Nurses – the key to a harmonious practice?

13 February 2023

Empowered nurses are an incredible force. With insight into nearly all aspects of the practice, clinical knowledge and people skills, nurses are uniquely placed to ensure a practice runs efficiently and effectively.

But harnessing the full potential of this team isn’t easy. Depending on the circumstances it can require structural changes, a shift in organisation culture, investing in people and perhaps the hardest thing of all, time.

At BSAVA’s Congress 2023 Andy Green, People Director at Pennard Vets in Kent, and RVN, Helen Silver-MacMahon, VN Research and Development Director at VetLed, will be discussing many of these topics in the leadership and time management modules.

“High functioning practices, revolve around the nurses,” says Andy. “Naturally, they are a communication hub. And let’s face it, if a vet wants to do something outside of the consult room, they will need a nurse. It makes sense to recognise the essential role they play and develop a nurse-centric structure.”

“The question then becomes, how can we help nurses upskill and become confident in working at the highest possible level?” adds Helen.

The answer, according to both Helen and Andy, is multi-faceted, requiring the right working environment, a broad organisational structure, alignment of goals, open communication and training. Empowering the nursing team can seem a daunting task but when the benefits include mitigating the effects our recruitment and retention issues, surely it is worth the effort?

“Start by making sure you’ve enough nurses and look at how the rota is set up. Ensure everyone understands the practice’s vision and mission, as well as the shared values and the behaviours which demonstrate those values,” begins Andy. “When there’s alignment between individual and organisational goals and values, you all naturally pull in the same direction.

“Then it’s about how the day is set up and who runs each part. In our practice, the nurse is responsible for the running order, for allocating who’s doing what and making sure everyone understands their roles, and liaising with the vets. It’s about ‘working in flow’.”

For Helen, empowering nurses is as much about how the team interacts, as its structure: “Like anyone else, nurses need to be acknowledged and have a psychologically safe space to discuss ideas and challenges,” she says. “We can all build trust by being curious and asking lots of different questions. Experienced team members need to be fallible and humble, setting the scene so that everyone in the team has voice. Ideas should be expected, and welcomed – after all, the outcome of a patient is rarely due to just one person’s expertise.”

One aspect they both agree on is nurses can make great leaders, but it requires vets and practice managers to master the art of delegation.

“Where nurses’ contribution and potential are recognised, and the hierarchy is shallowed, they make incredible leaders,” observes Helen.

“At BSAVA Congress 2023, I’ll be speaking about delegation. As leaders we feel we have to ‘own’ tasks and that inevitably means doing it ourselves. But that’s not always the best option. It can leave leaders feeling overwhelmed. Whereas delegating tasks can empower others, build resilience within the team and help with retention.

“In the NHS they’ve really embraced the idea that people have different strengths, empowering them to use them and teach others. It’s something Rebecca Robinson, Practice Director at Lynwood Vets and Vet Dynamics coach, Tess Plagis communication advisor at St Anna Advice and I will be exploring in the session ‘MARVELOUS teamwork: identify your superheroes!’”

Andy agrees: “Identifying and nurturing the talents and passions of team members helps retain people – something which is so important at a time when recruitment is so challenging. People want to progress. They crave those feelings of autonomy and mastery.

“Small practices often have that traditional command and control structure – it’s the classic triangle, where the owner sits at the top with others underneath.  Broadening that hierarchy is both possible and practical. It’s unfair to expect leaders to be brilliant at everything – they will have their strengths and weaknesses too. It’s the perfect opportunity to delegate to those whose strengths are the owner’s and practice manager’s weaknesses.  Leverage the talent on the team, grow it, develop it and you’ll be nurturing next level of the leaders.”

Andy admits that he has sometimes found it a challenge to let go. “Like many vets, I used to be a bit of  a control freak and had to consciously learn to delegate. It’s accepting that others may do it differently, and at first, not as well or as quickly as you. The temptation is do it yourself but it immediately blocks others from learning the skill and hampers growth within the team.”

When considering promoting anyone into a leadership position, it is important to remember that it isn’t always an innate skill. Helen sees many individuals that grasped new opportunities with both hands but let go when their fingers get burnt.

“Often, nurses become experts clinically, and then get asked to become leaders in that area. This is difficult for some people. They feel they should be able to do it, but have had very little training on the subject, don’t have the knowledge or skills and therefore feel unsupported in their role.”

As the pressure mounts, stress levels rise and it starts to impact on their wellbeing potentially great leaders step down. “When this happens everyone loses, and is why I’m so passionate about leadership training.”

To hear Helen and Andy talk about leadership and time management, come to BSAVA Congress 2023 at Manchester Central on 23rd-25th March 2023. Discover the full programme or book your ticket at