Internal Medicine Nurses
April 5, 2022
Our Internal Medicine Nurses care for patients requiring medical management of conditions, including endocrinopathies, immune mediated diseases, and urogenital conditions. Our INTM nurses support patients requiring investigatory and medical procedures such as, endoscopy, bronchoscopy and bronchoalveolar lavage, fluoroscopy, joint taps, bone marrow biopsies, and oesophageal feeding tube placement.
1. Morning rounds
The medicine nurse will start their shift attending morning rounds with the internal medicine nurses, clinicians, residents, and interns on shift. Hospitalised cases are presented by the clinician in charge, discussing clinical signs, differential diagnosis’ and treatment plans, along with any scheduled procedures. In addition, cases arriving for routine appointments each day are discussed to assist with the scheduling of diagnostics and investigations. The INTM RVN is responsible for relaying inpatient updates to the Wards RVN to highlight any treatment changes and procedures the patient will be receiving that day. Following AM rounds, the INTM RVN will provide a nurse update to the owners of hospitalised patients.
Following consultation with the internal medicine specialist, the INTM RVN will prepare the case for scheduled investigations; this can include intravenous catheter placement, internal/external blood sampling, preparation of sedation/ anaesthesia for diagnostics, and the delivery of inpatient treatments. Once the patient is prepared, the RVN supports the patient throughout their procedure, which may include radiography, ultrasonography, endoscopy, fluoroscopy, and arthrocentesis.
3. Clinical skills
Our INTM RVNs are encouraged to develop and practice a variety of clinical skills including urinary catheter placement, nasooesophageal/ naso-gastric feeding tube placement, and arterial blood gas sampling/arterial catheter placement. Our nurses will assist the case clinician with a variety of procedures, which may include thoracic/abdominocentesis, arthrocentesis, and bone marrow biopsies.
4. Emergency care
INTM RVNs are currently heavily involved in the triage, investigatory work-up and treatment of many of the emergency cases that present at Southfields. This role includes the triage of the patient, obtaining informed consent for any emergency procedures, and delivery of care under veterinary supervision. This varied emergency case load exposes our RVNs to a variety of clinical presentations, enabling them to work confidently and independently to gain valuable emergency and critical care nursing experience.
5. Evening rounds
Following the day’s procedures, the INTM clinicians and RVNs hold evening rounds to discuss clinical findings and agree overnight treatment plans for their hospitalised patients. The INTM RVN will, once again, relay this information to the Ward RVNs to support the delivery of care out of hours. External lab samples associated with the day’s procedures are prepared for collection and processing.
6. Follow-up nursing care
A follow-up call is scheduled with the owner at the time of discharge to provide an opportunity for the INTM RVN to gain an update on the patient and to support the client with any questions or concerns they may have. Follow-up appointments can be arranged with an INTM RVN to perform blood tests, dispense prescribed medication, and provide endocrinopathy monitoring support (diabetes, hyperadrenocorticism etc). Our INTM RVNs assist our clinicians with follow-up MRCVS appointments, where required.
To find out more about the different roles within our Nursing team, visit: southfields.co.uk/join-our-team