Regulation

Email Regulation of Veterinary Nurses-page-001-199 



Veterinary Nursing Regulation in New Zealand


Announced at the NZVNA Conference 14 August 2015
By Jennifer Hamlin

 
Terminology

For the purposes of this discussion, the term veterinary nurse will be used, and in most cases it is assumed to be equivalent to a veterinary technician.
 
Professionals are those represented by a professional organisation. They are those who are responsible for their own continuing education and who act autonomously at times making independent clinical judgements. Veterinary allied professionals include veterinary nurses and veterinary technicians.
 
In contrast, allied veterinary para-professionals such as veterinary nursing assistants, receptionists, and administrative staff do not have professional representation, continuing educational requirements, nor do they act independently to make clinical decisions.
 
 
What is the current state of veterinary nursing in New Zealand?

It is important to review what a veterinary nurse is.
 
“Veterinary nursing is the use of clinical nursing judgment in the provision of care to enable pets/animals to improve, maintain, or recover health, to cope with health problems, and to achieve the best possible quality of life, whatever their disease or disability, until death.”
Source: http://www.rcvs.org.uk/news-and-events/past-events/vn-golden-jubilee-seminar/
 
There is no doubt that the skills and attributes of a qualified and experienced veterinary nurse are an essential part of modern veterinary practice and the profession contributes significantly not only to animal health and wellbeing, but also in supporting the human animal bond and by promoting public health by minimising zoonotic disease spread from animals to humans. 
 
 
Who can be a veterinary nurse in New Zealand?

Currently any individual in New Zealand can call themselves a veterinary nurse, even if they have no formal veterinary nursing education or training. For a position as essential and highly regarded as veterinary nursing, this is entirely unacceptable.
 
Furthermore, even qualified veterinary nurses may practice with no consequences for professional misconduct, or negligence. In North America, veterinary technicians are regulated. In Ireland, veterinary Nurses are regulated. In the UK, veterinary nursing is expected to be fully regulated in the near future. In New Zealand, veterinary nurses are a completely unregulated profession. In terms of healthcare related professions, this is a rarity.  
 
 
What are the risks of having unqualified staff in practice?

Unqualified staff are an immense liability to the veterinary practice. Untrained staff potentially exposes animals to harm by risking inaccurate medicating of patients, inadequate anaesthetic monitoring, insufficient barrier nursing/infection control, poor nutritional support, incompetent fluid monitoring, poor bandaging and many others, the consequences of which can easily be serious harm or even death.
 
In addition, unqualified staff can expose the public, including clinic staff, to harm by inadequately handling controlled drugs, antibiotics, cytotoxic drugs, hazardous chemicals, radioactive waste (I131), taking radiographs, dispensing drugs, disposing of clinical waste and many others.
 
All of these things dramatically increase liability for the veterinarian, the risks of which could be mitigated by ensuring that veterinary allied professional staff are qualified and regulated making them responsible for their own actions.
 
 
Even for those who are qualified, there are some issues

Education quality is extremely variable between NZ providers – there is minimal consistency with delivery, quality of staff, and even with curriculum design.
 
In addition, the minimum education level is possibly lower in some cases than other modern nations, specifically in that New Zealand has allowed people to gain the title veterinary nurse after only one year full time equivalent (FTE) education which includes only a few hundred hours of clinical work experience and little or no relevant pre-requisites. In this way, New Zealand is well behind other countries with modern veterinary nursing standards. The new qualifications coming out this year go some way toward rectifying this, but the deficient work experience hours and lack of pre-requisites remain a significant problem that will continue to hold back professionalism in the veterinary nursing field.
 
In addition to the educational issues which may contribute to deficiencies in clinical skill for practicing veterinary nurses, there is also no statutory requirement to maintain currency with continuing education or fitness to practice. This means that a veterinary nurse could have qualified 20 years ago with a one year FTE qualification, she may have not worked in practice at all after she qualified, not completed any continuing education in those 20 years, and she still can legally work as a veterinary nurse, potentially exposing animals and the public to serious harm.
 
There is no statutory code of conduct or disciplinary process for veterinary nurses so the veterinarian is ultimately responsible for any veterinary nurse misconduct or malpractice. In an increasingly litigious society, this is becoming a greater risk for practice owners than ever before.
 
Veterinary nurses need to be regulated for a number of reasons, including:
  • To better protect animal health and welfare.
  • To serve the public interest, and safeguard public health.
  • To be accountable for their own professional practice.
  • To ensure consistency of education, care, and wages.
 
 
Regulation - What is regulation, and why do we need it?

In New Zealand, veterinary nurses have representation, but they do not have regulation. It’s important to note the difference between a regulatory organisation and a representative organisation.
 
The New Zealand Veterinary Nursing Association (NZVNA) is a representative organisation, representing veterinary nurses in New Zealand.
  • It advocates for and represents veterinary nurses by speaking on their behalf to the public and to the professional community.
  • It represents the profession of veterinary nursing and promotes it to the public.
  • It provides career and employment support for veterinary nurses and other veterinary allied professionals.
  • It encourages and facilitates continuing education.
 
The NZVNA acts in a similar role as the New Zealand Veterinary Association does for veterinarians.
 
A veterinary nursing regulatory organisation does not yet exist in New Zealand. If it did, it would be responsible for:
  • Protecting animal welfare and the public interest by ensuring that veterinary nurses are fit and competent to practice.
  • Maintaining a register of veterinary nurses that are fit to practice.
  • Setting and enforcing standards of practice and education.
  • Administering a national registration exam.
  • Operating under legislation (Veterinary Act).
 
A veterinary nursing regulatory organisation would act in a similar role to the Veterinary Council of New Zealand (VCNZ) which regulates practicing veterinarians.
 
 
Why does New Zealand need regulation of veterinary nurses?

In addition to the significant benefits to public health and safety, as well as protecting consumer rights for clients of veterinary practices, regulation would protect and elevate the profession of veterinary nursing.
 
Not only would regulation make veterinary nurses accountable as professionals in their own right it would benefit the professional community by giving veterinary nurses a voice in policy for animal care in New Zealand. It would safeguard animal welfare, and the public interest and it would provide national and international consistency for the veterinary community and society as a whole surrounding issues of pet care and animal welfare.
 
 
Making full regulation a reality in New Zealand

The process of regulation involves many steps including:
  1. Introducing a voluntary register and list for veterinary nurses and technicians.
  2. Establishing a veterinary nursing regulatory organisation
  3. Changing the Veterinary Act to include veterinary nurses as a legal profession
 
 
Step 1 – Establishment of a Voluntary Register and List

Voluntary registration of veterinary nurses will commence in 2016.
 
There will be two separate groups - a register and a list, as explained below under standards for entry.
 
1.1 The register and list will be administered initially by NZVNA and handed over to the new regulatory organisation once the infrastructure for regulation is in place.
 
Standards for entry to the register:
  • Holding a valid 2-year full time equivalent (min) VN/VT qualification.
  • Completion of 20 hours of continuing education, per year.
  • Completion of 40 hours in clinical or academic veterinary nursing related practice per year.
 
Standards for entry to the list:
  • Holding a valid VN/RAT or other veterinary nursing based qualification that is less than two years FTE (e.g. NCVN).
  • Completion of 20 hours of continuing education, per year.
  • Completion of 40 hours in clinical or academic veterinary nursing related practice per year.
 
1.2 Staying current on the register and list each year will require annual completion of 20 hours continuing education, and 40 hours clinical or academic veterinary nursing practice. It also will require a minimum standard of conduct under the law. 
 
1.3 NZVNA membership is not a requirement for entry to the list or register. However, logging of CPD hours and verification of clinical hours will incur an administrative fee.
 
1.4 Once the regulatory organisation is in place, additional requirements for entry to the register may be required, including gaining a qualification from an accredited provider, and passing of a national registration exam.
 
Important point: A grandfathering exception clause will be in place for these additional requirements to the register. In this clause, examination will not be required for those entering the register prior to the date that the national examination is first administered. Similarly, provider re-accreditation will not be required prior to the date that the educational standards are first set. These dates are unclear at this stage, but additional requirements will not be imposed before 2018 at the earliest.
 
1.5 Eventually the register will become statutory meaning it is unlawful to practice without being registered. In addition, there will be a statutory requirement to hold a valid qualification from an accredited provider.
 
1.6 In good faith, and until there is statutory protection of title, only registered veterinary nurses/veterinary technicians (VNs/VTs) may use the post nominal: RVN/RVT or call themselves a registered veterinary nurse or technician. Failure to comply will be subject to disciplinary measures which may affect future chances at becoming registered.
 
1.7 Employers will be able to access names on the register to ensure they are hiring a registered veterinary nurse or technician. Eventually with statutory regulation, it will be a legal requirement for practicing veterinary nurses to be registered but in the meantime, it is hoped that employers, particularly those in the Best Practice scheme, require their employees to be registered.
 
1.8 There may be additional options for entry to the register including enrolled VN status whereby veterinary nursing students can enter a probationary register. This will be determined once the regulatory organisation is fully established.
 
1.9 Veterinary nurses with a 1-year FTE qualification (e.g. NCVN) are encouraged to be proud of being on the list as it will be upheld and promoted as an important part of New Zealand veterinary practice. It will ensure that these listed VNs are current with CPD, and fit to practice in New Zealand. If these VNs wish to enter the register, they will need to upskill and gain the additional year of education toward a diploma in veterinary nursing or higher.
 
1.10 Unqualified staff, even those who have been acting in the capacity of a VN for more than a decade, will not be eligible for entry to the register unless they gain a valid veterinary nursing qualification.
 
1.11 The distinction between the list and register is essential for employers and the public to be aware of the level to which the veterinary nurse was educated. This distinction is designed to acknowledge the fact that New Zealand has historically awarded a 1-year FTE veterinary nursing qualification and thus graduates of 1-year qualifications have rightly earned the title veterinary nurse. However, the 1-year qualification is not of the same level as the 2-year qualifications, most having notable deficiencies in the curricula including infectious diseases, barrier nursing, management of fluid therapy, advanced nutrition, assisted feeding, intensive care, and many other areas which are well known to be essential in a basic comprehensive veterinary nursing qualification. Thus, the register and list will be distinguished by their base qualification requirements so that there is no confusion as to the minimum level of New Zealand veterinary nurses.
 
It is important to note that the list is self-limiting as after the current Targeted Review of Qualifications is fully implemented, there will be no new veterinary nurses entering the list. Any remaining 1-year FTE veterinary nursing based qualifications will be assessed on their own merits once the regulatory organisation is fully established.
 
 
Step 2 – Establishment of a Regulatory Organisation

The NZVNA has appointed a committee to establish the new veterinary nursing regulatory organisation which will carry the name Veterinary Nursing Council of New Zealand (VNCNZ).
 
The VNCNZ will set and enforce standards for clinical practice, VN education, fitness to practice, and codes of conduct. It will impose a disciplinary process for misconduct as well as addressing breaches of the code of conduct, and responding to complaints by the public.
 
The organisation will include governance including maintaining the register, auditing and quality control of CPD, setting and administering the national examination, and auditing educational providers and qualifications.
 
 
Step 3 – Legalising the Veterinary Nursing Profession

Once the infrastructure is in place for the VNCNZ, parliamentary lobbying will take place in an effort to amend the Veterinarian’s Act to include veterinary nurses as a legal profession and establishing complete protection of title prohibiting unqualified persons from calling themselves a veterinary nurse or using the post nominal abbreviations RVN, RVT. It will impose statutory regulation of veterinary nurses making it unlawful for any non-registered veterinary nurses to practice as a veterinary nurse.
 
 
Progress Report

The voluntary register and list are in place for 2016.
 
The regulation committee is currently in the process of setting up the infrastructure for the regulatory organisation. It is working in consultation with other regulatory organisations in NZ and overseas to ensure that the Veterinary Nursing Council of New Zealand meets the needs of New Zealanders and sets up future proofing to meet or exceed international standards for veterinary nursing regulation.
 
The regulatory committee has the full support of the Companion Animal Society (CAS), New Zealand Veterinary Association (NZVA), and the Veterinary Council of New Zealand (VCNZ).
 
As the VNCNZ is still in the early planning stages, some changes are inevitable. Thus, this document is subject to change at any time.  
 
 
Questions
Email: regulation@nzvna.org.nz
 
 
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