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Life as a dermatology vet nurse

Written by: Emma Marshall
Published on: 20 Jul 2021
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Emma Marshall

I started veterinary nursing back in 2006. My journey began in general practice, where I remained for 10 years while working to qualify as an RVN and then became senior nurse.

In 2015, I made the move into referral nursing, where I started as an inpatient care RVN before quickly discovering my passion for dermatology nursing.

In 2018, I took on a new challenge as head RVN, where I remain today, for an innovative research and development company called Vet AI and its Joii app, which provides instant access to symptom checkers, and to video consultations with both vets and nurses.

Dermatology nursing is a discipline that I feel strongly passionate about. I love using my skills as an RVN to provide the support to patients and clients, which I feel RVNs are so adept at delivering, and that sits so nicely alongside the role of a referral clinician.

Supporting clinicians and pet owners

Every day as a dermatology nurse provides me with a new challenge; each patient and owner has very individual needs. Indeed, as I was discovering my passion for dermatology, it quickly became clear to me no one size fits all in this field.

One of the most rewarding aspects of being a dermatology RVN is being able to assess the needs of my patient and owner from the second they enter the consultation (be that in a traditional consultation room face to face or remotely via a telemedicine platform). In many cases, this is the start of a very lengthy journey as we know skin disease is often chronic and life-long in nature, and these owners need a great deal of emotional support along the way.

Indeed, this is one of my favourite aspects of the role – creating a bond with worried owners. Seeing their pet suffering with a chronic, unrelenting and relapsing skin condition can be very distressing and upsetting, as well as frustrating. It can take time to educate the owner, and explain what is happening to his or her pet and how best to manage it in the long term, as well as potentially making changes along the way. Rarely does a treatment plan stay the same for the life of a dermatology patient.

The day-to-day tasks that are undertaken as a dermatology RVN involve the following:

  • diary management
  • 1:1 work alongside a clinician
  • assisting during consultations
  • preparing patients for procedures
  • preparing and performing laboratory tests, both internal and external
  • communicating with other teams to schedule and perform procedures
  • assisting during procedures
  • client communication and support
  • general patient care
  • nurse clinics
  • pharmacy tasks

While in referral practice, our dermatology service offered consultations with a veterinary dermatologist part-time – I was then able to supplement this and provide almost a full-time service by offering our clients nurse clinic appointments. This then became an integral part of their ongoing treatment regimen.

These clinics would include immunotherapy injections, updates on progress, dietary advice, modifying treatment plans and schedules for owners – all under the guidance of the clinician. They also offered regular touchpoint support to owners, allowing them to feel reassured when they needed it. This is an area I particularly feel, as an RVN, I can be very involved in almost independently.

While all recommendation and treatment plans should be followed in accordance to the clinician’s specifications, as nurses, we are able to really take hold of the support and guidance owners need. This is often an area that is overlooked due to lack of interest and time in practice. I would encourage all nurses with a dermatology interest to highlight the importance of these clinics, and the benefits to both the practice and owners.

Move to telemedicine

Now I have moved away from a traditional bricks and mortar practice situation, and have taken on a role within telemedicine, I am still very much able to continue my role as a dermatology nurse, alongside my responsibilities as a head RVN for Joii.

I can provide invaluable support to owners within the comfort of their own homes via a video call. Although I am unable to perform physical tasks, I am still perfectly able to offer them support and knowledge to maintain their pet’s dermatological needs.

As part of Joii, we offer referral consultations with a veterinary dermatologist, and, as a dermatology nurse, much of my day-to-day life has remained the same. I still assess every individual patient’s clinical needs and adhere to the advice given by our dermatologist. I will often provide follow-up advice calls, organise external lab tests, and offer dietary and product advice and recommendations.

It is also great to be able to work alongside vets in practice building relationships, and promoting the more physical aspects of dermatology investigation and treatment, where required, and see the two aspects of the profession coming together.

Multimodal approach and advancement of topical therapies

We are fortunate in the world of dermatology that so many effective treatment options exist for our patients and most skin diseases require what we call a multimodal approach, whereby many different factors are addressed at the same time. This can be labour intensive for owners.

I often find compliance can be improved dramatically if I help them design a treatment timetable or spreadsheet that works with their daily lives so this is easy for them to follow long term, and monitor which treatments have been most effective.

We know the skin is the largest organ in the body and its surface perfectly designed for the effective delivery of topical medications; this is the case even in some circumstances where the patient has a particularly dense coat. We also know that, generally speaking, topical treatments are far safer than systemic treatments because they act locally rather than systemically, and are usually extremely well tolerated.

In recent years, the expansion of topical ranges to include alternative delivery methods such as mousses/foam, gels, wipes and sprays, in addition to traditional shampoos, has hugely improved owner compliance.

Conclusion

I enjoy dermatology nursing just as much as ever and it gives me great rewards to be so involved in the care of my patients.

My passion for the discipline remains in a way adapted for developing innovative technology and the use of telemedicine, which undoubtedly will form an important part of our future profession.

Case study

The author was involved in a case study within her telemedicine provision involving a male rescue cat with no obvious signs of environmental stress presenting with significant, self-induced symmetrical hair loss on his ventral chest and abdomen, and medial and lateral aspects of all four limbs. To view it, visit https://bit.ly/3BpqL7M