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InFocus

A day in the life of an exotics nurse

“While great strides have been made and will no doubt continue to be made, in day-to-day life the simple fact is that many people don’t appreciate the complexities of what VNs do”

Originally, the intention of this article seemed comparatively straightforward: to provide an insight into the role of an exotics nurse. However, while sitting down to write, it became apparent that while the author knew in detail what an exotics nurse can face, it is hard to succinctly summarise within a comparatively short word count the detail and depth of this. It should also be noted that experiences within exotics range from clinic to clinic and country to country so please do not take this as gospel but rather an overview of the author’s own thoughts within this area of specialist nursing.

The complex role of a veterinary nurse

This is a brief note covering old ground, but as we know, veterinary nurses (VNs) are often the forgotten element of veterinary care. While great strides have been made and will no doubt continue to be made, in day-to-day life the simple fact is that many people don’t appreciate the complexities of what VNs do.

FIGURE (1) Owl receiving treatment

In 2023, the RCVS VN Council classified veterinary nursing as follows:

“Veterinary nursing aims to ease the suffering and pain of animals and to improve their health and welfare.

“This includes providing any medical treatment or any minor surgery (not involving entry into a body cavity) to animals under the direction of a veterinary surgeon who has that animal under their care.

“Veterinary nursing can be either proactive or reactive, and autonomous or collaborative. It is carried out in a wide variety of settings, for animals at all life stages, and considers the background and needs of the animal’s owner or keeper.”

It is a seemingly simple statement that took a lot of effort from those involved to define. As veterinary nurses, we are often asked the classic “Did you not get into vet school?” and so forth. Historically, perhaps this was the case, but veterinary nursing is now an increasingly recognised profession in which many diversifications are possible.

Exotics, but not really exotic

Exotic species themselves are defined as foreign, but while their origins are from distant countries, the lineages of many of the individuals we see have been within captivity for many generations. Rabbits, for instance, are the third most common pet in the UK. Exotic pets have traditionally been seen to be niche and, especially with the keeping of reptiles, almost for a select group of individuals. This could not be further from the truth today. In 2023, the Rabbit Welfare Association & Fund estimated there were a total of 1.5 million rabbits kept as pets in the UK, an increase of 50 percent since 2022 (Rabbit Welfare Association & Fund, 2023).

The BSAVA estimated there were around 700,000 pet snakes in 2023 (BSAVA, 2023), while a joint review by the Born Free Foundation and RSPCA estimated 1.8 million reptiles, amphibians and invertebrates and a further 1.1 million birds were kept (Born Free Foundation and the Royal Society for the Prevention of Cruelty to Animals, 2021). The reality is that even outside of a practice which specialises in exotics, you are likely going to see an exotic animal at some point in your nursing career. They should never be written off as being of lesser importance; equally, do not allow yourself to feel inadequate to provide the care they need. Research and compassion are two key steps on the way to a successful outcome regardless of what species is presented.

The reality is that even outside of a practice which specialises in exotics, you are likely going to see an exotic animal at some point in your nursing career

Adaptability, variety and urgency

Exotics nursing, in the author’s experience, is unfixed in comparison to other nursing. Beyond the vaccinations and neuter cases, albeit only performed in some of the species, it is hard to create a day-by-day structure with exotic caseloads. The author works solely within an exotics hospital, so he concedes that this may differ in other practices; however, if a rabbit presents with an obstruction, then it will present as an emergency, the same as a dog would with a GDV.

No day is the same; anaesthetics, diagnostics and procedures are daily occurrences; different species present every day (and often zoo/wildlife species as well): all resulting in a unique job role. In exotic nursing, you will likely undertake a large proportion of these elements, especially anaesthesia. Running and performing further diagnostics and care are also all likely. Even the basics, such as placing an IV cannula, can differ greatly from rabbits to other mammals to birds, and blood sampling can differ even within individuals of the same species or order. Caring for so many species and assisting these individuals is varied and enjoyable.

FIGURE (2) Otter cub

The general rule is that with most of the species seen in exotic nursing, when they are sick we don’t have the ability to wait to offer appointments as their conditions can deteriorate quickly. A rabbit with gut stasis can deteriorate and require obstruction surgery within a few hours, while an African grey parrot may go into hypocalcaemia during the journey to the clinic. As predominantly prey animals and comparatively undomesticated, exotic species are well adapted to hide symptoms as a survival response. Indeed, as a survival strategy even predatory species will not show clinical signs. Owners, therefore, can face an understandable disadvantage when monitoring their pets and often presentation to clinic occurs when the patient has been ill for some time and has simply lost the ability to hide its clinical signs any more.

The general rule is that with most of the species seen in exotic nursing, when they are sick we don’t have the ability to wait to offer appointments as their conditions can deteriorate quickly

The author believes the closest thing to exotics within traditional companion animal work is likely to be emergency and critical care. The unknown element of the cases, the lack of routine work and often the ability to react correctly to the uncertainty of presenting cases all closely align with a large proportion of exotic caseloads.

Exotic nursing can be tiring, frustrating and obsessive, but the same can be said of any veterinary nursing. The key difference for those within exotic nursing is the variety of species we see. The routine consulting day rarely exists; having enjoyment in your own ability to react to differing occurrences is key to being a successful exotic nurse. Nursing for exotic species is varied and unpredictable.

As previously discussed, exotics are often seen as alternative pets away from the main populace, when they are actually commonplace within a lot of households. Exotics are not purely rabbits, other small furries or reptiles, either. Exotic cases can and will cover individual species across all of the main taxonomic groups and having the ability to plan where appropriate and, otherwise, react to the unexpected is key. Adaptability is vital and a day in exotic nursing can change either positively or negatively within a short time frame.

The routine consulting day rarely exists; having enjoyment in your own ability to react to differing occurrences is key to being a successful exotic nurse

FIGURE (3) Aldabra tortoise surgery

Often, the animals may not like you, but that’s understandable and OK. Not every rabbit wants to be cuddled, or parrot wishes to talk, but as within small animal practice, they often just need some reassurance to really help their progression in recovery. Some love human attention, with the bonded birds being the classic example, and require more to stop them deteriorating. With so many different species, differing individuals can be seen in them all, and it is enjoyable for this reason. Yes, even some of the less traditional companions, such as reptiles, often have differing personalities.

Being traditionally book smart helps, but it isn’t the be-all and end-all. Exotic nursing, as with all veterinary nursing disciplines, requires a sense of pride in one’s work and a desire to progress while aiming for the highest levels of animal care. The desire to gain new experiences and use this for the good of your patients is the only way to underline theory into practice. With so many species, at no point should an exotic veterinary nurse feel they know everything, and with ongoing updates in research and understanding, exotics is a continually developing area of veterinary care.

Exotics allows nurses within supportive practices to flex their hard-earned skills and knowledge and progress the care within the practice. It can allow those with specific interests to focus on these areas, and when working with a diverse range of individuals, it means that together you can create a group of people who bring continually fresh and new thought processes to ways of working. The best team is a diverse team and while it is important to do so in the correct manner, no nurse should ever feel their voice is not heard.

Final thoughts

As veterinary nurses, we are often considered different in our career choices, and exotics can certainly make you realise why people outside of the industry believe that. Exotics isn’t for everyone, and that’s OK as no one discipline of veterinary nursing is, but ensuring all animals get treated with the respect they deserve is the minimum we as nurses should push for. Exotic nursing is often challenging, frustrating, high-pressure and tiring, but it is also without doubt rewarding, diverse, non-stagnant and, most of all, fun. For the author, the variety and sense of passion, with the challenges it presents in itself, are the key enjoyment factors of working with exotics.

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