This is an interesting question that gets right to the heart of the distinction between a vet nurse and a vet (or, as they’re legally termed, veterinary surgeon).
The Veterinary Surgeons Act 1966
All medical or surgical treatment of animals in the UK is governed by the Veterinary Surgeons Act 1966. This clearly states that only a vet (someone who is a Member of the Royal College of Veterinary Surgeons, with the letters MRCVS after their name) can perform “acts of veterinary surgery”. To make matters as clear as possible, this law also specifies the four things that “count” as veterinary surgery:
- Diagnosing a disease or condition
- Giving advice about the treatment of a disease or condition relating to that diagnosis
- Prescribing medical or surgical treatments
- Performing surgical operations
However, the situation is nowadays a bit more complex. There is an appendix to the law called “Schedule 3”, which lists those tasks that, although strictly acts of veterinary surgery, can still legally be carried out by other people. There is scope here, for example, for minor medical treatment (e.g. giving tablets) to be given to a pet by their owner or a family member of the owner. There is also the legal capacity for vet nurses (i.e. those nurses who are themselves Registered with the RCVS) to carry out “any medical treatment or minor surgery (not involving entry into a body cavity)”.
But what can a nurse actually do?
So, a nurse can definitely treat an animal (which is good – it’s one of the things that they do!), and can even perform some types of surgery (e.g. lump removals, but not castrations, spays or dental extractions, for instance) if directed by a vet.
However, they cannot prescribe medicines (prescribing rights for POM-V medications are restricted to vets; NFA-VPS medications, such as some wormers and flea treatments can only be supplied by vets, pharmacists or people who have completed a special course to become AMTRA SQPs). Likewise, they cannot recommend a specific surgical procedure – only the vet can do that.
Finally, a veterinary nurse CANNOT diagnose a disease condition in an animal – this is a criminal offence and could result in the nurse being struck off or even prosecuted.
But the nurses are always giving advice!
Legally, that’s entirely different – a nurse can always give advice about how to manage the overall health and welfare of a patient. Indeed, that’s one of their main roles – vets are trained and qualified to find and fix specific medical problems, while nurses are complementary to them and are trained primarily to maintain the patient’s welfare in a more holistic sense.
So, if a condition has been diagnosed by a vet, a nurse can of course advise the owner on how best to look after them, or how to give a medication, or even check the pet over to see how they’re doing. Nurse-led clinics are really important in managing many chronic diseases, such as diabetes, for this reason. If a new symptom appears, the nurse is fully qualified to assess whether or not it is likely to be due to the underlying (known and diagnosed) medical condition or not – although strictly, it is up to the vet to make the final determination if it is a new disease.
In the case of parasites, however, the situation is slightly different. It would, for example, be strictly speaking illegal for a nurse to say “your dog is itching because of the fleas I can see here”. However, if you listen closely, that isn’t what they say – they’ll say something like “your dog is itching, and there are a lot of fleas which might well be the cause”. A nurse can certainly advise on flea control, or worm control, as long as they are not diagnosing – in other words, deciding that a particular symptom has been caused by a particular parasite or disease. Identifying the fleas present on the animal is not diagnosis, but deciding that they are definitely the cause of the itching (and not just a possible cause) would, strictly speaking, be.
That sounds like a really complicated grey area!
Yes, it is! However, although the two can get seem very similar, in legal terms there is a world of difference between diagnosing a patient and advising on a patient’s care. The former is the vet’s job, whereas the latter is the speciality of the vet nurse – and that’s one of the reasons we need both in practice!