeks old. We recommend that each vaccinations are given singly one week apart for maximum protection All rabbits need an annual booster to maintain protection when both vaccines can be given together.
Monthly Healthcare Lectures On the first Thursday of each month Richard does a healthcare lecture from 7pm to 8pm. ALL vaccinations must be offered this as part of the vaccination program.
Worming The flea is an intermediate host of the tapeworm larva, therefore discussions of fleas and worms go hand in hand. Practice policy is to worm the pet to coincide with its annual booster and then 3 monthly but if an animal regularly hunts then a more frequent worming regime may be required and should be discussed with the owner. For animals that have been seen within the practice we can offer Milbemax, Drontal Suspension or Panacur. For animals that have not been seen we recommend Sherley’s Multi-wormer available at the pet shop. Until the age of six months all puppies must be wormed regularly with Drontal suspension at 3, 6, 9 and 12 weeks or Milbemax tablets depending on the puppies weight. Worming with Panacur can be used in kittens starting at 3 weeks old, repeated at 6, 9 and 12 weeks. Panacur 2.5% or liquid can be offered for the treatment of worms in pregnant and lactating cats and unweaned kittens. The correct dose rate is listed on the bottle depending on the animal’s weight. Milbemax is given to pregnant and lactating bitches. Remember to re-weigh puppies and kittens prior to dispensing repeat worming medication as they will have put on weight since the last time they were seen. In cats that are impossible to give tablets to, offer Stronghold as it kills roundworm as well as fleas and then Droncit Spot on for the tapeworm element
Anrich Rescue Fund The Anrich Rescue Fund is administered by Anji. It was set up to help stray animals by paying for medication, hospitalisation and costs associated with re-homing.
Anrich Benefit Scheme This scheme was run for two years but due to many problems associated with the type of client on it, it has now been terminated. No clients will be offered these terms in future.
Appointments Our consulting times are:
MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY
MORNING 9.00 – 11.00 9.00 – 11.00 9.00 – 11.00 9.00 – 11.00 9.00 – 11.00
EVENING 4.00 – 6.30 4.00 – 6.30 4.00 – 6.30 4.00 – 6.30 4.00 – 6.30
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SATURDAY
9.00 - 1.00
EMERGENCIES ONLY
Appointments are made at ten-minute intervals. Try to accommodate clients by offering them a choice of times and vet. If possible, try to group appointments together so that the vet does not have large gaps between consultations. Saturday mornings should be kept for emergencies only, unless a client cannot attend at any other time. All Saturday morning appointments are booked under Richard no matter who is on duty. If a client arrives who does not have an appointment, try to slot them in to the current surgery or ask them to make an appointment and come back later. Always inform clients that consultations are by appointment only and give them a card with our consulting times for future reference. If, due to unforeseen circumstances, appointments run late, apologise to clients and offer them the opportunity of re-making their appointment if required. Appointments for animals coming in for operations should be made at ten-minute intervals from 8.00am. This allows time for the Nurse to complete all checks prior to admitting the animal (see earlier section). If a client can not bring the animal between 8.00am - 9.00am then an appointment can be made for admission the night before. The client will not be charged for this overnight stay.
Charities
Cats Protection League (CPL) The CPL run a neutering scheme whereby clients can apply to have some of our fees paid for by them. Usually the client will give us a voucher worth £17.50 towards the cost of neutering. The operation will be priced as normal and the voucher deducted from the client’s record prior to payment. The client pays any outstanding amount once the voucher has been deducted. All vouchers must then be passed to Anji who will reclaim them from the CPL.
Guide Dogs for the Blind (GDBA) We have many Guide Dog owners registered with us. Each Guide Dog gets a six-monthly health check, which is paid for by the Guide Dogs Association. Each owner has a book, which is completed by the veterinary surgeon at every visit. The top page is detached for our records and should be passed to Anji. Prescriptions food is sold at no cost to the Guide Dog Owner and reclaimed by us through completing a Hills Replacement Form. Science Plan is claimed from GDBA. Make sure you know where these forms are kept and fill them in each time a Guide Dog has been treated.
Dogs Trust (formerly NCDL) The Dogs Trust have a neutering scheme for owners on benefit. The qualifying benefits are in the front of the book of application forms. Owners must provide evidence of benefit which bust be photocopied and retained with the application form. The client pays £25 plus any other charges incurred eg if the bitch is pregnant, has bloods, vaccinated etc.
Royal Society for the Protection of Cruelty to Animals (RSPCA) The RSPCA also offer a neutering scheme. Local Vets have agreed a special price for animals neutered under this scheme. Currently clients pay the RSPCA and the RSPCA pay us. The client will give us a voucher
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proving they qualify under this scheme. Ensure the Consent Form is marked RSPCA so that the procedure is priced correctly. The client is responsible for any additional work that is not associated with routine neutering. A new scheme is currently being considered whereby the local practices discount the normal cost of neutering, the RSPCA pays 30% and the client 30% of the remaining cost. This scheme is not in place yet and you will be informed of any changes to the current system when they occur.
ClientManagement Most clients will have appointments. When a client enters the reception they must always be acknowledged within the first minutes of entering. If dealing with a phone call or another client, a pause should be requested to put the incoming client from the appointment list to the waiting list or to ask them to take a seat until you can deal with them. New clients and those who have not been for more than three years must be given a registration form to fill in and sign. Puppies and new clients’ pets should be weighed before going into the consulting room. All ops should be weighed on admission. Puppies under 12 months of age should be weighed every time they come into the Hospital. Establish which practise a client has been to prior to registering with us and get the history from them immediately. Never book a new client in if it is undergoing surgical treatment by another practice without first discussing the situation with Richard so that he may contact the previous practice. Receiving clients from the consulting rooms, especially in a busy surgery requires skill and diplomacy. Again clients must never be ignored. It should always be endeavoured to minimise clients waiting times. There is usually one receptionist per Vet consulting, so ideally one should be responsible for answering the phone and the op discharges and the other for those clients coming out of the consulting rooms. Only when there are no discharges and phone calls will that receptionist deal with the overflow from the consulting rooms. When a client comes out of the consulting room to the reception, they will either be there to make a further appointment and pay, or they will be required to sign a consent form for an op or euthanasia. In the former case, the waiting list will tell you when the Vet wishes to see the client again. The first action is to inform the client of the date requested and make a mutually suitable appointment. Next check the history for any comments that may need reinforcing or possibly the client may need reassurance. Ask if they were happy with the advice given and understood what they were told. Check they have any leaflets relevant to the conditions being treated. Finally check the client and animal details again then take payment.
End of Day Routine A Non Payers report must be run first. Check that and correct any errors then run the cashing up report. A Cashing Up Report needs to be run every night after evening surgery. Consult the Mentor Users Guide if you are unsure how to run this report. Additionally this report needs to be run if any money has been taken out of hours. This out of hours report must be done before any money is taken during normal working hours. When the report is run at the end of the day the credit card terminal must be Z’ed.
Nurse Clinics A Consulting Room has been assigned for Nurse Clinics. It is anticipated that Nurses will set up their own clinics to offer basic advice and examinations in the following areas: Flea / Worm checks Dental examinations Senior pet examination Weight Watchers Clinic Puppy / Kitten checks Nail / Beak Clips Nutritional Advice It is vital that the animal is fully examined and the owner made aware of any findings. Checks to perform are:
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1.
Weigh and record the animal’s weight. If over or under-weight recommend client to attend WeightWatchers and recommend an appropriate diet.
2.
Check the pet’s eyes/ears/nose and mouth paying particular attention to the teeth and gums. Advise any dental treatment as necessary.
3.
Ask about polydipsia / polyuria and offer urinalysis if necessary.
4.
Check the skin for lumps or skin conditions.
5.
Trim nails if needed.
6.
Check temperature / heart rate / pulse / respiration rate / colour of mucous membranes / CRT / lymph nodes / mammary glands / genital areas.
7.
Give general advice on vaccinations / worming / flea prevention / insurance / nutrition and identichip.
8.
If you find anything abnormal make an appointment for the client to see a Vet.
Nurse Duties
Cleaning Room KNOW HOW TO USE: Ultrasonic Cleaner Autoclave Washing Machine X-ray Machine: Cleaning Cleaning plates Completing Forms Instruments: Cleaning Packaging ASIF Kit: Cleaning Putting together Orthopaedic Instruments (Know them) Towels: Bitch Spey Cat Spey Swabs (2 to a pack) Cleaning and Checking ET tubes Cleaning Syringes Disposal of Sharps and Bottles Folding and Packaging Gowns Foot Bags Drill Shrouds Know where Autoclaved Catheters are
INITIAL WHEN TAUGHT:
X-Ray Room REQUIREMENTS: How to load Cassettes How to develop Films
INITIAL WHEN TAUGHT:
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How to clean Cassettes Awareness of Safety Procedures Where Cassettes and Film are kept How to write up an X-ray and file
Operating Theatre REQUIREMENTS: Know the Anaesthetics Monitor animals under Anaesthesia Assist Vet during operations Gowning yourself up and assisting Vet Scrubbing up Topping up: Isotec Spirit Pevidene PDS Blades, etc. Changing Bulb on operating light Changing Soda Lime How to operate table and clean Setting up: Diathermy Suction Pump Electric Saw Drill burr Know where Emergency Kit is and check regularly Know where Clinical Waste is Clean: Walls Windows, etc
INITIAL WHEN TAUGHT:
Prep Room REQUIREMENTS: Know the Anaesthetics Monitor animals under Anaesthesia Shaving and Scrubbing Dental Machine: Use Calibration Topping up: Needles Syringes Trolley, etc. How to set up/use: Auroscope Endoscope Pulse Oximeter Drill Incubator Know Safety procedures for Cryo and how to fill up Sterilise rubber equipment with Pevidene Cleaning: Walls Windows, etc.
INITIAL WHEN TAUGHT:
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Laboratory REQUIREMENTS: How to use: Vettest Vetlyte LaserCyte Centrifuge How to do: FIP Test FeLV Test Snap Test T4 Allergen Test Dermafyt How to fill in Lab forms and send off to Grange Calibrate Blood machines and change fluid pack Dispose of Lab samples Enter results on computer Filing Results: Blood Histology ECG, ect. Know where: Blood Tubes Swabs Microscope Slides Refractometer Cover Slips Histology Pots Faeces Pots Request Forms Lab Files are kept Which machines to switch on and off (am/pm) Change Ink Cartridge on Printer How to use Microscope
INITIAL WHEN TAUGHT:
Dispensary INITIAL WHEN TAUGHT: Always take Stock off computer Know where all Drugs are kept Inform someone if you remove last bottle, etc. How to make up a Rosse/Buster Collar Keep Clean
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Consulting Room The following items need to be checked before every surgery REQUIREMENT: Ensure Computer Logged on for Vet/Nurse Clean: Walls Table Sink (ensure dried also) Cupboards Computer and Keyboard Sweep / Mop Floor Empty: Waste bin Syringe / Bottle bin What to top up: Vaccine Tray Used Drugs Syringes / Needles / Blades Pill Bottles Spirit / Virkon Feline / Canine Growth Clean J cloth Tablets: Qty / pack Milbemax Cat 1 x 50 Milbemax Dog 1 x 50
INITIAL WHEN TAUGHT:
General REQUIREMENTS: Gases: How to change Switch on and off Change Labels Check Cryo is full How to use Crusher for rubbish disposal How to give injections Restrain animals correctly Raise veins Assist Vet with Euthanasia How to use Emergency 02 valve and squeeze bag Know where Emergency Kit is Check Visit Case Drip Therapy: Monitoring Patient What if Drip stops? How to recognise infectious diseases and use as much sterility as possible for self and other patients. How to take temperatures How to fill in Op and Hospital forms Fill in Dangerous Drugs Book and where it is kept Work out sedatives: ACP Atropine Discharging operations Using Crusher Cage Muzzle Dog Clip Nails
INITIAL WHEN TAUGHT:
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Nights REQUIREMENTS: Gases: How to change Switch on and off Change Labels Telephones: Diverting Night service Cordless phones Alarms: Setting and un-setting Pier alarms and Link monitoring Passwords and faults External sensors and lights Internal sensors and contacts Doors and Windows Rotas Computer back up and Product index
INITIAL WHEN TAUGHT:
Shifts 8.00am - 5.00pm
10.00am - 7.00pm
Nights
Admit and sedate ops Assist with ops Deal with any inpatients Assist Vet during Consultations Assist with any cleaning when ops are finished
Finish off ops Cleaning Autoclave Instruments Topping up for following day Rubbish Discharge ops Following days ops on board Assisting Vets during Consultations Start cleaning Consulting Rooms
Feed inpatients and give drugs Finish cleaning Check all topping up done and everything out for next days ops File and write up any x-rays Autoclave any instruments Do washing Put ops on board Clean scrub sink Clean Consulting Rooms and Waiting Area Record all phone calls Do backup before going to bed Switch off gases, Lab machines (Vettest, Printer only), Dental machine Change Video in morning Run Daybook if you have seen anyone Cash up at end of week and ensure change in float
All Shifts Pass all information (and keys) onto next Nurse Make up Sterile towels and Swabs Fill in Hour Sheets
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Weekend and Night Duties Know and feel confident with Anaesthetics Handle animals confidently Able to recognise an Emergency and what to do: Gastric Torsion Caesarean Collapsed or unconscious Choking Bleeding Diaphragmatic Hemia Orthopaedic Infectious Diseases Pyometra
}
KNOW WHERE ALL EQUIPMENT IS KEPT
Able to change Gases Observe animal on drip Backup and Day Book Check the water pressure on both boilers at the start and at the end of your week. Be sure you know and understand how to re-pressurise the systems. Clean and tidy the staff room every night. Wash the dishes. Tidy away books and magazines. Check the coffee, tea and sugar levels and put note in Anji’s tray to order as necessary. Put milk bottles out and leave note for milk man for number of pints required next day. BEFORE letting anyone in at the door telephone Vet and inform someone here
Specific Night Duties Case Hand Over The night nurse will arrive 10 minutes before her shift is due to start. She will check the hospitalised cases with the late shift day nurse and where necessary the case vet. She will identify any wounds or surgical incisions and know what they look like at that time and what is expected during the night. Medical cases will always require some medication, so the night nurse needs to know what medication the cases have had throughout the day and what needs to be given during the night and when. They need to know how often the case needs to be observed and checked. In the morning, a similar and full report will be given to the early day shift nurse.
Problems The nurse will identify from the day nurse if there have been any problems with equipment or cases that require any special attention during the night.
Security The night nurse will check all windows and doors (except shop and front) are locked before the day staff leave. The shop and front doors will be locked immediately the last member of staff leaves the building. The hospital front door will be locked at 1pm on a Saturday and remain locked until 8am on Monday morning. Doors and windows will be checked morning and evening every day. It is important not to forget the Academy entrance, the fire door where the safes are and the two doors in the store room and pets corner. The outside sensors will be switched on when the last person leaves and switched off before 8am in the morning. The sensors will be checked every night to be sure the light comes on. It is the night nurses
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responsibility to make sure all the CCTV cameras are working inside and outside the building and to report any problems to Richard. The side gate must be closed immediately after the last person leaves. Both these gates will be opened at 8am Monday to Saturday.
Till The nurse will cash up after or with the night receptionist. The receptionist will certify on the daybook that the float in both the hospital and the shop till is £75. The night nurse run a daybook and put it in the safe, even if no money has been taken. She will sign this daybook to certify that the float is handed over at £75 in both tills. The Saturday morning surgery will be cashed up, debt list and daybook run by the morning receptionist. The night nurse will run a debt list, daybook and cash up at 5pm on Saturday and Sunday as well as every morning before 8am.
Bodies and Gases The night nurse will ensure all bodies are removed to the freezer before the last nurse leaves at 7pm. The gases (all cylinders) will be switched on at 7.30am and switched off at 7pm before the last nurse leaves. She will check the valve on the cylinder and the switch over valve to confirm there is sufficient gas in all the cylinders. She will record these levels every morning when switched on. If one is empty she will ensure that a new one has been ordered before she goes home.
Telephone The telephone is the lifeline of the business. The night nurse will endeavour to fully understand all aspects of the telephone system and how it works. She will switch the system onto “nights” at 7pm. She will divert one phone to extension “63” and carry that phone at all times, whether inside or outside the building. She will appreciate that there are two lines “ 242001” and when on one will not hear the other unless she moves to a reception where she will hear another incoming call. When in the nurses flat, she will answer the cordless “63” and therefore will hear the ext 25 if another call comes in. She will not make private outgoing calls. Any private calls must be incoming on 242001. She will be responsible for ensuring Alison has a cordless on her person at all time and has the shop phone (ext 22) diverted to it. Taking calls at night: questions to ask and things to say. -
Registered with us? If not, who are you registered with? Have you tried to contact them? Name Address Contact number Look at phone to see if number corresponds If not or withheld, ask why Name, breed and age of animal
If they are not a client of ours: - Vaccination status - Last vet visit - Current medication If the caller is a client of another practice, ascertain whether they have called their own vet. If not, suggest that they do so – the reason for this is that their own vets will have access to the animal’s records, as well as the fact that it is considered unprofessional to “poach” other practices clients and more importantly “supersede” a current treatment. For reasons of welfare we will not refuse to see another practice’s client; we do however have a £17.88 surcharge. If the client then stays with us we will deduct this surcharge off the cost of the first booster vaccination we give. Make sure the caller is aware of this if it is applicable – the reason is to discourage other practices from providing poor out of hours service rather than to punish the client for wanting to
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change practices! If unsure about whether the surcharge is applicable or not, explain that it may be applicable but that you will bring it to the attention of the practice principal and he may waive it. You can now proceed with a discussion of the current problem, the details of which are beyond the scope of this document. Ascertain whether a consult and/or visit is required and make sure the owner is aware of the costs involved. For out of hours calls the costs are:
PLUS PLUS PLUS
Visit plus consult Out of hours Consultation fee Surcharge if applicable Drugs
If the owner is requesting euthanasia the euthanasia fee is added on to this as well. After informing the client of the fees you will likely reach one of the following conclusions. 1.) The owner wants a consultation to set their mind at rest. If this is the case we will always comply with the owner’s wishes even if we suspect that peace of mind is the only benefit the consultation will provide. 2.) The owner is relying on your judgment as to whether a consultation is required. If you are not confident about your judgment it is better to say so and speak to a vet – it is possible to dial through to a vet at home and conduct a 3-way call As with consultations, we will not refuse to visit the animal at home. However it is normally better, if possible, if the owner can bring the animal into the practice. Not only does it stave off problems a vet may have in finding an address, and the security risks to the vet, we have many more treatment options at our disposal here. If transport is a problem the following taxi companies will accept animals, although if the animal is likely to soil the taxi it will probably be cheaper for us to visit anyway! “I can’t afford that” Assume that money is not a problem unless the client brings it up. You can then suggest the following. 1.) The RSPCA will give vouchers for out of hours consultations to those on housing benefits or income support; these are normally up to £75 and the owner will have to pay any surplus. If they want to do this give them the number of the RSPCA central office which is 08705 555 999 and tell them to get the voucher number before coming down and to remember to bring proof of benefits. If the owner can get credit, we can provide interest free credit, which enables them to spread costs over ten months. However in its current state only Jo Gore is familiar with the forms involved and we can only provide this for bills under £200 with Richard’s express permission: if you get to this stage a telephone call to Richard is in order, whoever is on call, because neither assistant has the authority to make alternative arrangements for payment.
Alarm The night nurse will not go to bed before midnight and the alarm will be set at that time. Any faults or problems will be reported to Richard but if the alarm will not reset, it is the night nurses responsibility to ensure Pier Alarms are called out to reset it. If a nurse or Vet sets the alarm of they will have the £30 reset fee deducted from their wages. No excuses are acceptable.
Duties Floors swept and mopped after every surgery.
Payments All treatment must be paid for at the time of the consultation. We accept the following methods of payment:
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CASH:
Please check notes for signs of forgery, especially £20 notes. Use the checker pen located at Reception. If the note is a forgery the mark will turn brown.
CHEQUES:
Only accepted with a Bankers Card. On the back of the cheque write the cheque card number, expiry date, name and address of client. If a bill comes to more than the card limit then separate cheques will need to be taken. For example if cheque guarantee card is for £50 only and the bill is £120, you will need 3 cheques (2 for £50 and 1 for £20). These cheques can not be dated for the same date and must not be post-dated. If we were taking payment on 5th July, the 3 cheques would need to be dated 3 rd, 4th and 5th July respectively. Always inform clients that a bounced cheque will incur bank charges. If a client does not have a Banker’s Card then authority from Richard is needed before the cheque is accepted. Put you initials on the back of the cheque
CREDIT CARDS:
We accept Switch, Visa Delta, MasterCard, Visa, American Express. If possible do not accept Switch or Visa Delta for bills under £13.50. It is cheaper for us to have MasterCard and Visa for payments under £13.50 and Switch and Delta for payments over £13.50. If you accept a Switch or Visa Delta for less than £10, the client must be charged £0.50p. The credit card machine should be Z’d between 18:30 and 20:00 every day including Saturday and Sunday. After Saturday morning surgery the machine should be X’d to give you the total for the morning without zeroing the daily totals. Put your initials on the credit card slip.
Pet Shop Duties
Checkout/rear reception 1.
Open Mentor first and minimise the screen and the open Sales Stream. Thus both shop and Vet customers can be dealt with on the till.
2.
Maintain cleanliness and tidiness of checkout area, especially shelves under checkout.
3.
Face up and stack shelving in view of checkout.
4.
Be vigilant and aware of security problems by monitoring CCTV.
5.
Answer telephone calls whenever possible and deal with as required.
6.
Promote Customer Loyalty Scheme by giving all customers a leaflet and explaining how system works. Ask clients for their card before entering sales transactions to automatically add points.
7.
Notify Anji of any problems with stock, prices or loyalty scheme so they can be sorted quickly.
8.
Refunds / Exchanges can only be made by the Supervisor.
9.
Record all shop details and events on the diary in Mentor under Anji’s login name.
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Shop Floor 1.
Maintain cleanliness of shelves and stock.
2.
Face up stock as required and ensure all stock is correctly priced.
3.
Maintain cleanliness of Shop Floor.
4.
Check stockroom for items of stock to come out.
5.
Maintain cleanliness of stockroom.
6.
Check “Best Before” dates on stock and notify Store Manager of any short-dated stock.
Deliveries 1.
Check stock received against the invoice and notify Store Manager of any discrepancies.
2.
Check for price changes and re-price old stock when necessary including updating the computer.
3.
Check “Best Before” dates and place new stock behind old stock on the shelves.
4.
Any stock that will not fit on the shelves should be neatly stored in the storeroom.
5.
All pallets should be neatly stacked and rubbish compressed and removed.
Livestock Feeding 1.
Make sure that all animals and birds have fresh food and water daily but not to excess.
2.
Collect fresh fruit and vegetables for animals/birds.
3.
Give all rabbits and guinea pigs hay daily.
4.
Keep feed room clean and tidy.
5.
Do not throw away uneaten food.
Cleaning 1.
Wooden pens must be cleaned at least twice a week.
2.
Glass pens should be cleaned once a week.
3.
Mobile aviaries cleaned when needed.
4.
Large aviaries cleaned as necessary.
5.
Parrots / Caged birds daily if possible but at least 3 times a week. Remove old fruit and vegetables daily. Ensure all perches are cleaned as well/
6.
Spray all birds weekly, and two to three times per week in summer.
7.
Only throw away soiled bedding.
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Pet ShopManagement
Code of Practice for Retailers The purpose of this Code of Practice is to: promote responsible pet ownership and welfare develop staff training programmes improve trading standards promote a better understanding between customer and retailer simplify complaints procedures provide a conciliation service when complaints cannot be easily resolved
The Livestock Code All members selling livestock must be in possession of a current Pet Shop Licence. The licence or a copy of the licence, should be suitably displayed to the public in a prominent position. N B. For security reasons the licence should not display the licence holder's home address.
Accommodation Animals shall at all times, whether displayed indoors or outdoors, be kept in accommodation suitable with respect to construction, size, temperature, lighting, ventilation and cleanliness. Animals shall not be exposed to draughts. Housing shall be constructed of non-porous materials or be appropriately treated. Animals shall not be kept in housing in such a way that they can be interfered with by other animals or the public. All livestock, for sale, must be readily accessible and easy to inspect. Accommodation shall be cleaned as often as necessary to maintain good hygiene standards, consistent with the rate of stock turnover Where accommodation is on a tiered system, water, food or other droppings shall not be allowed to enter the lower housing. All accessories provided in the accommodation shall be suitable for the species.
Exercise Facilities Suitable and sufficient facilities must be available where appropriate. For example, in the case of kittens, an exercise pen should be provided.
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Register of Animals A livestock purchase register must be maintained for all species. A livestock sales register must be maintained for: puppies kittens psittacines species contained in the Schedule to the Dangerous Wild Animals Act 1976 (as modified) NB.
This can be by cross reference to an invoice file. The purpose of the register is to ascertain the source of livestock and for emergency contact of purchaser. The name and telephone number of the purchaser is, therefore, sufficient. Other animals need not be listed in the sales register.
Stocking Numbers and Densities The maximum numbers of animals to be stocked on the premises will be determined by the accommodation available. As a guide to good practice please refer to the following tables. Table 1: Cage Birds Table 2: Small Mammals Table 3: Ornamental Fish Table 4: Other Species
Health, Disease and Acclimatisation All stock must be in good health as far as can be reasonably determined without veterinary inspection. Any sick or injured animal must receive appropriate care and treatment without delay. N.B. This may include euthanasia. Inexperienced staff must not treat sick animals unless under appropriately experienced supervision. Veterinary advice should be sought whenever necessary. Any animal with an obvious significant abnormality, which would materially affect its quality of life, must not be offered for sale. When in doubt veterinary advice should be sought. All animals must be allowed a suitable acclimatisation period before sale. The facility to isolate sick animals must be provided. All reasonable precautions must be taken to prevent the outbreak and spread of disease. Puppies and kittens must be kept separate from other litters. All necessary precautions must be taken to prevent the introduction to the premises, or harbourage of rodents, insects and other pests. N B. 'Rodent' and 'insect' excludes livestock for sale or for feeding. No animal which is suffering from or could reasonably be suspected of having come into contact with any other animal suffering from any infectious or contagious disease, or which is infested with parasites shall be brought into or kept on the premises unless effectively isolated.
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Food and Drink Animals must be supplied with adequate amounts of food and drink, appropriate to their needs, and at suitable intervals. All foods must be suitable for the species concerned. Food and drink receptacles must be constructed and positioned to minimise faecal contamination. A sufficient number of receptacles must be provided and cleaned at regular intervals.
Food Storage All food, excluding live foods intended for feeding to livestock on the premises, must be stored in impervious closed containers. The containers and equipment used for feeding must be kept in a clean condition.
Observation All livestock must be attended to at regular intervals, appropriate to the species, in no circumstances less than daily.
Excreta and Soiled Bedding All excreta and soiled bedding must be stored in impervious containers with close fitting lids. Excreta and soiled bedding should be removed from the premises on a regular basis, at least weekly, and disposed of to the satisfaction of the appropriate local authority. All containers must be kept in clean condition.
Transportation When receiving stock, the licensee must make every effort to ensure that it is transported in a suitable manner Any livestock received or consigned shall be transported according to the regulations laid down in current legislation. For air transportation the IATA guidelines must be followed.
Transportation Containers Livestock must be transported or handed to purchasers in suitable containers.
Sale of Livestock All livestock sold must be in good health and free from obvious parasitic infection as far as can be reasonably determined without veterinary inspection. No mammal shall be sold un-weaned or, if weaned, at an age at which it should not have been weaned. In the case of non-mammals they must be capable of feeding themselves. No animal should be sold to any person under the age of 16 years who is unknown to the licensee unless that person is accompanied by a parent or legal guardian or provides appropriate written consent.
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Subsequent sales to a juvenile less than 16 years (but over 12 years) of age who is known to the licensee can be carried out in the absence of a parent or legal guardian or appropriate written consent, provided that the licensee is satisfied as far as possible that: the parent/guardian would not object to the acquisition. the juvenile is sufficiently knowledgeable as to the needs, care and nature of the species acquired. the juvenile's intention towards the acquisition is consistent with the well being of the animal concerned.
Dangerous Wild Animals When dangerous animals are kept, the cages must be of a secure construction. A fine wire mesh, glass or plastic safety barrier must be incorporated into the cage system. Licensees selling animals on the Schedule to the Dangerous Wild Animals Act should: (a) inspect the purchaser's licence or the local authority's written permission to keep such an animal; (b) inform the issuing authority of the details of the purchase.
Pet Care Advice Pet care leaflets or other similar written instructions should be made available to customers where appropriate at the time of purchase. Purchasers of accessories should, where necessary, be given proper advice as to their maintenance and use. Reference books must always be available for use by staff
Staff Training and Livestock Knowledge No animal should be stocked or sold unless the staff (or a member of the staff) is familiar with the care and welfare of that animal. In respect of new applications (not renewals) at least one member of staff working at the licensed premises must hold the City and Guilds Pet Store Management Certificate, or some other appropriate qualification. Alternatively, they must be in the course of training and obtain the qualification within two years of the licence being granted. The licensee must formulate a written training policy for all permanent staff, and will be required to demonstrate that systematic training is carried out.
City and Guilds A home study course, developed and operated by Pet Care Trust, is available for all staff to study for the City and Guilds Pet Store Management Certificate (776). Staff should be given every encouragement to take this examination.
Boarding of Animals Members may only board those species of animals for which they are licensed to sell. N B. Boarding of dogs and cats require an additional licence under the Animal Boarding Establishments Act.
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Fire and Other Emergency Precautions Suitable emergency precautions and written procedures shall exist and be made known to all staff, including the arrangements for the evacuation of livestock. N B. The general maxim of 'people first' is good advice. Entrances and exits must be clear of obstructions at all times. Fire extinguishers must be provided and sited as approved by the local Fire Protection/Prevention Officer The fire-fighting equipment must be maintained in good working order The licensee or a designated key holder must at all times be within reasonable distance of the premises and available to visit the premises in case of emergency. A list of key holders must be lodged with the local police and fire brigade. In the interest of animal welfare the following notice must be displayed at the front of the premises. "In case of emergency telephone 999".
Sale of Goods Act and Supply of Goods and Services Act 1982 and Other Related Legislation All transactions should be conducted within the terms of these Acts. The goods must: correspond with their description be of satisfactory quality be fit for the purpose If a customer insists on making a purchase against the member's advice he should be warned at the time of purchase that his rights under the Act might be limited. Full and clear information must be given upon request regarding goods, services and livestock. All services provided must be undertaken with reasonable care and skill and, unless a specific time has been agreed beforehand, within a reasonable time. The customer must be prepared to pay a reasonable charge. A customer cannot query a price which has been agreed beforehand.
Pricing Misleading price offers must not be used. Discounts offered should be based on fair comparisons. Any credit facilities offered must be clearly stated in writing, and members must abide by the terms of the Consumer Credit Act 1974. Members are reminded that a licence may be required.
Complaints The member will make every effort to resolve any dispute between himself and the customer. All staff must be suitably trained to deal with complaints, but should difficulties arise the matter should be referred to a senior member of staff. At all times the person dealing with the complaint should adopt a courteous manner, act with tact and handle the problem sympathetically. The problem should be settled speedily if at all possible.
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If the complaint cannot be resolved the following procedures are available: Local Advice Both the member and the customer have the right to contact the Trading Standards Department or the Citizens Advice Bureau. Conciliation Service If there is still no agreement Pet Care Trust can be asked to offer a conciliation service. Details of the complaint should be sent to the Pet Care Trust's office for consideration by the Pet Care Trust Conciliation Panel. There is no charge for this service. Pet Care Trust can be contacted on 01234 273933 Arbitration Should the problem still remain unresolved an independent arbitrator can be appointed. The arbitration procedure relies on documentary evidence and none of the parties or their representatives may attend in person. Pet Care Trust will pass all documents to the Chartered Institute of Arbitrators, who will in turn advise the parties concerned of the material evidence in their possession. Both parties will then be asked for any further relevant written information to be sent to them. The Institute will select an arbitrator from an approved list and will arrange for the arbitration to be carried out in a speedy manner. Parties to arbitration will be required to pay a registration fee. Customers who are successful with their claims will have the fee refunded. Alternatively the customer may seek redress in County Court.
Stocking Densities The following tables have been prepared by the Pet Care Trust as a guide to housing those species which are most commonly stocked in pet stores. Consideration should be given to increasing the size of the accommodation for any livestock being housed for an extended period of time. Further detailed advice for other species can be obtained from the Pet Care Trust. TABLE 1 Length of Bird
CAGE BIRDS
Floor area (sq. cm) Each Single Additional
Floor area (sq. ins) Each Single Additional
Cage Height cms
ins
Budgerigar
650
200
100
30
30
12
Canary
650
250
100
37
30
12
Cockatiel
1000
250
170
45
40
16
Cms
Ins
Finches
Up to 12.5 12.5-17.5 over 17.5
5 5-7 7
650 750 1000
100 150 200
100 115 170
15 20 30
30 30 30
12 12 12
Parakeet
Up to 25 25-35 over 35
10 10-14 14
1000 1000 1400
250 250 450
170 170 215
45 45 75
30 40 50
12 16 20
Parrot
Up to 30 30-35 over 35
12 12-14 14
800 1250 1500
275 625 750
130 200 260
45 100 115
40 50 60
16 20 24
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N.B.
All birds should be housed in accommodation which is of sufficient size to permit the bird to stretch its wings freely otherwise an offence may be committed under the Wildlife and Countryside Act 1981. For perching species, a perch or perches of appropriate size must be provided at such a height that the bird can stretch to its full height without its head touching the top or its tail touching the bottom of the cage. A quality padded net should be used when catching birds in an aviary.
TABLE 2
JUVENILE SMALL MAMMALS
No. of Animals
1-4
5
6
7
8
9
10
Min Cage Height
Min Cage Depth
Mice, Hamsters, Gerbils
Sq. cm Sq. in
450 72
525 84
600 96
675 108
750 120
825 132
900 144
25 10
25 10
Rats
Sq. cm Sq. in
675 108
785 126
900 144
1010 162
1125 180
1235 198
1350 216
30 12
30 12
Guinea Pigs
Sq. cm Sq. in
1350 216
1570 252
1800 288
2020 324
2250 360
2470 396
2700 432
30 12
30 12
Rabbits up to 2kg, Kittens, Ferrets, Chinchillas, Chipmunks
Sq. cm Sq. in
2250 360
2625 420
3000 480
3375 540
3750 600
4125 660
4500 720
40 16
30 12
Puppies
Sq. cm Sq. in
10000 1550
12500 1940
15000 2325
17500 2710
20000 3100
22500 3490
25000 3880
Double height at shoulder min 50/20
0.9m 39
TABLE 3
STOCKING DENSITIES - ORNAMENTAL FISH
It is virtually impossible to determine the quantity of fish to be kept in a tank purely on a weight/volume or numbers of fish/volume. The variation in system design, husbandry techniques and types of fish involved would render any such method too simple to be useful or too complicated to be practical. The maintenance of water quality standards is essential and is a simple but effective way to determine stocking densities. Water quality testing should be carried out at least once a week in centralised systems and 10% of individual tanks should likewise be tested. Unsatisfactory test results must be recorded in a register together with the corrective action taken. Further tests must be carried out when visual inspection of the tanks indicates the need.
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Water Quality Criteria
(1mg/litre - 1ppm) Cold Water
Tropical Fish
Tropical Marine Species
*Dissolved Oxygen *Free Ammonia Nitrite Nitrate *Dissolved Oxygen *Free Ammonia Nitrite Nitrate *Dissolved Oxygen *Free Ammonia Nitrite Nitrate
-min -max -max -max -min -max -max -max -min -max -max -max
*pH (topical marine only)
-min
6mg/litre 0.02mg/litre 0.2mg/litre 50mg/litre above ambient tap water 6mg/litre 0.02mg/litre 0.2mg/litre 50mg/litre above ambient tap water 5.5mg/litre 0.01mg/litre 0.125mg/litre 40mg/litre This is an absolute figure; it does not relate to ambient tap water 8.1
*These parameters should be checked first. Only if a problem exists with these tests is it necessary to check nitrite and nitrate levels. With acknowledgment to Ornamental Fish Industry (UK) Ltd. Further advice may be obtained from: OFI (UK) Ltd, PO. Box 1860, Unit 5, Narrow Wine Street, Trowbridge, Wilts. BA14 8FJ Tel: 01225 777177
TABLE 4
Lizards, Terrestrial and Semi-Terrestrial Newts, Salamanders and other tailed amphibians Up to 5cm (2in) Over 5cm (2in) up to 10cm (4in) Over 10cm (4in) up to 15cm (6in) Over 15cm (6in) Terrapins, Box Turtles, Terrestrial and SemiTerrestrial Frogs, Toads, Tree Frogs and other tailless amphibians Up to 3cm (1.2in) Over 3cm (1.2in) up to 5cm (2in) Over 5cm (2in) up to 10cm (4in) Snakes
Aquatic Amphibians
REPTILES AND AMPHIBIANS Display Accommodation Min Length Min Depth Min Height 45 cm 25 cm 25 cm 18 in 10 in 10 in
Max Number/display
1 – 25 1 – 15 1–8 1-4 45 cm 18 in
25 cm 10 in
25 cm 10 in 1 – 20 1 – 10 1–4
2/3 length of snake
15 cm 6 in
10 cm 4 in (or 4x thickness of snake) As Ornamental Fish
Notes – All Categories Nursery/isolation Units: (labelled as such) for hatchling/newborn specimens or single specimens of small, inactive species. Minimum size 22x10x10 cm high (9x4x4in). Stock/Breeding Accommodation: off display. As Display Accommodation, including Nursery/lsolation/Pairing Units (unlabelled) for hatchling/newborn specimens or 1-2 specimens of small, inactive species, of minimum size 22x10x10 cm high (9x4x4in).
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Snakes: Stock/reeding Accommodation: as above, but minimum height for arboreal species - 1/3 length of snake. Stocking densities must depend not just on the floor area, but also the furnishings within the vivarium. For c1imbing species the sides and roof should also be considered as part of the effective floor area. Behavioural trends of individual species should also be considered.
All Stocking density tables published in the interest of pet welfare by: Pet Care Trust Bedford Business Centre 170 Mile Road Bedford MK42 9TW Tel: 01234 273933
Fax: 01234 273550
Police When handling Police callouts ensure the following details have been taken: PC Name and Number Log Reference Number Where / Details of animals Inform Vet Insist the PC remains at the scene. If the PC will not remain at the scene, advise that the Vet will not attend if this is not adhered to.
Pre-OperativeProcedures Pre-meds should be given more than 20 minutes before the operation is due to commence if the animal is fit and health and in for routine surgery, with the exception of those listed below. Pre-medications to use are: ACP:
Cats and dogs should be pre-medicated with ACP (2mg/ml) at a dose rate of 0.25ml per 5kg. This MUST be given intramuscularly. At the discretion of the Vet, this may be given intravenously if quicker sedation is required.
ATROPINE:
Given subcutaneously at the same dose as ACP.
ROMPUN:
Very aggressive animals will be sedated with ROMPUN instead of ACP. This MUST be given intramuscularly. It only lasts for one hour so must be given within an hour of the procedure being started.
METACAM:
In the case of particularly painful procedures, the Vet may also wish the patient sedating with METACAM. Check with the vet in the case of all orthopaedic operations.
Animals that should not be sedated on admission are:
Boxers Animals over 8 years old Animals on medication Animals having blood profiles done
Prep Room Checks Circuits:
Ayres T-piece for animals under 7kg Circle for animals over 7kg
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Isoflurane vaporisers full Pulse oximeter fully charged and working Apalert respiratory monitor fully charged and working Tube of correct size ready, clean and patent Dental machine plugged in, clean, water full and working Rapinovet ready in the syringe at 1ml per 2.5kg If a cat then have intubeeze ready
Theatre Checks Circuits:
Corresponds to prep room and functional Isoflurane vaporisers full Table set to correct angle and direction Kit tray out, set and spirited Correct kit, towels and instrument for the operation in hand Set up and check ventilator if required for op
Patient Checks Get the patient from the kennel and place on the tub table. Raise the vein whilst restraining the animal’s head with your hand under its chin. If the animal is nasty then muzzle a dog and scruff a cat. Wild cats should be wrapped up in a towel. Once the needle is in the vein release the vein whilst still holding the animal’s leg behind the elbow. When the animal goes to sleep, lay it on one side and raise its head with one hand whilst supporting its neck with the other, keeping the neck straight at 45 degrees to the table. Before connecting to the machine, turn on the Oxygen first and then, if required, the Nitrous Oxide. Turn on the Isoflurane initially at 0% but adjust as directed by the Vet to eventually stabilise at approximately 1.5-2%. NEVER increase Isoflurane level without the Vets direction. Record the time at every change in % and what the new level is. When the animal is stable, it may be clipped up and scrubbed for the required procedure. Always check with the Vet that the area clipped is satisfactory before scrubbing. Always work in a methodical and clean fashion. Remove hair immediately it is clipped off and put in the bin. Once scrubbed, move patient to op theatre and restabilise using, initially, the same anaesthetic settings as the prep table.
Vet Support Give Vet sterile gown Give Vet instruments Give Vet paragon blade Have extra swabs ready for Vet on demand Have PDS ready for when Vet needs it. Learn the order of events during operations so that you can anticipate the Vets requirements thus improving the efficiency of the procedure.
Post-operative Examinations All operations with the exception of Castrations need to have a check-up after five days which is normally carried out by a Vet. If an owner has any concerns this check-up may be brought forward.
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Reception/Waiting Room We now have two Reception areas. The Main Reception (off Chapel Street) should be manned through all surgeries if possible. If we have insufficient staff available then signs must be clearly displayed directing clients to the second Reception and the telephones must also be diverted to the second Reception. When manned the Front Receptionist duties are: 1.
Greet clients and ensure they are shown as Waiting on the appointments list.
2.
Ensure dogs and cats go to the appropriate waiting room.
3.
Weigh pets prior to their annual booster, or more frequently if advised overweight or on a special diet.
4.
Answer all in-coming telephone calls and action appropriately.
5.
Asses the clients in the waiting room and make sure none have been missed and that anyone waiting too long is communicated with and reassured of the expected waiting time.
6.
Check off paperwork for inpatients.
7.
Discharge inpatients from the hospital list, make check-up appointments, take payments and ensure that the Nurse is aware pet is ready to go home.
8.
Prepare any repeat prescriptions.
9.
Give advice as necessary.
10. Filing 11. Ensure TV’s are turned on and the practice video running. 12. Ensure posters are neat, tidy and relevant. Change posters at least once a month. 13. General cleanliness of the Reception / Waiting areas. 14. Check the coffee and drinks machine are filled and clean. The Rear Receptionist duties are: 1.
Receive clients from the Vet, check all medication is correct and clearly labelled, make appointments for follow up visits, take payments.
2.
Ensure all clients sign a consent form if their pet is admitted during a consultation and, if staying overnight, a hospital sheet is printed and given to the Nurse.
3.
Answer the telephone after 4 rings if the Main Receptionist is unable to do so.
4.
Check the fax machine for incoming faxes, print and ensure given to the relevant person.
5.
Give advice as necessary.
6.
General cleanliness of the Reception area.
7.
Z the credit card machine at the end of evening surgery.
8.
Print Cashing up summary and cash up.
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9.
Cover Main Reception duties if main reception is unstaffed.
10. If a queue starts either get another nurse or pass people onto the shop till. It is important to remember that the first impression a client gets of the Hospital is from the Receptionist. Therefore staff presentation, behaviour and attitude are of the highest importance. The Reception area should never be left for more than a minute and at the end of a shift always ensure that the next person is available to take over before leaving.
Road TrafficAccidents(RTA’s) We can only attend RTA’s if the owner is present or we have been asked to by the Police. If a member of the public who is not the pet owner contacts us, they must be asked to contact the Police. If an animal involved in a RTA is brought directly to us then emergency aid must be given. Where possible if the injuries do not appear life threatening get the finder to take the dog to the Police or else they will be asked to pay the bill.
Shoplifters You have the right to arrest a thief but you must follow the correct procedure or you could be sued for damages, assault, malicious prosecution or false imprisonment. The definition of theft is “the dishonest appropriation of property belonging to someone else and the property has been taken with the intention of permanently depriving the owner of it”. To apprehend a shoplifter you must see the person taken an item, secrete it on their person or in their shopping bag for example, and leave the store without paying. Make sure they still have the stolen property on them and that they have not passed it to an accomplice or got rid of it knowing you have been watching them. When you stop a thief do not use force unless it is absolutely necessary. You are legally entitled to use “reasonable” force to arrest someone by the word “reasonable” is highly debatable. It is far better to approach them and say something like “I believe you have taken an item which you have not paid for. Will you please return to the store with me”. On returning to the store there are a few points you should bear in mind: 1.
Immediately call the police, allow them to conduct the interview.
2.
Under no circumstances search the thief. You can ask them to turn out their bag or pockets but if they refuse do not carry out the search yourself.
3.
Do not try to write down a statement from a thief. The police will do this.
4.
When the police arrive tell them exactly what happened. When the police have taken the thief away make a note of everything that happened including what the person said to you at the time and then sign the notes stating the date and time.
5.
If possible try to have another member of staff with you at all times.
With regards to prosecution you must leave it to the police to decide if to prosecute or not.
StockOrdering
Drugs If you notice a particular drug is running low, bring it to the attention of the Anji, or add it directly to the next order to be placed from Centaur. The late shift nurse must place the Centaur order every night before 7pm and
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must remember to add food orders to the list if not already done. To send the order use Acorn on front reception.
Instruments If an instrument is broken, bring this to the attention of the Head Nurse or, if possible, find out how much a replacement item costs or if the broken item could be fixed. Once you have gained as much information as possible regarding the instrument, see Richard for authorisation to proceed with repair or replacement. If an item is sent for repair, remember to log when it should be returned and to chase it if overdue.
Pet Food Complete a Pet Food form from the client’s record on the computer. Print this out and place in the Pet Food Order book at Reception. Explain to clients that ordered food will be held for one week past the date due for collection and if it is not collected will be returned or sold. Apart from the printed form, place the order on Centaur order and note on the form it has been done.
Pet Shop If you notice a particular item is running low bring this to the attention of the Pet Shop Manager. Most items for the pet shop are ordered from Batleys who deliver weekly on a Friday. If a customer wishes to order a nonstocked item this must be recorded in the Customer Order Book and actioned. If the item is not delivered as promised this must be chased and the client informed of the new delivery date. This book should be checked daily to ensure customer orders are met.
Livestock Livestock should only be purchased on the authority of the Pet Shop Manager or the Practice Principal.
Stray Animals Stray animals that are brought to the surgery will receive immediate first aid as required. If the animal is healthy and we have room it can stay for one week whilst the paper’s are contacted with an appeal for the owners. If we do not have room then the Dog Warden will have to be contacted to collect the dog and take to a local kennel. If the animal is rehomed then a Rehoming Form must be completed and signed by the new owners and the new owner registered as a client whether or not they remain with the Hospital. In some cases the Anrich Rescue Fund may be used.
Telephone Techniques When answering the telephone please use the following format: “Anrich Veterinary Hospital, this is (your name), how may I help you?” Before proceeding with any advice always take the clients surname and address and bring up the pet’s details before answering any questions. Before agreeing to dispense any repeat prescriptions check that the animal has been seen within the last 6 months and is up-to-date on it’s booster. Always check with a Vet before dispensing medication. Always scan the previous history BEFORE making a transaction.
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If an enquirer is not a client they are still entitled to the same level of advice as our own clients. If they require medication then the animal must be made an appointment with a vet. Try to accommodate clients with appointments convenient to them. If an animal is bleeding, been involved in a road traffic accident or is in severe distress the owner should be asked to bring their pet in immediately irrespective of surgery times. If in doubt refer to a supervisor. Every staff member is expected to know and understand the basic operation of the telephone system. See the manual for fuller details but the essential details are as follows. 1.
How to put a call on hold and then retake the call.
2.
How to put a call on hold and then transfer the call
3.
How to use the paging facility of the phone system to page a member of staff.
4.
To remember frequently used extension numbers. Eg both receptions, Richards and the nurses cordless phones.
5.
Richard will always carry extension 60 or 66 on him whilst in the building. The direct outside line number to this phone is 0871 223 2100
6.
Lydia will always carry extension 63 on her whilst in the building. The direct outside line to this phone is 01942 770225. When Lydia is not using this phone another nurse will use this phone whilst in the shop and pets corner area. When the building is closed the night nurse will carry this phone with her at all times. She will have this phone with her in the flat at night where it will be placed in the charger.
7.
When the front reception is unmanned, these phones will be diverted to the rear reception. The right phone to extension 20 and the left phone to extension 21It is therefore essential that every member of staff makes it there own responsibility to ensure they thoroughly know and understand how to operate the cordless phones.
8.
Out of Hours ALL phone calls will be logged on the out of hours log sheet. When there are no calls received, you will log “no calls“ on the sheet.
9.
At 7pm put phones on nights using extension 20 “Nights” button. Then check that the phone has diverted to PetMedics by phoning from extension 21.
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Vouchers If a Pets by Vets voucher is presented for Veterinary services then the amount must be taken off before asking the client for payment. A Pets By Vets voucher is treated as a work entry item and has stock items of 3 values £1, £2 and £5. Enter work entry and type pp voucher, at quantity type “-1”. Ensure the price in the total column is negative. Redeem each voucher as presented to you. The amount of these vouchers should now show in the clinical record. If it is correct proceed with taking payment for the rest of the service as usual. RSPCA and CPL vouchers are handled in the same manner but these must be brought to Anji’s attention so that they are added to the relevant record. This may only be done by Anji. Take the relevant amount of money to leave the voucher amount in debt and ensure Anji gets the voucher. Other vouchers can be taken off using the voucher element of the payments screen.
Wildlife Hedgehogs can be referred to Susan and treated by ourselves. Others, such as ducks, may be referred to the RSPCA wildlife sanctuary in Cheshire. Injured wildlife will be treated by the hospital free of charge. These cases will either be released by ourselves, if appropriate, or sent on to the RSPCA.
Government Legislation
Pets Travelling Abroad
Summary The relaxation of Quarantine is being replaced with PETS (Pets Travel Scheme). The pilot scheme starts in April 2000 or possibly as early as January 2000 if ready. Cats and Dogs may travel to and from the EC countries on the list (see later section). The rest of the world still requires animals to be quarantined for 6 months. To qualify under the scheme, all pets must be microchipped and vaccinated against Rabies (Rabies vaccine costs £25 on its own or £35 if done with booster). A blood test must be done 30 days later to confirm the level of immunity (at a cost of £35). The chipping, vaccinations and blood tests may be started immediately in preparation for next year. The Health and Vaccination Certificate may only be signed by a panel 2 LVI. Before returning to the UK, the pet must be treated for tapeworm and ticks and certified as such by a Vet in the country of departure 24-48 hours before returning.
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PETS Pilot Scheme – Interim Advice Introduction On 3 August 1999, the Government made a further announcement about the arrangements for the PETS pilot scheme. The date the Pet Travel Scheme becomes operational will be announced later but it will be in place in the early months of 2000. Quarantine is not being abolished altogether. The new system will allow pets meeting certain conditions to enter the UK without having to go into quarantine.
Conditions of the Pet Travel Scheme The pilot scheme: Only applies to pet cats and dogs; Is limited to animals coming from the countries and territories (see list below); Will only operate on certain sea, air and rail routes to England. Pet cats and dogs will not be able to enter the UK under the pilot scheme unless they meet certain conditions. They must: Be fitted with a permanent microchip; Have been vaccinated against Rabies using an approved inactivated adjuvanted vaccine (and have booster vaccinations at the required intervals) in a qualifying country or in the British Isles; Have been blood tested at a laboratory recognised by MAFF to show that a required antibody titre has been achieved in the animal following its vaccination; Not be brought into the UK until at least six months from when the blood sample was taken. Be accompanied by a health certificate that the above requirements have been met and signed by an official veterinarian (an LVI for UK resident pets travelling abroad subsequently to return); Have been treated for certain parasites (the fox tapeworm (Echinococcus multilocularis) and ticks to prevent a risk of potentially serious zoonotic disease coming into the UK. This should take place 24 to 48 hours before the pet enters the UK. The pet should be accompanied by a certificate signed by an official vet certifying that these treatments have been given.
Pilot Scheme Routes The routes are expected to include the Calais to Dover sea crossings, Eurotunnel Shuttle Services, certain sea routes into Portsmouth from France and certain air routes into Heathrow from Europe. These routes are not yet confirmed and it is too early for pet owners to book a ticket to travel with their pet.
PETS Pilot in operation Before the pet enters the UK on one of the pilot scheme routes, its microchip, health certificate of rabies vaccinations and certificate of treatment against certain parasites will be checked by the transport company. The transport company will be approved by MAFF and be subject to regular auditing. There will also be MAFF spot checks. Pets which fail to meet the conditions of the scheme will have to go into quarantine on return to the UK, or, in the case of pets from outside the UK, return to their country of origin. Pet owners are being advised to check that their pet meets the conditions of the scheme before they travel to the UK. For pet owners leaving the UK to return later, we are advising them to check that their pet meets the conditions of the scheme before they leave otherwise it may be refused entry or have to go into quarantine when it arrives back in the UK.
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Qualifying Countries Pet cats and dogs resident in the UK may visit one or more of the countries below and return to the UK under the pilot scheme without the need for quarantine. Pet cats and dogs that come from one of these countries and have been resident there for six months may also enter the UK without the need for quarantine. Andorra Finland Greece Luxembourg Portugal Switzerland
Austria France Iceland Monaco San Marino Vatican
Belgium Germany Italy Netherlands Spain
Denmark Gibralter Liechtenstein Norway Sweden
(France exludes French Overseas Departments and Territories, Norway excludes Spitzberfen, Portugal includes the Azores and Madeira and Spain includes the Canary Islands but excludes Ceuta and Melills). Pets resident anywhere within the UK will continue to be able to travel freely within the British Isles without the need for quarantine. Such pets will not be subject to quarantine, or to the Pet Travel Scheme. The pilot scheme relates to the UK only. An annoucement by the Irish authorities concerning the arrangements for pet cats and dogs entering the Republic of Ireland against the backdrop of the PETS project in the UK will be made in due course.
Guide Dogs and Hearing Dogs Dogs providing assistance to the disabled, including guide dogs and hearing dogs, will be eligible for the pilot scheme like any other dog. In addition, it is hoped that such dogs will be allowed to travel between the UK and Australia and New Zealand during the pilot scheme. This will depend, however, on discussions with the Australian and New Zealand authorities and on whether airlines are prepared to carry such dogs.
Documentation The pet health certificates (to be issued for UK resident pets by LVIs) will be available nearer to the scheme going live. For pets resident in a qualifying country and coming to the UK, those certificates will be issued by the country concerned. Discussions are underway between the UK Government and oterh Governments on the form of those certificates. Pet owners leaving the UK are also being advised that they may need a separate certificate for their pet to show that it meets the health requirements of the country (or countries) that they are visiting or travelling through. These requirements may be different from those of the Pet Travel Scheme.
What Pet Owners can do now Get their pet microchipped by their vet Get their pet vaccinated by their vet and Get their pet blood tested Any vet can arrange microchipping, vaccination and blood testing, but in the UK only Local Veterinary Inspectors (LVIs) on Panel 2 will be able to issue pet health certificates for the scheme. Appropriate training will be provided for Panel 2 members. For further information on becoming an LVI please contact your local Animal Health Office.
Microchip Identification No particular type or brand of microchip is specified but it is recommended to conform to ISO standard 11784 or to Annex A to 11785. If it does not conform to these standards it may not be able to be read by a standard microchip reader when the animal is checked at the time of travel.
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The microchip must be fitted before it is vaccinated against rabies. This is so that the microchip number and other details (such as the animal’s age) can be recorded on the vaccination certificate and ultimately the health certificate. We recommend that vets ensure that the microchip can be read when the pet is Vaccinated or given a booster, Blood sampled and Issued with its veterinary certificate. If the microchip cannot be read at the time of these procedures, vaccination, blood sampling and certification should not be undertaken until the problem is resolved.
Vaccination Two authorised brands of rabies vaccine are currently on the UK market: Rabisin and Nobivac. Rabies vaccines will now be made freely available to veterinary surgeons. This means that MAFF authorisation to purchase and use rabies vaccines will no longer be required. An animal must be at least 3 months old before it is vaccinated. Vaccination can take place any time after the animal has been fitted with a microchip. Before administering the rabies vaccine, the veterinary surgeon must check to confirm that the animal is identifiable by the microchip. Once identified, the microchip number must be entered on the vaccination record card at the same time of vaccination. If a pet has a previous history of vaccination against rabies (e.g has been resident abroad), without being identified by microchip, it must be vaccinated again after it has been fitted with a microchip. Once vaccinated the following details must be recorded on the vaccination card: The animal’s date of birth/age Microchip number (and date of insertion, if known) Date of vaccination Vaccine product name Batch number Due date of next vaccination (or booster)
Blood Testing Blood sampling and submission for testing at a recognised laboratory must be carried out by a veterinary surgeon. It is probably easier for the veterinary surgeon who has vaccinated the animal to arrange the blood test. UK vaccine manufacturers have advised that the best time for a blood sample to be taken for a blood test is about 30 days after the last vaccine injection. It may be possible for blood samples to be stored by laboratories for later testing. Before sampling and sending, veterinary surgeons should contact the laboratory and obtain the appropriate sample submission form and seek advice on the correct labelling and means of transmission of the sample. The blood test must be performed at a laboratory recognised by MAFF. Initially there is only one recognised laboratory in the UK, the VLA in Weybridge, along with ten other European laboratories (see list below). Further laboratories may be added to the list as the scheme develops. Veterinary surgeons should contact VLA about blood testing and not leave this to their clients. If a pet fails the blood test, it will have to be vaccinated and blood tested again. UK vaccine manufacturers have advised that a proportion of vaccinated animals may not show the 0.5 IU antibody titre on blood testing required by the Pet Travel Scheme.
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For the pilot scheme, a blood test is only required after the first vaccination (if successful) provided the pet has been re-vaccinated (booster vaccinated) at the intervals specified by the vaccine manufacturer. If there is a break in the specified vaccination programme, a further blood test will be required after re-vaccination.
Blood Testing Laboratories (UK) NAME & ADDRESS
TEL / FAX
Veterinary Laboratory Agency New Haw, Addlestone, Surrey. KT15 3NB UNITED KINGDOM Animal Health Divisional Office Garstang Road Barton Preston PR3 5HE Animal Health Divisional Office Hadrian House Wavell Drive Rosehill Ind Est Carlisle CA1 2TB Animal Health Divisional Office Government Buildings Otley Road Leeds LS16 5PZ Animal Health Divisional Office Castle House Newport Road Stafford ST16 1DL
Tel: 01932 377345
RECOGNITION DATE 27 May 1999
Fax: 01932 357856 Tel: 01772 861144
1 August 1999
Fax: 01772 861798
Tel: 01228 591999
1 August 1999
Fax: 01228 591900
Tel: 0113 230 0100
1 August 1999
Fax: 0113 261 0212
Tel: 01785 251147 Fax: 01785 259377
Blood Testing Laboratories (Overseas) NAME & ADDRESS
TEL / FAX
Agence Française De Securite Sanitaire des Aliments Nancy Domaine de Pixerecourt BP 9 F-54220 Malzéville FRANCE National Vetinary Institute Commision of Diagnostics, Section of Diagnostics Department of Virology, PO Box 585 BMCS-751 23 Uppsala SWEDEN Danish Veterinary Institute for Virus Research Lindholm DK-4771 Kalvehave DENMARK National Veterinary & Food Research Institute PL 368 (Heimeentie 57) 00231 Helsinki FINLAND Instut für Virologie Franfurter Strasse 107
Tel (+33) 3 83 29 89 50
RECOGNITION DATE 27 May 1999
Fax (+33) 3 83 29 89 59
Tel (+46) 1867 4000
27 May 1999
Fax (+46) 1847 14517
Tel (+45) 55 86 02 00
27 May 1999
Fax (+45) 55 86 03 00 Tel (+35) 89 393 1901
27 May 1999
Fax (+35) 89 393 1811 Tel (+49) 641 99 38350
27 May 1999
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D-35292 Giessen GERMANY Dept for Equine, Pets & Vaccine Control Virology Federal Institute for the Control of Viral Infection in Animals Robert Kochgasse 17 2340 Mödling
Fax (+49) 641 99 38359
Instituto Zooprofilattico Sperimentale delle Venezie Via Romea 14/A I-35020 Legonaro (PD) ITALY Direccion General de Sanidad de la Produccion Agaria Laboratoria de Sanidad y Produccion Animal del Estado, Camino del Jau, S/N E-18320 Santa Fé (Granada) SPAIN Institute Pasteur of Brussels Rue Engeland 642 B-1180 Brussels BELGIUM Institute of Veterinary Virology Schweizerische Tollwutzentrale Langgass-Strasse 122 CH-3012 Bern SWITZERLAND
Tel (+39) 049 80 70306
Tel (+43) 2236 46 640 902 or 906
27 May 1999
Fax (+43) 2236 46 640 941
27 May 1999
Fax (+39) 049 88 30046 Tel (+34) 958 44 03 75
27 May 1999
Fax (+34) 958 44 12 00
Tel (+32) 2 373 31 8
27 May 1999
Fax (+32) 2 373 31 74 Tel (+41) 31 631 23 78
27 May 1999
Fax (+41) 31 631 25 34
Further Information PETS Helpline (general information on scheme)
Tel: 0181 330 6835 Email: pets@ahvg.maff.gov.uk Web: www.maff.gov.uk/animalh/quarantine/default.htm
Veterinary Laboratory Agency (blood testing)
01932 357 345
HEALTH & SAFETY / SOP’S Control of this will be by the appointed Safety Officer, Lydia Sagar. General Health & Safety is outlined and detailed in the Salus Manual. This is made available for reference to all members of staff. An abridged version will be mandatory reading and all staff must sign that they have read and understood the safety issues.
Cleaning Room 1.
Each member of staff must be instructed in the use of the Autoclave before use.
2.
The cleaning of instruments is to be carried out in the ultra sonic cleaner which is to be cleaned out daily.
3.
X-ray film processor is only to be used by staff trained to do so. It is to be cleaned out every 3 weeks. An apron and gloves must be worn when cleaning is being carried out. Chemicals must be mixed as instructed on the Manufacturers label.
4.
Used Developer and Fixer chemicals must be stored in separate containers until collection. They MUST NOT be poured down the drain.
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5.
All sharps, i.e. needles and blades, must be disposed of in the Sharps Bin.
6.
Bottles must go into the Danni Bin and when the bin is full collection should be arranged.
Clinical Waste Sharps Bin:
Use this for needles and scalpel blades.
Danni Bin:
Use this for vials, drug bottles and vaccine bottles.
Clinical Waste:
The following can be put in clinical waste bins; soiled bedding from patients in isolation; bloodied drapes, swabs, etc,; animal tissue removed surgically, potentially zoonotic material, e.g. hair, from suspected ringworm cases; cotton wool or blue towel contaminated with pus. All other soiled bedding can go in with the normal rubbish.
Syringes:
Autoclave and re-use ALL syringes. When syringes are ready to be disposed of you must, clean all residue from syringe; remove the rubber plunger; autoclave syringe bodies so they are fully sterile; snap the end so needles cannot be joined onto the syringe. Once sterile they can be thrown out with normal rubbish.
Consulting Room 1.
Dispose of Sharps in container provided - never leave needles on syringes.
2.
All Clinical Waste must go in yellow bin.
3.
Use only Virkon for disinfecting surfaces.
4.
Always dry stainless steel after cleaning.
5.
Use gloves when filling spirit container.
6. 7.
After each surgery ensure sump pump switched on. Ensure no hair or Jif is washed down the sink plug-hole.
Dispensary 1.
Gloves will be worn when handling Spirit, Grisovin and Fulcin.
2.
The controlled drugs used in the Practice are: Hypnorm Pethidine Pentobarbitone Injection Phenobarbitone These drugs will be kept in a locked drugs cabinet at all times. Ordering and usage will be kept in the dangerous drugs register. The key to the dangerous drugs cabinet is in the possession of the Duty Nurse at all times.
3.
All loose tablets will be dispensed in child proof plastic bottles. All blister pack tablets will be dispensed in their appropriate labelled envelopes. All medication whether PML, POM, GSL and diets whether Prescription or Science will be properly labelled before being dispensed.
4.
No medication or food will be sold to non-clients.
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5.
Repeat Prescriptions for medication must be cleared by a Veterinary Surgeon, preferably the Vet in charge of the case. No repeat prescriptions will be allowed if the patient has not been seen within six months. Flea and worming medication will only be re-prescribed for animals whose vaccination is current.
6.
All drugs and biochemical slides will be stored at the relevant temperature and light conditions for that product.
7.
In the case of medicinal emergencies both human and animal refer to the duty vet and the emergency handbook.
FreezerRoom 1.
All animals for cremation are to be placed in yellow carcass bags and then into the freezer to await collection.
2.
Freezers must be turned on at all times and checked daily to see if they need defrosting.
Gases 1.
All gases are to be turned off when anaesthetic machines are not in use.
2.
Gas cylinders must be attached to the walls at all times.
3.
Cylinders are only to be moved by BOC staff.
4.
Gas cylinders are only to be changed by trained staff.
5.
Smoking and naked flames are banned at all times.
6.
When handling Liquid Nitrogen, goggles and insulated gloves must be worn.
7.
Liquid Nitrogen must only be dispensed into the cryo-jet by trained staff.
Laboratory 1.
All Laboratory equipment to be calibrated and maintained as per Manufacturers Warranty Schedule.
2.
All slides, blood, urine and pathological specimens to be disposed of in Clinical Waste.
3.
Any glass slides or vials to be disposed off in Sharps container.
4.
All surfaces to be cleaned with Virkon.
5.
All stainless steel to be wiped dry after use.
6.
No hair or Jif to be flushed down the sink plug-hole.
Operating Theatres 1.
Maintenance of general anaesthesia will be the responsibility of the Veterinary Nurse under the supervision of a Veterinary Surgeon.
2.
Anaesthetic equipment is to be maintained daily as instructed in the Manufacturers Manual.
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3.
The ventilation system must always be turned on when anaesthetic equipment is in use.
4.
Surgical spirit must not be used on any area of the animal when diathermy equipment is to be used.
5.
Anaesthetic monitoring equipment i.e. pulse oximeters and apalerts, must be checked and cleaned daily.
6.
Smoking is totally banned in this area, as are any naked flames.
7.
All animal tissues must be disposed of in the clinical waste bin.
8.
Swabs, dressings and animal waste products must also be disposed of in the clinical waste bin.
9.
Any animal limbs or large amounts of animal tissue must be disposed of as a small animal carcass.
10.
Clinical waste bins are to be collected weekly by Time Right. The bags in the bin is put in the body freezer when full
Prep Room/ Kennels 1.
Sedation of animals can be carried out by Veterinary Nurses under the guidance of Veterinary Surgeon.
2.
General Anaesthetic will only be induced by Veterinary Surgeons.
3.
Anaesthesia will be maintained by Veterinary Nurses under the guidance of Veterinary Surgeons.
4.
Maintenance of Anaesthetic Machines will be carried out daily as scheduled in the Manufacturers Manual.
5.
Animals will be restrained by the Veterinary Nurse as instructed by the Veterinary Surgeon.
SECURITY Personnel
No-one should be admitted to the surgery during emergency hours without having telephoned first, unless you are very sure they are genuine and their animal is in need of urgent attention.
Cash
During the working day the tills in use should be kept closed with the cash out of sight of the clients as far as is possible. The reception area should never be left unattended, but if it is necessary, the till must always be closed and out of sight. You should ensure that there are never large amounts of cash at Reception at any time. Excess cash should be placed in a sealed marked envelope and placed in the safe. At the end of the working day the takings must be put into the safe. This is the joint responsibility of the Receptionist and Nurse working the late shift.
Premises
At the end of each working day or after a return to the premises out of hours it is essential that you check that you have secured all the doors and windows properly. Do not assume that someone else has checked, make certain yourself. Office personnel are responsible for their own rooms and logging off their computer at the end of each day. Make sure any gas taps or electrical apparatus not in use are turned off and receptionists must ensure that the telephone is transferred to nights.
Computer Disk
Back up disks are to be made of computer data at least once each working day, usually after evening surgery. The night nurse is responsible for ensuring that this backup is carried out each day. The back up tape should be changed daily and the previous night’s backup placed in the safe. The safe-keeping of such disks is the responsibility of the Practice Principal.
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Equipment
When equipment has been used it must be properly cleaned (and sterilised if appropriate) and returned to its secure place of storage as soon as possible after use.
Animals
In the case of animals staying overnight it is the responsibility of the Veterinary Nurse who admitted the animal to inform the night nurse of any relevant details. The night nurse is responsible for overnight care. The CCTV camera will be used whenever and animal is at risk.
Alarm System
The alarm system is located on the left of the staff entrance into Pets Corner. All personnel have their own unique security code, which must be kept confidential. If you feel that this code has become known to someone other than yourself please contact the Principal and get it changed. Some doors have contacts and these doors must be closed before setting the alarm. To set the alarm, enter your four-digit code, to deactivate re-enter the same four-digit code. The alarm should be set at night when the Nurse is satisfied the building is empty. During the day the alarm will act as a chime for any door that has a contact on it. These doors are: Hospital front door, Shop door, Pets Corner entrance, the Fire Escape at the bottom of the flats stairs and the Fire Escape at the bottom of the office stairs. Once the alarm has been set, entry to the hospital is via the Pets Corner entrance where the alarm must be deactivated. Any activation of the alarm system will dial directly to the monitoring station who will inform the Police immediately. The alarm sensors (PIR’s) are infra-red sensors that detect movement. It is therefore vital that no animals are placed in front of these, as they will set them off. The PIR’s are located: Pets Corner, Shop, Dog Waiting Room, Main Office, Staff Room. Pier Alarms Ltd service the alarm system once a year in April. Any problems with the alarm should firstly be brought to the attention of the Head Nurse or Richard. In their absence any problems should be reported directly to Pier Alarms. They may be contacted on 01942 235415 between 0900 and 1700 hours. Outside these hours and at weekends you need to contact Custodian on 01942 829022. They will ask you for a password which is PETCAT. When Richard and Anji are on holiday, their house may be empty. It is also alarmed and monitored by Pier alarms and Link monitoring. The Hospital is the first key holder. The house key is in the safe and the alarm code will be notified to one member of staff before they go on holiday. The password for the house is also PETCAT.
Panic Button
Pressing the Panic Button will alert the monitoring station who will call the police IMMEDIATELY. The Police should arrive is less than a minute. No audible warning will be heard to indicate that the alarm has been activated. ANY threat to personal safety is accepted as good cause to press the button. However, in judicial use will result in a reduced response time and ultimately have response removed altogether.
Outside sensors There are two sensors outside which cover the side alley and the rear shop door. These should be activated after dark after the last person leaves. The key pad is on the wall at the rear reception. CCTV
This is here for your safety. If you see something that appears a security risk press the Panic Button immediately. The police will arrive in 30-60 seconds. Notify Richard. Lesser problems can be notified to Richard immediately without the need to contact the police. There are five CCTV cameras inside the building and three cameras outside: Inside: Camera 1 Camera 2 Camera 3 Camera 4 Camera 5
Pets corner Shop till Shop floor Front reception Kennels
Outside Camera 1 Camera 2 Camera 3
Front Hospital door Side alleyway Rear shop door
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There is a monitor in reception, at the till and in the nurses flat. Vigilance should be second nature to all nurses. Watching what is going on outside will maintain safety and security of both buildings both inside and out. The images are recorded on the video recorder. The tape should be rewound at 0800 hours and changed for the next one. Before changing after the rewind play the first minute or two to be sure the recording is constantly of good quality.
FIRE PRECAUTIONS All members of staff will make the position of fire extinguishers and emergency exits known to themselves. There are different types of fire extinguishers to deal with different types of fires and these must be learned. A fire drill will take place in the first week of January, April, July and October as arranged by the Fire Officer. Fire Exits Ground Floor
Hospital front door Shop door Pets Corner store room
Fire Exits First Floor
Foot of stairs from shop to offices Stairs from offices to front car park Stairs from flats to Chapel Street
Fire Extinguishers
Pets Corner entry/exit Shop door Exit at shop stairs to offices Hospital front door Exit at stairs from flats Exit at stairs from offices to car park Corridor outside staff room Main office
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FIRE PREVENTION
The Fire Precautions Act 1971 To comply with the above legislation all staff will receive formal training in fire prevention and precautions, and the procedures in the event of fire.
Action on Discovery of a Fire: 1)
Raise the alarm, do not be afraid to shout “FIRE”, to warn all staff and visitors.
2)
The nearest person may attempt to extinguish the fire using the nearest appropriate fire fighting equipment, provided this is done without risk to themselves and provided that the alarm has been raised.
3)
If the fire is an electrical fire, then the equipment involved should be immediately switched off, provided that no personal risk is involved.
Action on Hearing the Fire - Alarm: 1)
All staff and visitors must leave the building immediately, by the nearest exit route, closing the doors behind them, and assemble outside for a roll call. There must be no delays to collect belongings. Provided that no personal risk is involved, animals should also be evacuated - dogs on leads, small animals in baskets.
2)
Fire Officer must telephone “999” for the fire service and give clear details: the name of the Company the proper postal address the telephone number brief details, such as “fire in Store Room”
3)
The Fire Officer or the senior person present will carry out a roll-call and identify all personnel.
4)
No person is to re-enter the building until the all clear is given.
Reception of the Fire Brigade: 1)
The Fire Officer or the senior person present must inform the fire brigade of the names of any persons not accounted for at roll-call and the location of any packs containing information such as the layout of the building, fire protection measures or lists of hazardous substances in particular areas.
Fire Drills: 1)
The fire/smoke alarms will be tested each week.
2)
At least twice a year a practice fire drill will be carried out, simulating conditions, during which the escape routes from the building will be tested.
All fire drills and alarm tests, plus actions required/taken as a result, will be recorded.
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General FireProcedure
FIRE INSTRUCTION IF YOU DISCOVER A FIRE: 1.
Raise the alarm by operating the nearest alarm point.
2.
Attack the fire with the equipment provided only if it is safe to do so.
3.
Leave the premises by the safest route.
IF YOU HEAR THE FIRE ALARM: 1.
Leave the premises by the safest route.
2.
Close all doors behind you.
3.
Report to the assembly point.
4.
Ensure Fire Service has been called.
DO NOT: a)
Re-enter the building until authorised by a Fire Brigade Officer.
b)
Shout or run. This tends to cause panic.
THE ASSEMBLY POINT IS: THE CAR PARK, CAROLINE STREET
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FIRE OFFICER’S RESPONSIBILITIES
FIRE OFFICER:
Lydia Sagar
DEPUTY:
Anji Weston
To ensure the safety of the customer in the event of fire. To lead out customers with minimum fuss and panic to the safety of the Assembly Point. To phone the Fire Brigade and give appropriate details. To take a Roll-call and advise Fire Officers of any “missing persons”.
FIRE DRILLS AND ALARM TESTS Company Fire Officer: Local Authority Fire Officer: Fire Alarm System: Fire Alarm Engineers: Guardian Technical
Deputy Fire Officer: Tel: Date Installed/Modified: November 2003 Tel: 01942 208101
FIRE ALARM TESTS Date
Date & Time
Result
Comments/Actions
Date
FIRE DRILLS Nos. Present on Site Evacuation Staff Visitors Patients Time
Result
Comments/Actions
Comments / Actions
Additional Comments / Actions:
Record Checked By:
Date:
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USEFUL CONTACTS Most contact telephone numbers can be found on Mentor.
DANGEROUS ITEMS Controlled drugs must be kept in the controlled drugs cabinet. Keys are held by the Vets and the Head Nurse. Controlled drugs must be handled by Veterinary Surgeons only. A register must be maintained when controlled drugs are used. This register is kept with the dangerous drugs. This register must be kept for a minimum of two years after the date of the last entry. Lay staff are, under no circumstances, to handle the substances listed below unless in original boxes, and they have been instructed to do so by a member of the professional staff: Prostaglandin Cytotoxic Drugs Immobilon
Phenol Formalin Sodium Nitroprusside Liquor Ammon Forte (strong Ammonia)
Full protective clothing must be worn when handling cytotoxic drugs. For full details please refer to the main Health & Safety manual located in the administration office.
COMPUTER SYSTEM Manuals for printers, Windows and Mentor can be found the fileserver (anrich_fs_0). Should you require a printed version this can be found in the administration office. Ask Richard. The fileserver is in the store room. If Mentor cannot be accessed from any workstation, it means the fileserver is locked or crashed and needs rebooting. Training will be given when a new staff member joins the practice. Training will be continued at regular intervals. It will, however, be the staff’s responsibility to browse through all aspects of Mentor and familiarise themselves with every button and every function. Staff will be liable for losses incurred by the practise for inaccurate and made up ledger and cash entries. Staff will NOT override the computers request for money. If a client feels this is inaccurate, they must pay what’s asked for and the apparent error must be reported to Richard IMMEDIATELY. The client must be reassured that if there is, in fact, a computer error, they will be reimbursed. Mistakes that are found months later will be deducted from the staff member who NEXT dealt with that client after the error was made.
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Templates Various templates (documents that can be used without over-writing the original) have been set up for use within Word and Excel to make repetitive jobs easier to do. They can be accessed from the relevant program (Word or Excel) by choosing File & New. A box will appear with different names across the tope, clicking these names will change the choice of templates. The following list shows the type of document available: Document Name: Animal Healthcare Services
Program: Excel
Anrich Fax Anrich Letterhead
Word Word
Anrich Memo Anrich Prescription (General)
Word Word
BSAVA confirmation to practice BSAVA Inspector’s confirmation Cardiophone ECG
Word
Contracts Court Summons
Word Word
CPD
Excel
Dunlops Prescription Form
Word
Idex (Grange) Prescription Invoice
Word Word
Job Applicant Job Offer PBV Fax PBV Letterhead
Word Word Word Word
PBV Memo Pet Travel Scheme – Rabies Rehoming Strays Retail Order Sheet
Word Word Word Word
RSPCA Statement 1 & 2
Word
Standard Terms & Conditions Tenancy Agreement Tracer
Word
Work Exp
Word
Word Word
Word Word
What it does: Allows services & products to be entered together with prices to work out an annual expenditure per animal of a client Click and Fill fax with Anrich logo and address Copy of letterhead on computer for letters that are to be faxed or e-mailed Click and Fill memo with Anrich logo Click and Fill form to enter client and animals details together with prescription requirements to be signed by Vet and taken to a chemist Fax set up to confirm Richard’s visit as a BSAVA inspector to site being inspected Fax set up to confirm date of inspection to the BSAVA for their records Form to fill in to go with ECG printout for interpretation by Andrew Carmicheal Draft copies of contracts of all staff positions Form to match those required for submission to the County Court for small claims purposes Form to list all continual professional development for each member of staff. Note: this would only be used to start a new year as one should already be in use for the current year. A signed prescription form ready to be completed for order and sent to Dunlops Similar to Dunlops but for tests required from Grange Form for invoicing of goods or services not sold through Mentor. Various letters for accepting/rejecting job applicants Draft copies of job offers Click and Fill fax with Pets By Vets logo and address Copy of letterhead on computer for letters that are to be faxed or e-mailed Click and Fill memo with Pets By Vets logo Rabies blood test submission form Document for new owner to sign as acceptance of pet Formerly the Seddons sheet. This has been modified to cater for current pet shop suppliers. Orders can be entered here to give a guide to the order value and to place with supplier. Set to correspond with the layout of the RSPCA’s paper. 1 is the 1st page, 2 is for 2nd and subsequent pages. Originals are located in the office. Terms & Conditions of employment to be issued to new members of staff on commencement. Legal document for tenants. Originally set up to correspond with the tracer paperwork. This needs to be checked as it has not been used for a while and I believe new forms have been issued since created. Various letters for accepting/rejecting work experience applicants.
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ADDITIONS TO MANUAL The page number for additions to this manual will be placed here for at least one month. They will be written in GREEN and remain and be changed to black on the last day of March, June, September and December. Each employee must read this page weekly to ensure that they have read and understood new elements relevant to this manual. After the one-month period new additions will be incorporated into the full manual. All changes have last been implemented into the manual on 24th May 2005. The current manual will be dated 1st June 2005. No additions to the manual will be implemented in future until agreement is signed by both Principal and Staff of the Hospital.
Number of changes since last update are
0
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