Veterinary supervision

veterinarians must use their judgement when determining the level of oversight or supervision that is required of the person that has been instructed to administer a veterinary medicine and carry out the agreed course of action (e g a procedure or treatment) in considering whether to direct staff or students or veterinarians receiving training (the person) to carry out a treatment, the veterinarian must consider the risks associated with the restricted veterinary medicine (rvm), how difficult the treatment or procedure is in the light of any associated risks note that section 15 of the animal welfare act 1999 https //www legislation govt nz/act/public/1999/0142/latest/dlm50406 html#dlm50406 requires that veterinary students performing surgical procedures must do so under the direct supervision of a veterinarian the person must have been trained or is suitably qualified to treat the animal/s concerned, understands the associated risks and has the necessary experience and good judgement to react appropriately if any problem should arise the veterinarian must also be sure that they will be available in a reasonable timeframe to answer any call for assistance and should be satisfied that the person feels capable of carrying out the treatment competently and successfully lastly the supervising veterinarian must turn their mind to the aspect of consent – what would the owner reasonably expect of the veterinarian when giving their consent this should be included in the consent form and the wording may include, for example for a veterinary team undertaking training ‘our trained and qualified veterinary staff, which includes vet techs and vet nurses being supervised by a veterinarian, will be performing the procedure on your animal today’ or something similar for a student undertaking experience ‘ a suitably trained veterinary (nurse/tech) student being supervised by a veterinarian, will be performing the procedure on your animal today’ or something similar when ensuring the client is informed and their consent obtained, the veterinarian should use their judgement and acknowledge differing levels of risk associated with different procedures and varying competence of persons in training for example it would be prudent that a veterinarian disclose and ensure that a client is aware of all the facts should a veterinary student be performing a desexing procedure under supervision discussions for obtaining consent with clients should include who will be performing the procedure, their training and experience and what support will be provided to the person in order to address potential risks in summary the veterinarian must consider whether the competence of the individual that will be administering the rvm and performing the activity or procedure is appropriate i e whether the person has been suitably trained and is experienced and capable of performing the activity correctly in relation to the person’s competence, the level of supervision is appropriate the authorisation of the rvm is appropriate in the circumstances and the stewardship requirements will be met the health and safety risks associated with the rvm can be sufficiently mitigated any animal welfare issues that may arise can be appropriately managed adverse events and emergencies can be managed appropriately the authorised rvm will be used and stored safely, and their use appropriately reconciled noting that as the level of risk associated with the rvm increases so does the expectation of veterinary oversight and caution if the veterinarian is uncomfortable with the level of risk associated with the authorisation of an rvm it is acceptable to decline to authorise it definitions vcnz has interpreted the levels of supervision that a veterinarian could reasonably apply as follows the examples provided are intended to explain what is allowed and to promote concepts within the profession veterinary direction 'veterinary direction ' means the veterinarian instructs the person as to the tasks to be performed and is confident the person is suitably trained and experienced and capable of performing the activity correctly and the veterinarian is not necessarily present examples a veterinarian may authorise rvms to be administered for a junior veterinary nurse to premedicate an animal in hospital while they perform a house call in anticipation of performing an anaesthesia on their return suitably qualified and experienced veterinary nurse to sedate and prepare an animal for a radiography series on a patient while they are returning to from a house call suitably trained and experienced veterinary nurse to conduct adult cat and dog vaccinations while they are out of the clinic (refer to the guidance on authorisation of adult cat and dog vaccinations for administration by veterinary nurses during the current veterinary workforce shortage docid\ c9tiz4ppxnmmql26dk87u ) technician to perform teat sealing on a client’s heifers – the veterinarian does not need to be on farm trained and experienced technician to sedate using xylazine and local and perform disbudding on a client’s calves – the veterinarian does not need to be on farm trained and experienced technician to visit and perform an equine artificial insemination procedure the veterinarian does not need to be on farm veterinary supervision 'veterinary supervision ' means the veterinarian provides oversight to and ensures the activity is done correctly and that they are on the premises and readily available to provide advice and support to the person and ready to respond to a request for assistance if needed examples a veterinarian may authorise rvms to be administered for a suitably qualified and experienced veterinary nurse to anaesthetise (including for example performing the premedication, induction, intubation and anaesthetic maintenance) and perform prophylactic dental procedures (as far as current legislation allows) on a patient while they are also in the building performing consultations relatively inexperienced but trained technician to sedate calves with xylazine and instil local anaesthetic in order to disbud them while they meet with the farmer separately but remains on the premises (e g at the yards) relatively inexperienced yet trained technician to perform metrichecking procedures while they administer treatments separately but remains on the premises (e g at the yards) veterinarian being supervised while retraining to return to practice from parental leave performs a number of desexing surgeries while they are also in the building taking client calls direct and constant veterinary supervision 'direct and constant veterinary supervision ' means the veterinarian is physically present and giving the person their undivided personal attention and oversight to ensure the activity is performed correctly and the veterinarian is prepared to rapidly assist as needed examples a veterinarian may authorise rvms to be administered for a veterinary student to anaesthetise and perform a desexing surgery on a patient while they are present in surgery to observe the procedure (per section 15 https //www legislation govt nz/act/public/1999/0142/latest/dlm50406 html#dlm50406 of the animal welfare act 1999) veterinarians should use their judgment as to whether they need to be scrubbed and prepared to intervene or not depending on the level of risk associated with the procedure and the experience and confidence of the person being supervised relatively inexperienced veterinary technician (as part of a training program) to perform a local anaesthetic administration for disbudding, while they (the authorising veterinarian) are present relatively inexperienced veterinary technician (as part of a training program) to pass a nasogastric tube in a horse with colic, while they (the authorising veterinarian) are present veterinarian being supervised while retraining in production animals having only done companion animals previously performs their first caesarean section surgery on a cattle beast, while they (the authorising veterinarian) are present during the procedure veterinarians should use their judgment as to whether they need to be scrubbed and prepared to intervene or not depending on the level of risk associated with the procedure and the experience and confidence of the person being supervised