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Are we dealing effectively with the challenges of pregnancy in a practice?

by
01 April 2016, at 1:00am

Periscope continues the series of reflections on issues of current concern.

HEALTH AND SAFETY IS OFTEN THE SUBJECT OF RIDICULE and one could argue that this is not without reason.

Most of us can cite an apparently ludicrous example of when a good idea has been squashed on the spurious grounds of H and S, though in truth I suspect many of these are in fact urban myths rather than things that have actually happened. The problem with this somewhat light-hearted approach to the subject is that the very serious risks that H and S is most designed to tackle can slip through the net.

I was moved to write about this topic by a report published in January this year by the VMD which details a total of 30 Adverse Events (AEs) involving vets and vet nurses during 2014.

The most alarming of these involved three members of staff at a UK practice, two vets and a vet nurse, who suffered miscarriages over a period of 12 months. Another vet at the same practice experienced a premature birth at 32 weeks’ gestation during the aforementioned period. The cause is postulated to be exposure to the anaesthetic gas sevo urane, and the practice in question did not apparently have an active scavenging system in place. 

I have no personal knowledge of the events described in the report and I certainly don’t want to comment directly on a situation that is no doubt distressing for all concerned. What I do want to do is to use it as a means of drawing attention to the need for the profession as a whole to recognise the gender bias of the profession and the challenges this might pose during pregnancy. 

Girl power

From the very start of the veterinary nursing profession it has been almost exclusively female and it has changed little in this respect to the present day. And we are all familiar with the increasing female representation in the veterinary profession itself. This has clear implications for managing the issue of pregnancy and is something that all practices need to take on board.

When I first graduated I remember that probably only around 30% of veterinary graduates were female, but nearly 100% of veterinary nurses were female. Most partners in veterinary practice were male (and possibly still are though I’m happy to be corrected), and I can clearly remember the reaction of many of them on being informed by a VN or vet that they were pregnant.

The word “congratulations” rarely left their lips. There was a heavy atmosphere around the place as though the female member of staff in question had just announced they had been engaged in something illegal. It was often several days before any of us dared mention the forthcoming “happy” event without fear of being censured.

I’m no longer working in practice so I don’t know what the current situation is on the ground. Certainly legislation and general public opinion have changed dramatically over the last 30 years and so I would hope that there is much more enthusiasm shown by practice owners to the news that the “practice family” is to welcome a new addition. But I suspect that there may still be an undercurrent of resentment on hearing the news.

Enlightened approach

With the changing gender composition of graduate vets I would assume there are more and more practice principals out there who are female. That being the case, I would hope they have a more enlightened approach to those “sisters” who announce they are pregnant because they themselves may already have been on the rough end of the experience.

Unless, of course, they feel that because they had a hard time of it, “justice” demands the next generation should go through the same.

I have no doubt it was attitudes like this that perpetrated (and anecdotally continue to perpetrate) the belief that assistant vets need to know what it’s like to work and be on-call for several days in a row in order to call themselves “proper” vets.

That’s an attitude which in my opinion certainly helps to cause the drain of vets leaving the profession just a few years after graduating.

Leaving aside any possible difficulties caused to the practice by a staff member becoming pregnant, and I understand completely that in small practices these difficulties can be substantial, it is clearly essential that practices go out of the way to protect the health of the mother and her unborn child.

That may mean making sacrifices and/or undergoing extra expense in order to take on other staff to cover for them. This is not something that can or should be dealt with in an ad hoc manner with a fingers-crossed approach.

It requires thought, planning and commitment, a genuine desire to do the best for the staff member which, ultimately, is likely to be for the best for the practice too.

Clearly, vets and vet nurses have a responsibility of their own once they discover they are pregnant and should inform their employer at the earliest opportunity so that any changes to working practices can be put in place at the outset.

They also have a responsibility to inform themselves of the risks involved and to make sure that anything they are being asked to do by their employer is safe.

The RCVS Practice Standards Scheme includes a module that covers anaesthesia and the BVA can provide expertise and advice and a template risk assessment form that can be used during pregnancy.

It is not just anaesthetic gases that constitute a risk, however. Exposure to x-rays, infectious agents such as Toxoplasma spp., and drugs such as chemotherapeutic agents all pose a speci c risk during pregnancy. And while there is plenty of advice available to help minimise these risks, it is probably the attitude of the employer that makes a real difference.

Positively embracing the almost inevitable likelihood of pregnancy among key staff in a veterinary practice, and really working hard to make things as safe for the person as feasibly possible, is the real key to avoiding highly regrettable and avoidable consequences.