Class of 2019...how ya doing?

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Lupin21 said:
picking up my first additional shift at local er clinic tomorrow. Here's hoping after an exhausting week, one less day off is worth the extra monies. haha
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Well, I survived. Exhausted but happy to see some more variety to improve my skills.
 
that redhead said:
As someone in the general area, I have heard Not Good things about their internship program.
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I attended one of the Skype q+a's they put on with current interns and one of them didn't have good things to say, which really tells ya something :shrug: I remember her saying how there literally wasn't even physical space for interns to be there and you had to find a tiny nook just to write records. I get that a lot of these places were built with certain things in mind and most specialty centers are outgrowing their buildings, but it just sounded like a level of frustration I didn't need. She also said it was pretty much 4th year all over again, that you didn't really do anything other than watch. That could very well be her personal experience though, and not something that everyone would experience.

I wouldn't say my current internship is super great in terms of interns (who write all the records) always being able to access a computer, but it still seems better than what the Friendship intern described.
 
pinkpuppy9 said:
I attended one of the Skype q+a's they put on with current interns and one of them didn't have good things to say, which really tells ya something :shrug: I remember her saying how there literally wasn't even physical space for interns to be there and you had to find a tiny nook just to write records. I get that a lot of these places were built with certain things in mind and most specialty centers are outgrowing their buildings, but it just sounded like a level of frustration I didn't need. She also said it was pretty much 4th year all over again, that you didn't really do anything other than watch. That could very well be her personal experience though, and not something that everyone would experience.

I wouldn't say my current internship is super great in terms of interns (who write all the records) always being able to access a computer, but it still seems better than what the Friendship intern described.
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Not having computer access reliably would drive me nuts. Not just for record writing but I also like to look up certain things on VIN regularly.
 
that redhead said:
Not having computer access reliably would drive me nuts. Not just for record writing but I also like to look up certain things on VIN regularly.
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It is super annoying. We sometimes just have to wait a while (which is still annoying) because we don't have a ton of work stations, and you can't use certain workstations when certain clinicians are around because it's 'theirs' and you will get kicked off. Stupid stuff like that. If you have a computer and you get up to grab a record, pee, etc, you run the risk of losing it and waiting for a station to free up all over again.

Hell, I even got asked to move from where I was standing during ER rounds on my first day because that's where a certain clinician always stands. The pits of intern life, lol.
 
Skimble said:
Just checking in, how is everyone doing? I'm pretty happy with my job and life choices. Some days are hard, and I'm always busy, but it's still good.
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Sounds the same for me. Some days I just come home and go to bed, but I have plenty of good days too. I am so happy to be living like a regular human being again for sure. haha
 
Rough day for exotics. I had a rabbit that was a rescue that had sedated grooming as was one giant matt not return to function after a couple days of pain management, critical care and fluids. Got euthed at the eclinic on my day off. Colleague was battling a chinchilla scrotal abscess from neuter and it crashed after sedation today. On top of it, chinchilla was one of the assistants. Made everyone cry. Fragile little prey beasts. 🙁
 
Lupin21 said:
Rough day for exotics. I had a rabbit that was a rescue that had sedated grooming as was one giant matt not return to function after a couple days of pain management, critical care and fluids. Got euthed at the eclinic on my day off. Colleague was battling a chinchilla scrotal abscess from neuter and it crashed after sedation today. On top of it, chinchilla was one of the assistants. Made everyone cry. Fragile little prey beasts. 🙁
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I feel like they're just programmed to shut down sometimes. I've been trying to learn rabbit dentistry, and 2 out of the 3 mouths I've worked on just haven't made it. One was a real heartbreaker too because she perked up for like a week or two after her dental, started gaining weight, the owner came home and found her dead.
 
genny said:
I feel like they're just programmed to shut down sometimes. I've been trying to learn rabbit dentistry, and 2 out of the 3 mouths I've worked on just haven't made it. One was a real heartbreaker too because she perked up for like a week or two after her dental, started gaining weight, the owner came home and found her dead.
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yeah. I'm a little mad at myself because I had originally a much gentler sedation protocol for the rabbit planned, but my tech wanted it out cold to make the process go better. Can't say for sure that it would have made a difference and in the end it was my decision to be more aggressive, but ugh. One of those times being in charge can stick with you.
 
@genny any favorite rodent dentistry resources? I have a sweet burr (with guard) I got last year but I feel like I’m never aggressive enough.

@Lupin21 I think especially as newer grads, experienced techs can be amazing to have for guidance. The flip side is that we can be easily swayed by their opinions and it can be tough to stand your ground. I did something stupid a couple years back because of a tech’s well meaning comment and while it turned out fine in the end, I remember it. That doesn’t mean I’ll always be the right one but I need to be able to sleep at night. I’m sorry about that bunny- like you said, may not have changed the outcome anyway- but remember to trust yourself too 🙂
 
Picked up another ER shift that went from ending on Friday normal workday straight into eclinic shift going til 9 am next morning. So tired. Also lots of more intensive cases past couple of weeks. I'm growing so much, but I'd really like a long two week nap now. haha
 
Lupin21 said:
I am actually quite thankful for my time working er shifts as I feel it is definitely making me a more well rounded veterinarian. Man, do I wish I had more ultrasound under my belt though. heh
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There is apparently a good ultrasound CE in Texas that a bunch of the docs I work with have gone to. I could get more information if you’re interested.
 
Rabbit dental wet lab at VMX was amazing. I feel so much more confident. We did both intraoral and mandibular surgical approach for extractions. They also had guinea pigs, chinchillas, and a ferret for practice too. Instructors were super friendly and very good at explaining and demonstrating. There were 2 dvms and an lvt for 28 students, so I felt like I was able to get individual attention when needed.
 
genny said:
Rabbit dental wet lab at VMX was amazing. I feel so much more confident. We did both intraoral and mandibular surgical approach for extractions. They also had guinea pigs, chinchillas, and a ferret for practice too. Instructors were super friendly and very good at explaining and demonstrating. There were 2 dvms and an lvt for 28 students, so I felt like I was able to get individual attention when needed.
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Thanks for following up on this! Obviously I couldn’t go this year but I’m hopeful I can get in on the next one 🙂
 
Had my first I want to see another doctor moment today. Woman who rescues cats but has lot of financial limitations. Brought in two cats with severe stomatitis, one that also had severe URI as well. The other had had most the teeth removed, but the canines remaining were foul. Also had severe plasmacytic pododermatitis by the looks of the back foot pads, one severely ulcerated. Then, she had an open wound over the front paw that had tendons exposed and disarticulation of the distal phalanx that O had been trying to treat with Bag Balm and neosporin.

It looked bad as soon as I walked in and I expressed concern that it needed to be amputated and I couldn't even rule out neoplasia. O insisted that she didn't seem to be in much pain and the teeth were her main concern. I told her I would take her back and at least see if I felt like there was enough healthy tissue to expose to investigate healing by second intention. But after seeing just how bad it was, I told her it was amputate or humanely euthanize. She still wanted to to try medical management, and I wish I hadn't gotten upset, but I told her it was medical malpractice in my opinion to try and treat this medically with tendon and joint exposure.

She got mad at me and wanted to see another doctor. I told her my fellow doctor was in today and would have him evaluate her and give his opinion then left. Poor fellow. He went in to tell her that he agreed that it really needed to be amputated, but that medical management might be attempted as long as she knew EOD bandage changes and wound management would be crucial and likely for months of recovery. He gave her estimate for that and amp and after a while (meaning she turned on him and told him we both had horrible bed side manner), she decided to euthanize.

I understand that she felt guilty about having such financial limitations to help cats, but harrumph. She declined to take home meds for the other cat but is going to schedule a dental to have his teeth out. These are the things that you don't get exposed to in school. Do your best folks to not put them in a defensive position, but it is incredibly hard. I sincerely hope the other cat gets his dental. I wanted to go back in to convince her he needed abx at least, but she wanted nothing more to do with me.
 
genny said:
Hugs! I'm glad the other doctor had your back.
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hehe. Yeah, we have a very good support team here and will fire clients no problem. I feel like I didn't adequately warn him of her though as he was a bit wide eyed coming back out to chat with me about it. We both learned though about different strategies on approaching these cases as he is also a newer grad.
 
@Lupin21 Ugh, I’m sorry. If it makes you feel better, I think I was TOO nice to these people early on. (I’m still probably too gentle if reading some things VINers say is any indication but that’s just not me.)

I think realizing the need to remain at least outwardly non-judgemental is important. We’ve all seen those cases where clearly the animal has been ill for a long time and owner is just now bringing them in, or trying to treat something at home with ridiculous or awful methods. I try to remind myself that they really do care about Fluffy and they just lack the finances and/or common sense to bring them in sooner. I think they get embarrassed and you’re right- once they feel attacked they clam up or get nasty and then helping the animal becomes even harder!

Hang in there. It gets a little easier with time, but is still one of the hardest things about the profession.
 
Lupin21 said:
Oof. Rough week full of sympathy cards. I am still thankful we are open to help, but I'm exhausted emotionally. Physically, it has been much better medicine without the clients in the room interrupting my focus. haha
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I have to euthanize one tomorrow that I diagnosed today. It's tough explaining complicated diagnoses over the phone. I miss being able to visually check in with how they're grasping things.
 
Work keeps getting complicated. Today, electricity was out, got generator running to at least have phones/cornerstone for what should have been people who have emergencies or didn't know better to stay home in a snow storm. Nope. All tech nail trim appointments showed up and only one emergency. Phones went down again anyway and our people had to keep going out in the snow to ask what they were here for. lol
 
Lupin21 said:
Work keeps getting complicated. Today, electricity was out, got generator running to at least have phones/cornerstone for what should have been people who have emergencies or didn't know better to stay home in a snow storm. Nope. All tech nail trim appointments showed up and only one emergency. Phones went down again anyway and our people had to keep going out in the snow to ask what they were here for. lol
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I just went outside for a fresh handful of snow though to flavor my wine. Quite refreshing.
 
Lupin21 said:
Work keeps getting complicated. Today, electricity was out, got generator running to at least have phones/cornerstone for what should have been people who have emergencies or didn't know better to stay home in a snow storm. Nope. All tech nail trim appointments showed up and only one emergency. Phones went down again anyway and our people had to keep going out in the snow to ask what they were here for. lol
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My computer system was giving me trouble yesterday as well. It was my main case management program having issues, so without it I couldn't report or release any cases. I spent my time looking at slides and taking written notes on paperwork of my findings so I could go back and dictate reports once it was fixed. After about 2 hours it basically fixed itself before IT even got to it, probably because I was logged off long enough the connection reset on its own. But it's amazing/awful how dependent we are on technology to do our everyday jobs.
 
I know we all know it, but man, it makes a world of difference when we get thanked for the effort we put into our jobs. One of our clients did a drive by staking outside the clinic to give the feel goods, and even proper grammar!!!
thankyou.jpg
 
I am becoming the one who all the employees come to for their pets care. This is a scary responsibility. I missed/had it but denied it with an FIP case the other day. It doesn’t help that we are short staffed and I was overbooked with all sick appointments and it was one of the lasts few appointments of the day...but still.

I knew it when I looked at the bloodwork, but fellow vet offered up their thoughts and I went with it. Best thing I did was convince owner that emergency clinic was the best chance at helping it. I sent them with meds based on my diagnosis and even transferred myself in hopes of conferring with again another set of eyes. But they were already overwhelmed so I had to just give the techs my instructions for starting and go on my way.

Sadly, side bar, as I was leaving one of the eclinic vets who is full time and only thought she was working that evening was on her way out, and I paused to check in on her. Complete melt down with how overwhelmed they are because all the local clinic have been limiting their hours/shutting down over the virus. I did what I could by just being an ear to listen and encourage her to take better care of herself. HELPLESS.

I worried all freaking weekend over this cat and the other hard cases/surgeries I had during the week. Vet I work with that picked up a shift at clinic texted me back after checking in on her since it was her weekend also for our clinic, and she noted that FIP was diagnosed during PE and fluid aspiration with US that night and O euthanized.

I have been hard on myself over this because I had a feeling it was not IMHA/Evans based on some other changes on bloodwork, but just didn’t have time/energy to really follow up. My boss who is always supportive told me to look at it this way, “They got a diagnosis within 4 hours. You knew to get it to the emergency clinic and the best possible outcome was achieved despite the sadness. That typically never happens in human medicine. You did your best and still did best for your patient.”

Just remember folks, that you will have times that you do your best but you need others. Don’t be hard on yourself. Today I felt like a rockstar. We were still overbooked and crazy, but I took everything one step at a time, put out fires as they came, kept my teams spirits up as best I could, and finished staying late as our tech/office manager came racing up just as we were leaving with her dog that had lacerated a couple paws on a sharp something or other. I took care of it swiftly and without drama. She was grateful and noted she was glad I was the one there to help.

Feel goods mixed with terror and self doubt and all the confidence in the world. Being a vet is...

I went on a ramble because I euthanized 5 animals in a row along with seeing a brand new puppy and kitten and everything in between ~30 patients today. Tomorrow is my day off. Most needed.
 
Another rough week. So much tension in the air also making things difficult. I really wish a cloud of positivity would rain down on the world for at least a while to even everyone back out. Just gonna keep doing my best for pets and clients and staff though. I did get a very nice letter yesterday from the owner of a very lovely cat that had blocked. They didn’t have the money to have the eclinic take care of him over the weekend, so I dedicated my time to keep him in hospital and get him properly washed out. Good deeds are their own reward, but it’s nice to also have a letter. Haha
 
genny said:
I empathize with this. It's hard to continue to be a ray of sunshine lately.
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Yeah. It doesn’t help that since it’s the same fewer staff on every day, our bodies are also starting to break down involving restraint and what is normal routine not noticed until volume overloads. I’ve tried to start yoga-esque type stretching in the evening to unwind, but it tightens right back up two hours into the next work day. haha
 
Today was interesting. I've been feeling overwhelmed with the load on our shoulders as we move into our natural busy season while dealing with COVID changes to the business. A month ago, I felt like I was back in 1st semester vet school haha

But now, as my case experience has increased exponentially and I've learned from the cases I would have handled differently now after the fact, I feel excited for the graduating class. I've been out one year, and I've become a leader, a good veterinarian, and someone who looks out for both the animals and the owners while simultaneously making sure those who work alongside me know they are valued.

I have a very long ways to go, but knowing our profession is adding plenty more smart, hardworking, and compassionate people with the new grads makes me excited like the incoming classes to vet school. It really is all relative and I hope people keep trying to find the things that make life not so bad sometimes.

TlDr: First year out is like first year vet school, when you're approaching 1 year DVM your feel like you've grown in 1 year as much as graduating 4 years vet school. haha
 
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