Surgical Nursing

The surgical nurse/tech/assistant is an essential part of the surgical team. A good working knowledge of both surgical principles and equipment is essential to ensure surgical asepsis and safety to both the patient and surgical personnel. This module will cover all of the surgical principles and review surgical asepsis, sterilisation and surgical personnel preparation techniques. The range of surgical instrumentation and equipment has increased in recent years and is now more easily accessible; this module will introduce you to its use and maintenance.

Key learning objectives:

• Discuss how hospital layout affects the running of a clinic in relation to infection control

• Distinguish between the terms of disinfection and sterilisation and how these techniques are implemented within the surgical and hospital setting

• Have an overview of theatre set-up, maintenance and the importance of surgical traffic etiquette

• Gain knowledge of the importance of the appropriate selection, preparation, storage and usage of equipment in theatre including surgical instruments and drapes

• Demonstrate aseptic techniques when assisting in surgery either as a scrub assistant or as a non-sterile assistant through appropriate hand preparation, gowning and gloving

• Appreciate the importance of surgical Health & Safety. Be able to identify potential risks and hazards within the surgical setting and have the knowledge of how to reduce these risks

• Know how hospital-acquired infections are obtained and spread, as well as the different types of infection

 Speaker: Claire Dorey-Phillips BSc (Hons) ISFM DipFN RVN

Claire Dorey-Phillips

BSc (Hons) ISFM DipFN RVN

Claire graduated from the University of Bristol in 2005 with a BSc (Hons) in Veterinary Nursing and Practice Administration. Following graduation, Claire joined a multidisciplinary referral hospital where she went onto lead various departments including surgery and medicine before becoming a head nurse and, finally, clinical nursing training manager. During this time Claire's passion for feline medicine and surgery grew and I 2015 Claire left to take up the role of a Lead Nurse primarily in Feline Medicine and to help set up another multidisciplinary hospital in Hampshire, where she was instrumental in obtaining gold Cat-Friendly Clinic status as well as obtaining her diploma in feline nursing. Claire's main interests are feline medicine/ surgery, and emergency and critical care.

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The success of a surgical procedure depends primarily on good planning and the awareness of potential patient risk factors. The surgical nurse/tech/assistant is an integral part of the surgical team. This module will give you the background understanding and knowledge of the importance of pre-surgical assessment and patient preparation. With the background knowledge of disease pathophysiology and surgical techniques, this module will give you the confidence to nurse the peri-operative patient.

Key learning objectives:

• Discuss the importance of patient pre-surgical assessment and be able to identify which technique is most appropriate

• Select the appropriate patient preparation technique and positioning required for specific surgical procedures

• Be able to explain the importance of nursing care plans and their use in pre and post-operative surgical patients

• Obtain knowledge of the role of nutrition in the surgical patient, identifying the advantages and disadvantages of both enteral and parenteral administration and how to manage these cases in the clinic

• Appreciate the importance of client communication in relation to a hospitalised patient

 Speaker: Claire Dorey-Phillips BSc (Hons) ISFM DipFN RVN

Claire Dorey-Phillips

BSc (Hons) ISFM DipFN RVN

Claire graduated from the University of Bristol in 2005 with a BSc (Hons) in Veterinary Nursing and Practice Administration. Following graduation, Claire joined a multidisciplinary referral hospital where she went onto lead various departments including surgery and medicine before becoming a head nurse and, finally, clinical nursing training manager. During this time Claire's passion for feline medicine and surgery grew and I 2015 Claire left to take up the role of a Lead Nurse primarily in Feline Medicine and to help set up another multidisciplinary hospital in Hampshire, where she was instrumental in obtaining gold Cat-Friendly Clinic status as well as obtaining her diploma in feline nursing. Claire's main interests are feline medicine/ surgery, and emergency and critical care.

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There is no such thing as a safe anaesthetic only a safe anaesthetist’. This module will give you the ability to approach the anaesthesia of more critical surgical patients to optimise outcomes. The ability to confidently calculate drug requirements and understand monitoring equipment will help you navigate a surgical list with ease.

Key learning objectives:

• Review acid/base balance, the practical application of blood products and explain when different fluid replacement options should be used

• Demonstrate the ability to perform all types of fluid administration calculations

• Explain the importance of client consent forms, patient anaesthesia records and be able to complete both correctly

• Describe the use of different pre-anaesthetic medication, induction and maintenance agents, explaining the advantages and disadvantages of each in specific cases

• Identify different types of endotracheal tubes and their use explaining the advantages and disadvantages of each. Demonstrate the skill of intubating easy and more difficult patients

• Obtain knowledge of basic through to advanced monitoring including the pros and cons of multi-parameter monitoring

• Be able to describe and explain abnormal pulse oximetry values and abnormal capnography waveforms and suggest options to improve them

 Speaker: Nicola Grint BVSc PhD CertVA DVA DiplECVAA MRCVS

Nicola Grint

BVSc PhD CertVA DVA DiplECVAA MRCVS

Nicki graduated from Bristol Vet School in 2000, and stayed on to undertake an internship and then residency in veterinary anaesthesia. In 2005, she moved to Liverpool Vet School to undertake a three year lectureship post, becoming head of division in 2007.

After leaving Liverpool, Nicki locumed at the Animal Health Trust, the Royal Veterinary College, and Ross University School of Veterinary Medicine. She has just completed her PhD at Bristol University and holds the RCVS certificate and diploma in veterinary anaesthesia, and is also a European diplomate in veterinary anaesthesia and analgesia. She currently runs the anaesthesia service at Cave Veterinary Specialists near Wellington.

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Anyone involved in a surgical list will need to be up-to-date on pain assessment and multi-modal options for managing pain peri-operatively. This module will give enable you to promote patient welfare by using a pro-active and thorough approach to analgesia.

Key learning objectives:

• Appreciate the pathophysiology of pain and be able to identify pain in different species using pain scoring methods

• Explain the different classes of analgesia, including opioids, NSAIDs, local anaesthetics and other agents and their pharmacology

• Appreciate the use of a pre-emptive and multi-modal approach to analgesia

• Demonstrate different intravenous catheterisation techniques including central venous catheterisation

• Be able to identify appropriate analgesic agents for the use of CRI, when and how these should be used/monitored and be able to perform a CRI calculation

• Obtain knowledge of different local anaesthetic techniques and which surgical cases benefit from their use

• Be able to demonstrate the safe administration of local anaesthetics via transcutaneous electrical nerve stimulation

 Speaker: Nicola Grint BVSc PhD CertVA DVA DiplECVAA MRCVS

Nicola Grint

BVSc PhD CertVA DVA DiplECVAA MRCVS

Nicki graduated from Bristol Vet School in 2000, and stayed on to undertake an internship and then residency in veterinary anaesthesia. In 2005, she moved to Liverpool Vet School to undertake a three year lectureship post, becoming head of division in 2007.

After leaving Liverpool, Nicki locumed at the Animal Health Trust, the Royal Veterinary College, and Ross University School of Veterinary Medicine. She has just completed her PhD at Bristol University and holds the RCVS certificate and diploma in veterinary anaesthesia, and is also a European diplomate in veterinary anaesthesia and analgesia. She currently runs the anaesthesia service at Cave Veterinary Specialists near Wellington.

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This module will allow you to have a deeper understanding of the part imaging plays in a busy surgical setting. The ability to confidently acquire diagnostic radiographs, triage patients using ultrasound and identify those patients who would benefit from advanced imaging will be of great benefit to you.

Key learning objectives:

• Explain the different radiographic techniques available, their pros and cons and uses in specific situations

• Revise contrast studies, becoming familiar with their use and the specific equipment required to perform them

• Demonstrate correct positioning of a patient for specific pre and post-surgical assessment views

• Improve your basic film reading, identifying radiographic artefacts and faults

• Explain ultrasonography techniques including AFAST™ and TFAST™ and how these techniques benefit surgical cases when diagnosing and monitoring for complications

• Identify specific equipment and materials required for ultrasound-guided procedures

• Describe the use of echocardiography in the surgical patient, both pre-operatively and as part of a diagnostic workup

• Develop your knowledge of the equipment and materials required for interventional radiography

• Review advanced imaging (CT/MRI and Scintigraphy) and their uses in diagnosis, pre and post-surgical assessment of the surgical patient

 Speaker: Barbara Jardim Gomes IMVM MVMV CertAVP(DI) DipECVDI MRCVS

Barbara Jardim Gomes

IMVM MVMV CertAVP(DI) DipECVDI MRCVS

Barbara graduated with an integrated Master’s in Veterinary Medicine from the Technical University of Lisbon, Portugal in 2009. After graduation, she worked for a year in a small animal practice in Portugal. In 2011 Barbara moved to the United Kingdom to undertake a one-year rotating internship at a referral practice in Swindon followed by three years working in general practice. In 2015, she began a four-year senior clinical training scholarship in Diagnostic Imaging at the University of Glasgow’s Small Animal Hospital. During her residency, Barbara obtained the RCVS Certificate in Advanced Veterinary Practice in Diagnostic Imaging in 2017 and a Master’s degree investigating canine oesophageal disease in 2019. After completing the residency Barbara moved to the northeast of England to work in a multidisciplinary small animal referral practice and gained a Diploma in Small Animal Diagnostic Imaging in February 2020.

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By the end of this module, you will be able to prepare confidently for a wide variety of soft tissue procedures through your understanding of the underlying conditions and risks associated with the procedure.

Key learning objectives:

• Explain the principles of surgical technique in order to achieve a good surgical outcome

• Review the variables affecting the choice of suture material

• Revise the main pathways of haemostasis and discuss the options for controlling haemorrhage at surgery

• Demonstrate a good knowledge of appropriate surgical instrumentation for a variety of soft tissue surgical procedures through familiarity with nomenclature and instrument handling

• Understand the pathophysiology of GDV and the steps necessary to optimise outcomes and minimise morbidity/mortality

• Describe the pathophysiology of a variety of surgical conditions of the gastrointestinal tract, options for treatment and complications associated with it, including peritonitis

• Be familiar with surgery of the head and neck including Brachycephalic Obstructive Airway Syndrome, Maxillectomy/Mandibulectomy, TECA-LBO and ophthalmic surgery

• Understand the pathophysiology of pyometra and discuss options for treatment

• Demonstrate the correct handling, maintenance and storage of endoscopic surgical equipment for laparoscopy/thoracoscopy

• Review suture patterns and techniques

 Speaker: Darren Barnes MA VetMB CertSAS DipECVS MRCVS

Darren Barnes

MA VetMB CertSAS DipECVS MRCVS

Darren graduated from Cambridge University in 2006, spending a one year rotating small animal internship at the Animal Health Trust, Newmarket thereafter. He then spent 5 years in general practice in Bishops Stortford whilst studying for the RCVS Certificate in Small Animal Surgery under the supervision and guidance of Dick White. He returned to Cambridge University as a Staff Surgeon for one year before completing a three year Surgery Residency training at Dick White referrals. He was awarded the Diploma in Small Animal Surgery by the European College of Veterinary Surgeons in February 2017 and continues to work as a Specialist in Small Animal Surgery at Dick White Referrals.

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This module will expand your knowledge of fracture types, their repair and a variety of other orthopaedic procedures. Attentive and proactive rehabilitation nursing care is one of the most integral parts of successful postoperative outcomes. This module will give you the understanding to select which of these techniques is likely to be most useful in specific cases.

Key learning objectives:

• Consolidate your knowledge of a wide range of orthopaedic equipment including basic instrumentation, plating kits, external fixation kits, joint surgery, spinal surgery and arthroscopy

• Transform your understanding of the use, care and maintenance of orthopaedic equipment to maintain quality and efficient stock control in your clinic

• Have an overview of the different fracture types and options for their treatment including forelimb, hindlimb and skull

• Understand the principles and mechanics for specific joint surgical procedures including joint replacement

• Revise the pathophysiology of different conditions of the spine and the specific surgical procedures necessary to treat them

• Be familiar with the pros and cons of a variety of rehabilitation techniques and the importance of their role in the patient after specific surgical procedures

 Speaker: Alison Mann BSc (hons) Dip HE CVN Dip AVN (small animal) RVN

Alison Mann

BSc (hons) Dip HE CVN Dip AVN (small animal) RVN

Alison graduated from Writtle College in 2005 with a BSc (hons) in Equine Science and qualified as a small animal VN in 2009 whilst working in mixed practice in Bristol. In 2010 she moved to Langford Vets to work as a surgical nurse. During this time she has achieved the Dip AVN (small animal). For a few years she worked as a clinical teaching nurse for the University of Bristol, teaching practicals and lectures to undergraduate VNs in the Veterinary Nursing and Bioveterinary degree course. She moved back into clinical nursing in 2018, returning to the theatre team, becoming Head Theatre Nurse in 2019.

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As per Simon Sinek “Always plan for the fact that no plan goes to plan”. This module aims to give you the knowledge of potential complications that can arise and hence the confidence to deal with them effectively to ensure a positive outcome. Wound management is also an integral part of the nursing aftercare. This module will review wound types and discuss advances in their treatment.

Key learning objectives:

• Revise the collection, analysis and handling of surgical samples to maximise the chance of a diagnosis and minimise the risk of lost or non-diagnostic samples

• Become familiar with identifying surgical complications early and consolidate your knowledge of how to minimise them

• Develop your skills in managing surgical complications

• Transform your understanding of wound management to enable you to become comfortable handling some of the more challenging cases

• Recognise the importance of appropriate post-operative management after discharge and how to communicate this to the client

• Appreciate the importance of clinical governance in a veterinary practice

 Speaker: Darren Barnes MA VetMB CertSAS DipECVS MRCVS

Darren Barnes

MA VetMB CertSAS DipECVS MRCVS

Darren graduated from Cambridge University in 2006, spending a one year rotating small animal internship at the Animal Health Trust, Newmarket thereafter. He then spent 5 years in general practice in Bishops Stortford whilst studying for the RCVS Certificate in Small Animal Surgery under the supervision and guidance of Dick White. He returned to Cambridge University as a Staff Surgeon for one year before completing a three year Surgery Residency training at Dick White referrals. He was awarded the Diploma in Small Animal Surgery by the European College of Veterinary Surgeons in February 2017 and continues to work as a Specialist in Small Animal Surgery at Dick White Referrals.

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