Nurse three surgical patients from admission to discharge

What is going on

Wednesday's surgery list has a castration on a labrador, a dental scale and polish on an elderly poodle and a lump removal on a cat. The senior nurse has asked you to take primary responsibility for surgical nursing: preparing packs and the anaesthetic machine, running pre-anaesthetic checks, monitoring anaesthesia and analgesia, managing recovery and preparing discharge instructions. The poodle has a heart murmur noted on her record, and the cat is flagged as difficult to handle. Every controlled drug used must be entered in the Controlled Drugs Register at the time of use, and the Clinic Case Log must reflect each patient's stage in real time.

Your brief

Provide safe, well documented surgical nursing for three patients, including anaesthetic preparation and monitoring, controlled drug recording, recovery care and discharge planning, escalating any concern to the veterinarian immediately.

Work through it

You do not need to do it all. Doing a few of these will show you what the work is like. Your ticks and notes stay on this device.

• Review the Clinic Case Log entries for the three patients and the Controlled Drugs Register document, and list the risk factors for each patient that change your anaesthetic plan.
• Prepare the surgical packs, instruments and anaesthetic machine, and complete the daily machine checklist including the scavenger connection noted in a recent hazard report.
• Carry out the pre-anaesthetic checks for each patient, including weight, temperature, heart and respiratory rate and blood results, and record them in the case notes.
• Record every controlled drug drawn up in the Controlled Drugs Register with the animal identifier, dose, route, balance and countersignature, following the register rules exactly.
• Monitor and chart anaesthesia and analgesia at five-minute intervals for one procedure, and describe the values that would make you alert the veterinarian.
• Manage recovery for each patient, applying the safe handling steps for the flagged cat, and update the Clinic Case Log as each patient moves to recovery and discharge.
• Write discharge instructions for each owner covering wound care, medication, feeding, activity and warning signs, and note the recheck booking.
• Report any near miss, sharps issue or equipment fault from the day on the Incident and Hazard Report Form.

What someone in this role would produce

• Pre-anaesthetic check records for three patients
• Anaesthetic monitoring chart
• Controlled Drugs Register entries
• Updated Clinic Case Log entries
• Three sets of discharge instructions