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“If you don’t know where you’re going, any road will get you there”

“If you don’t know where you’re going, any road will get you there,” said the Cheshire Cat to Alice when she tumbled into Wonderland in Lewis Carroll’s timeless tome.

Sometimes, it can feel like we’ve fallen down the rabbit hole completely, with no sense of direction or idea of where we should go or what we should do next.

Challenge accepted

Yet, it appears RVNs can do plenty if contemplating a new challenge, as you will hopefully see in the October edition of VN Times – from volunteering with rhinos to topping up your skill set or retraining completely, all while still putting your knowledge to good use by caring for animals in need.

Research has revealed confusion still reigns around the exact nature of the role of the RVN, which suggests more needs to be done to raise its profile in the eyes of colleagues and clients.

Yet, take heart. As we speak (or indeed, as I write), steps are being taken across the profession to tackle this issue – from career advisory days to research projects on how to effect change.

What’s more, moves are also being made to boost diversity in all forms, as you will see in the pages of October’s VN Times. So, instead of existing in a career cul-de-sac, it would appear a plethora of new paths exist for RVNs to take.

Make your choice

The only real problem is choosing which exciting route to traverse first.

When Alice asked the Cheshire Cat which way she ought to go, he said: “That depends a good deal on where you want to get to.”

The question is, rather excitingly, where do you want to go? Look to the horizon; the possibilities are endless.

October 5, 2018
Is the grass greener?

My classmates and I recently reunited at our beloved university to celebrate joining the profession as qualified vets around a year ago. While there we attended a CPD event based around managing difficult situations as a new grad, be that with clients, colleagues or bosses.

While the scenarios were entertaining, they also highlighted aspects of working life as vets that were very relatable, sparking a number of interesting discussions. Many issues were covered, but the most significant points were certain legal or business aspects of veterinary work rather than clinical ones.

Contractual obligations

“Some vets are finding themselves drawing the short straw when it comes to holiday entitlement.” Image © dragon_fang / Adobe Stock

For many of us, our first job as a vet will also be our first full-time, salaried job. As such, many new grads may be unsure of their basic minimum legal entitlements, such as holidays, sick leave and contracts, and, therefore, will not necessarily realise if they are receiving these.

Almost one-third of attendees, despite having been graduated for well over a year, still had not received a contract – much to the shock of the representatives from the various veterinary organisations running the session. I, too, find it incredulous some practices deem themselves impervious to certain legal requirements.

This is perhaps one of the ways in which corporate practices actually have the upper hand on independents – they tend to be better at the paperwork side of things and, even though the contracts can often be vague, they are present. This does not, however, make them any less likely to take advantage of the absolute minimum benefits that can be offered.

More for less

For example, the legal minimum holiday allowance is calculated in weeks. For some of my colleagues who work a four-day week, this means their holiday entitlement seems outrageously small, even if it is, in fact, correct when counting the weeks.

What is not taken into account is many of those who work a four-day week will work longer hours on each of those days, which means they’re still working a 40-hour week. Because of this, and despite working the same amount of hours, some vets are finding themselves drawing the short straw when it comes to holiday entitlement.

The veterinary profession is unique in many ways, but that does not make veterinary employers exempt from their legal responsibilities or from trying to allow employees to have a good work-life balance.

Second time around

There is so much variation within the profession, with some practices hitting the nail on the head when it comes to looking after their vets, while others work them into the ground and wonder why they have an issue with staff retention.

It is issues like these that contribute to the loss of young vets from the profession so quickly after graduating.

While many of my university friends are happy in their current roles, a lot (myself included) are already in their second roles, due to problems or changes in circumstances with their first jobs – and, while some of us feel confident about a long-term veterinary career, some are already considering the options for diversification after getting a bit of experience in clinical practice.

A glimpse of the other side

“Many of us have partners, friends or family in other professions who seem much better off financially, socially and physically that it becomes impossible not to wonder whether the grass is greener elsewhere.” Image © michaklootwijk / Adobe Stock

Many of us have partners, friends or family in other professions who seem much better off financially, socially and physically that it becomes impossible not to wonder whether the grass is greener elsewhere. While we do have an extraordinarily variable and interesting day job, the stress and poor remuneration compared to other roles makes you wonder whether it’s really worth it.

I look at my friends who work flexible hours and can accrue almost double the amount of holiday time I get by working only a couple of hours extra a week (which vets inevitably do anyway without time in lieu or overtime pay). They can book last minute holidays and take sick days with no questions asked – all without feeling they are putting everyone else under pressure when they do. They are often less qualified (sometimes with no qualifications at all), yet earn more, have far better pension packages, guaranteed pay rises and bonuses.

Yet, some veterinary employers can’t even hoof a contract together within an acceptable time frame.

The good, the bad and the understaffed

Some veterinary employers are on the button; they have realised the way to keep staff is to give them comparable benefits and treat them like humans, not just robots with no life outside work, but unfortunately a lot aren’t.

I appreciate the nature of our work makes it unpredictable, that we do have to work late sometimes, that we can’t all be allowed time off at the same time, and, in some respects, it simply isn’t comparable to some other jobs. But when talking to some of my veterinary friends this weekend, I was genuinely angered at the raw deals some of them seem to be getting, and infuriated some practices still get away with treating professionals this way.

It does seem to be getting better, though – slowly, but surely, the profession is being dragged into the modern way of working, and practices that continue to dig their heels in will soon find themselves without any staff.

October 1, 2018
Reflecting on the good moments

As me and my (non-vet) partner sat down for a rare mid-week breakfast together, I made an offhand comment about “having” to vaccinate 15 puppies that day.

“What do you mean ‘have to’?” was his response. “Most people would love that, and you get paid for it.”

I considered this – and, while I’m more of a kitten person than a puppy person, who doesn’t love puppies? It‘s the little things like this we, perhaps, take for granted.

Sharing the joy

All too often, as vets, we focus on the negatives: the long hours, on call, the stress of trying to keep to time when everything goes belly up, the emotional strain, the difficult clients, surgical complications, mystery cases with unanswered questions… the list goes on.

In the midst of it all, while we‘re able to show enthusiasm during the puppy or kitten vaccine consult, sharing the owners’ joy is soon forgotten when it is swiftly followed by a few challenging consults or clients.

At the end of a couple of stressful working weeks (for a number of reasons), I found some peace having formulated a plan for a couple of complicated medical cases and finally convincing a difficult client to get on board with a particular treatment.

Living the life

It‘s the little things, such as vaccinating puppies, vets, perhaps, take for granted. Image © Gorilla / Adobe Stock

It’s easy to get wrapped up in the vet lifestyle – researching cases when you get home at night (and even when you don’t), not being able to sleep because, subconsciously, you’re trying to work out the best course of action for one of your patients.

Rattling off the list of procedures or appointments for the day will just seem the norm to other vets, but take a step back and remove the “vet blinkers” and actually think for moment about what we do.

If you talk to any non-vet friend or family member about your working day, they often show seemingly exaggerated enthusiasm or squeamishness. It’s tempting to brush this off, but it’s usually genuine. From their perspective, our “normal” work can be fascinating.

Everyday heroes

We may not be saving lives in a dramatic fashion every day (or maybe you do), but, as vets, we get to help a number of animals on a daily basis and, as a result, their owners.

This can be done in what feels like the smallest of gestures sometimes; as much as we may resent the notorious anal gland appointment, what that actually involves is giving a poor dog (or cat) almost instantaneous pain relief.

While I don’t think any vet will particularly enjoy an anal gland appointment, my point is to look at the bigger picture: what may be mundane to us does actually make a difference to the individual – our day-to-day routine work is far more interesting than a lot of other jobs.

Let it go

Being a vet is mentally and physically draining at times, but no day is the same and we will always have stories to tell.

So, if you’ve had a bit of a crap week (or haven’t), take a moment to think about what you’ve actually done in the past few days and enjoy the good moments – whether that’s the puppy vaccination or draining the really satisfying cat (or, in my case, cow) abscess. Then think of the clients who have been thankful for your help (even those who don’t show it) and let go of the bad moments in between.

September 19, 2018
Seven – the magic number?

The veterinary community is changing. We are gradually moving towards a world of better work-life balance. Rotas vary massively from practice to practice, and even within practices, depending on particular species bias. One way some practices are adapting rotas is using a seven-day working week.

The knee-jerk reaction is often negative – especially when we consider the seven-day week in relation to the NHS. We’ve witnessed the junior doctor strikes to negotiate better contracts. No doubt, some of us have experienced the NHS staff squeeze first-hand, having been presented with long waiting lists for diagnostics or procedures.

Ludicrious?

A seven-day week for human medicine could lead to staff squeezes and long waiting lists, whereas Jordan Sinclair thinks the veterinary world is a better fit. Image © Picture-Factory / Adobe Stock

With this in mind, the suggestion of a seven-day week for our human medical counterparts seemed ludicrous in the beginning – if staffing was an issue before, surely aiming to provide more services, such as routine procedures at the weekend, would only worsen the problem?

Be that as it may, the veterinary profession is not the NHS. We are more attributable to private medical services, where work-ups can be done immediately, results reviewed and treatments provided much faster. While we, too, are in the midst of an employment crisis, each practice varies wildly and some remain fully staffed.

Advantage

For adequately staffed practices, the seven-day week can, indeed, be implemented to everyone’s advantage. This doesn’t mean everyone works more, it just means the rota has to be managed differently.

An equine practice I’m aware of runs this rota. To my knowledge, the way it is implemented is some vets work alternate weeks – that is, seven days “on” and seven days “off” – while others work four days “on” and four days “off” in turn. Weekends are treated as a normal working day, so there are no more “weekends on call”, and the nights on duty are simply distributed within each vet’s working days. As you can appreciate, this means, for some staff, the days off are constantly shifting.

This is just one example of how the seven-day working week can be implemented, and, ultimately, results in more availability for clients and more time off for the vets. However, this sort of rota would not necessarily work in all practices or fit in with all lifestyles. The workload would have to be sufficient to make it economically viable to treat weekends as normal days and the staff would have to assess whether this sort of rota would work for them.

Work-life balance

“Numerous ways exist to implement a better work-life balance, with the seven-day week being one of them.” Image © jolopes / Adobe Stock

Many people value the traditional weekend, because it fits with non-vet partners’ working weeks, family or other weekend commitments, which is the main barrier to the introduction of this sort of service on a nationwide scale.

The seven-day week doesn’t mean working seven days a week, every week. It simply means providing normal daytime services to the client seven days a week, with vets slotted into working hours accordingly.

In a stressful professional work environment – taking into consideration on-call work and the 5:30pm pyometra surgery that keeps you working well beyond your alleged finish time – forward-thinking practices should be allowing their “full-time” vets adequate downtime: be that time off in lieu, a four-day working week as standard, and flexible working patterns or shifts, opposed to the traditional 11-hour days. Numerous ways exist to implement a better work-life balance, with the seven-day week being one of them.

Retention solution?

With the staff retention problem in the profession, it is imperative those practices still dragging their heels and working their vets into the ground take on board these ideas, and change their rotas for the better.

Likewise, vets are struggling with their mind-bogglingly old-fashioned rotas should not stand for them – there are better options. If vets start voting with their feet, eventually, those workplaces stuck in the past, will have to adapt, otherwise they will find themselves even shorter of staff.

August 15, 2018
An unrecognised reliance on technology

It’s surprising how much we rely on the internet and associated technologies. In fact, you don’t quite realise how much it helps until you find yourself without it.

I experienced a weird widespread internet fault. I’m not sure if it was localised to to my geographical area, but, for a few hours, neither my mobile data would work on my phone or the internet on the practice computers (although I’m not sure if they were just being their usual painstakingly slow dinosaur selves) – even the clients were commenting there seemed to be a data blackout.

Regardless, it made my consulting morning surprisingly more challenging.

First appointment

Repeat aglepristone injection for mismating

I go to check the protocol as I know the timings are different to when given for pyometra. The BSAVA app crashes four times on opening before I accept defeat and find a bound copy of the formulary.

I then realise things are listed by drug name rather than brand name and draw a blank. I try to open the NOAH website on the consult room PC, but this inevitably crashes the internet browser. Of course it does.

Suddenly the name aglepristone is dragged from the depths of my brain and I leaf through the formulary once more. That wastes nearly the whole appointment time before I even manage to find the drug, draw it up and give it.

Second appointment

“When your consults are only 10 minutes, that extra couple of minutes in each one adds up and very quickly I found myself getting behind, and, therefore, more stressed.” Image © WavebreakmediaMicro / Adobe Stock

Potential re-admit from the previous day

The computer freezes while trying to print consent forms. Luckily it’s a fairly straightforward admit for fluids/treatment and the client knows the drill. I hand over to the ops vet and leave her to work out doses.

Third appointment

A transfer from the out-of-hours provider

After skim reading the long history (that consists mainly of numerous phone calls back and forward as to whether the owner could get the collapsed dog in the car), I finally get to the point and call the client in.

The dog is bouncing and back to normal, apart from a stonker of a heart murmur. Cardiology is not my strong point and after a lengthy discussion about starting medication, and much faff flicking through the compendium trying to remember various side effects, I manage to convince them to trial medication.

Fourth appointment

Vaccination

Yay, no formulary needed.

Fifth appointment

Medicine check

One client thinks her dog has gained weight since being prescribed a particular medication. I highly doubt this is the cause of weight gain, but say I will quickly (or not so) check the data sheet.

I reach for the NOAH Compendium (when I manage to locate a paper copy) rather than the formulary, because I can’t for the life of me spell the active ingredient. On skim reading the page, can’t find anything about weight gain or appetite, but it’s not as clear cut as the lovely “clinical particulars” or “contra-indications and adverse reactions” tabs on the website. I close the book.

The client seems to be in a rush, but wants to discuss lowering the dose (are you serious? Could you have not said that while I had the page open?). I flick through and eventually find the page again, and work out the dose as they’re practically running out of the door.

Sixth appointment

Pregnant bitch

The owner asks about worming and once again I leaf through the compendium to find the protocol, only to realise we don’t have that formulation in stock.

Of course I’ve shut the book – but, before I find the right page again, one of the fantastic receptionists has materialised a bottle from somewhere and is flashing the data sheet in front of me for reference.

Seventh appointment

As she had no internet, Jordan turned to the NOAH’s Compendium for guidance, with varying results.

Dog bitten by a ferret

Small wound, possibly infected, but the dog is very wriggly. I prescribe Amoxyclav – one of the few things I instinctively know the dose of – and meloxicam (definitely no books required to work out that dose).

Eighth appointment

Puppy diarrhoea

Can you give young puppies probiotic paste? Back to the book…

It’s not listed in the compendium, and the box doesn’t indicate a minimum age – normally I would check the product website… Sigh. I search for the other vet to ask what feels like the 100th stupid question today. So it went on…

No time to lose

The point is, I didn’t realise quite how much using the internet on my phone sped up my consults. A 10-second search on an app turns into a couple of minutes leafing through a book for a drug dose. When your consults are only 10 minutes, that extra couple of minutes in each one adds up and very quickly I found myself getting behind, and, therefore, more stressed.

I can’t retain numerous drug doses in my head – or at least don’t trust myself to rely on memory for many of them except the most common ones – so maybe this dependence on technology is more of an issue for new grads than more experienced vets who seem to be an encyclopaedia of drug doses.

I was thankful this hadn’t happened on a large animal day – as someone with a terrible sense of direction, I would definitely have been stuck in the middle of nowhere with no Google Maps to get me home.

July 18, 2018
The importance of pre-purchase nurse clinics – the missing piece?
It is a renowned fact among the veterinary profession that the number of brachycephalic breeds in rehoming centres is soaring.

As veterinary nurses it needs to be our role to educate owners-to-be on which breed of dog is the most suitable for their circumstances. This allows owners to make informed decisions when opting to either purchase a puppy or rehome a dog.

Statistics

In September 2017, Battersea Dogs and Cats Home published a press release featuring the story of Piccalilli the French bulldog, which also contained information on how the rehoming centre was experiencing an increase in the number of brachycephalic breeds needing homes. In 2017, it took in 29 French bulldogs for rehoming, whereas in 2014 only 8 were taken in.

“The French bulldog had overtaken the Labrador retriever as the UK’s most registered puppy for the first time, with 8,403 French bulldog puppies registered in the first quarter of 2018, compared to 7,409 Labradors.” Image © otsphoto / Adobe Stock

The Kennel Club (KC) also published data stating the amount of registrations for French bulldogs has also increased greatly. In 2007, 692 French bulldogs were registered. Whereas, by 2016, 21,470 were registered – that’s 20,778 more French bulldogs in the space of nine years.

In June 2018, The KC revealed the French bulldog had overtaken the Labrador retriever as the UK’s most registered puppy for the first time, with 8,403 French bulldog puppies registered in the first quarter of 2018, compared to 7,409 Labradors.

All in all, the breed has seen an “astronomical” 2,964% increase in the past 10 years, The KC said.

Why is this happening?

Pugs, French bulldogs and bulldogs – collectively known as “brachycephalic” breeds – are widely deemed as “fashionable” due to the number of celebrities who own and flaunt them on social media platforms.

The influence from celebrities and the media, such as TV adverts, are having a strong impact on the public’s demand and want for these breeds. They are being bred uncontrollably to emphasise the large bulging eyes, tight skin folds and extremely short snouts causing their distinctive “snorting” noise. These features on the pug and French bulldog are all considered as cute by members of the public, and demand is high for them – and where there is demand, there will always be supply.

Unrecognised health issues

The reason why we are seeing the increase of brachycephalic breeds in rehoming centres is due to the health problems owners are unaware of, and the lack of funding to afford the veterinary bills to manage or correct them.

When these dogs are bred irresponsibly (for example, to exaggerate the “flat face” look), they can incur a whole lot of health risks. The most common is brachycephalic obstructive airway syndrome, which occurs in all brachycephalic breeds to a greater or lesser extent.

Other health problems in these breeds include:
- entropion
- luxating patella
- hip dysplasia
- skin disease
- uroliths
- intervertebral disc disease
Owners are not being made aware substantially of these health risks and the seriousness of them – most of the disorders listed require either surgical correction/repair or life-long medication, which, in turn, costs a fair amount of money.

What can VNs do?

I believe nurse clinics are one of the most important aspects of our job.

“In clinics, we are given the opportunity to build up a rapport with clients and, consequently, a trust relationship with them.” Image © Monkey Business / Adobe Stock

In clinics, we are given the opportunity to build up a rapport with clients and, consequently, a trust relationship with them. Often – as opposed to vet consultations – we can spend more time with our clients in a more relaxed setting. These are a great opportunity to educate clients and use tools to demonstrate our knowledge as VNs.

Done incorrectly, the prospect of pre-purchase consultations with nurses could come across to clients as “lecture-like” or monotonous, but they don’t need to be like this. Instead, they could be based on a puppy party structure, but for pre-puppy or dog owners.

Clarification for clients

To begin, prepare a questionnaire for them to fill out in advance, taking details of their home circumstances, then bring together a group of three or four clients to discuss different breeds and their suitability.

Informational leaflets can be designed for prospective owners, explaining how to choose a healthily bred puppy and what to ask breeders; and fact sheets could include details of breed health pre-dispositions, how much food and exercise certain breeds require, as well as information on training and puppy classes. A “pre-parent pack” could be put together containing this information.

If we can educate owners on health problems – not just brachycephalic breeds – it could deter clients from purchasing breeds inappropriate for them or their lifestyles, and provide accurate information on how to purchase responsibly. This could contribute to breaking the “supply and demand” cycle of irresponsibly bred dogs.
July 13, 2018
How to survive your first weeks as a new grad
You’ve done it – five long years of hard work and study have paid off and you’ve graduated as a fully fledged vet. Welcome to the veterinary community.

And it is just that – a community of people who’ve all been there and had a first day as a vet. You’ll find that everyone (meaning more senior vets than you, which is basically any vet) is happy to offer what I consider “well-being” advice, such as “don’t be too hard on yourself, you will make mistakes” or “don’t be afraid to ask if you don’t know”.

Now, while this sort of advice is true, I don’t think it’s practically helpful for getting you through those first few weeks. No matter how much positive encouragement you receive from other vets, you will probably still be terrified for your first day/week/month.

Practical advice

“Familiarise yourself with the drugs in the dispensary. At uni, you learn drug names, now you’re in practice you will have to learn the brands.” Image © JackF / Adobe Stock

Having been there only a year ago, I have some practical tips and tricks to help get you through the day during those first few weeks:

In-practice consultations
- Make sure you know where things are kept in the consult room, so you don’t have to open every drawer in front of the client to find the syringes on your first consult.
- Likewise, familiarise yourself with the drugs in the dispensary. At uni, you learn drug names, now you’re in practice you will have to learn the brands.
- Make a note of the vaccination protocol used at the practice and the most common recommended flea/worm treatments (such as those on the pet health plan, if your practice has one).
- Note down anything you may want to look up quickly, particularly premed doses. Depending on how your practice works, nurses may draw up premeds and have vets check before giving them, which can sometimes just be a waft in the vet’s direction for assertion – don’t panic and agree just because you don’t know what the dose is off the top of your head.
- Keep a health plan or puppy/kitten package leaflet handy for when clients ask about them.
- The stethoscope is one of the most useful tools for allowing yourself time to think without the client bombarding you with questions.
- ALWAYS leave something essential outside of the consult room (a thermometer, fluroscein or tear test strips, for example). This gives you an excuse to leave the room have a flick through a book or ask another vet (don’t do it too many times in one consult).
- If it’s something you want another vet to look at, most owners respond well to getting a second opinion. Alternatively, take photos “for comparison” then go and show another vet (be careful here – you need permission from the owners and check your practice policy regarding GDPR. You may be okay to use a work phone/camera, but not a personal one).
- If you want to remove the animal from the owner – either to get another vet to look or for thinking space – ask if you can go and get a nurse to help restrain.
Being on-call/farm visits
- Open things before your first equine/farm visit (gloves, lube, etc) to avoid awkwardly trying to rip open boxes while the farmer is waiting.
- Save dropped pins on Google maps or your satnav for your main farms or big equine clients. Again, work within GDPR, which may only allow this on work phones.
- Make a cheat sheet for the car detailing drug doses for the most common things you use on farm – to avoid the inevitable mind blank resulting in an inability to do simple mental maths while staring at the bottle of Pen and Strep with the farmer staring at you. I made one for a 300kg/500kg/750kg size horse for quick reference.
- If you need to call a colleague for advice while on farm, make an excuse to go back to the car. I would go to examine the animal first with minimal kit (just a stethoscope, for example) then, if necessary, make a call when I had to go back for a thermometer or relevant meds.
- Make a note of who to contact regarding out-of-hours, door codes and alarm codes – and make sure you have practice keys.
- Be prepared to be tired. It doesn’t last forever, but working as a vet is very tiring to begin with – don’t make too many plans for week nights or weekends for the first couple of weeks to allow you to relax when you get home.
- Plan easy, quick meals so you don’t end up ordering a takeaway every night.
General advice
- Have a pocket-sized notebook and pen at all times, and hold on to that pen for dear life. Pens have a habit of wandering in vet practices.
- Take a look at one of my previous blogs on language (Fake it ’til you make it) for some handy phrases to help assert your ability when you don’t really have a clue what’s going on.
- “Plan easy, quick meals so you don’t end up ordering a takeaway every night.” Image © serguastock / Adobe Stock
  
  Have a couple of books handy for quick reference when you need a memory jog. I use 100 Top Consultations in Small Animal General Practice and Gerardo Poli’s The Mini-Vet Guide for small animal, but I hear good things about the “Nerdbook” as well. For equine, I find the Handbook of Equine Emergencies great for quick reference on the go, along with the Saunders Equine Formulary.
- Make lunch in advance to start with. It may be that you always get a lunch break, but sometimes things are manic, so ensure you have food to keep you going.
- Take part in any work social activities and get to know your team – it will make the working day much more fun if you get on with those around you.
- Book a holiday for three months time. You will need it.
Handy resources

Make use of the vast range of apps and websites out there. Here are some I found really helpful:
- BSAVA app for the formulary (it’s quicker to search drugs than flicking through the paper formulary).
- BEVA apps – which features drug doses, certain procedures and joint blocks.
- NOAH Compendium – there isn’t an app (at the moment), but the mobile version of the website works well. Open the NOAH website on your computer before a consulting session starts – practice computers are notoriously slow and I guarantee it will freeze when you’re desperately trying to do a quick search for doses while the client is waiting.
- Norbrook app – for drugs not on NOAH.
- BHA Vaccination Date Calculator for horses saves a lot of time when working out vaccine validity.
- MSD Vet for the Merck manual.
- Vet Calculator for various calculations, particularly the heart rate counter.
While the word “survive” carries negative connotations about veterinary practice (and I have previously discussed how this sort of language can be harmful), I do think you feel like you’re firefighting in those first few weeks.

There’s no doubt it is a steep learning curve, but I’m confident you’ll come out the other side and thrive on the challenges of being a new grad.

Good luck and enjoy finally being able to say you’re a vet.
July 2, 2018
Supporting new grads: are you up to the job?
As I discussed in my previous blog post, if you are a boss, partner or practice manager, it’s important to consider whether your practice is suitable for a new graduate, before taking one on.

Perhaps you’re considering taking on a new grad for the first time, or maybe you’ve employed them before, but are struggling to attract candidates for your job vacancies – or it might be your new grads are leaving you after a short spell of employment.

If any of these apply, or you’re simply looking for inspiration on what you could do to offer support to new grads, I’d like to offer some suggestions from the new grads themselves.

Friendly face of support

Every new graduate looks for “support” in his or her first (or, in my case, second) vet role, but what exactly does that look like?

By far the most important aspect of support is communication – we’re all different, and the key to a great working relationship with a new grad is asking him or her the kind of support wanted or needed, and discussing how you can provide that.

This should also be considered a fluid, flexible conversation that continues through the first few months of employment – the rate at which a new grad gains confidence and experience will vary due to individual personalities, but will also greatly depend on caseload.

Being patient, friendly and answering questions are all important when dealing with a new grad. Image © .shock / Adobe Stock

Never assume

If your practice doesn’t see many cats, your new grad’s first cat spay might not happen for several months, and you can’t just assume having performed a lot of other surgeries, he or she will be fine to just get stuck in, when he or she may never have used a flank approach before.

On the contrary, some new grads can be dangerously over-confident, and that’s where your clinical and character judgement will be vital in ensuring the safety of their patients.

It can be a very delicate balancing act between pushing a new grad to improve, and not letting him or her charge in all guns blazing without the right skills.

Suggestions

The answer is not straightforward – no “one size fits all” new graduate induction plan exists – but a number of areas can be considered to help your new grad settle in.

I’m not suggesting you action all of them, or even that they’d all be suitable for every new grad or practice – they’re just ideas to think about.
- Provide a booklet with practice protocols – for example:
  - vaccine protocol
  - neutering advice (ages)
  - treatment protocols for common ailments (as a starting point)
  - what should be included in estimates for operations
- Order uniform or name badges and have them ready for the first day. It may seem trivial, but it symbolises being part of the team. Being asked 10 times a day who you are, or “are you new here?” gradually chips away at what little confidence you have as a new grad.
  Ordering a name badge for your new grad can help him or her feel part of the team. Image © kegfire / Adobe Stock
- Have him or her spend a morning on reception to learn how to book appointments and other tasks, to get used to the computer system.
- Put a nurse or receptionist in consults with the new grad to help him or her navigate charging for consults, saving notes, making up estimates and so on.
- Have the new grad observe some consults or accompany other vets on call-outs to help him or her grasp how the practice runs and to introduce some of your regular clients.
- Allow the new grad to pick up consults from a general list at his or her own pace.
- Book out double appointments for the new grad initially, then shorten these as he or she gets more confident – and, therefore, faster.
- Always have a more experienced vet available (in the prep room, perhaps) to answer those quick questions while the new grad is consulting. He or she need not be twiddling his or her thumbs, but, if performing procedures, ensure your new grad knows he or she can pop in and ask without feeling like an inconvenience.
- Decide on a maximum length of time for a consulting block and allow breaks for the new grad to catch up or have five minutes to gather his or her thoughts.
- Assign a formal buddy or mentor within the practice (not the boss) for him or her to go to as a first port of call for any problems – clinical or non-clinical.
- Provide regular constructive feedback – we don’t know if we’re doing okay unless you tell us!
- Have formal scheduled progress review meetings to let the new grad discuss any issues in a fair manner (the boss informally asking “how are you doing?” in front of half the staff will not always elicit an honest response).
- Have a working list of procedures or cases your new grad wants to gain experience in so all staff know to try to involve him or her if they get one in. Similarly, have a list of procedures he or she is happy to do alone (and an expected timescale) so reception staff don’t book in three bitch spays on day one.
- Supervision for operations – ask your new grad whether he or she wants someone scrubbed in, either in the same room or just within shouting distance, for different procedures.
- Have goals for the new grad to work towards without pressurising him or her.
- Show the new grad respect. Don’t undermine him or her in front of clients, even if he or she is in the wrong – better ways of addressing it exist without shattering the new grad’s confidence and credibility.
  Assigning your new grad a buddy or mentor can help as a first port of call for any problems he or she may encounter. Image © michaeljung / Adobe Stock
- Take on board any suggestions the new grad may have in practice discussions – he or she will have the most up-to-date knowledge, and it can be a huge confidence boost to have your ideas taken up.
- Try not to put your new grad to the bottom of the pile for holidays. In fact, some bosses almost force new grads to book a holiday after two months because they know they’ll need it.
- Give the new grad a Christmas at home (or at least the choice of doing so). Nobody wants to work at Christmas, but is it advisable to have a stressed out new grad – who will likely still need backup in December – on call for the busiest “my dog’s eaten the Christmas pud” poisoning fest of the year? He or she will have likely moved a long way from home and will be particularly lonely at this time of year.
- Have formal second on-call in place for as long as the new grad needs. Don’t assume he or she will be fine after six months – this will vary greatly depending on caseload.
Making a difference

From discussing our varying inductions and levels of support with my university friends, by far the most important thing is just being patient and friendly – even when it’s crazily busy.

Taking 30 seconds to answer a question will make a huge difference for the new grad, rather than letting us spend ages unable to find the answer in an ancient textbook.

If you take an interest in your new grad’s learning and development, rather than just employing us for cheap labour, you’re already heading in the right direction and your efforts to welcome us into the profession will be greatly appreciated.
February 27, 2018
Buying or selling a vet practice, part 1
Last time we looked at some hurdles owners of veterinary businesses have to overcome in finding their way to the exit door. However, once you have one hand on the door handle, what can you expect to follow?

Practices that have been on a “buy and build” strategy will be familiar with the acquisition process, but many owners will only ever be involved in one sale process.

Business owners in this situation often rely heavily on friends and contacts that have been through the process before, but, in many cases, those people can paint an unflattering picture.

Parts of the process

So what is actually involved? Is it as time-consuming and stressful as many claim?

Generally, the process can be broken into six main phases:
- pre-due diligence
- due diligence
- documentation
- pre-closing
- closing
- post-closing
In this article, we look at the first phase and how to deal with some issues that arise.

Pre-due diligence

Headline price

Before letting a potential buyer inside your business, it is important to establish at the outset the price range they are prepared to pay, or at least how the price will be calculated.

From a combination of publicly available financial information and additional (non-sensitive) financial information supplied by the business owner, a potential buyer is usually able to give an indicative price.

However, a number of assumptions are likely to have been made when calculating this price and it will be important for the practice owner to understand what they were.

Structure

In addition to the headline price, how and when that is payable should be discussed at an early stage.

As an owner, you will usually want to get as much of the price in cash as soon as possible. A buyer will usually look to defer paying as much of the price as possible, particularly in a veterinary business where personal relationships between the vets and clients are key.

Given the number of issues that need considering if payment is deferred or subject to an earn-out (in which case, the price depends on the post-completion performance of the practice), it is vital a business owner understands whether this is the buyer’s intention and engages early with advisors to understand the issues in more detail.

Know your buyer

Every business owner understands a buyer will want to know as much as possible about the business it is buying before the sale completes, but not every owner appreciates the importance of knowing the buyer. For example:
- If any deferred consideration takes place, will the buyer be good for the cash?
- If an earn-out exists, do you trust the buyer to not manipulate the short-term profits to reduce the price payable?
- If you are continuing in the business for a period after completion, can you work with the buyer?
Consider speaking to the owners of previous businesses that have been bought by the buyer. Putting a bit of effort into this phase can help you gauge how likely the sale is to complete and the success of the exit.
February 7, 2018
New year, new me

January brings with it an onslaught of well-intentioned gym memberships, diets and resolutions that often get forgotten fairly rapidly.

For me, my “happy new year” was tainted with uncertainty, as I had made the scary decision to leave my first job as a new graduate vet – quite literally forcing the “new year, new start” cliché on myself.

This decision was not made lightly. In fact, if I had listened to my gut feeling that things weren’t right, I probably would have left much earlier, but I stuck it out for five months. I had to be sensible – I had rent to pay. But, similarly, I was not going to stay any longer at the cost of my sanity.

Time to take action

Many of my new graduate friends also struggled at their respective workplaces to begin with, so I couldn’t help but think maybe it was just supposed to be hard. But as they all settled, and I seemed to just get more wound up with my situation, I began to accept it wasn’t right.

So, what were my options?

Address my employment concerns

Despite being advertised as a truly mixed practice, I found myself working as a TB tester virtually every day, which became unrewarding and a huge hindrance to my personal development as a vet.

I tried to address the situation, but was met with non-committal responses, such as: “Well, we are very busy with TB at the minute.” No offers of sharing it out were made, considering myself and another new graduate were carrying out all the testing. In fact, I ended up organising the whole practice’s TB equipment, paperwork and bookings.

The other issues I had were also met in a similarly non-helpful manner.

Go above the powers that be

One of the (few) advantages of working for a corporate group is you can go above the powers that be.

Although this provided a friendly listener on the end of the telephone, it didn’t actually achieve much after helping me explore the options of transferring to another practice within the group. As I was still looking for a mixed role, it came to a dead end pretty swiftly.

Hand in my notice

I was very aware my notice period tripled after I had worked at the practice for six months, so I had the choice of leaving before the six months were up or being stuck for at least nine months.

I did try addressing my employment concerns and going above the powers that be first, but I think I knew all along that, in the end, I was going to leave; it was just a question of when – before or after six months, considering the notice period, and before or after I had found another job?

Choice made for me

In the end, some timely external circumstances forced my decision – my landlord informed me he was selling his house, so I would only have a few months left of the lease anyway.

Once I came to the realisation I needed to leave, I felt relieved. This was ultimately short lived as I then faced the question of what to do afterwards – I even started to consider whether I actually wanted to look for another vet job.

But I didn’t have to look far to find some inspiration – my university friends were very supportive of my decision to leave my practice, but their stories of their own experiences were reassuring. The key was finding the right practice and being able to enjoy being a vet rather than seeing it as the stressful, unfriendly job with long hours it’s often portrayed as.

Negative into a positive

I began the job search slightly before handing my notice in – I think as a safety net, as I was still very apprehensive about being caught out with no work. I was also very concerned about how not having spent very long in my first practice would look to potential employers – would they think I couldn’t hack the pressure and gave up too easily?

My first interview this time around, however, was a massive confidence boost – my worries were ill-placed as my decision to leave my practice was only viewed as a positive move; that I was being proactive in my career development and not putting up with an environment in which I wasn’t progressing.

When more interviews and then job offers started emerging, I found the confidence to not only hand in my notice, but also to turn down offers that weren’t right for me.

Disguised desperation

We regularly hear about the shortage of vets in the veterinary press, on Facebook, through word of mouth and, for those working in understaffed practices, via first-hand experience. But nothing confirmed the veterinary employment crisis more than the poorly-disguised desperation some practices exhibited when I enquired about vacancies.

Yes, I was a little more desirable than a new graduate fresh out of university because I had worked for a few months, but I was still virtually a new graduate. If anything, I felt my skills had regressed since graduation because my confidence had been knocked so severely in my first role.

But I did know how to consult, interact with clients, break bad news, and offer and carry out euthanasia with the client in the room. These are the things you don’t really learn until you qualify; the small things that make a difference between being a startled- looking graduate in your first week being asked “is it your first day?” by a client, and a recent graduate who can give a calm impression of confidence and knowledge (even when you’re a little unsure).

It took me a while to convince myself I’d be employable enough to be picky, but with a few offers under my belt, I entered the new year jobless, but knowing so many practices out there were looking for vets.

It did, however, still take a considerable amount of moral fibre to swallow my pride and go to the job centre to sign up for jobseeker’s allowance. This was not without an added push from my ever-knowledgeable other half, who bluntly said: “You’ll be paying into it for the rest of your life, so you may as well claim it while you can.”

Daunting, but rewarding

Although it was daunting to quit one job without having something else lined up, it was the right thing to do and, inevitably, things worked out in the end. With a bit of patience and perseverance, I have now found what I think is the right job.

Although I can’t quite squash the niggling feeling it could all go wrong like the previous one, I like to think I’ve learned something from that disastrous experience, and am feeling much more optimistic.

After much reflection, I think I was just very unfortunate with my first role and a number of factors occurred that I could never have foreseen.

Take advantage

For many people, despite the new year clichés, January becomes a time of reflection. I’m not too sure about “new year, new me” but I’ve certainly ended up with “new year, new job”.

If you aren’t happy in your job, don’t be afraid to take the leap – especially if you’re a new graduate. It is so important your first job is right for you, otherwise it could scar you, and ultimately ruin your entire veterinary career.

It isn’t worth the stress of staying where you are unhappy – so many jobs are out there. It is, as they say, an “employee’s market” at the minute – take advantage of it.

January 16, 2018