Radiographer or Diagnostic Imaging Technician

One distinct area which some RVNs choose to develop is diagnostic imaging. A practice with a high lameness caseload may have scope for a dedicated radiographer and some hospitals also offer advanced imaging modalities such as magnetic resonance imaging (MRI), computed tomography (CT) and nuclear scintigraphy. Diagnostic imaging RVNs can be utilised for the daily operation and maintenance of the equipment and machines involved in these different imaging modalities. A variety of diagnostic imaging continued professional development (CPD) courses are offered for RVNs with an interest in this area and manufacturers of specialised imaging equipment offer training tailored to their products.

Equine Neonatal Intensive Care Unit (NICU) Nurse

A small number of equine practices have a dedicated NICU due to having a high caseload of sick neonates. These practices tend to be in areas with a dense population of breeding stock, usually Thoroughbreds and are surrounded by studs. The NICU is seasonally busy and often extra RVNs are taken on for the foaling season. Foals in the NICU require very intensive nursing (Figure 19.1). The NICU RVN is able to develop practical skills, such as arterial blood sampling, rapidly due to the frequency of requirements for such procedures. Undertaking a seasonal role like this is a good way to experience life in other countries without committing to emigrating permanently. Sometimes, seasonal RVNs are offered permanent positions at the end of the season, and this is a great way to spend a few months experiencing what it is like at a practice before taking on a permanent role.

Senior Nurse

Experienced RVNs may take on a senior role within a practice which involves greater responsibility without traditional management duties. A senior RVN may be responsible for a specific area or department, mentor junior team members, provide a channel of communication between management and the nursing team, or take on extra areas of responsibility.

Nurse Clinics

Some RVNs find interacting with horse owners rewarding, enjoy client education and as such are drawn to providing nurse clinics. Clients can make an appointment to bring their horse to see an RVN, much like they would for a vet appointment. Procedures such as repeated blood sampling for monitoring chronic conditions, weight checks and nutritional advice or dressing changes can be offered as well as many other services. This role can give RVNs a greater sense of autonomy while still having the security of being based at a practice.

Ambulatory Nursing

In addition to nurse clinics, there is also scope to offer an ambulatory nursing service and this area is rapidly growing in popularity, as its benefits are becoming more widely recognised. Providing nursing care at the patient’s home means less stress, no requirement for transportation and convenience for the client. RVNs may be utilised to expand the service provided by the ambulatory team as well as sharing the established workload. Appointments may be offered for tasks such as taking radiographs, collecting blood samples, dressing changes, rehabilitation treatments and medication administration or demonstrations. Ambulatory RVNs could also offer appointments for behavioural issues and help clients and their horses with issues such as fear of clipping, needle‐shy patients or difficulty in administering oral medications.

Dental Technician

An area that some RVNs may wish to develop is dentistry and if this is something that they are passionate about, they may decide to undertake formal training to become a British Association of Equine Dental Technicians (BAEDT) qualified Equine Dental Technician (EDT). This qualification can be utilised in a hospital setting providing routine treatment alongside a more comprehensive dental service, or it could be used to provide an ambulatory dental service. Some veterinary surgeons choose to focus on dentistry as their preferred area of practice and offer a wide range of advanced dentistry procedures. Some RVNs may find they enjoy assisting with this type of work and might choose to undertake further training to develop skills and understanding of the procedures, as well as training on the use and maintenance of the specialist equipment.

Laboratory

Often, the RVN role involves some laboratory work and it is possible to develop this as an area of interest. In equine practice, it is more common for large laboratories to be attached to hospitals rather than stand‐alone as is common in small animal practice. Therefore, there may be more practical opportunities for RVNs to develop their interest in laboratory diagnostics. The laboratory technician role encompasses operating haematology and biochemistry machines as well as manual testing such as faecal worm egg counts, logging samples and recording results (Figure 19.2). In undertaking laboratory duties, an RVN may find an interest in a particular area, such as microbiology or polymerase chain reaction (PCR) testing and wish to focus on this and learn more about the technical aspects and how it relates to clinical practice.

Rehabilitation Nurse

Some conditions and treatments require an extensive rehabilitation period and while there is no longer a requirement for hospitalisation, it may not be possible for the care required to be given at home. In this case an RVN may be the ideal person to provide the extra care required. This role may be offered as an ambulatory service at the patient’s home, at the veterinary practice, or at another location such as a livery yard with useful facilities for rehabilitation, that are not available at the patient’s usual stabling. The role of the rehabilitation nurse may include hand walking, long‐reining, bandaging, administering medications or provision of therapies such as magnetic diathermy, K‐wave laser or shockwave (Figure 19.3). It is possible that this role could be encompassed within the ambulatory nursing role.

Physiotherapist

Further to the rehabilitation nurse role, it is possible to obtain a physiotherapy qualification which could be complemented by the knowledge and understanding an RVN has. To practice physiotherapy, you must obtain a qualification, and this can be achieved in one of three ways. Either a degree in veterinary physiotherapy, a human physiotherapy degree followed by further veterinary‐specific training, or a postgraduate certificate in veterinary physiotherapy, are required to practice as a physiotherapist for horses [1]. The equine physiotherapist’s role involves visiting and treating patients in their home environment, at a practice, or at a competition venue.

Pharmacy Roles and Suitably Qualified Person (SQP)

An interest in medication, stock control and dispensary management may lead RVNs to a role in their practice pharmacy or dispensary. An RVN may wish to undertake a further qualification to become an SQP which allows them to prescribe and dispense certain medications from a licensed premises. Registration with the Veterinary Medicines Directorate (VMD) and an approved body, following successful completion of examinations set by that body, is required to become an SQP [2]. Once qualified, an SQP is required to undertake regular CPD which is applicable and relevant to the role. The role of veterinary pharmacist is one which appears to be more prolific in the United States but is also increasingly seen in the United Kingdom. General Pharmaceutical Council (GPC) registered pharmacists receive some training on veterinary medications and are legally allowed to dispense and prescribe some veterinary products [3]. It is possible for an RVN with a veterinary nursing or animal science degree to undertake a veterinary pharmacy postgraduate course from postgraduate certificate to master’s degree level. Courses are also offered in veterinary pharmacy management if a master’s degree is not accessible, but this is an area you wish to pursue.

Clinical Supervisor (formally known as a clinical coach)

The role of clinical supervisor allows experienced RVNs to teach and mentor student veterinary nurses (SVNs) in a clinical setting. To become a clinical supervisor, an RVN must be employed within an RCVS‐accredited training practice and is required to undertake a clinical supervisor training course. Most veterinary nurse training providers offer clinical supervisor training for free or reduced cost if the supervisor’s SVN is enrolled with that training provider. Clinical supervisor training courses typically last one day and attendance of a refresher standardisation course is required every year. A clinical supervisor’s role involves working closely with the SVN, teaching skills, observing, supporting and assessing progress. The clinical supervisor is required to record in an online central skills log, the SVNs progress and performance in relation to specific clinical skills. The clinical supervisor should arrange regular meetings with their SVN and allocate teaching time, assessment time and regular practice sessions for clinical skills to support the student to obtain their veterinary nursing qualification.

Locum Nurse

While not as commonplace as in small animal practice, opportunities do exist for equine RVNs to work as locums. Locum nursing involves working at more than one practice for short‐term periods usually covering for maternity leave, sick leave or staff shortages. Some benefits of locum work can include:

• Freedom to select when and where you wish to work.
  
• Chances to experience different practices and facilities.
  
• Often a higher rate of pay than permanent roles.
  
• An opportunity to work in a practice and assess its suitability before committing to a permanent role.

Some negatives to this type of work could be:

• Lack of stability and regular income.
  
• Having to learn to work with new equipment, people and protocols frequently.
  
• A requirement to travel far from home depending on where demand is.

Locum RVNs may choose to be self‐employed, work under an umbrella company or make other arrangements with the practices they work for. When working under an umbrella company, many elements are taken care of such as invoicing, tax and insurance. However, the umbrella company will collect a fee for this. When working in a self‐employed capacity, it is important to check the most up to date requirements for insurance, tax, national insurance and invoicing. It may also be pertinent to consider income protection insurance as well.