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Tag: equine

  • The revision roller coaster

    The revision roller coaster

    At this stage of the year, it’s hard for me to write about anything but revision. So, for those of you reading this as a means to escape, I can only apologise. At the same time, if your idea of time off from studying is reading my work-related articles, then I think we need to have a little sit down and a talk about healthy revision outlets…

    With my last ever university exams (yeah, like, ever!) rearing their heads, I’m finding my own is a bit of a jumble.

    The last several weeks before the big day can often feel, at least for me, like a bit of a roller coaster ride. There are ups and downs; terrifying “grip the handlebar” kind of moments; and occasional points where you reach the top, clear the clouds and see everything below you with level-headed clarity – and then the whole thing starts again from the beginning.

    Happy birthday to me?

    First of all there’s the build-up. Personally, I think the build-up to exams can be worse than actually taking the things.

    As somebody with a birthday plonked squarely in early May, this has led to the anniversary of my birth becoming somewhat bittersweet over my past 20 (yes, 20) years of education. I’ve even had friends and classmates willing me not to age, just to fend off the dreaded exams.

    If you’re lucky, it will have been a good year since your last exams, so it’s almost easy to tell yourself it can’t really be as bad as you remember it, and sure, you’re here to tell the tale!

    So what’s all the fuss about? Besides, it’s months away, right… right?

    Then the realisation hits you that those months have melted away into a measly finger-countable number of weeks. This is the feeling akin to the hard “thunk” of that metal seat belt bar strapping you in before the roller coaster ride. You’re locked in now, and the only way is onwards.

    Image © Anna / Adobe Stock

    Highs and lows

    Like with any good roller coaster, the journey of revision is marked by a series of highs and lows. You can sometimes spend a day or two feeling really very good about yourself, quite smug actually, especially in the early swathes of revision while your brain juices are still flowing nicely.

    “Wow”, you think to yourself. “I remember everything I read today. It may have taken 13 years of exam practice, but I think I’m getting the hang of this revision malarkey after all”.

    Then a day comes when you wake up and it feels as though everything you once knew has fallen out of your ears overnight. Your brain feels like a clogged artery and the juices just can’t quite make their way round the bends. Paragraphs, facts and figures can start to swim together. Do horses lay eggs? Do chickens neigh?

    It can feel like five years’ worth of content is trying to make it’s way to the forefront of your mind all at once, with no polite or mannerly order.

    Image © Jacob Lund / Adobe Stock

    Stay in control

    The important thing, I find, in order not to let the roller coaster get the better of you, is to make everything else in your life as smooth a ride as possible. Obviously, this is easier said than done, I’m no fool. Life will always throw things at you, especially when you feel like you already have enough on your plate, but start by controlling the things you can.

    Remember the basics:

    • Sleep.
    • Eat.
    • Hydrate.
    • Practice self-care.

    Treat yourself to that leftover easter chocolate, keep making plans with friends as something to look forward to, and let yourself clock off for a couple of hours before bed.

    It all matters

    It has been scientifically proven that increased levels of stress actually reduce our ability to take in new information – which is, ironically, something on this year’s syllabus – as do lack of sleep, under-eating, dehydration and depression.

    Trying to revise under any of these conditions is like fighting with one arm behind your back, so never forget that what you do outside of your revision schedule is just as important as what’s in it.

  • DO look a gift horse in the mouth

    DO look a gift horse in the mouth

    If you don’t come from a “horsey background” (like me) then the equine side of the vet course can feel a little overwhelming.

    From a different number of ribs and guttural pouches to the inability to vomit, horses have an abundance of clinical differences to our smaller patients, and so (quite rightly) often need to be studied in their own right, much the same as with farm animal medicine.

    Clinical aspects aside, the world of equine also comes with a wealth of nomenclature that seemed to me, at first, like a second language. A disease called “glanders and farcy” was a particular favourite equine term of mine, as it sounds deceptively quaint despite in fact being an incredibly serious and often fatal notifiable disease.

    For these reasons, in all honesty, I was a little apprehensive of my first equine clinical placement – most likely not helped by a distinct lack of large animal clinical EMS up until that point (thank you COVID-19).

    As it turns out however, the two-week placement became one of my favourite so far. So, for those of you with it still to come, here are a few things I wish I’d known going in…

    Time to smell the hay

    Small animal medicine can sometimes be fast paced, and patients can come and go in a blur. With 15-minute consults and a lot to pack in within that time, there sometimes just aren’t the opportunities for students to ask questions or for advice.

    On the other hand, equine and large animal medicine placements are often a little less patient intensive, affording students the opportunity to really dive into each individual case, rather than losing track of how many they’ve already seen that morning.

    The drive between clients can also provide time for asking questions, filing in your case logs for the last animal, and reading up on the next.

    Communication, communication, communication

    Depending on the client, of course, a lot of call outs will involve a certain amount of time standing around the horse with the client waiting patiently at the reigns.

    Dentals, in particular, can take a surprisingly long time and while in small animal practice the vet can typically just stick the radio on, plonk on a stool and get to it, that might seem rather rude with the animals owner standing right next to you. Being able to hold a conversation with the client, whether its about their animal or just the nice weather we’ve been having, is a skill that can sometimes be sidelined in favour of clinical competencies.

    Making conversation can also be extra difficult if you’re trying to be clinically competent at the same time – and this is where multitasking comes in, as vets will often have to engage with the client for more than an hour while performing tasks on the animal that a smallies vet would probably take a dog out the back to do.

    As a student, spending long periods of time with a vet and a single client is a great opportunity to practice client engagement and communication. If in doubt, and you’re left alone with the owner while the vet runs back to their car, try asking about their animal (how long they’ve had it, if it’s their first, and so on). We all love gushing over our pets, and it goes a long way to show enthusiasm instead of the vet coming back only to find the two of you staring in silence at the grass.

    “Jugulars like drain pipes”. Image © charlymorlock / Adobe Stock

    Bigger can be better

    When you’re not feeling 100% on your catheter placement or blood sampling, it helps to have something big to aim for. This is where horses come in…

    It’s almost like they’ve gone out of their way to be the perfect injection-giving training wheels, with jugulars like drain pipes and large obvious muscle bellies for you to grab in one hand and pop a needle in with the other. Once you’ve mastered the horse IV and IM, it’s only a matter of sizing down.

    My main takeaway from this placement was a reminder not to shy away from practising things that don’t come naturally, or aren’t your favourite thing in the world. There’s no point practising the things you know you’re best at, for the sake of feeling good about succeeding in something you already knew how to do.

    You’ll feel much better after that initial leap out of your comfort zone, when you succeed in something you couldn’t do before.

  • What about vets on the front line?

    What about vets on the front line?

    Our profession is generally pretty good at pulling together in the face of adversity.

    I’ve always loved the community feel of being able to go to CPD events, and usually know someone, or have connections with someone, who is there.

    I love being able to send a message to my uni friends at any time of day or night – be that for clinical advice, moral support or reassurance on something entirely non-vet related – and get a reply. Failing that, you can often seek an answer or support from one of the vet Facebook groups on numerous topics.

    In light of COVID-19, the veterinary world has rallied together… to a point.

    One for all, and all for…

    Those who have been furloughed are finding a wealth of free online CPD available to fill their time and keep connected clinically. Not only are there webinars, but there’s a plethora of online workouts or discussion groups to actively engage in.

    That all sounds lovely, but what about those of us who are still working? What support is there for the minimal staff left in clinics who (despite all these figures on turnover being down) are battling ridiculous increases in workload?

    Less is… less

    There’s less staff in most clinics, to varying degrees, but I have heard horror stories about severely restricted numbers and even certain groups furloughing everyone but vets.

    Whatever business decision may lie behind that, these clinics must be in chaos. Vets, who are already stretched trying to do their “normal” jobs (it is currently far from normal), are also running their own bloods, cleaning, answering phones, chasing and taking payments, sorting insurance claims and ordering stock, among other things.

    These tasks may be alien to some of us, and trying to navigate previously undiscovered depths of the practice management system at the end of an exhausting shift adds unnecessary stress.

    We love our nurses and receptionists as it is, but those who are currently deprived of them will be unearthing a a gargantuan respect for them in the future.

    Crisis consulting

    Consulting in this environment makes you realise how much multitasking we would ordinarily do. Currently, my consults look like this:

    • Owner arrives and calls reception.
    • I try to work out which car he or she is in, then take a brief history from 2m away.
    • Take the animal into the practice.
    • Find a nurse to assist with the handling.
    • Examine the animal.
    • Telephone the owner from the practice or go back outside to discuss with him or her from a safe distance, before returning to the animal to give treatment.
    • Give the animal back to the owner.
    • Dispense medication, then ask the owner to call reception again to pay…

    This takes a lot longer than normal consults, so working to offer the same number of appointment slots is both relentless and draining.

    Lies and abuse

    Everyone is used to certain number of disgruntled clients, but the barrage of abuse those on reception are receiving from clients is unprecedented.

    It would seem many members of the public are not getting the “stay at home” message and are furious when we explain a nail clip is not an emergency. As a result, we are now seeing clients exaggerating, or just plain lying, in order to be seen.

    A choice example last week was a dog booked for a potential euthanasia, but turned out to be a weight clinic. We then had to stifle our disbelief and anger at these time wasters before moving on to the next client, who has desperately tried to hold off from having to make the difficult decision to say goodbye to their dearest pet under these circumstances – and yet we can only offer words of comfort from a distance and inject from the end of a drip line, which really doesn’t seem enough.

    Unfortunately, the COVID clearout seems to be worse than the annual Christmas clearout, and these scenarios are not isolated, but heartbreakingly frequent.

    Lost in translation

    And what support do we get? We get the RCVS and BVA back-pedalling on their original statement, to then shirk responsibility and leave it “up to individual practices” to interpret the “guidance” how they wish.

    After the clarity of the original stance on vaccinations, this ambiguous follow up was very disappointing. The truth is many vets feel that corporates and business owners will take this as a green light to return to business as usual, while firmly claiming that it is most definitely not business as usual.

    I can agree with that – the way we are working is certainly not the usual, but if we are now to do vaccines and neutering again, what exactly are we missing? Stable med checks, done via telephone rather than in person?

    Taking the high or low road?

    We get colleagues taking the moral high ground, questioning our commitment to the oath we took on graduation to put animal heath and welfare above all else. Just because I don’t think vaccinations are currently a priority, it doesn’t mean I don’t care about my patients anymore – human health has to come first.

    We get corporates issuing yet more paperwork to encourage us to document risk assessments – while seemingly offsetting the responsibility to us – so that if their business gets sued for denying to provide care or (God forbid) agreeing to see an animal that results in transmission of COVID-19 between owner/vet, it was the vet or receptionist who took the phone call’s fault for making that decision.

    Aside from this, the phones are ringing off the hook and vets are running around like blue-arsed flies, so practically, where are we going to find the time to fill in these bloody forms?

    Horseplay

    Before any of that, the request to risk assess mild ailments is fundamentally flawed when we are being told to go out and do horse boosters.

    While equine vaccinations and other routine work that is now being pushed again, because equine turnover is the most severely affected of all veterinary sectors, we are told to maintain safe social distancing at all times.

    With equine vets reported to be one of the most dangerous occupations, is it sensible to expect us to administer vaccines with no one holding the horse? In some, if not most, cases, that will probably be okay. But with owners consistently lying to us to be given an “emergency” appointment, how long before an owner lies about his or her severely needle/vet-shy horse and one of us pays the price?

    Heading for burnout

    I don’t pretend to understand the intricacies of business management, but you cannot flog a dead horse. Many vets who have barely had time to inhale lunch are working different and longer shifts just to cope with the “emergencies” – and yet you’re asking us to do more?

    It’s incredulous that the veterinary sector seems to think itself superior to all the other thousands of businesses up and down the country that are struggling or facing collapse. By continuing to pile the pressure on to staff with increasing risk of burnout, you might preserve some income, but you’ll be lucky to have any vets left by the end of this.

    Is anybody listening?

    We are angry that the higher-ups in the profession are treating us this way. We feel guilty for being jealous of, or feeling antipathy towards, our furloughed colleagues. We are emotionally drained. We feel guilty because this can only be a fraction of how front-line NHS staff must be feeling – and above all, we are exhausted.

    In a profession with an already poor record for mental health and suicide, we are now even more stretched, under even more pressure from all angles – and no one seems to be listening.

  • Oh, what a month

    Oh, what a month

    What a month is has been. Surely, August 2018 will go down in the annals of history as one the most prolific in the fight for animal welfare in England.

    From the banning of puppy and kitten sales in pet shops to outlawing electric shock collars, campaigners have had a spate of notable victories to celebrate in a matter of weeks which, it is hoped, will enhance animal welfare and shape a better future for pets and owners alike.

    Indeed, such has been the influx of news, we were still filing articles on the day of going to print, to ensure the latest news – the electric collar ban – reached you hot of the press.

    But new causes and campaigns are never far away, as evidenced by the fact that, according to some organisations, cats are the latest victims of the public’s “thirst for endless novelty” with RVNs again “ideally placed” to help tackle the issue.

    Every little helps

    Yet it doesn’t matter if you are fighting on the front line of a campaign trail or caring for a forlorn feline in a small animal practice; every act, every consult and every action is an amazing feat and should be applauded.

    You transform the lives of animals and their owners daily, and make their futures a little brighter in the process.

    With so much demanded of RVNs, I imagine it could be easy to get a little overwhelmed. In the face of conflict, Second World War politicians sought to raise the British public’s morale with the ”Keep Calm and Carry On” posters. They seemed to work. Sound, and still relevant, advice methinks.

    If animals could speak – from kittens in clinic to rescued horses – I am think they would say “thank you” for all your hard work. Which is what I want to say too, as it happens.

    Whoever you are and whatever you do, keep up the amazing work and (to coin the phrase) keep calm and carry on. When future generations are reflecting on this pivotal time in animal care, you can say with pride “I was there”.

  • Seven – the magic number?

    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?

    waiting
    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

    rota
    “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.

  • Corporate vet school

    Corporate vet school

    The announcement of a corporate veterinary group’s collaboration with the new Keele University/Harper Adams veterinary school struck a few chords, and seemingly opened a figurative can of worms that (like their literal parasitic counterparts) just doesn’t sit well in my gut.

    A few points to consider here, the first of which I have written about before, although not about this particular arrival on the vet school scene.

    More vet schools needed?

    Do we need more vet schools? The short answer, in my opinion, is no. The employment crisis in the veterinary industry as it stands is multi-faceted – pluck a reason out of the air and it almost certainly has some impact on why practices are begging for vets:

    • compassion fatigue
    • poor working conditions
    • work-life balance
    • salary
    • lack of long-term prospects
    • Brexit
    • client pressure
    • under-supported young vets

    I could talk about any one of these reasons at length (and have done), but, for the purposes of discussing the above gem of veterinary news, I will focus on the last point: support for new graduates or young vets.

    Vicious cycle

    circle
    “This lack of support leads to high stress levels, young vets becoming fed up and looking elsewhere for a different career that provides them with the mental stimulation they desire, but with better support, hours and pay to go with it.” Image © Michael Brown / Adobe Stock

    Some practices are excellent at providing a nurturing environment for young vets, but many are not and often not through any fault other than lack of staff.

    This lack of support leads to high stress levels, young vets becoming fed up and looking elsewhere for a different career that provides them with the mental stimulation they desire, but with better support, hours and pay to go with it – thus the vicious cycle of extremely talented young people leaving the profession after a few years begins.

    Problem solver?

    Will opening more vet schools help the staffing problem? No. It is a short-sighted, temporary solution to fill a gap nobody seems to be able to plug. But the more graduates that accept jobs from practices who ideally wanted an experienced vet and can’t source one, the worse the retention problem will become. It is unfair on both parties to take on a new grad if a practice does not have the resources to sufficiently train and help them through their first few years.

    To solve the retention problem, the profession needs to improve working conditions and encourage vets to stay, not just find more avenues to farm out new grads to try and bridge the gap.

    Are corporates good for the profession?

    I could (and probably will) discuss corporates at great length, but there is no clear answer for them being good for the profession. Having been stung with the sore end of the corporate tail once before, I’m inclined to say no, but that would be based on my experience of one particular practice. Conversely, I have colleagues who work for corporate practices that seem to be very well run and provide a great environment for learning.

    My opinion is not fact and, to keep it short and sweet, is summarised below:

    • The idea behind corporate practices is often well meaning, but does not always work when put into practice. For example, the graduate schemes sound great, but only work if they are implemented correctly on an individual practice level.
    • Some corporates are extortionately priced compared to independents – there is a fine line between charging appropriately and taking the biscuit. This is likely exaggerated because many independents have been selling themselves short for years; however, it is not okay to triple prices in a week when an independent practice is taken over. All it does is feed the myth that vets are only in it for the money.
    • Long-established corporately owned practices seem to have better client satisfaction than practices newly acquired under a corporate brand as the shock of takeover, staff changes and price increases are long gone.
    • Corporates aim to provide better working hours (a four-day week, for example) and flexible working patterns, but, again, this varies on an individual basis.
    • The hand of many partners in independent practice has been forced as the profession continues to change. Young people do not have the disposable cash to buy into partnerships, as was the tradition. Corporates have taken advantage of this by buying out those wishing to retire without any new blood coming through.

    Corporate practices can vary wildly even within the same group – much of it comes down to the individual practice, as with independents. As much as corporates offer many benefits with their nice shiny contracts, many independents match or better these. Likewise, an independent or corporate practice can be an equally catastrophic place to work in if managed badly at the practice level.

    Now, to the elephant in the room…

    Should a corporate group be running a vet school hospital?

    Is a corporate running a vet school hospital any different from the outsourced rotation format of the other newest veterinary schools – Nottingham and Surrey – whereby they have no on-site university clinic, but rotations are undertaken in nearby hospitals?

    nocash
    “The hand of many partners in independent practice has been forced as the profession continues to change. Young people do not have the disposable cash to buy into partnerships, as was the tradition.” Image © MHChristine / Adobe Stock

    The concern with new veterinary schools popping up and proposing this sort of final-year teaching is the associated practices are then less available to provide EMS placements for local students. The purpose-built corporate hospital that is to be partnered with the new veterinary school avoids this particular hurdle in part, at least (there’s no mention of an equine hospital or farm clinic), but is it still a good idea?

    Remaining impartial

    It comes down to whether the corporate presence is going to be ingrained into the teaching. Will the graduate scheme offered by the group be heavily recommended? Would the business structure and branded drugs be taught to the students?

    At university, we were always told to learn drugs not brand names to remain impartial. Would that impartiality be maintained appropriately in a hospital that uses own-branded drugs and whose bigwig advisory boards dictate which products should and shouldn’t be offered?

    Encouraging research into all available treatment and diagnostic options is a key aspect of learning and practising evidence-based medicine on rotations.

    Familiarity breeds

    Even if no direct corporate emphasis exists, surely the undercurrent is going to sway the students into applying for jobs in sister practices under a graduate scheme.

    As a new grad, you are bewildered by everything and getting a heads-up on even the smallest of obstacles can make a huge different to your day in the first few weeks. Therefore, simple things, such as the practice management system used in every practice the group owns, may be enough to sway the decision between accepting one of two jobs, simply because using a system you’ve gotten used to on rotations will make your life that bit easier during day-to-day practice.

    Conclusion

    It remains to been seen if a corporate partnership with the new vet school will be a success for the students under their care and the profession as a whole, and I’ll withhold judgement for now.

    However, with predictions corporate takeover will saturate at 70% of practices in the profession, it is undeniable the veterinary landscape is moving further adrift from its once independent roots as the corporate giants continue to tighten their grip.

  • How to survive your first weeks as a new grad

    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."
    “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."
      “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.

  • Aggressive patients

    Aggressive patients

    I’ve discussed before the massive emotional shift that seems to occur in the transition from a student to a new graduate – namely due to the responsibility – but the transition to being an actual vet also means being on the front line when it comes to aggressive patients.

    As a student, you are often given the “nice” patients to practise blood sampling or catheterising – or even just examining. If a pooch utters a slight growl, the muzzle will be on, with a confident RVN holding for you at worst, but, in most cases, the vet would just take over to keep you out of harm’s way.

    As such, when I started out as a “real vet”, this meant I had very little experience in dealing with the more difficult patients.

    Exposure

    At vet school, we were shown how to make a bandage muzzle if all else failed and practised stuffing a cuddly toy cat into a cat bag, but, again, we were rarely involved with any real-life angry cats or dogs.

    Obviously, this was in the interests of our safety, and I’m not suggesting they put us in dangerous situations deliberately, but in the real vet world, we are now the ones who ultimately need to gain that blood sample, despite flailing paws and teeth.

    Safe handling of aggressive, or often just scared or nervous, patients who lash out from fear is something that can only be gained from experience – which, as a new grad, is fairly limited at this point. Drawing on ideas from your colleagues and nurses is probably the best way to learn – especially for behaviour-related things that aren’t necessarily taught very well at university.

    Near misses

    IMAGE: jonnysek / fotolia.
    Dealing with difficult patients on the front line is “quite a scary place to be”. IMAGE: jonnysek / fotolia.

    Nearly being bitten by a little dog with severe dental disease (who could blame it for not wanting me to touch its mouth), that then seemed immune to sedation and therefore needed a general anaesthetic to even examine its mouth, was my first taste of having to make a call based on my own safety, but also the need to make an accurate assessment.

    I’ve also had a few near misses with horses – in particular, one that really did not fancy a nerve block and decided to fling its front legs at mine and the other vet’s head height instead.

    Support each other

    Being a vet can be a dangerous job, since we work with unpredictable living creatures better equipped with natural defences than us, and often a lot bigger and heavier. We just need to help each other work as safely as possible around them. But, if you’re on your own with bared teeth, it’s still quite a scary place to be.

    Just another thing to add to the list of “things they don’t teach you at vet school”.

  • Preconceptions

    Preconceptions

    Many preconceptions about the veterinary profession exist, with many of us having heard the old “is that seven years of training?” or “vets are all loaded” comments (cue eye roll). But what about on a personal level?

    Now I’ve finished vet school and passed (yippee!), I’ve been faced with a couple of misconceptions when I’ve told people I’m a qualified vet (pending graduation).

    Most frequently – and from almost every person who didn’t already know I’ll be starting a mixed job – I’ve been faced with the assumption I’ll be a small animal vet. After the fourth time this happened, I started to wonder…

    Do I have the “smallies vet” look? Is there even a “look”?

    I always thought I had the look of an equine vet, if anything. Is it because I’m slight and average height? Perhaps it is assumed someone of my build couldn’t possibly wrestle a sheep or calve a cow.

    Old-fashioned ‘values’

    Perhaps the prejudice stems from deeper than that. Is it because I’m female?

    Despite the proportion of graduates entering the profession now being 80% female, I think the public still expects a farm or mixed vet to be male. Why? A simple misconception or an age-old prejudice whereby it is assumed men are more intelligent than women?

    So far, I have been lucky to have never found myself in a demeaning situation in veterinary practice in the UK because of my gender (other than having to clarify it to avoid assumptions based on my name alone). I do, however, have colleagues who have been faced with sexism in a veterinary context.

    Maybe it just hasn’t happened to me yet, or maybe I’m too bloody-minded to notice. I think that’s why the assumptions about my career choice took me by surprise.

    Midlife crisis

    Another odd question I was asked recently was: “Are vets like GPs – arrogant middle-aged men?”

    I didn’t really know how to answer that…

    Yes, there are older vets (not always men) who have something of a superiority complex and view internships as a rite of passage, whereby it is to be expected to be overworked and underappreciated and, because they went through it once – and have progressed in their career – they now have the right to treat the interns like dirt.

    So yes, I guess so. There’s no question many of these exist, but many more wonderful, experienced vets exist who remember how hard it was in the beginning and try to help, teach and guide you where they can.

    The veterinary profession is changing and, although it might take a while for the preconceptions to catch up, the public view of it will change too. Maybe I’m wrong and I’ll still be fighting the assumptions 40 years down the line.

    Like they say, to assume makes an ass out of u and me!

  • Getting the most out of EMS placements

    Getting the most out of EMS placements

    A few weeks ago, I finished my last final year rotation, and I’m days away from finishing my last ever EMS placement – where has the time gone?!

    Everybody warned us final year would fly by, but this is ridiculous. Surely it can’t be almost a year since I sat in one of the small animal hospital meeting rooms, practically shaking with fear on my first day of emergency medicine – my first day of final year – and yet, here I am.

    EMSWith 12 weeks of preclinical and 26 weeks of clinical EMS under my belt, I’ve picked up a few handy tips along the way.

    On the whole, I’ve had some fantastic placements, seen some incredible things and travelled to a number of far-flung destinations, but (as ever), with hindsight, there are a few things I may have done differently.

    So, for those students in their earlier years, here are some things to bear in mind.

    Plan your placements

    This sounds obvious, and the majority of placements will need to be planned well in advance (often a year or more), purely due to practice availability. But, if you have the luxury of choice (if the practice has lots of free dates), really think about what you want to achieve before final year, and try to have at least a taste of small animal, farm and equine before rotations, if possible.

    I got to final year and realised I’d had very limited experience in farm practice, so felt a bit lost at the beginning of the farm rotation. However, having now done more farm EMS – which accidentally ended up all happening at the end of final year – I feel so much more confident.

    Also, think about how much EMS you want to do at which stages of the course.

    You have to spread it out and start somewhere, and while you need to give yourself some downtime in final year, I think you also get a lot more out of placements the further through the course you are.

    Listen to recommendations

    Talk to people in your year and in the years above.

    Some practices are really keen to teach, which results in a much more helpful experience for you and them alike.

    The quality of your EMS placements can make a real difference – don’t get stuck somewhere you’re only allowed to stand in the corner and watch.

    Do a spay clinic

    spay
    Spay clinics allow you to gain hands-on experience that may be tricky to come by otherwise.

    The quality of the surgery might be different to what you would see in the UK, but these clinics allow you to get hands-on experience, which may be more tricky to come by at home.

    You will practise tissue handling, suturing and ligature placement – all transferable skills.

    Again, listen carefully for recommendations as some clinics are better than others.

    Be adaptable

    There’s more than one way to skin a cat – likewise, you’ll see many different approaches to the same technique, which could be something as simple as giving an IV injection.

    I was “told off” in the university hospital for giving a horse an IV the way I’d been shown on EMS. The following week – on the first opinion part of our rotation – I was told to do it a different way, again.

    Learn how your supervising vet would like you to do things to stay out of trouble, but in the end you will find your own preference.

    Take tips on board

    The vets you meet on EMS have been in practice a while – they’ve made their mistakes and got the T-shirt, so take stock of any handy tips they might give.

    Recently, one vet expressed surprise I was rectalling cows with my “strong” hand (I’m right handed), but didn’t really expand on why they were taught to use the left.

    Another, older vet, strongly advised me to switch to my weaker arm because “years of having your hand squeezed inside a cow will give you horrendous arthritis”, and you’d rather that happen to your left hand and keep your right hand working. Subsequently, I swapped and soon felt competent with my left hand. I do still think the right hand is better for horses though…

    Most importantly, while it can be difficult to tread the line between being too imposing and too shy, you do need to put yourself out there. Offer to do things to help you know you’re capable of, such as setting up a fluid bag.

    And, most importantly, enjoy yourself!