Depressing Aspects of Clinical Placements

[Hollycozza]

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So I am just feeling a bit down at the moment about the fact that, unlike in human medicine, the value of the patient is completely determined by the owner. At my university when we're on our clinical placements we get assigned cases which we work with really closely- doing vitals every few hours, following up on all the diagnostics, etc. Anyway last week I had a patient who came in very sick but was doing quite well, and who we thought had cancer but then found out he didn't, so we were treating him with antibiotics and waiting to see if he got better.

Now the owner has been having some other issues of their own, and I just found out that the patient got put down over the weekend because they have other things to deal with. And he was doing okay and it seemed moderately positive for him (although he was still very sick).

Its a fair enough call by the owners, but makes all our efforts seem a bit futile, and its all a bit depressing.......... 🙁

 

[sofficat]

I'm really sorry to hear that. I understand (although I'm a few years away from clinics). That kind of stuff, unfortunately, comes with the territory. It really stinks that you weren't part of the decision making, or that you weren't told it was going to happen. We do our best, but the ultimate decision is up to the owners. I guess that is why my previous vets had 20 dogs... most of them came from owners who were going to euth. It doesn't really make sense that the dog was doing better and that is why they decided to euth. Did anyone perform a necropsy or anything to figure out what was wrong?

 

[Hollycozza]

There was no PM. The owner is very old, and the animal had bad kidney signs (isothenuria and azotaemia) but the azotaemia had improved a lot. Very sad stuff although I guess it is going to happen all the time...

 

[LVT2DVM]

Im not a vet student (yet) but as a tech of many years, I can tell you the number one complaint of the new grads Ive worked with is How frustrating it is dealing with financial and emotional constraints of clients. In VA they call it Ivory Tower Syndrome. You spend you whole vet education learning how to do the very best and go the extra mile (ive been told) and then you leave the "Ivory Tower" and enter the "Real world".

I think it helps to focus on the idea that there will be those clients who will do WHATEVER they can regardless of pocketbook or burdens. Those are the patients and clients that will get into your heart and make it all worth it. KEEP the FAITH!

 

[Bill59]

This is something every veterinarian has to come to grips with at some point. Ideally, you and the client come together to agree on what's best for the patient.

But we live in the real world not an ideal world so there are going to be cases where the client won't or can't follow your recommendations. Ultimately it's their decision

BTW, I'm not convinced the MDs have it any better. Patients continue to smoke after they're O2 dependent, eat BigMacs until they're in the back of the ambulance with chest pain, smoke crack until their water breaks, shake their babies until their little brains are mush ...

come to think of it, I think the MDs have it worse.