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Tag: RCVS

Practice in practices makes perfect, in practice…

In a world currently filled with sacrifice and compromise, the cancellation of a week’s EMS over the Easter holidays did not, at first glance, seem like a hardship.

Of course I had been looking forward to my first ever farm-practice placement – especially as only a week or so before I had tried my hand at my very first rectal exam and even understood, with sudden and unexpected glee, what some of those lumps and bumps actually were.

But the idea of a little extra time with the family and a whole additional week to focus on upcoming exams meant that, initially, I was not too disheartened.

What does it mean?

Now we’re several weeks deep into lockdown, with no clear end date on the calendar and firm Government advice to “not expect a return to normality anytime soon”, what does this mean for my friends, colleagues and peers at veterinary school – my unlucky year in particular? The situation is different for each year.

First-year students

Poor freshers have had to miss out on Easter lambing season – an unspoken rite of passage into the vet student community. After all, if you’ve never come home without bodily fluids in your hair, are you really one of us?

Second-year students

Second years are having to postpone pre-clinical EMS, compared to those in their fourth year who are sacrificing what could be termed “the good stuff” – that is, real problems in real practices, suturing, injecting, slicing, dicing and all of that (though maybe not the last one). But hopefully the majority of these students will have managed to gain experience in their respective levels of training over the summer of 2019.

Final-year students

Final years have been somewhat of a priority, and rightly so, with special arrangements being made to ensure they graduate fully qualified and at no more of a disadvantage than those who graduated the year before.

My friends and I

Enter now the third years – the year I myself am a part of.

This year marks a transition for us; a stepping stone from sweeping dung from a variety of sources and essentially stepping back to watch the magic happen, to actually doing the magic – or at least attempting it with a sweaty brow under the watchful eye of several veteran professionals.

It’s a big thing. A big, scary, daunting prospect of a thing, but a thing nonetheless – and, given the uncertainty we’re facing in terms of what the future holds for anything and everything, the question is being opened as to what this means for the next generation of vets.

Abnormal

We’ve been told by many officials not to expect “normality” for some time.

“Normality” in this case meaning “the way we’ve always done things” – crowding together in coffee shops, restaurants, and hospital and practice waiting rooms without a care in the world.

“Virus? What virus?” we would say.

But, although certain establishments can change the way they operate – cafés can upregulate hygiene and waiting rooms can impose distancing restrictions – EMS is another matter entirely.

Impractical

Veterinary practices and animal hospitals are undoubtedly some of the cleanest places in the world – because they have to be – and vets themselves are no strangers to singing Happy Birthday twice before eating their lunch. But opening their doors to one or several new vet students each and every week in the coming months might just not be feasibly possible.

A lot of practices – especially independents – are small compared to their human counterparts, which has never really been a problem for us because, luckily, a lot of animals are also rather small. It does mean, however, that, a lot of the time, the two-metre rule just wouldn’t be practical – even if your only purpose is to stand and observe.

For those still needing to undertake pre-clinical placements, a whole new set of challenges exist, including the willingness of farmers to take on students whose help would not be essential, as viral exposure for them could mean a complete loss of livelihood.

Preclinical conundrum

It is an RCVS requirement for all students to complete a minimum of 12 weeks’ preclinical and 26 weeks’ clinical EMS. However, fourth-year students have already had their mandated clinical minimum halved to a mere 12 weeks.

While other years are currently expected to be able to “make up” any missed placements before graduation, the fact the situation is constantly in flux means the RCVS has admitted further reductions may be needed.

While this would certainly be helpful and take some of the pressure off for those of whom meeting the usual requirements would be an impossible feat, one has to worry how this will affect student confidence in the long run.

Key experiences

There is a reason the RCVS has always asked for a certain amount of EMS, and while the number seems daunting at first, it’s only during (or perhaps after) each placement that you can truly see its value.

Practice makes perfect – but, more than that, it builds confidence. It provides an environment in which mistakes are not life-threatening and are safe to be learned from.

With the loss of these key experiences that have helped shape generation after generation of vet students, it is perhaps inevitable that vet schools will have to adapt even further than they already have to limit the knock-on impact of a scenario we have never had to face before.

June 10, 2020
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.
April 29, 2020
Who runs the world?
Toward the end of my first year at university, a friend of mine stumbled upon a funny online student-made list of “things NOT to expect at vet school”. From memory, I think it included things we all related to such as Christmas holidays (curse you, exams), summer holidays (why, EMS, why?) and “a coolness status to rival the medics” (we are real doctors, I swear).

But what was probably the most relatable, and yet the one nobody really expects before vet school without already being in the know, is: “an abundance of men”.

Now, I’m not saying I signed up to the course for the sole purpose of a live action performance of It’s Raining Men, but, at the same time, you can’t help but be taken aback by the sheer volume of girls compared to guys the first time you walk into that lecture theatre.

While stereotypical – are women more likely to love all things cute and fluffy? – wonders Eleanor Goad.

Why, oh why?

Just to put it into perspective for you, my cohort for the year is roughly 150 students and 10% of those students are male.

According to gender statistics recorded by the Vet Futures project, it’s been like that for some time, in fact, the veterinary graduates’ ratio of female to male has only been increasing over the past few decades.

Nobody is really sure why. In human medicine the ratio is relatively even, so what is it about animals that strikes a chord with women more than men?
- A maternal nature?
- A love for all things fluffy?
Both these solutions seem a little stereotypical and, to be honest, we’re probably most unsure about the reason behind the numbers because nobody wants to touch this landmine of a topic with a 10-foot barge pole.

I really don’t have the answers myself, either – but it’s a curiosity I can’t not address.

Imbalance

I suppose I never noticed it growing up, or even doing work experience prior to vet school – which makes sense when you look again at the statistics as the gender gap seems to rein in after graduation. So, although around 70% of vet graduates are female, the number of practising female vets is more like 50%.

That difference doesn’t seem so odd once you’ve factored in maternity leave, but it’s not the only disparity. Despite the fact the veterinary population spewing out of universities across the country each year is overwhelmingly female, men make up the majority of those working as RCVS specialists, as farm/mixed practice vets and as RCVS fellows – the people committed to advancing the veterinary profession.

In essence, the vets who specialise outside of “general practice” are confusingly male. Positions of power in general practice, such as partner positions, are also held by men in a greater proportion than women.

How can this be?

As a veterinary student with, as yet, only a teeny tiny foot in the clinical world, I can only really speculate.

The best-case scenario for these statistics would be simple chance, that more men happen to have been interested in specialised careers than women, but this seems unlikely. It could also be down to the fact that maternity leave and childcare can unfortunately, but ultimately, lead to a lack of “career propulsion” (for lack of a better term), and can make it a little harder to advance in your profession at the same rate as male peers. More woman might choose job stability over returning to education or pursuing a less predictable career for the same reason.

These outcomes are understandable, but at the same time, nobody should be – or feel as if they are being – held back.

It’s my hope that, in future years, the gap between the genders closes, for more guys to aspire to a veterinary career, and for more practising female veterinary surgeons to pursue whatever career they chose, general or specialised.
January 22, 2020
Votes for… well, everyone really

It is a universally acknowledged fact that 100 years ago, millions of women won the right to vote.

What is not so well known, perhaps, is the same passage of time has passed since men were also granted suffrage.

Prior to the 1918 Representation of the People Act, democracy was restricted to wealthy males. After its introduction, suddenly, and for the first time, a generation of working class British men – some still embroiled in the First World War – were able to have a say on who they wanted to see in power.

Now, I am no politician, nor a member of your esteemed profession, but if I could vote in VN council elections or express my view via the ongoing consultation, I would.

Make a difference

Democracy was restricted to wealthy males until 1918, when a generation of working class men – some of whom served in the First World War – were able to vote. “British soldiers in action” by Champagnepapi22 is licensed under CC BY 4.0

People fought tooth and nail – some even gave their lives – to enable every man and woman to vote. Compared to that, putting a cross on a ballot paper seems ridiculously easy, and surely worth a few minutes of anyone’s time?

As incoming RCVS VN council chairman Racheal Marshall says in the August edition of VN Times, this is your profession and you can play a vital part in shaping it.

Life is about looking forward with hope, not backwards with regret. Your voice can make a difference to your future life and career – and to those people yet to come. Why not make it the best version possible?

That is, after all, what those brave people did for us many years ago. The simplest of human rights seemed like an impossible, unobtainable goal, but they never gave in and, in so doing, altered the course of history.

Positive change can occur, if only we have the courage to take the first step.

August 8, 2018
VN Times calendar competition 2018 – terms and conditions
1. The competition is only open to practising RVNs, SVNs and veterinary nursing assistants who subscribe to VN Times, who work in veterinary practices and are residents of the United Kingdom aged 16 years or over. Veterinary surgeons are unable to enter. All entrants will be checked against our Vetfile database and the RCVS register for eligibility.
2. Employees of pharmaceutical companies and veterinary companies that provide a service to veterinary practices are not eligible to enter. Any such entries will be invalid.
3. Entries must be received by midnight on Sunday September 16, 2018. Entries will be shortlisted and readers of VN Times will vote to determine the top 12 and one overall winner. The winners will be notified by email or telephone by Monday November 5, 2018.
4. We will accept a maximum of three photographs per person but please note that when it comes to short-listing only one of those entries will be able to go through to the final choice.
5. Photographs must be in keeping with the theme “Out and About”, (i.e. animals outside) and must be accompanied by a brief description of the subject with a maximum of 100 words.
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8. Veterinary Business Development Ltd accepts no responsibility for incomplete or delayed entries.
9. Each entry should include the animal’s name (if known), your name, telephone number, your qualification(s), practice name and practice address.
10. By entering the competition you are giving Veterinary Business Development Ltd permission to publish the photograph and details in the VN Times 2019 wall calendar and for the free use of the image elsewhere by Veterinary Business Development Ltd.
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12. All photographs must be the entrant’s own work. If you are submitting a photograph of your animal taken by someone else, please supply written permission from the owner that they are happy for you to enter it in the competition and for you to receive the prize if you are a winner.
13. Photos may only contain animals or people if you have the owner’s/person’s prior consent. Written consent will be required from a parent/guardian/carer if any person under the age of 18 or vulnerable adult is photographed.
14. First prize: £1,000 Amazon.co.uk voucher. Runners-up: 11 people will each receive a £50 Amazon.co.uk voucher. All 12 winning animals will feature in the VN Times 2019 wall calendar, with the first prize-winning entry appearing on the front cover.
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July 10, 2018
Accountability and responsibility: which causes more fear?

It’s very daunting standing in your first consult as a real, qualified vet – even if it is “just a vaccine”, which invariably turns into “actually, this has happened“, or “now you mention it“, and so on.

But why is it we have that constant feeling of being on edge – more so than a few months previously, when we were still students?

A noticeable shift certainly occurs to being an actual vet, rather than someone who always has a supervisor to have the final say, or take the brunt of the backlash of a mistake.

However, is it the accountability or the responsibility worrying us the most?

Pressing concern

Mistakes are inevitable, but rarely catastrophic. IMAGE: pathdoc/Fotolia.

As soon as we swear the oath enabling us to register as veterinary surgeons in the UK on graduation day, we become accountable to the RCVS.

In the past year, I have witnessed more than one speech telling us a) not to be scared of the college, and b) not nearly as many complaints, disciplinaries or registration removals occur as we think.

Exact figures aside, the take-home message has been: if you don’t knowingly do anything wrong or illegal, the likelihood of serious consequences is very low. You can’t get struck off for making a simple mistake.

The veterinary press, however, seems to over-represent those who are struck off or reprimanded; after all, you never hear about how many vets were not struck off this month or doing their jobs as they should.

Perhaps this is where the unease stems from? And why the RCVS seems so keen to tell us these individuals convicted of misconduct are a very small minority of the profession?

Are new grads really scared of the RCVS?

Talking to my colleagues, the general feeling is we understand we won’t get struck off for making a mistake. However, if the fear has anything to do with our regulatory body, it’s more the confidence knock we would have as a consequence of having a complaint against us made to it.

Of course, an element of worry surrounds being banned from practising as a vet, but I don’t think I would rank it top of the “things to be afraid of as a new graduate” list.

Instead, in that list, I think responsibility carries a greater weight. As students, we were always supervised and, ultimately, the fate of an animal’s life never truly rested in our hands. Any decisions we made were either backed up or steered in the right direction by clinicians.

Now, it’s down to us. Yes – other, more experienced colleagues should be in each practice with whom to discuss cases or reaffirm decisions, but when it comes to the consult room, you’re on your own.

Experience is king

Jordan, pictured during her final-year rotations.

What if I miss a heart murmur? What if miss signs of glaucoma, a pyometra or a lump? The list goes on. What if I could have done more investigations earlier? What if I misdiagnose something and prolong pain because I didn’t prescribe the right treatment first time?

These questions going on in our heads, coupled with a niggling feeling we have forgotten something or misread a dose, are the root of the fear. I believe this is what scares us, more so than the RCVS.

The animals – and us inherently wanting to do our best for them – makes us worry. We worry our lack of experience could be at the expense of an animal’s health – or even their life.

The only way to get past this is to gain that experience to have confidence in our decisions and learn from the mistakes we will, undoubtedly, make.

My mum said to me this week: “This is the only time you’re ever going to feel like this,” and she’s right. (But don’t tell her I said that). Even if we start a new job in the future, we will have a lot more experience under our belts, so shouldn’t, in theory, feel as lost or scared as we do now.

Being a new graduate vet is a unique position for a myriad of reasons and we need to embrace it. The fear that comes with this newly found responsibility will ease with time, and we can take our careers in whichever direction we choose.

August 16, 2017
New vet schools are not the solution

We’ve barely had a day of news in the past year that didn’t include Brexit. Yet, do any of us really know what the real consequences will be?

Within the veterinary profession, specific factors are undoubtedly going to be influenced by Brexit, even if we don’t know the extent of these yet. They do, however, include a great deal of legislation on welfare and meat hygiene, but also the future of the UK veterinary workforce.

It has been suggested the proposed coalition of Keele University and Harper Adams for yet another UK vet school may help boost numbers of veterinary professionals in the UK post-Brexit, especially when it is suspected we may be facing a shortfall.

I disagree.

Not a new problem

Is training new vets going to be of detriment to the health and well-being of those in the profession already? IMAGE: GianlucaCiroTancredi/Fotolia.

Yes, the veterinary profession has a shortage of experienced veterinary surgeons right now, but this was the case before the EU referendum was even in the pipeline – SPVS, for example, called for veterinary surgeons to be added to the UK’s shortage occupation list in 2015.

Sure, post-Brexit, it is likely to get worse – for example, the uncertainty surrounding the whole situation is (anecdotally) already seeing some of our EU vets searching for jobs overseas and leaving. This isn’t just “vet news” either – the BBC (despite the ambiguous statistics quoted) also recognised the effects of Brexit on the veterinary profession in an article this week.

But opening new vet schools isn’t the answer. For example, there is increasing awareness in the veterinary profession of the importance of mental health and a resultant expanding of the resources available for those who are struggling.

We also frequently hear buzzwords such as “compassion fatigue” and “burnout”, which we need to do more about.

My point is: we need to look after our current vets. This would prevent them getting tired and fed up, and ultimately leaving the profession – or, at least, leaving a clinical practice role.

Sold the wrong idea?

The Voices from the Future of the Profession report produced by the BVA/RCVS Vet Futures initiative in 2015 stated 50% of recent graduates thought their working lives did not meet their expectations. This disillusionment, set among a feeling of being undervalued, overworked and lacking a good work-life balance (something I’ve written about at length) leads to vets turning to other careers before they have a great deal of experience – this is what should be addressed.

We need to focus on the well-being of the vets we have instead of luring even more school leavers into a profession they have false preconceptions of.

More new graduates will not solve the problem – and this is coming from one. They will simply dilute the profession and struggle because there are less “experienced vets” to mentor them and help them hone their skills and knowledge. Ultimately, a large proportion of these will become stressed and leave within a couple of years – the vicious cycle is thus complete.

Teaching tussles

On a vet school level, irrespective of Brexit, this announcement is too not welcomed. At Glasgow, I have met clinicians that have chopped and changed between vet schools because there aren’t enough experts willing to teach, resulting in a bidding war between the universities.

We now have nine vet schools across the UK and Ireland. The Aberwysth-RVC programme (for which updates on their plans were announced earlier this week) and the Keele-Harper Adams course are only going to add fuel to that fire. Where are we going to suddenly magic up so many more diplomats and EU specialists to teach? Or, for that matter, clinical skills and first opinion teachers?

Couple-of-years-qualified graduates aren’t going to have the same breadth of experience to prepare students for a variety of surgical or clinical scenarios – they are not an adequate substitute.

Reasoning questioned

Is it simply a case of money, as Jordan claims?

The plans for new vet schools is not about saving the profession, nor is it about Brexit. It is down to academic institutions seeking high-achieving school leavers to attract more undergraduates and gain more funding.

It is ludicrous a university can just decide to open a vet school off its own back and threaten the resources of current vet schools, which include teaching staff and the availability of EMS placements, especially since many of the new course models (Nottingham, Surrey and the two proposed courses above) do not have their own teaching hospitals and, instead, use external practices.

It is true the new courses will be monitored and analysed once they have an intake of students to assess whether the graduates will be allowed to practice as veterinary surgeons, but by then, it’s too late.

There needs to be regulation to prevent it getting to that point, for the sake of the profession and the disillusioned school leavers applying en masse to these new courses.

July 30, 2017
Stitches

Legality within the veterinary profession can be a bit of a minefield, especially when it comes to things like drug licensing. This leaves many new graduates in fear of doing something against the law without even realising.

However, while some veterinary legal principles are complicated but clear, others are genuinely vague, leaving us unsure on where we would stand in a court of law.

A stab in the dark

It was recently reported that stab victims, scared of the inevitable police involvement if they were to present at A&E, were turning to vets to have their wounds sutured, albeit at a handsome price of about £200. While the morality of doing a procedure such as suturing on people may be questionable, the legality certainly is.

The RCVS clearly states vets are not legally allowed to prescribe pharmaceutical products for people, but they have no specific guidelines on wound treatment.

It could be argued that, ethically, suturing should involve the use of some form of local anaesthetic (either by a local block or a transcutaneous patch) and, therefore, cannot be allowed as this would involve drug administration.

However, that’s not to say a person can’t consent to old fashioned gritting their teeth and bearing temporary pain for the sake of saving a four-hour wait in A&E.

Friend or foe?

For those who could be potentially incriminated if they sought medical help at a hospital, you can sort of understand why they’d ask someone else, like a vet, for stitches. But they aren’t alone…

A number of vets who become injured either on the job, or elsewhere, will seek the help of their colleagues, rather than take the majority of a day off to wait for the NHS to achieve a vastly similar result. After all, vets are pretty damn good at suturing and would arguably do a better job than the junior doctor on an emergency ward.

You could discuss the ethics of whether a vet should help someone who needs medical attention in varying situations and whether they are legally allowed to do so. However, charging for the service is an altogether different matter – stitching up a fellow vet, or even a family member, wouldn’t raise the question of fees, but a stranger who walks in off the street?

Cash in hand

A BBC article from 3 March (Stab victims ‘paying vets to stitch up their wounds’) reported the “going rate” to be around £200 – does this not infer the image of an underground medical procedure market, whereby vets can earn a bit of extra cash to extend their services to animals of the two-legged kind?

You have to admit, when you consider the rough cost of a bitch spay at around £150 (weight and complication-dependent), that figure has quite an impressive profit margin. Once a vet charges for the privilege, it becomes a business venture, not just an act of goodwill.

Stab victims are reportedly turning to vets to have their wounds sutured, in an attempt to avoid police involvement. IMAGE: vzmaze / fotolia.

And yet the NHS is screaming for help in A&E departments. With average waiting times at an extreme high, it’s begging prospective patients to consider whether their ailments are worthy of the emergency room or whether they could be seen elsewhere – the GP, minor injuries, pharmacy… and now the vet?

By applying skills used on animals every day, would vets not be easing some of the burden on our struggling NHS?

Risky business

But what if something went wrong? An infection of a wound, of which the bearer couldn’t explain who sutured it, should surely raise some eyebrows – and, after all, with vets being legally unable to prescribe drugs to people, the injured party could not return to the surgeon responsible and ask for antibiotics.

This is where the legal grey area becomes pertinent. Where would a vet stand if sued for wound breakdown? Members of the Veterinary Defence Society are supported for claims against their actions involving animals… but humans?

There are a lot of unanswered questions that, for me, make conducting procedures such as suturing on members of the public too risky.

Final decision?

It may be different if it were a colleague or close family member who understands the trust he or she is putting in you to do a “simple” procedure works both ways. However, even then, it’s not without elements of risk.

On a wider scale, should we, as a profession, be seen to advocate such practice? Or should our representing bodies be defining the limits of our medical interventions and reprimanding those who see the injured public as a business opportunity?

But then, would we live in even more fear of being prosecuted just for helping a fellow vet who knows full well what he or she is agreeing to?

March 20, 2017
The consequences of making a mistake
Beef farms in Scotland can be quite picturesque.

Fertility work makes up a large proportion of cattle veterinary work in the UK and, after spending a month on the farm rotation at university, I can appreciate the importance of getting it right – and how hard it can be.

Experienced large animal vets make it look easy – they scan the uterus and ovaries, and decide what drug to give to aid getting the cow in calf, all in a minute or two.

In the meantime, I’m still fumbling about trying to palpate what, I think, may be the uterus or ovaries while the cow squeezes and gradually cuts off the circulation in my arm until I can barely feel my fingers.

Meanwhile, the vet has zipped through several cows already.

When things go wrong

What happens if you misdiagnose a pregnant cow as negative and administer prostaglandin, or give a cow steroids without realising she’s in calf?

On one fertility visit this week, we discussed when things go wrong. For example, what if:
- you misdiagnose a pregnant cow as negative and administer prostaglandin (PGF_2α)?
- a vet gives a cow steroids for any number of reasons without realising she’s in calf?
The outcomes of both of these scenarios are almost inevitably abortion, which can have a number of repercussions on the farm – and, potentially, the vet.

Negligence or misconduct?

Many new graduates are terrified of being called up for “fitness to practice” for making a mistake such as those aforementioned. However, during a Veterinary Defence Society (VDS) workshop at the SPVS Lancaster weekend earlier this year, it was emphasised a difference exists between negligence and misconduct in the eyes of the RCVS.

What I took away from this session was, in simple terms, negligence involves making a mistake – such as missing a diagnosis, giving the wrong treatment accidentally, eliciting side effects from something due to missing something in the case history – whereas misconduct is actively doing something you know you shouldn’t – such as trying to cover up a mistake, lying or misleading a client.

Mistakenly giving PGF_2α to a pregnant cow would be classed as negligence and, on the whole, the VDS would have your back; the farmer may receive some compensation for his losses, but the incident wouldn’t tarnish your career. In the same situation, misconduct would be denying you had administered any treatment.

In short, you won’t get struck off for easily made, one-off mistakes, but you may if you lie about them.

In the news

Our conversation about accidentally aborting cows led us to discuss the case of Honey Rose, the optometrist convicted of gross negligence manslaughter. News reports vary, but, from what I can gather, she failed to diagnose papilloedema (swollen optic discs) in an eight-year-old boy, which would have been an indication of the hydrocephalus he died of five months later.

It is reported she claimed to have been unable to examine his eyes properly because he had photophobia – a claim considered false by the judge. However, she had also failed to look at retinal photos taken by a colleague, on which the papilloedema was evident.

Going by the RCVS’ rules, missing the diagnosis or not looking at the retinal photos would be negligent. However, denying she’d been able to carry out a thorough examination, despite written records suggesting otherwise, would be misconduct.

Rose was found guilty of gross negligence manslaughter and was handed a two-year prison sentence, suspended for two years, and a 24-month supervision order, and was ordered to complete 200 hours of unpaid work.

In your defence

As vets, we have the VDS to help us in these situations – and, while it would be truly awful to make a mistake resulting in an animal’s death, we would not be at risk of imprisonment.

Doctors and dentists also have defence societies that will fight their corner, but optometrists? To my knowledge, an equivalent does not exist – and this was the first case of an optometrist convicted of manslaughter in the UK, which added to the complexity of the legal battle.

The death of a little boy is devastating, but, as medical professionals know, death is a risk with many procedures, no matter how small the risk may be. It’s frightening to think jail could be a consequence for those in the medical profession.

So, while I gradually lost the sensation in my right arm as I tried to reach an ovary of the 10th cow in a row, I mulled this over and realised I was extremely thankful for the safety net the VDS provides and would not take working with animals for granted.

After all, if I’d decided to be a doctor instead, I could be rummaging around in another human’s back end rather than a cow’s!
- For further details of the Veterinary Defence Society and its services, visit www.thevds.co.uk
October 19, 2016
Communication is key

Recently, I have been engaged in a battle with my internet provider and – ignoring the fact I’ve been without the world wide web for a month – no one seems capable of doing anything about it.

If avoiding angry customers is the aim, communication is key, says Jordan.

Despite these grievances, it’s actually a) the communication factor and b) lack of desire to please the customer annoying me most.

Over the years I’ve worked in retail, and I have been a waitress, during which I was expected to bend over backwards for the customer for fear of garnering a complaint.

I even remember training sessions where we were shown graphs showing the number of complaints received versus words of praise, and how likely the customer would be to spread the word regarding bad service compared to good.

The gist of it all was to not anger anyone because bad news travels fast… and this is just as applicable in the veterinary profession.

The customer is always…

Contrary to the popular saying, the client is most definitely not always right, and as the point of a veterinary consultation is for us to impart our professional knowledge gained through – long and thorough – training, we are obliged to possess pretty fantastic communication skills.

Yes, having to tell a client their beloved pet died unexpectedly during routine surgery is a bit different to being put on hold for the umpteenth time because the advisor on the phone hasn’t read the account record properly, but the underlying principle is the same – so good communication is essential.

As vets, continuity isn’t always possible, but if you have an unknown client on the list you would be expected to brush up on the history and have a vague idea of why they’ve made an appointment. Anything less would be unprofessional – so why do other businesses think this is acceptable?

Strength in numbers

Is there anybody listening?

For these international corporations, the single customer is just a drop in the ocean – losing a few hundred quid a year when I cancel my contract is just pennies to them, and no matter how much of a fuss I kick up, realistically, it won’t touch their reputation.

For vets, however, it’s different – any complaint not only reflects badly on the individual involved, but on the practice and also the profession.

We cannot afford to lose the trust of our clients over silly things like calling a male dog “she” or not spending a few minutes reading through the patient’s notes before they walk into the consult room.

Poor communication is one of the most frequent reasons a complaint is made to the RCVS, and I suspect this is why the vet schools now have a much bigger focus on communication – to help us hit the ground running and (hopefully) avoid such negativity.

Practise makes perfect

Communication skills come with experience, and while they aren’t classically thought of as something that can be taught, we can be armed with certain tools to help us communicate more effectively.

The practical communication skills sessions we’ve had over the years involving actors have been an ideal way of letting us practise dealing with “difficult” clients before being in that situation for real. And now, in our final year, we’ve transitioned into taking our own consults, either with the clinician keeping an eye on us or confirming our findings afterwards and asking the client any questions we may have forgotten.

Being a vet encompasses so much more than clinical knowledge and surgical skills, and my recent phone arguments with various technical support advisors have made me appreciate just how highly trained we are in terms of communication – and that’s something we should aim to maintain to continue to be respected as professionals.

August 17, 2016