October 14, 2024 • 23 mins
Discover how to maximise the value of your clinic's Veterinary Nurses and boost your clinic's revenue in this ideas-packed episode of Veterinary Voices.
Julie South catches up with Michelle Cameron, a New Zealand Registered Veterinary Nurse with extensive experience in emergency and critical care (ECC), and an Executive Member of the New Zealand Vet Nurse Association (NZVNA).
Michelle shares valuable insights on leveraging the skills of veterinary nursing professionals.
Key topics covered:
- Implementing nurse fees: Discover about charging for services such as overnight patient care and surgical preparation, which are often provided by nurses but not billed separately.
- Overcoming resistance: Understand the challenges of introducing new billing practices and how to address concerns from both staff and management.
- Improving clinic culture and profitability: Explore how recognising and valuing nurses' professional skills can positively impact both team morale and the clinic's bottom line.
- Practical examples: Gain specific ideas for billable nursing services, including hospitalisation fees, surgical prep, and nurse-led consultations.
This episode offers valuable insights for Veterinary Nurses looking to increase their professional value, Practice Managers seeking to optimise clinic operations, and Veterinarians interested in maximising team efficiency.
This episode can seriously be revolutionary in regards to how you approach veterinary nursing and clinic billing practices!
Struggling to get results from your job advertisements?
If so, then shining online as a good employer is essential to attracting the types of veterinary professionals who're a perfect cultural fit for your clinic.
The VetClinicJobs job board is the place to post your next job vacancy - to find out more get in touch with Lizzie at VetClinicJobs
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:04):
Welcome to Veterinary Voices Episode 207.
I'm your host, julie South,with a bit of a croaky voice.
With listeners in 1,400 citiesaround the world, veterinary
Voices celebrates all that'sgreat about working in New
Zealand's veterinary industry.
You can find back copies atveterinaryvoicesnz.
(00:25):
Veterinary Voices is brought toyou by VetStaff, new Zealand's
only recruitment agencyspecialising in helping
veterinary professionals findjobs that they're excited about
going to on Monday mornings inKiwi Vet Clinics, vetstaffconz.
(00:46):
This episode goes to air theweek after Veterinary Nurse
Awareness Week in New Zealand.
By the time you're listening tothis, the NZ VNA will have
announced this year's Vet Nurseof the Year.
Whoever you are,congratulations.
I look forward to having you asa guest on this show in the not
(01:08):
too distant future.
Today, I'm really excited toshare the chat I had with
Michelle Cameron.
Michelle's an executive memberof the NZVNA, the New Zealand
Vet Nurse Association, andbecause she talks about
something close to my heart andto the two vet nurses on my team
, which is how vet nurses can upthe ante and raise the
(01:31):
perception of theirprofessionalism by including
their fees and clinic invoices.
I'm really excited to bringthis show to you, vet nurses.
Stay tuned, because if you wantideas on how you can earn more
for you and your clinic.
This is one of the episodesthat tells you how to do that.
(01:52):
So who is Michelle Cameron?
She's a registered veterinarynurse who graduated from Massey
University with a diploma inveterinary Nursing in 2002.
In 2016, she gained her VN CERT, ecc, which is the Veterinary
Nursing Certificate in Emergencyand Critical Care in the UK.
(02:15):
Michelle worked in New Zealandfor a few years before heading
off on her OE to the UK andEurope, where she ended up
spending most of her time inGlasgow, scotland.
As a veterinary nurse.
She locummed in many differentclinics across the UK the RSPCA,
an orthopedic specialist clinicand an after-hours emergency
(02:37):
clinic.
Michelle undertook assessortraining whilst in the UK, which
is now a clinical coachingwhich the New Zealand version is
based on.
Michelle currently works in abusy as in busy mixed practice
in New Zealand's rural NorthIsland under the job description
of clinical operations andadministration.
(02:59):
As well as being a registeredveterinary nurse working in a
four clinic practice, michelleis also an executive member of
the NZVNA.
When she's not busy at work,she's busy at home, being a mum
and a wife.
Her family consists of twohuman children, three feline fur
babies, as well as Michelle andher husband.
(03:21):
Stay tuned, because Michelledelivers heaps as in heaps of
value, both this week and nextweek.
She talks about ways thatnurses can start including their
time on bills, about how theycan help pay for some new kit,
new gear in their clinic, how toovercome resistance when
(03:41):
they're sometimes seen as beingperhaps a little bit less than
the highly skilled veterinaryprofessional that they really
are.
This is part one of two Heads up.
You'll notice that the audioisn't as good as it usually is.
Unfortunately, michelle and Ihad heaps of technical issues
getting this episode recorded,which was a little while back,
(04:05):
and the 200 plus episodes thatI've recorded of this podcast.
I've never had a show with theissues that we experienced here.
It was pretty obvious to methat when we had those
experience that Michelle hadworked in ECC, emergency and
Critical Care, because shedidn't get flustered once.
(04:26):
Even when the first recordingplatform developed attitude, we
failed on Zoom, ended up onTeams, which failed a few times
as well.
All through that, michellemaintained her cool and calm.
We joined the conversation herewhere I asked Michelle about how
vet nurses can earn their keepin clinic.
(04:47):
And oh, quickly.
If the term VOI is a new one toyou.
It stands for VeterinaryOperating Instructions.
Michelle.
We are talking about, to put itpretty crudely, pretty bluntly,
nurses earning their keep.
(05:08):
Now, we all know that they dothat.
I hope I hope listeners havethat same respect as well, and
we all appreciate that there islots of potential, lots of
untapped potential in clinicwith veterinary nursing skills.
What do you think could be thefirst step in a clinic where
(05:35):
nothing that a nurse does isbeing charged for?
Where do you think they couldstart?
Speaker 2 (05:47):
for where do you think they could start?
Where they can start isdepending on what their skill
sets are and where the nursesare being utilized.
In the beginning you will havea nurse that's interested in
surgery or a nurse that'sinterested in consulting, and
those are two completelydifferent areas in which fees
can be associated with thenurses under that kind of
umbrella, where they are pullingin those fees or fees
(06:09):
associated with them as well.
So I would say likely it'sgoing to be in clinic, out the
back, where they've got theirprep room and the hospital and
we have patients that stayovernight.
The patients that stayovernight will generally have a
fee associated with ahospitalisation stay and this is
(06:31):
where often in the past is acharge or a price that is
removed when people don't feelthat their invoice is correct
with the estimations and theytake off that hospital overnight
stay.
That hospital overnight stay inmy experience is used for the
(06:53):
person that gets up in themorning, goes in first thing
before everybody else goes in inthe morning.
They check all the animals,make sure everyone's okay.
They will take the dogs out andwalk them.
They'll clean out those kennelsthat they've been in.
They'll take the beds out.
They'll wash them, remove allthe bowls, clean them all up and
(07:14):
then they'll start with theirmedications and their feeding
and that sort of thing.
And that's also sort of duringthe day that hospital care
walking the dogs, feeding,toileting, et cetera.
Cats again litter trays and allthat kind of thing as well.
And that fee is not a vet feeis that that's all done by a
(07:34):
nurse.
At this stage, and in the pastI suppose this has always been a
job associated with someonethat doesn't have any
qualifications or skills, andnow we do have those
qualifications available for thenurses or veterinary nurses, I
should say that they can bebringing in those fees for them
(07:56):
as well.
So when the charge is removedfrom that hospitalisation, it
means that basically you'resaying that all that time that
that person has spent on thatpatient means nothing, means
absolutely nothing that could be.
You know there's lots ofdifferent ways, prices and
charges and numbers and you knowmoney value to that and it
(08:17):
means something different toeach practice as well.
So I'm not going to go intoexact money, but just the fact
that it is time and it is money,creating fees where that can be
taken away from the veterinarynursing sort of side under that
umbrella bracket of the feesthat they can create as well.
So a starting point is makingsure that we're invoicing that
(08:39):
hospital stay for that patient,because that's the be all and
end all At the beginning.
We have patients that stayovernight, we have patients that
stay during the day Again,hospital stays often will get
removed as well for that andthat's that person again walking
, feeding, medicating, recordingall the things that they do as
well.
That would be one of the thingsthat I would start with.
(09:00):
And also the other thing thatwe're doing in all of our
practices is, generally patientswill come in and have surgery
and the surgery you have a vetthat will do all the veterinary
kind of things with regards tooperating, making decisions on
what medications they're using,etc.
(09:20):
And then you'll have a nursewho's going to be monitoring the
anaesthetic, gatheringeverything ready, preparing that
patient, preparing that surgeryready, and that can also be
created into a fee for thenursing side, a nurse
preparation fee for surgery, orit could be a nurse preparation
fee for a procedure as well.
(09:41):
So usually the fee can beassociated with time.
So 10 minute units is a goodway to start and depending on
how long that procedure takes.
You know they can increase thattime component with it as well.
Associated with the other thingsthat we're doing is that I've
always said the um, you know thewhen you're doing a bandage on
(10:04):
a conscious patient, sometimesthe nurses will do it in pairs a
nurse will hold the patient andthen the nurse.
The other nurse will put thebandage on, or you're the nurse
is holding the patient and thenthe vet's putting the bandage on
.
The time associated with thatprocedure would always go to the
vet, so the vet time wouldalways be associated with that
bandage.
Putting that on it could take20 minutes, depending on if
(10:27):
they're doing a splint andwaiting for it to dry and things
, but you always need a nurse tohold that patient.
Sometimes you need two as well.
So wherever there's vet timethere should always be a
corresponding nurse time as well, and that is associated in the
fees.
With regards to in thebackground fees, I suppose, as
well.
Those are the main ones that Iwould start with and then,
(10:50):
depending on if people are doingconsulting and allowing their
nurses to do consults, that's awhole nother bracket of fees
where they are actually doingtheir own consulting with the
VOI training under the directionof a vet and being able to
start doing their vaccinations,or pen stands, cytopoint
injections, those repeat ones,not the initial ones, where the
(11:12):
vet needs to prescribe theminitially as well.
So that's probably where Iwould start.
Speaker 1 (11:19):
Begin with, julie, you raise some great points
there as I was listening to you.
To downplay, to not includework that a vet nurse does is
almost insulting for him or herand it's not a great way to
build great culture.
Speaker 2 (11:40):
No, not at all, and that's why we fight so hard to
make sure that the nurses arehaving their time valued as well
as a professional.
All of the nurses that I workwith are registered vet nurses.
They're not just people off thestreet, as they were in the
past.
I've been a nurse for a verylong time and the stigma that
still comes from way back 20years ago plus is still with us
(12:04):
today with regards to nurses notbeing recognised with their
professional titles, not beingrecognised with their
qualifications and things likethat as well.
So it's something that we feelquite strongly about that.
You know we can help, and inways that is beneficial to
everyone, to the practice.
They're part of it.
They, you know.
(12:24):
Often we hear people sayingthat we'd fall down without them
.
You know you don't have a vetand a nurse.
You know it's not.
Speaker 1 (12:31):
It's not going to last.
When you've introduced this,what kind of resistance or
obstacles have you had toovercome in clinic and how did
you get over them?
Speaker 2 (12:42):
I think the main resistance is worked through.
Sometimes we've had withinclinic we may have.
For instance, we have differentadmin teams, we have small
animal teams, large animal teams, etc.
We have small animal teams,large animal teams, etc.
We are looking at resistancewithin teams with regard to
(13:03):
something that we've nevercharged for before, but did the
consult or something like thatand now we're charging.
There's always a questionraised about why we're doing
that now, and the responsegenerally is because why
shouldn't we?
Why are we doing a consultationwith a patient and a client
without having a fee associatedwith it?
(13:23):
With a consultation fee Withthe nursing sort of consults
versus a vet consult, it's a lotless, but it's still a fee that
we can use for the nurses invaluing their time, I suppose as
well, and their skills, whichthen frees up the vet to do
other things.
Speaker 1 (13:43):
Also with that though and I'm wearing my former
business coaching hat here thereis a cost.
There's a direct cost to theclinic to provide that service.
Yeah, there's all the overheadsthat go with turning on the
lights and opening the doors ina clinic, and then there's the
(14:04):
overheads of what it actuallycosts to staff the clinic.
So it's got to be good for theclinic to start recouping some
of these costs, and also it'sgood for the clinic because it,
I believe, live according toJulie, it improves the morale
and shows respect for theprofessionally qualified people
(14:30):
that work out the back.
Speaker 2 (14:33):
Absolutely.
We have had many timesthroughout the years where we've
had different you know how youhave your wellness webinars and
things where they will show uson our screens various people
talking, and usually it's somesort of American one.
It was talking about fees andshowing value for your fees, and
(14:57):
this wasn't just for vets, itwas for nurses, it was for the
admin staff at reception,because if they don't believe
what we're doing and they can'texplain to the client that's
standing on the other side ofthe counter why we have charged
what we have charged, then it'sfalling apart.
If they can understand wherethat total amount comes from and
(15:22):
they can have that explained tothem right at the start, before
they get that big bill, as theyput it.
If we can explain that to them,then the client is always much
happier.
They're well informed.
That communication has happenedreally well.
The estimation at the beginninghas happened and then the fees
are able to be included in thatas well and it can be explained
(15:47):
why that's there.
Why is there a nurse feeassociated with my surgery for
my dog that had, I don't know, atoe removal, something?
There's also a bandage feethere.
That can be explained becausethe nurse is there holding that
dog, putting that bandage on orusing their skills.
The nurse was there monitoringyour patient the whole time for
(16:08):
the anesthetic.
What would happen?
What do you think?
When you're talking to people,how else can you explain it?
Would you rather them not havesomebody there watching them?
I'm not sure.
I think that we all know whatthat answer is, but they don't
understand because they don't goout there.
They don't see it as well.
So using that tool, I supposefor people is that making the
(16:32):
entire clinic understand wherethese fees are coming from, is a
big thing before you can startputting it on people as well, on
the on the clients end andthings as well, I would say
Julie.
Speaker 1 (16:49):
I just want to interrupt this chat for a very
brief moment to share somethingimportant for clinics doing
their own recruitmentvetclinicjobscom.
You probably already know andagree that well, traditional
recruitment methods just aren'tcutting it anymore, which means
a new and a different approachis necessary.
(17:10):
New and a different approach isnecessary.
This means that you need todifferentiate and showcase what
makes your clinic a great placeto work.
Vet Clinic Jobs is all aboutboosting your clinic's employer
brand not to be confused withyour clinic's client brand and
VetClinicJobscom is totallyaffordable brand and
(17:36):
vetclinicjobscom is totallyaffordable.
Give your recruitment marketingthe oomph it needs through
vetclinicjobscom.
Now let's get back to today'sshow.
I would just like to saysomething quite, I think,
provocative here, and this issomething that I have been
saying for the last five yearsand I honestly believe, hand on
(17:58):
hearts, that hand on my heartthat clinics will function a lot
better and they will be a lotmore profitable.
Even though it doesn't soundlike it, it If and when clinics
have dedicated receptionists whoare not nurses, and the reason
(18:19):
I say that is I could be areceptionist.
I would be a really goodreceptionist.
I believe I can do that job.
I cannot do your job.
The skill set is completelydifferent.
I don't have the training, andyet I think that when clinics
(18:40):
put highly qualified, highlyskilled nurses at the front of
house which is great becausethey've usually got the people
skills house which is greatbecause they've usually got the
people skills but they'reputting them front of house, the
clients that come in kind ofdiscount the skills, the medical
(19:00):
skills.
If you go to your doctor, yourdoctor is not going to put one
of his highly skilled registerednurses manning the phones on
the front desk, absolutely.
And yet that's what happens ina veterinary clinic.
When Tanya and I are workingwith clinics in a consultancy
(19:22):
type capacity, one of the firstthings that we try really hard
to get them to do is to look athow they can get their
receptionist as a dedicated,non-nurse receptionist Unless
it's a nurse who might bereturning to the workforce.
(19:46):
Perhaps they are one of those20 years ago nurses that
pre-diploma, pre-certificate andthey are absolutely happy to be
on the front desk.
They don't want to do surgicalnursing again.
That's different, but I dothink it's a total waste of
(20:06):
skills.
I'm not discounting the skillsthat receptionists have, because
it's a skilled job as well.
I had a conversation a few yearsago with a principal.
It was a small, independent.
Well, it wasn't so small, butit was an independent clinic.
I was talking with one of thedirectors and I was saying to
(20:28):
him that you need to startcharging for your nurses.
It was almost insulting to him.
He could not get his headaround the fact that nurses are
valuable.
How do you suggest if there's anurse listening here or a
practice manager and wants toput it to their principal?
(20:49):
How do you suggest that theybroach that?
Speaker 2 (20:51):
it to their principal .
How do you suggest that theybroach that?
Well, I would first of all comeup with a list of things that
you could bring to the clinic.
First of all, there's lots ofdifferent ideas up on you know,
I suppose, the NZVNA website.
There's lots of things onsocial media and things that
people are doing as well.
People are talking quite a lotwith regards to nurses and them
(21:16):
feeling that they're not beingwell utilised.
So there's lots of differentideas that you can bring to the
table, sound them out, and ifyou are able and competent to be
able to do these things, thenwhy shouldn't you?
We have these veterinary nursesas professionals in their own
right, basically, and they havea fee earning potential so you
(21:39):
can bring revenue into theclinic.
So how can that be bad?
At the end of the day, we canhave nurse fees under that
umbrella, where it can covertheir entire wage or even
supersede it, depending on howmany nurses you've got in the
clinic that works with you.
So I would say, get your listready, see what you can do, even
(22:02):
if it's if they're not going togive you consulting time, maybe
out the back, you know thingswhere you can be monitoring
anesthetics and things like thatas well.
That can all go under a nurseumbrella kind of fee and you can
build.
It doesn't have to start with50 different fees as well.
Start with two or three.
See what happens.
Speaker 1 (22:25):
I hope you found this really helpful.
Regardless of whatever role youhave in your veterinary clinic,
there's something in thisepisode, I believe, for everyone
, and the same for next week aswell.
So make sure you tune in nextweek as well, because Michelle
talks about different invoiceline items that not only make a
(22:46):
difference to a veterinarynurse's self-esteem because
they're being recognized asadding value, but also make a
positive difference to a vetclinic's bottom line.
So stay tuned for that Untilnext week.
This is Julie South signing offand inviting you to go out
(23:06):
there and be the mostfantabulous, resilient version
of you.
You can be Kakiti Ano.
Welcome to Veterinary Voices Episode 207.
I'm your host, julie South,with a bit of a croaky voice.
With listeners in 1,400 citiesaround the world, veterinary
Voices celebrates all that'sgreat about working in New
Zealand's veterinary industry.
You can find back copies atveterinaryvoicesnz.
(00:25):
Veterinary Voices is brought toyou by VetStaff, new Zealand's
only recruitment agencyspecialising in helping
veterinary professionals findjobs that they're excited about
going to on Monday mornings inKiwi Vet Clinics, vetstaffconz.
(00:46):
This episode goes to air theweek after Veterinary Nurse
Awareness Week in New Zealand.
By the time you're listening tothis, the NZ VNA will have
announced this year's Vet Nurseof the Year.
Whoever you are,congratulations.
I look forward to having you asa guest on this show in the not
(01:08):
too distant future.
Today, I'm really excited toshare the chat I had with
Michelle Cameron.
Michelle's an executive memberof the NZVNA, the New Zealand
Vet Nurse Association, andbecause she talks about
something close to my heart andto the two vet nurses on my team
, which is how vet nurses can upthe ante and raise the
(01:31):
perception of theirprofessionalism by including
their fees and clinic invoices.
I'm really excited to bringthis show to you, vet nurses.
Stay tuned, because if you wantideas on how you can earn more
for you and your clinic.
This is one of the episodesthat tells you how to do that.
(01:52):
So who is Michelle Cameron?
She's a registered veterinarynurse who graduated from Massey
University with a diploma inveterinary Nursing in 2002.
In 2016, she gained her VN CERT, ecc, which is the Veterinary
Nursing Certificate in Emergencyand Critical Care in the UK.
(02:15):
Michelle worked in New Zealandfor a few years before heading
off on her OE to the UK andEurope, where she ended up
spending most of her time inGlasgow, scotland.
As a veterinary nurse.
She locummed in many differentclinics across the UK the RSPCA,
an orthopedic specialist clinicand an after-hours emergency
(02:37):
clinic.
Michelle undertook assessortraining whilst in the UK, which
is now a clinical coachingwhich the New Zealand version is
based on.
Michelle currently works in abusy as in busy mixed practice
in New Zealand's rural NorthIsland under the job description
of clinical operations andadministration.
(02:59):
As well as being a registeredveterinary nurse working in a
four clinic practice, michelleis also an executive member of
the NZVNA.
When she's not busy at work,she's busy at home, being a mum
and a wife.
Her family consists of twohuman children, three feline fur
babies, as well as Michelle andher husband.
(03:21):
Stay tuned, because Michelledelivers heaps as in heaps of
value, both this week and nextweek.
She talks about ways thatnurses can start including their
time on bills, about how theycan help pay for some new kit,
new gear in their clinic, how toovercome resistance when
(03:41):
they're sometimes seen as beingperhaps a little bit less than
the highly skilled veterinaryprofessional that they really
are.
This is part one of two Heads up.
You'll notice that the audioisn't as good as it usually is.
Unfortunately, michelle and Ihad heaps of technical issues
getting this episode recorded,which was a little while back,
(04:05):
and the 200 plus episodes thatI've recorded of this podcast.
I've never had a show with theissues that we experienced here.
It was pretty obvious to methat when we had those
experience that Michelle hadworked in ECC, emergency and
Critical Care, because shedidn't get flustered once.
(04:26):
Even when the first recordingplatform developed attitude, we
failed on Zoom, ended up onTeams, which failed a few times
as well.
All through that, michellemaintained her cool and calm.
We joined the conversation herewhere I asked Michelle about how
vet nurses can earn their keepin clinic.
(04:47):
And oh, quickly.
If the term VOI is a new one toyou.
It stands for VeterinaryOperating Instructions.
Michelle.
We are talking about, to put itpretty crudely, pretty bluntly,
nurses earning their keep.
(05:08):
Now, we all know that they dothat.
I hope I hope listeners havethat same respect as well, and
we all appreciate that there islots of potential, lots of
untapped potential in clinicwith veterinary nursing skills.
What do you think could be thefirst step in a clinic where
(05:35):
nothing that a nurse does isbeing charged for?
Where do you think they couldstart?
Speaker 2 (05:47):
for where do you think they could start?
Where they can start isdepending on what their skill
sets are and where the nursesare being utilized.
In the beginning you will havea nurse that's interested in
surgery or a nurse that'sinterested in consulting, and
those are two completelydifferent areas in which fees
can be associated with thenurses under that kind of
umbrella, where they are pullingin those fees or fees
(06:09):
associated with them as well.
So I would say likely it'sgoing to be in clinic, out the
back, where they've got theirprep room and the hospital and
we have patients that stayovernight.
The patients that stayovernight will generally have a
fee associated with ahospitalisation stay and this is
(06:31):
where often in the past is acharge or a price that is
removed when people don't feelthat their invoice is correct
with the estimations and theytake off that hospital overnight
stay.
That hospital overnight stay inmy experience is used for the
(06:53):
person that gets up in themorning, goes in first thing
before everybody else goes in inthe morning.
They check all the animals,make sure everyone's okay.
They will take the dogs out andwalk them.
They'll clean out those kennelsthat they've been in.
They'll take the beds out.
They'll wash them, remove allthe bowls, clean them all up and
(07:14):
then they'll start with theirmedications and their feeding
and that sort of thing.
And that's also sort of duringthe day that hospital care
walking the dogs, feeding,toileting, et cetera.
Cats again litter trays and allthat kind of thing as well.
And that fee is not a vet feeis that that's all done by a
(07:34):
nurse.
At this stage, and in the pastI suppose this has always been a
job associated with someonethat doesn't have any
qualifications or skills, andnow we do have those
qualifications available for thenurses or veterinary nurses, I
should say that they can bebringing in those fees for them
(07:56):
as well.
So when the charge is removedfrom that hospitalisation, it
means that basically you'resaying that all that time that
that person has spent on thatpatient means nothing, means
absolutely nothing that could be.
You know there's lots ofdifferent ways, prices and
charges and numbers and you knowmoney value to that and it
(08:17):
means something different toeach practice as well.
So I'm not going to go intoexact money, but just the fact
that it is time and it is money,creating fees where that can be
taken away from the veterinarynursing sort of side under that
umbrella bracket of the feesthat they can create as well.
So a starting point is makingsure that we're invoicing that
(08:39):
hospital stay for that patient,because that's the be all and
end all At the beginning.
We have patients that stayovernight, we have patients that
stay during the day Again,hospital stays often will get
removed as well for that andthat's that person again walking
, feeding, medicating, recordingall the things that they do as
well.
That would be one of the thingsthat I would start with.
(09:00):
And also the other thing thatwe're doing in all of our
practices is, generally patientswill come in and have surgery
and the surgery you have a vetthat will do all the veterinary
kind of things with regards tooperating, making decisions on
what medications they're using,etc.
(09:20):
And then you'll have a nursewho's going to be monitoring the
anaesthetic, gatheringeverything ready, preparing that
patient, preparing that surgeryready, and that can also be
created into a fee for thenursing side, a nurse
preparation fee for surgery, orit could be a nurse preparation
fee for a procedure as well.
(09:41):
So usually the fee can beassociated with time.
So 10 minute units is a goodway to start and depending on
how long that procedure takes.
You know they can increase thattime component with it as well.
Associated with the other thingsthat we're doing is that I've
always said the um, you know thewhen you're doing a bandage on
(10:04):
a conscious patient, sometimesthe nurses will do it in pairs a
nurse will hold the patient andthen the nurse.
The other nurse will put thebandage on, or you're the nurse
is holding the patient and thenthe vet's putting the bandage on
.
The time associated with thatprocedure would always go to the
vet, so the vet time wouldalways be associated with that
bandage.
Putting that on it could take20 minutes, depending on if
(10:27):
they're doing a splint andwaiting for it to dry and things
, but you always need a nurse tohold that patient.
Sometimes you need two as well.
So wherever there's vet timethere should always be a
corresponding nurse time as well, and that is associated in the
fees.
With regards to in thebackground fees, I suppose, as
well.
Those are the main ones that Iwould start with and then,
(10:50):
depending on if people are doingconsulting and allowing their
nurses to do consults, that's awhole nother bracket of fees
where they are actually doingtheir own consulting with the
VOI training under the directionof a vet and being able to
start doing their vaccinations,or pen stands, cytopoint
injections, those repeat ones,not the initial ones, where the
(11:12):
vet needs to prescribe theminitially as well.
So that's probably where Iwould start.
Speaker 1 (11:19):
Begin with, julie, you raise some great points
there as I was listening to you.
To downplay, to not includework that a vet nurse does is
almost insulting for him or herand it's not a great way to
build great culture.
Speaker 2 (11:40):
No, not at all, and that's why we fight so hard to
make sure that the nurses arehaving their time valued as well
as a professional.
All of the nurses that I workwith are registered vet nurses.
They're not just people off thestreet, as they were in the
past.
I've been a nurse for a verylong time and the stigma that
still comes from way back 20years ago plus is still with us
(12:04):
today with regards to nurses notbeing recognised with their
professional titles, not beingrecognised with their
qualifications and things likethat as well.
So it's something that we feelquite strongly about that.
You know we can help, and inways that is beneficial to
everyone, to the practice.
They're part of it.
They, you know.
(12:24):
Often we hear people sayingthat we'd fall down without them
.
You know you don't have a vetand a nurse.
You know it's not.
Speaker 1 (12:31):
It's not going to last.
When you've introduced this,what kind of resistance or
obstacles have you had toovercome in clinic and how did
you get over them?
Speaker 2 (12:42):
I think the main resistance is worked through.
Sometimes we've had withinclinic we may have.
For instance, we have differentadmin teams, we have small
animal teams, large animal teams, etc.
We have small animal teams,large animal teams, etc.
We are looking at resistancewithin teams with regard to
(13:03):
something that we've nevercharged for before, but did the
consult or something like thatand now we're charging.
There's always a questionraised about why we're doing
that now, and the responsegenerally is because why
shouldn't we?
Why are we doing a consultationwith a patient and a client
without having a fee associatedwith it?
(13:23):
With a consultation fee Withthe nursing sort of consults
versus a vet consult, it's a lotless, but it's still a fee that
we can use for the nurses invaluing their time, I suppose as
well, and their skills, whichthen frees up the vet to do
other things.
Speaker 1 (13:43):
Also with that though and I'm wearing my former
business coaching hat here thereis a cost.
There's a direct cost to theclinic to provide that service.
Yeah, there's all the overheadsthat go with turning on the
lights and opening the doors ina clinic, and then there's the
(14:04):
overheads of what it actuallycosts to staff the clinic.
So it's got to be good for theclinic to start recouping some
of these costs, and also it'sgood for the clinic because it,
I believe, live according toJulie, it improves the morale
and shows respect for theprofessionally qualified people
(14:30):
that work out the back.
Speaker 2 (14:33):
Absolutely.
We have had many timesthroughout the years where we've
had different you know how youhave your wellness webinars and
things where they will show uson our screens various people
talking, and usually it's somesort of American one.
It was talking about fees andshowing value for your fees, and
(14:57):
this wasn't just for vets, itwas for nurses, it was for the
admin staff at reception,because if they don't believe
what we're doing and they can'texplain to the client that's
standing on the other side ofthe counter why we have charged
what we have charged, then it'sfalling apart.
If they can understand wherethat total amount comes from and
(15:22):
they can have that explained tothem right at the start, before
they get that big bill, as theyput it.
If we can explain that to them,then the client is always much
happier.
They're well informed.
That communication has happenedreally well.
The estimation at the beginninghas happened and then the fees
are able to be included in thatas well and it can be explained
(15:47):
why that's there.
Why is there a nurse feeassociated with my surgery for
my dog that had, I don't know, atoe removal, something?
There's also a bandage feethere.
That can be explained becausethe nurse is there holding that
dog, putting that bandage on orusing their skills.
The nurse was there monitoringyour patient the whole time for
(16:08):
the anesthetic.
What would happen?
What do you think?
When you're talking to people,how else can you explain it?
Would you rather them not havesomebody there watching them?
I'm not sure.
I think that we all know whatthat answer is, but they don't
understand because they don't goout there.
They don't see it as well.
So using that tool, I supposefor people is that making the
(16:32):
entire clinic understand wherethese fees are coming from, is a
big thing before you can startputting it on people as well, on
the on the clients end andthings as well, I would say
Julie.
Speaker 1 (16:49):
I just want to interrupt this chat for a very
brief moment to share somethingimportant for clinics doing
their own recruitmentvetclinicjobscom.
You probably already know andagree that well, traditional
recruitment methods just aren'tcutting it anymore, which means
a new and a different approachis necessary.
(17:10):
New and a different approach isnecessary.
This means that you need todifferentiate and showcase what
makes your clinic a great placeto work.
Vet Clinic Jobs is all aboutboosting your clinic's employer
brand not to be confused withyour clinic's client brand and
VetClinicJobscom is totallyaffordable brand and
(17:36):
vetclinicjobscom is totallyaffordable.
Give your recruitment marketingthe oomph it needs through
vetclinicjobscom.
Now let's get back to today'sshow.
I would just like to saysomething quite, I think,
provocative here, and this issomething that I have been
saying for the last five yearsand I honestly believe, hand on
(17:58):
hearts, that hand on my heartthat clinics will function a lot
better and they will be a lotmore profitable.
Even though it doesn't soundlike it, it If and when clinics
have dedicated receptionists whoare not nurses, and the reason
(18:19):
I say that is I could be areceptionist.
I would be a really goodreceptionist.
I believe I can do that job.
I cannot do your job.
The skill set is completelydifferent.
I don't have the training, andyet I think that when clinics
(18:40):
put highly qualified, highlyskilled nurses at the front of
house which is great becausethey've usually got the people
skills house which is greatbecause they've usually got the
people skills but they'reputting them front of house, the
clients that come in kind ofdiscount the skills, the medical
(19:00):
skills.
If you go to your doctor, yourdoctor is not going to put one
of his highly skilled registerednurses manning the phones on
the front desk, absolutely.
And yet that's what happens ina veterinary clinic.
When Tanya and I are workingwith clinics in a consultancy
(19:22):
type capacity, one of the firstthings that we try really hard
to get them to do is to look athow they can get their
receptionist as a dedicated,non-nurse receptionist Unless
it's a nurse who might bereturning to the workforce.
(19:46):
Perhaps they are one of those20 years ago nurses that
pre-diploma, pre-certificate andthey are absolutely happy to be
on the front desk.
They don't want to do surgicalnursing again.
That's different, but I dothink it's a total waste of
(20:06):
skills.
I'm not discounting the skillsthat receptionists have, because
it's a skilled job as well.
I had a conversation a few yearsago with a principal.
It was a small, independent.
Well, it wasn't so small, butit was an independent clinic.
I was talking with one of thedirectors and I was saying to
(20:28):
him that you need to startcharging for your nurses.
It was almost insulting to him.
He could not get his headaround the fact that nurses are
valuable.
How do you suggest if there's anurse listening here or a
practice manager and wants toput it to their principal?
(20:49):
How do you suggest that theybroach that?
Speaker 2 (20:51):
it to their principal .
How do you suggest that theybroach that?
Well, I would first of all comeup with a list of things that
you could bring to the clinic.
First of all, there's lots ofdifferent ideas up on you know,
I suppose, the NZVNA website.
There's lots of things onsocial media and things that
people are doing as well.
People are talking quite a lotwith regards to nurses and them
(21:16):
feeling that they're not beingwell utilised.
So there's lots of differentideas that you can bring to the
table, sound them out, and ifyou are able and competent to be
able to do these things, thenwhy shouldn't you?
We have these veterinary nursesas professionals in their own
right, basically, and they havea fee earning potential so you
(21:39):
can bring revenue into theclinic.
So how can that be bad?
At the end of the day, we canhave nurse fees under that
umbrella, where it can covertheir entire wage or even
supersede it, depending on howmany nurses you've got in the
clinic that works with you.
So I would say, get your listready, see what you can do, even
(22:02):
if it's if they're not going togive you consulting time, maybe
out the back, you know thingswhere you can be monitoring
anesthetics and things like thatas well.
That can all go under a nurseumbrella kind of fee and you can
build.
It doesn't have to start with50 different fees as well.
Start with two or three.
See what happens.
Speaker 1 (22:25):
I hope you found this really helpful.
Regardless of whatever role youhave in your veterinary clinic,
there's something in thisepisode, I believe, for everyone
, and the same for next week aswell.
So make sure you tune in nextweek as well, because Michelle
talks about different invoiceline items that not only make a
(22:46):
difference to a veterinarynurse's self-esteem because
they're being recognized asadding value, but also make a
positive difference to a vetclinic's bottom line.
So stay tuned for that Untilnext week.
This is Julie South signing offand inviting you to go out
(23:06):
there and be the mostfantabulous, resilient version
of you.
You can be Kakiti Ano.
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