Candidate Instructions 🧒

You are on your Small Animal first opinion hospital rotation. 'Rosa' Parker, a canine patient is being admitted by a nurse for general anaesthesia and a surgical ovariohysterectomy.

Mrs Parker is concerned about the procedure and has some questions. The nurse invites you in to the consult room.

Please answer all of Mrs/Mr Parker's questions and address his/her concerns.


Station Material (ONLY OPEN WHEN PROMPTED)

There are no station materials for this station

Actor Instructions 🤒

Details:

Name: Mr Peter/Mrs Mary Parker
Age: 30 years +
Patient name: Rosa
Species: Canine
Breed: Labrador crossbreed
Age: 3 years
Sex: Female entire

You are to begin in a standing position.

Agenda:

  • You are very worried about Rosa, you love her dearly.

    • You acquired Rosa from a friend when she was 11 weeks old, for free because your friend had to move into rented accommodation that didn't allow dogs.
    • You were Rosa's life line.
  • You feel extremely guilty about putting your best friend through this surgery.

    • You know it is in her best interests as she has been suffering with irregular seasons and behaviour changes in the last year and the vet has advised that this is the next best course of action.
    • Rosa is healthy and enjoying life and you are very concerned the surgery might make things worse instead of better.
  • You are so anxious that you think something bad will happen; Rosa could bite someone, or be in pain, or die on the operating table.

Questions:

(If not already addressed):
  • Why do I have to put Rosa through this procedure?
  • How will this procedure help or benefit my Rosa?
  • What happens during the surgical procedure?
    • Can you explain everything to me step by step so I know exactly what will be happening?
  • How do you know exactly what parts of Rosa to remove?
  • What are the risks?
  • Could Rosa die?
  • Could Rosa bite someone?
  • How long will the surgery take?
  • Will she be in pain?
  • When can I call to get an update?
  • How long will she take to recover?
    • When can she come home?
    • When can she eat?
    • When can I walk her again?

Mark Scheme ✍️

Introduction

Greets client in a welcoming manner
Introduces self and role
Confirms client's name and animal's name
Explains purpose of consultation
all-markschemes.introduction

Ideas, concerns and expectations

Encourages client to express their ICE without interruption
Summarising and checking the information the client has given
Checks client's concerns regarding the procedure
Checks client's understanding of the proposed plan
Demonstrates a genuine interest
Demonstrates empathy
history-markschemes.ideas-concerns-expectations

Why

Explains the intended benefits of spaying

Removing the behaviour changes and distress caused by pseudopregnancy
Cessation of oestrus and therefore irregular seasons
Removing the risk of pyometra
Reduction of unwanted litters
explanation-markscheme.why

Description

Explains the surgical procedure

A surgical incision through the skin and underlying layers of the abdomen will be made
The ovaries and the uterus will be removed
Internal sutures will be used which are absorbable
External sutures will be used in the skin which are usually non-absorbable
Uses clear and appropriate language
explanation-markscheme.description

Risks

Explains the risks of surgery

Haemorrhage
Surgical injuries e.g. ureteric damage, ovarian remnants
Infection
Wound site breakdown
Pain
explanation-markscheme.risks

Explains the risks of anaesthesia

Check the Client's awareness and knowledge about general anaesthetic
Hypothermia
Hypotension (low blood pressure)
Minor drug reactions
Prolonged recovery
Regurgitation (rare)
Anaphylactic reactions (rare)
Death (very rare)
explanation-markscheme.risks

Before

Explains the mitigation of risks 1

Food has been withdrawn to reduce the risk of regurgitation and vomiting
A pre-anaesthetic blood test has been taken to screen for organ function
A full clinical exam (including assessment of the heart and lung function) will be completed before any medication is given.
explanation-markscheme.before

During

Explains the mitigation of risks 2

Careful monitoring (manual and electronic) during the procedure and in recovery
Trained staff with expertise are performing the surgery, monitoring the anaesthetic and recovering our patients
An intravenous catheter is placed into the vein to give access to the blood stream in an emergency
An endotracheal tube is placed into the airway, keeping the airway open and protected
Sedative and muscle relaxing drugs are given before the anaesthetic to calm our patients
Pain relief is provided before, during and after the procedure and as required
The anaesthetic agents that are used are short acting providing a quicker recovery
explanation-markscheme.during

Conclusion

Invites questions or concerns
Summarises explanation of procedure, risks and mitigation of risks
Checks client's understanding, offering to repeat any section
Asks if client is happy with the plan
Addresses concerns calmly, with empathy and without judgement
Provides a safety net for the client e.g. info leaflet
Signposts the client back to the nurse to complete the admission procedure
all-markschemes.conclusion

Other

Client's perception of communication

I felt comfortable and reassured during the interaction
The information was provided in easily assimilated chunks throughout
The candidate checked my response as a guide on how to proceed
I felt able to ask questions and voice concerns
The consultation was thorough and not rushed
explanation-markscheme.other

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