As someone who has always promoted the value of veterinary nurse consults, it is good to see they are now commonplace in the majority of veterinary practices as their benefits are widely recognised.
The pet and its owner benefit by the owner being educated and supported on how to keep his or her pet healthy, vet time is freed up for more critical cases, and the nurses themselves enjoy more variation and increased job satisfaction.
However, are these benefits really being maximised to their full potential?
At the beginning of this new decade, I would encourage everyone who is offering VN consults to evaluate the following five key areas:
- Owner education and support – what do all of your team know and how is this delivered?
- Vet referral and support to the VN team – how are clinical cases passed back to vets, how are vets referring suitable cases to the VN team and does the reception team know?
- How do clients learn about the value of the VN team and the benefits they bring to their pets?
- How do you measure the success of your nurse consults?
- What do you and your team think about charging for VN consults?
Owner education and support
If you look up what it means to be a veterinary nurse on the RCVS website, the role is partly described as: “Veterinary nurses play a significant role in educating owners on maintaining the health of their pets.”
This description is applicable to VN consults, but we know the syllabus for nurse training is weighted to clinical care and surgery, with little room for the “maintaining health” aspect of the role.
When talking to owners about what education they would like to help them maintain the health of their pet, it is often about the right food; basic behaviour; and training such as socialisation and house training for puppies, neutering, parasite control, insurance, scared of fireworks, house spraying cats and other non-clinical issues.
For the owners, most of these questions can be answered by internet searches and really good information exists on trusted websites that educate owners; but it would be better if we led this advice. Speaking to a lot of nurses who offer consulting, these questions can’t always be answered by them due to their lack of knowledge, so perhaps your consults are not educating owners as much as may be believed.
It is important to say this is not the VN’s fault if he or she has not had the opportunity to learn, but it is something that should be reviewed in practice to find any knowledge gaps so additional training can be given to help the practice educate clients to continue to build client relations.
As well as considering the nurses, what do the vet and reception team say about these topics? The whole practice should be saying the same so that a consistent message exists. The grey area for a lot of practices in respect to client communication is the change to neutering advice for cats.
Clients can learn from trusted sources such as International Cat Care and Cats Protection about early neutering, but do your reception and nurse teams know how to answer a client’s request for this if your practice doesn’t offer it, in a way to ensure you don’t lose that client to another practice?
Vet referral to nurses
During a nurse consultation, a time will occur where a vet’s input will be required (a nail clip could have a sore ear), so the practice needs a process to ensure the client is not kept waiting too long and neither are other clients inconvenienced too much while the vet assists another colleague.
This can be seen as an obstacle in practice and a reason why some practices don’t offer nurse consults, but it needn’t be.
With team training and prior agreement to the process for these cases, this is manageable and continues to benefit the vet team by allowing it to concentrate on the clinical cases.
The other referral is how will vets refer cases to the VN? Weight management cases are common consults that nurses want to help with, but not all clients are made aware of this service. Quite often nurses can feel this is because vets don’t want them to do this or don’t trust them, but this is often more likely due to vet habits and busyness; they can be forgotten.
Decide on a process in practice that can support referring cases to nurses; this can be as simple as agreeing it is okay for the nurse to make follow-up telephone calls to the client to invite him or her for a nurse appointment. Don’t forget the receptionist’s role in this, too, as he or she is vital for making the appointment with the correct team member.
VN promotion to client
Unfortunately, not all clients are aware of the VN qualification, and nurses can still be viewed as “someone who helps the vet”. Also, our own promotion does not always help explain what our nursing team can offer.
Nurse consults promoted on websites don’t always fully explain the value – for example, our promotion may list “puppy advice”, but with no explanation to what this actually means. A short sentence to say “puppy clinics to answer any questions you may have about your puppy, such as how to stop chewing and advice on house training” gives the client more information and promotes the skills of the nursing team.
We shouldn’t only rely on websites and social media for promotion, though. A survey I conducted at the BVNA found only 29% of VNs always introduced themselves as RVNs to clients, so this is something we can easily improve on with every opportunity for nurses to introduce themselves as qualified professionals being taken.
Measuring success
How do you, as managers, measure the success of your VN consults? Nurses should all know the importance for using treatment codes so that the number of clients seen by them can be quantified.
I have found when I speak to nurses about this that this is not always done and they only write in clinical notes for a patient if it was a zero charge consult. For the business to fully appreciate the impact of nurse consults, we should be measuring all appointments – even those that are not charged.
This information can be used to show the nursing team what impact it is having on the business and the benefits it brings to the clients. It will also tell you how much of your nursing team’s time is being used to consultations, should you need to evaluate your team’s work capacity.
Charging
When I began consulting in the late 90s, VN consults were an additional benefit of what the practice offered to help attract and retain clients. But we are now more than 20 years on, so should we still be giving all of our nurses’ professional skills and time away for free?
A survey conducted with pet owners in 2019 on the topic of paying for VN consults found favourably for accepting a fee for these, with only 12% saying they would not pay for nurse-led preventive health care consultations.
I think this would be a great service and would happily pay for their time/advice on how to best care for my dogs. I often ask my vet’s advice on health/diet/behavioural issues at appointments but am conscious of his time, so it would be great to have the option of these services as a way to focus on a specific concern.
The general opinion to the amount charged was also commented on.
I feel it’s like the doctor’s surgery. If you’re in for routine things like blood tests, injections and so on then there’s no reason why the nurse can’t do it. And then it’s charged at around half the price of the vet.
The mindset to charging for consulting that might be the toughest to change, though, is that of the nursing team themselves. While in the BVNA survey, 70% of nurses answered that their consultations should be charged, concerns existed about the impact any charge would have on the client’s willingness to see them and the detrimental effect this would have on the pet if owners didn’t attend.
Reviewing your VN consultations and helping your team see the value of what it offers clients will help all team members consider if some (or all) of the services you offer should have a charge to the client.
Conclusion
Audit your VN consults to find out:
- Do all your nurses have the knowledge to educate owners on preventive health care topics? If not, set up some training and look at the good websites offered by some of the companies that can help upskill the team.
- Look at the referral process of cases between the vets and nurses, and also the reception team’s knowledge about who can see which case for what benefit, to avoid incorrect bookings.
- How are your clients learning about the skills of your nursing team members so that they want to book appointments with them?
- Ensure you are able to measure the amount of consults and share any successes with the nursing team members so they feel they are contributing to the business.
- Look at what opportunities you have for charging for nurse consultations and talk to the nursing team members to ensure they value themselves to want to charge for their time and skills.
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