Veterinary Internal Medicine Nursing

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How to push past the fear and succeed as a medicine nurse with Allana

We talk a lot here about diversifying your career, experiencing new clinics, and using more skills. And whilst I’m pretty good at sharing examples of how I’ve done this in my career in the hope that this helps people do the same, we all know that veterinary nursing (and veterinary technology) look different worldwide.

Today, I’m delighted to share Allana’s story with you. Allana is a member of the Medical Nursing Academy and works as an Internal Medicine nurse in a specialty clinic in Australia. She shares her journey so far, from completing her veterinary nursing certification to studying online for her nursing diploma, juggling many roles in a busy GP clinic, and then making the leap into specialty practice.

Whether you’re feeling the pressure to find a niche, exploring referral nursing, considering further qualifications you might want to complete, looking for lessons to learn from, or just curious about how nursing differs around the world, I know you’ll find so much value in Allana’s story today.

It started in 2008…

Allana began her journey to becoming a vet nurse in 2008 when she enrolled in the Certificate IV in Veterinary Nursing. 

While studying for her qualification, she began volunteering at a GP clinic and was offered a permanent receptionist position there six months later.

This allowed her to work in practice whilst finishing her nursing qualification, which she did in 2010.

And it didn’t stop there.

Allana completed extensive additional training on animal behaviour and handling and gained her Diploma in Veterinary Nursing (General Practice) in 2018. The Diploma is similar to the Advanced Certificates in the UK and allows students to specialise in one of four areas—dentistry, ECC, surgery, or general practice. It allows nurses to further their knowledge and develop new skills to help their patients.

Allana completed her studies online while working in practice full-time, juggling many roles in practice, as we all do. She went from a receptionist to a surgical, inpatient, and anaesthesia nurse before becoming the nursing team leader and training the junior nursing team.

But then it was time for a change…

In 2022, Allana made a big decision.

It was time to step away from general practice and take the plunge into referral practice. She wanted to take her nursing career to specialist level, and a new referral clinic opening near to home allowed her to do just that.

She headed to her interview and they asked her: ‘Which department would you like to work in?’

And then she realised - you get a choice. You can pick a set of the many skills you use and the many things you enjoy doing, and really hone in on them, learning even more about those diseases and developing new advanced ways of helping your patients.

“I realised, ‘Oh wow, I get to choose just one aspect of my many roles to hone in on, what on earth do I choose?!’

And I decided to take on the role of an Internal Medicine Nurse.”

What does this look like?

Like medicine nursing in other referral clinics, much of Allana’s role involves assisting with diagnostic imaging, endoscopy procedures, and other procedures such as bone marrow biopsies and joint taps.

She’s also responsible for creating nursing care plans for her hospitalised medical patients, allowing her to prepare detailed, tailored care for every individual and how their disease impacts them.

She also works closely with her anaesthesia team to create tailored anaesthetic and sedation plans for her medical patients, meaning she doesn’t miss out on those fun GAs.

And there’s some other fun stuff involved, too!

After a year as an internal medicine nurse, Allana was asked to run the practice blood bank. Now, as a fellow transfusion nerd, she’s a VN after my own heart—because on top of all her other responsibilities, she also screens potential blood donors, runs all of the blood donations in her clinic, and processes collected blood products.

This just shows that you can make anything you want out of your career. Think about what you’ve got a passion for - there will be a way you can implement this into your role!

Why medicine?

We all know that finding a niche is hard. It’s also completely fine if you don’t have one - because general practice is a niche in itself! But if you are choosing to specialise, when picking what you want to focus on, ask yourself this:

  • What skills do I really enjoy performing?

  • What sort of person am I, and what environment do I work best in?

  • What are some of my favourite patients I’ve nursed, and what do they have in common?

  • What cases/conditions/procedures really light me up?

For Allana she decided to pick medicine because she wanted a variety of skills when nursing medical patients and the ability to support the patient from start to finish:

“It allows you to be involved in your patient’s care in a variety of ways. You can perform anaesthetic procedures, imaging and bloodwork and then watch them recover in the hospital with a treatment plan that you are involved in.

Departments like oncology or cardiology get to see a very ‘niche’ part of the patient’s care, whereas I like working through the diagnostics with the patient and watching them respond to treatment.’

Allana finds medicine rewarding because there are so many ways that veterinary nurses can be involved in patient care—and being there, actively involved in that patient’s treatment, diagnosis, and nursing care, really makes a huge difference to their health and well-being.

“We can be responsible for performing the diagnostic tests, assisting with diagnostic procedures, and administering the medications or treatments for their condition. I love knowing that I was there, actively involved in a patient’s investigations, diagnosis and treatment and making a positive difference in their health.”

What diseases do we deal with?

We know that medicine is a very varied discipline, with many conditions requiring different treatment and nursing care. Allana’s favorites include immune-mediated diseases and hematology since these patients are often unstable on presentation and need intensive nursing management.

“I feel like there are many more cases I’ve yet to be exposed to, and there are so many I already enjoy!

Immune-mediated cases are very intriguing (IMHA, IMT, IMPA - they are all fun!)

I have a soft spot for immune-mediated haemolytic anaemia cases, and I love an agglutinated slide!

I like the process of dealing with these patients as they are often quite unstable, and they rely on the nurse to be in charge of a lot of the treatments that stabilise them and get them onto the road to recovery, which is so fulfilling.” 

What skills do we use?

Yes, medicine is full of fancy procedures and skills. Yes, we’re juggling endoscopes (not literally, of course - those things are expensive after all!), CT scans, feeding tube placements, laboratory procedures, and much, much more - but actually, some of the smallest skills are the ones that can make the biggest difference.

So, if you’re not in a fancy specialist practice and don’t have access to lots of kit, here’s Allana’s advice for better medical patient care.

These tips when nursing are simple but REALLY important.

First up is a very underrated one—to think not just about your patient’s health but also about their behaviour.

Think about when you’re unwell. To recover quicker, you need to feel better mentally, and we all know that hospitals can be challenging environments to feel better in.

So, taking this into veterinary medicine, how can we help our patients FEEL better in the hospital? How can we create a positive environment and support their well-being?

“I always have at the front of my mind, ‘How does this animal appear in hospital?

What can I do to make them more comfortable, medications aside?

It might involve giving them some love in between treatments to reinforce a positive interaction, providing them with some privacy to retreat to, or keeping involvement to an absolute minimum.

I’ll always feel strongly about behaviour, and I believe reducing a patient’s anxiety is vital for recovery.”

One simple but effective way we can do this when getting our patients out for examination or treatment is to consider how we’ll make them comfortable not just inside the kennel but out of it, too. Little things like having a towel or a blanket ready to make your patient comfortable during their examination can make a big difference.

Along Allana’s journey to becoming a medicine nurse, there have been many lessons.

No one’s career is linear, but those twists and turns take our career in amazing but unexpected directions.

Moving into specialty practice is tough. You’re seeing cases you’ve perhaps not been exposed to before, and it’s easy to feel like you don’t know enough or aren’t good enough—and spoiler alert, neither of those things is true.

Allana shares a fundamental lesson that we all need to remind ourselves of more often - to improve your skills, you must start from the beginning. And that self-kindness, not beating yourself up when things don’t go to plan, is the best way to get there.

“To succeed at something, you have to suck at it first!

I have such a nasty case of self-criticism and perfectionism and I judge myself so harshly when I cannot do something, it’s terrible.

I read this quote somewhere, and I realized that I need to give myself a break. I want to know it all and perform it all perfectly each time. It isn’t always like that (especially placing an IV first go or getting a great blood draw; sometimes those days just aren’t showing up!)

I need to start somewhere, and it’s never perfect on the first go. Until then, keep referring to the textbook, keep practising (or sucking at it!) until you realise you’re doing your best and you’re succeeding by trying.”

One thing that our brains LOVE to do when we’re changing clinics or pushing our comfort zones is tell us we can’t do it.

Yep, there’s that impostor syndrome again—it’s our body trying to keep us safe and protect us from feeling bad, and while that’s nice of it, it’s also keeping us from growing if we listen to it.

That voice popped up for Allana when she moved into specialty practice, too. But with a simple mindset shift, things got easier for her day by day.

“I was exposed to so much more nursing involvement, especially in more complex cases than I had ever experienced, it was a shock to the system and a bit of ‘imposter syndrome’ arose.

I felt like I wasn’t good enough to be here, I didn’t know enough to be in this role, and that I should go back to GP.

I overcame this by coming to work every day with the acceptance that I didn’t know it all, but I was here to provide the best nursing care possible for my patients and I know I would always provide that while learning new skills along the way.“

And even though it’s hard, and there are times when it might suck, it’s worth it.

If you take one paragraph away from Allana’s story today - let it be this.

Change is hard, and progress is hard. But it’s also where growth—and ultimately happiness—comes from.

“When I was unsure whether to leave the GP life I had always known, the advice I was given was that it would be hard.

There is a lot to know about internal medicine…

There’s all the diseases and conditions you’re exposed to.

Then there’s having that understanding of each of them…

And then there’s having to remember it off of the top of your head, instead of running for a textbook!

But it will fulfill so many reasons why you choose to be a nurse.

It will develop a greater knowledge of all of these conditions.

And it will improve patient care and hone your nursing with new skills.”

“My advice? If you want to broaden your knowledge of the various diseases and conditions in small animal practice, build on your current nursing skills and techniques and provide more informed and enhanced nursing care for your patients, then medicine is for you. It will be challenging, and you will not get it all at once (I tried that too!), but keep at it. It’s so worth it.”

And one thing that Allana did to help this was find a community of like-minded people.

In Allana’s case, that was the academy. She became a member after feeling overwhelmed at having many different diseases to learn about as a new medicine nurse. Now, she better understands not just those diseases but also how nurses can be involved in the procedures and care that patients need. Most importantly, Allana is now looking at new ways to advocate for herself and her career goals, inspiring her to think about specialising formally in the future!

“I’ve even begun to develop a better understanding of some cases and can preempt what diagnostics we would be performing and treatments to start, giving me more confidence in my abilities. The academy has also encouraged me to consider my long-term goals and I hope to study for my VTS in internal medicine in the future.”

The most valuable thing? The community of people there to support you when that impostor voice creeps up, or you start telling yourself that you’re not good enough.

Knowing that there’s a group of like-minded people worldwide has been a real help—whether they share their own experiences or just offer a kind word of encouragement at the end of a tough day.

So there you have it - from receptionist to referral nurse, I hope you’ve found inspiration in Allana’s story! She’s a great example of how pushing through your comfort zone can reap so many benefits in your career - and the importance of being kind to yourself whilst you do not. Yes, there are times when it’ll be hard, and it might even feel like it sucks - but it WILL get better, and it WILL be worth it. Don’t forget that.

Did you need to hear this reminder today? Do you want to be part of a community that will support you and cheer you on? Make sure you join the waiting list for the next round of academy spaces here, and I’ll let you know when you can get inside.