Mistakes at work!

[Justacatlover]

I don’t know where to post on here lol!!

Basically.. I was doing reception the other day and a assistant forgot to put a label on one of the meds (I think it was animax). The waiting room was busy and the other receptionist took the chart from the assistant to bill the clients out. The assistant said she had something else to do and asked me to make the label.

I took a look at the chart and I went to make the label and it already had pre typed instructions (in the computer) and it was the same as the chart said apply for two weeks then come back for recheck blah blah and everything but it said to ear instead of paw! The dog had a lick granuloma on its paw. I must have been reading too fast because I was busy and just printed it and stuck it on. (We don’t have a double check label thing we basically make it and slap on the label and give the meds to the client). So that was that and obviously I thought I made it right because I totally forgot that moment.

Fast forward a few days later (doing reception again) and we get a call and the other receptionist answers it and the person (owner) asked if we meant it was for the paw (since nothing is wrong with the ear and this is an ongoing problem with the lick granuloma so they are familiar with the ointment). The other receptionist told me about what the call was.

Now I’m sitting at home and remember I made that label! I feel so dumb I’ve never (I don’t think) messed up a label! Is that bad how I messed that up? I’m nervous I am going to get in trouble! I’m the type of person who loses sleep over stuff like this! Ugh

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[ajs513]

I don’t know where to post on here lol!!

Basically.. I was doing reception the other day and a assistant forgot to put a label on one of the meds (I think it was animax). The waiting room was busy and the other receptionist took the chart from the assistant to bill the clients out. The assistant said she had something else to do and asked me to make the label.

I took a look at the chart and I went to make the label and it already had pre typed instructions (in the computer) and it was the same as the chart said apply for two weeks then come back for recheck blah blah and everything but it said to ear instead of paw! The dog had a lick granuloma on its paw. I must have been reading too fast because I was busy and just printed it and stuck it on. (We don’t have a double check label thing we basically make it and slap on the label and give the meds to the client). So that was that and obviously I thought I made it right because I totally forgot that moment.

Fast forward a few days later (doing reception again) and we get a call and the other receptionist answers it and the person (owner) asked if we meant it was for the paw (since nothing is wrong with the ear and this is an ongoing problem with the lick granuloma so they are familiar with the ointment). The other receptionist told me about what the call was.

Now I’m sitting at home and remember I made that label! I feel so dumb I’ve never (I don’t think) messed up a label! Is that bad how I messed that up? I’m nervous I am going to get in trouble! I’m the type of person who loses sleep over stuff like this! Ugh

This kind of stuff happens from time to time. This is why there should always be follow through with the technician who was handling the case. But sometimes things come up. It all comes down to the fact that something got mixed up along the way and it was caught. And it’s for a medication where it’s not the end of the world that it was given incorrectly. I can promise you this isn’t the first time something like this has happened at your practice. Just the first time it’s happened to you.

Over the last three years I’ve messed up with medication instructions/given the wrong medication probably three times. It’s always been caught before it was an issue but it still doesn’t feel good. I accidentally handed someone rimadyl instead of levothyroxine because the bottles were right next to each other at the reception desk and I didn’t even think about it. The owner called before she got home, and I was about to call anyway to let her know my mistake. Another time I accidentally gave the wrong box of nexgard, and the owner noticed before she left the office. I forget what the third one was. But regardless, I owned up to the mistake each time and let them know that I was extremely sorry. That’s all you can do and that’s the best thing you can do. We live and learn and it makes us better so that it doesn’t happen again, or at least to the severity that it happened before. Now you’ll double check labels moving forward if you’re not exactly sure. I really wouldn’t expect to lose your job over this. It’s the cost of working in this field. Mistakes happen, clients either do or don’t get upset, and we move forward having learned a lesson.

 

[genny]

I don’t know where to post on here lol!!

Basically.. I was doing reception the other day and a assistant forgot to put a label on one of the meds (I think it was animax). The waiting room was busy and the other receptionist took the chart from the assistant to bill the clients out. The assistant said she had something else to do and asked me to make the label.

I took a look at the chart and I went to make the label and it already had pre typed instructions (in the computer) and it was the same as the chart said apply for two weeks then come back for recheck blah blah and everything but it said to ear instead of paw! The dog had a lick granuloma on its paw. I must have been reading too fast because I was busy and just printed it and stuck it on. (We don’t have a double check label thing we basically make it and slap on the label and give the meds to the client). So that was that and obviously I thought I made it right because I totally forgot that moment.

Fast forward a few days later (doing reception again) and we get a call and the other receptionist answers it and the person (owner) asked if we meant it was for the paw (since nothing is wrong with the ear and this is an ongoing problem with the lick granuloma so they are familiar with the ointment). The other receptionist told me about what the call was.

Now I’m sitting at home and remember I made that label! I feel so dumb I’ve never (I don’t think) messed up a label! Is that bad how I messed that up? I’m nervous I am going to get in trouble! I’m the type of person who loses sleep over stuff like this! Ugh

If I was your boss, I'd probably ask you to be more careful, but that would be the extent of it if it's just a one-time thing. Hopefully you remember this the next time you get asked to make a label, and you double check it, since the next mistake could be more serious than just ear vs. paw. Mistakes happen, and as long as you own up to it and learn from it, I don't think you need to lose any sleep over it.

 

[Justacatlover]

This kind of stuff happens from time to time. This is why there should always be follow through with the technician who was handling the case. But sometimes things come up. It all comes down to the fact that something got mixed up along the way and it was caught. And it’s for a medication where it’s not the end of the world that it was given incorrectly. I can promise you this isn’t the first time something like this has happened at your practice. Just the first time it’s happened to you.

Over the last three years I’ve messed up with medication instructions/given the wrong medication probably three times. It’s always been caught before it was an issue but it still doesn’t feel good. I accidentally handed someone rimadyl instead of levothyroxine because the bottles were right next to each other at the reception desk and I didn’t even think about it. The owner called before she got home, and I was about to call anyway to let her know my mistake. Another time I accidentally gave the wrong box of nexgard, and the owner noticed before she left the office. I forget what the third one was. But regardless, I owned up to the mistake each time and let them know that I was extremely sorry. That’s all you can do and that’s the best thing you can do. We live and learn and it makes us better so that it doesn’t happen again, or at least to the severity that it happened before. Now you’ll double check labels moving forward if you’re not exactly sure. I really wouldn’t expect to lose your job over this. It’s the cost of working in this field. Mistakes happen, clients either do or don’t get upset, and we move forward having learned a lesson.

This made me feel better! Everyone seems to make mistakes not only in life but especially in this field i here! I almost think maybe it’s better I made this more minor mistake because now I will really check everything before I make a major one!

 

[Justacatlover]

If I was your boss, I'd probably ask you to be more careful, but that would be the extent of it if it's just a one-time thing. Hopefully you remember this the next time you get asked to make a label, and you double check it, since the next mistake could be more serious than just ear vs. paw. Mistakes happen, and as long as you own up to it and learn from it, I don't think you need to lose any sleep over it.

Great advice thank you so much.

 

[Lupin21]

We have a policy that requires someone else to check off on the right med, right dose etc on label other than the person who filled it. I think it helps immensely.

 

[ajs513]

This made me feel better! Everyone seems to make mistakes not only in life but especially in this field i here! I almost think maybe it’s better I made this more minor mistake because now I will really check everything before I make a major one!

It sounds like you work in a small hospital where it’s not really possible to have all of the checks in place that a large hospital would have to prevent these mistakes. So this was bound to happen at one point or another. As you said, it’s absolutely better that when you made this mistake it was for something that didn’t really affect the patient vs something that could have been much more costly. Also I remember the third mistake I made, which didn’t affect the client or patient negatively but we lost money on it. I think we sent home clavamox and instead of putting down 14 tablets I put the quantity as 1 since I was thinking one strip of clavamox. It wasn’t a mistake worth hundreds of dollars, but it was brand name clavamox tablets which aren’t cheap. So with all those mistakes in mind, I check my labels for the right quantity, the right patient, the right medication, and the right instructions every time now.

 

[that redhead]

Mistakes happen to literally everyone at some point. I would be thankful it was a minor error and not something more serious. But yes, take this as a lesson to be very careful with details, no matter how busy the reception area is.

 

[katashark]

I've caught so many prednisone v. prednisolone mess ups. Mistakes happen, that's why it's good to double/triple check yourself! Or have another person check it. As redhead said, reception can wait the 1 minute it requires for you to check the label. Check the same things in the same order every time so you don't skip around like ajs said. Figure a system that works for you. Now you know. Sleep well!

 

[Hp48g]

Mistakes happen, I've had similar things happen, mistakes can cause big problems but this one clearly didn't. Don't sweat it, use it as a way to improve both your personal practices and the systems in your clinic (if possible).

 

[Minnerbelle]

We have a policy that requires someone else to check off on the right med, right dose etc on label other than the person who filled it. I think it helps immensely.

This! Either the doctor makes the label (so it’s on them if rx is wrong), and another person fills which gets checked by a third person. Or, dr writes down the rx somewhere, one person makes label and fills it, and a second person checks it against the written instruction from the doctor.

Prescription errors can be deadly, and it’s really important to have a check and balances system because mistakes do happen. We’re all human, mistakes will happen. I don’t care if I’m the checker as a doctor. I will always take the time to check it. I make mistakes sometimes with my prescribing, and I rely on my awesome staff to pick up on it, so everyone pitching in is important. It really helps to go at it with a team approach.

Especially for injectable drugs, always have a second person check the drug and volume and route of admin (typically someone with enough experience to know typical volume of drug that should be given to a patient of a particular size - if a 0.1 mL volume of ace doesn’t sound alarm for a little patient, that person shouldn’t be checking injectable drugs).

As the person responsible for systematic changes to reduce errors, I also limit drugs that might get confused with each other. Or for things that might lead to a fatal error (e.g. U-40 insulin syringes), I lock them up so that a doctor has to grab it.

You can make the excuse that the clinic can’t “handle” something due to size or lack of staffing or whatever, but then the doctor has to assume the risk of whatever mistakes the staff makes. It’s their license on the line. So I guess it’s up to them. I would never work anywhere that didn’t support a second check system. No ****ing way.

 

[Justacatlover]

This! Either the doctor makes the label (so it’s on them if rx is wrong), and another person fills which gets checked by a third person. Or, dr writes down the rx somewhere, one person makes label and fills it, and a second person checks it against the written instruction from the doctor.

Prescription errors can be deadly, and it’s really important to have a check and balances system because mistakes do happen. We’re all human, mistakes will happen. I don’t care if I’m the checker as a doctor. I will always take the time to check it. I make mistakes sometimes with my prescribing, and I rely on my awesome staff to pick up on it, so everyone pitching in is important. It really helps to go at it with a team approach.

Especially for injectable drugs, always have a second person check the drug and volume and route of admin (typically someone with enough experience to know typical volume of drug that should be given to a patient of a particular size - if a 0.1 mL volume of ace doesn’t sound alarm for a little patient, that person shouldn’t be checking injectable drugs).

As the person responsible for systematic changes to reduce errors, I also limit drugs that might get confused with each other. Or for things that might lead to a fatal error (e.g. U-40 insulin syringes), I lock them up so that a doctor has to grab it.

You can make the excuse that the clinic can’t “handle” something due to size or lack of staffing or whatever, but then the doctor has to assume the risk of whatever mistakes the staff makes. It’s their license on the line. So I guess it’s up to them. I would never work anywhere that didn’t support a second check system. No ****ing way.

Honestly after what everyone has said I think it’s time for me to find a new job. It sounds like everyone other place has a system of checking! At my hospital anyone can type up a label and nobody check it. We just type it and put it on the bottle and that’s it! Now after this incident I feel uneasy with the job and rather work somewhere else.

 

[MixedAnimals77]

Honestly after what everyone has said I think it’s time for me to find a new job. It sounds like everyone other place has a system of checking! At my hospital anyone can type up a label and nobody check it. We just type it and put it on the bottle and that’s it! Now after this incident I feel uneasy with the job and rather work somewhere else.

I mean I'm not sure that this is something to necessarily quit over. I've worked at a practice that whether a script gets double checked is hit or miss and I've worked at a place where things get double checked all the time. Place that double checks was a joke to work for while overall the other place is way better. If theres more to you leaving then that fine. Have you tried suggesting a double check process? Sometimes people just haven't thought of it! Just some thing to think about.

 

[Justacatlover]

I mean I'm not sure that this is something to necessarily quit over. I've worked at a practice that whether a script gets double checked is hit or miss and I've worked at a place where things get double checked all the time. Place that double checks was a joke to work for while overall the other place is way better. If theres more to you leaving then that fine. Have you tried suggesting a double check process? Sometimes people just haven't thought of it! Just some thing to think about.

I was thinking of suggesting it soon. I’m still anxious over this mistake! I would definitely like if they would agree to put a system in progress I just haven’t been back to work yet since then because I have 3 days in a row off right now.

 

[Minnerbelle]

Honestly after what everyone has said I think it’s time for me to find a new job. It sounds like everyone other place has a system of checking! At my hospital anyone can type up a label and nobody check it. We just type it and put it on the bottle and that’s it! Now after this incident I feel uneasy with the job and rather work somewhere else.

I mean as a doctor, I would not work at your hospital... but I’m not sure that’s necessarily a reason for you to quit, unless there are other things shady about this practice. No place is perfect, and if you quit over something like this, the next practice will likely have something else you’ll quit over.

 

[Justacatlover]

I mean as a doctor, I would not work at your hospital... but I’m not sure that’s necessarily a reason for you to quit, unless there are other things shady about this practice. No place is perfect, and if you quit over something like this, the next practice will likely have something else you’ll quit over.

Well it is very shady that’s not the only reason it’s kinda a bunch of things.

 

[ajs513]

Honestly after what everyone has said I think it’s time for me to find a new job. It sounds like everyone other place has a system of checking! At my hospital anyone can type up a label and nobody check it. We just type it and put it on the bottle and that’s it! Now after this incident I feel uneasy with the job and rather work somewhere else.

I think whether or not there’s an elaborate check system in place depends on how big the hospital is. At the hospital I work at now, there’s not really a system in place to check it. The doctor says “get 20 prednisone 20mg, taper dose” or “send home BNP HC, 1/4 inch strip in the left eye TID for one week” and we type it up, fill it, and put the label on it unless he types it up and makes the label first. Other than that if someone calls for a refill of a medication they’ve been on for a while and it’s approved to refill then we click refill/renew and fill what’s on the label. We have 3 people and the doctor on staff at a time, usually with one receptionist, tech, and one assistant who’s cleaning or in the room or doing something else. So when we’re busy there isn’t really time to wait around for 20 minutes for someone to double check things. We haven’t really messed up at all aside from what i described to you before and everyone is careful to just double check the prescription they’re filling themselves. Because we’re such a small hospital operating at a fast pace but comparatively low volume it isn’t really an issue that things aren’t physically checked by someone else. We’re not filling 5 prescriptions at a time for 3 different pets and sending home 100 different things a day. It’s maybe 10-15 a day spread across maybe 8 patients.

Basically, I wouldn’t fault the hospital too much unless mistakes are a common thing. It seems like you’re new to this so it’s okay to make a small mistake which you’ve definitely learned from. If it was a frequent and big issue then I’m sure it would be dealt with accordingly, but it likely isn’t.

 

[Justacatlover]

I think whether or not there’s an elaborate check system in place depends on how big the hospital is. At the hospital I work at now, there’s not really a system in place to check it. The doctor says “get 20 prednisone 20mg, taper dose” or “send home BNP HC, 1/4 inch strip in the left eye TID for one week” and we type it up, fill it, and put the label on it unless he types it up and makes the label first. Other than that if someone calls for a refill of a medication they’ve been on for a while and it’s approved to refill then we click refill/renew and fill what’s on the label. We have 3 people and the doctor on staff at a time, usually with one receptionist, tech, and one assistant who’s cleaning or in the room or doing something else. So when we’re busy there isn’t really time to wait around for 20 minutes for someone to double check things. We haven’t really messed up at all aside from what i described to you before and everyone is careful to just double check the prescription they’re filling themselves. Because we’re such a small hospital operating at a fast pace but comparatively low volume it isn’t really an issue that things aren’t physically checked by someone else. We’re not filling 5 prescriptions at a time for 3 different pets and sending home 100 different things a day. It’s maybe 10-15 a day spread across maybe 8 patients.

Basically, I wouldn’t fault the hospital too much unless mistakes are a common thing. It seems like you’re new to this so it’s okay to make a small mistake which you’ve definitely learned from. If it was a frequent and big issue then I’m sure it would be dealt with accordingly, but it likely isn’t.

We do have some faults sometimes. I’m just anxious now I think. I keep thinking I’ve made some huge terrible mistake and something bad will come of this. I just want to dog to be ok maybe I’m not cut out for the field since I’m so anxious over this?? I just can’t help but think something bad will happen now because of my mistake. Ahh

 

[ajs513]

We do have some faults sometimes. I’m just anxious now I think. I keep thinking I’ve made some huge terrible mistake and something bad will come of this. I just want to dog to be ok maybe I’m not cut out for the field since I’m so anxious over this?? I just can’t help but think something bad will happen now because of my mistake. Ahh

Don’t! It’s very difficult to push through after mistakes are made. But it’s entirely human and okay. And honestly, of all the mistakes you could have made as a learning experience, this is the most benign one possible. A medication that normally goes into the ear went into a dog’s ear instead of on its foot, so it just didn’t get treated for a couple days. But it’ll be fine.

I’ve made mistakes that I’m sure I’ll think about for the rest of my life. One mistake (that isn’t a mistake so much as I didn’t fully inform the client) was when a woman called saying her male cat who we’d seen before for urinary issues was licking himself down there, was straining to urinate, but still peeing. He was crying when urinating. I told her the doctor left a note to pick up c/d food since before it was crystals causing this issue. I told her to let us know if anything changes. She picks up food and I thought that was that. The next evening we get a notice from an emergency hospital that she brought the cat there because he collapsed, and elected to euthanize. Now, the cat could have been saved anyway but they opted to euthanize due to financial issues. This likely wouldn’t have changed since they would have had to have the cat unblocked anyway and couldn’t afford it. However, i should have checked with the doctor again, warned the owner that a blockage could occur at any time, and to go to emergency if she feels that the cat is in distress. Instead she waited longer than she should have and the cat was euthanized.

So while I didn’t directly lead to this cat dying, I feel that I could have done a little more to maybe smooth the situation out and properly warn her of the gravity of the situation. It didn’t help that she called us and blackmailed us to pay for the money she spent at the emergency hospital, but I digress. Now any time there’s the slightest suspicion of a blockage forming in a male cat I check all the boxes of what needs to be asked, what the owner can expect, what they should look out for, and the proper course of action. Because I learned the hard way how grave the situation is I’m now a much better technician. The same process now applies to any situation where the owner may need to seek emergency help. Don’t be scared of making mistakes. They’ll happen, but you need to learn from them and let them make you better.

 

[Minnerbelle]

We do have some faults sometimes. I’m just anxious now I think. I keep thinking I’ve made some huge terrible mistake and something bad will come of this. I just want to dog to be ok maybe I’m not cut out for the field since I’m so anxious over this?? I just can’t help but think something bad will happen now because of my mistake. Ahh

Dude, you have to relax or go find a therapist or some professional to help with your anxiety. Otherwise I’ll have to agree that maybe you’re not cut out for this field, which is stressful enough even if you don’t beat yourself up over minor mistakes. Mistakes happen. It’s to be expected. What matters is that you learn from your mistake and do what you can to not make the same mistake again. What’s most important is that you pay extra attention to things that can result in major consequences. But don’t sweat the little stuff, esp if it doesn’t harm the patient. Just learn from it and move on. Don’t make a huge deal out of it.

When mistakes happen, think about how much of it is you vs. systematically things are set up to lead to these mistakes vs. lack of training vs. lack of experience. Some of these things you can control, and some of these things you can’t. Some of these things just take time. As long as you’re trying your best and are overall competent, cut yourself some slack.

I’m a very detail oriented person who puts in 120% every day at work, and I’m hard on myself. But if I beat myself up to the extent you do for little mistakes, I probably would be in a mortuary by now. And I don’t say that as a joke. This profession is super stressful, and the level of stress/responsibility/liability becomes exponentially higher once you’re a doctor. There’s a reason why suicide is a huge issue in the profession.

 

[Justacatlover]

Don’t! It’s very difficult to push through after mistakes are made. But it’s entirely human and okay. And honestly, of all the mistakes you could have made as a learning experience, this is the most benign one possible. A medication that normally goes into the ear went into a dog’s ear instead of on its foot, so it just didn’t get treated for a couple days. But it’ll be fine.

I’ve made mistakes that I’m sure I’ll think about for the rest of my life. One mistake (that isn’t a mistake so much as I didn’t fully inform the client) was when a woman called saying her male cat who we’d seen before for urinary issues was licking himself down there, was straining to urinate, but still peeing. He was crying when urinating. I told her the doctor left a note to pick up c/d food since before it was crystals causing this issue. I told her to let us know if anything changes. She picks up food and I thought that was that. The next evening we get a notice from an emergency hospital that she brought the cat there because he collapsed, and elected to euthanize. Now, the cat could have been saved anyway but they opted to euthanize due to financial issues. This likely wouldn’t have changed since they would have had to have the cat unblocked anyway and couldn’t afford it. However, i should have checked with the doctor again, warned the owner that a blockage could occur at any time, and to go to emergency if she feels that the cat is in distress. Instead she waited longer than she should have and the cat was euthanized.

So while I didn’t directly lead to this cat dying, I feel that I could have done a little more to maybe smooth the situation out and properly warn her of the gravity of the situation. It didn’t help that she called us and blackmailed us to pay for the money she spent at the emergency hospital, but I digress. Now any time there’s the slightest suspicion of a blockage forming in a male cat I check all the boxes of what needs to be asked, what the owner can expect, what they should look out for, and the proper course of action. Because I learned the hard way how grave the situation is I’m now a much better technician. The same process now applies to any situation where the owner may need to seek emergency help. Don’t be scared of making mistakes. They’ll happen, but you need to learn from them and let them make you better.

You give such great advice and yeah that definitely wasn’t your fault! I feel like that happens a lot that people don’t exactly inform over the phone everything they should. I’ve seen it happen a lot at my practice I think it happens all the time.

I guess I should try and chill my brain from the “Now the dog is gonna die”.. “The hospital is gonna be in trouble for my mistake”.. “It’s the end of the world” type thoughts! I guess it’s just harder for some then others! Let’s hope I never make a bigger mistake or I may just have a heart attack haha

 

[Justacatlover]

Dude, you have to relax or go find a therapist or some professional to help with your anxiety. Otherwise I’ll have to agree that maybe you’re not cut out for this field, which is stressful enough even if you don’t beat yourself up over minor mistakes. Mistakes happen. It’s to be expected. What matters is that you learn from your mistake and do what you can to not make the same mistake again. What’s most important is that you pay extra attention to things that can result in major consequences. But don’t sweat the little stuff, esp if it doesn’t harm the patient. Just learn from it and move on. Don’t make a huge deal out of it.

When mistakes happen, think about how much of it is you vs. systematically things are set up to lead to these mistakes vs. lack of training vs. lack of experience. Some of these things you can control, and some of these things you can’t. Some of these things just take time. As long as you’re trying your best and are overall competent, cut yourself some slack.

I’m a very detail oriented person who puts in 120% every day at work, and I’m hard on myself. But if I beat myself up to the extent you do for little mistakes, I probably would be in a mortuary by now. And I don’t say that as a joke. This profession is super stressful, and the level of stress/responsibility/liability becomes exponentially higher once you’re a doctor. There’s a reason why suicide is a huge issue in the profession.

Thank you so much. I definitely honestly am thinking of seeing a therapist for real to help me level myself and stop beating myself up over everything. I probably won’t be able to make it in this field if I don’t straighten myself out. There have been so much worse mistakes then what I’ve done and I need to realize that. I’m sure hopefully after a week from now I’m not even thinking about this.

 

[ajs513]

You give such great advice and yeah that definitely wasn’t your fault! I feel like that happens a lot that people don’t exactly inform over the phone everything they should. I’ve seen it happen a lot at my practice I think it happens all the time.

I guess I should try and chill my brain from the “Now the dog is gonna die”.. “The hospital is gonna be in trouble for my mistake”.. “It’s the end of the world” type thoughts! I guess it’s just harder for some then others! Let’s hope I never make a bigger mistake or I may just have a heart attack haha

Thank you. I think it’s from the decade of therapy lol.

I can say for sure that you WILL make another mistake at some point. And since you set the bar pretty low, it’ll probably be a little worse. But again, that’s okay. Work hard to catch mistakes and prevent them, and for the ones you can prevent just move on and learn from them. You may hear the term “CYA” sometimes. That’s stands for “cover your ass.” No matter what you do, always make sure that at the end of the day it isn’t you on the line. For example, if someone doesn’t want to come in to see the doctor or take medications you’re recommending, be sure to tell them the possible consequences for declining the recommendations they were given. And document that. Just writing “o was recommended to go to emergency when she said that P has been gagging and straining to vomit and not defecating. Owner declined, and declined to come in for an exam.” Go as far as you feel you need to in explaining what the right thing to do is, and if you ever aren’t sure how far to go, simply say “if there is anything immediately concerning you, call us or go to an emergency hospital.” It’s a catch all for anything you may not anticipate, and it takes the onus off of you since you can’t be hovering over the owner’s shoulder every second of the day. This will help to give you a clear conscience because even if you couldn’t get them in the door, you informed them of other options.

So basically, CYA, double check meds you’re filling, don’t be too hard on yourself, and learn from mistakes because they will happen in the future. Also make sure you do call backs because that’s how you catch issues before they get out of hand. For example, call the next day and say “hey just checking in and seeing how fluffy is doing after yesterday. Did he give you any trouble putting the animax on his paw?” To which the owner probably would have said “oh that goes on his paw? I’ve been putting that in his ear.” It’s a quick and easy way to, again, CYA.

 

[Justacatlover]

Thank you. I think it’s from the decade of therapy lol.

I can say for sure that you WILL make another mistake at some point. And since you set the bar pretty low, it’ll probably be a little worse. But again, that’s okay. Work hard to catch mistakes and prevent them, and for the ones you can prevent just move on and learn from them. You may hear the term “CYA” sometimes. That’s stands for “cover your ass.” No matter what you do, always make sure that at the end of the day it isn’t you on the line. For example, if someone doesn’t want to come in to see the doctor or take medications you’re recommending, be sure to tell them the possible consequences for declining the recommendations they were given. And document that. Just writing “o was recommended to go to emergency when she said that P has been gagging and straining to vomit and not defecating. Owner declined, and declined to come in for an exam.” Go as far as you feel you need to in explaining what the right thing to do is, and if you ever aren’t sure how far to go, simply say “if there is anything immediately concerning you, call us or go to an emergency hospital.” It’s a catch all for anything you may not anticipate, and it takes the onus off of you since you can’t be hovering over the owner’s shoulder every second of the day. This will help to give you a clear conscience because even if you couldn’t get them in the door, you informed them of other options.

So basically, CYA, double check meds you’re filling, don’t be too hard on yourself, and learn from mistakes because they will happen in the future. Also make sure you do call backs because that’s how you catch issues before they get out of hand. For example, call the next day and say “hey just checking in and seeing how fluffy is doing after yesterday. Did he give you any trouble putting the animals on his paw?” To which the owner probably would have said “oh that goes on his paw? I’ve been putting that in his ear.” It’s a quick and easy way to, again, CYA.

Love this advice! You’re great!! Ill remember the “cya” for sure. And haha yeah maybe I should set that mistake bar a little higher so I don’t just fade away next time I do something worse ha.

 

[ajs513]

Love this advice! You’re great!! Ill remember the “cya” for sure. And haha yeah maybe I should set that mistake bar a little higher so I don’t just fade away next time I do something worse ha.

Quick warning though: don’t use cya as an excuse to punt clients/cases so it’s not your problem anymore. Just keep it in mind so when you’re unsure you can think “is there anything else I should’ve said to make sure that if this goes badly it’s not on us?” And also don’t take it as me saying to not trust clients. You’re there to give them good advice. But that advice also needs to protect the practice from repercussions should the client not do what is recommended of them.

 

[that redhead]

I worked with a vet who could not ever stop thinking about any possible repercussion of what she’d done- what if this other antibiotic had been better? What if she had done this differently? Etc. She couldn’t leave work at work. She was miserable and eventually left clinical practice where she is much happier. Like minnerbelle says, you WILL make another mistake (many, probably) but it’s higher stakes as the doctor. If you can’t get past this mistake (probably one of the mildest possible), this field will destroy you mentally. Not to say be careless and forget about it, but recognize that you need to learn, form a plan to avoid the mistake again and move on.

 

[twelvetigers]

I worked for a clinic that autoclaved and reused needles.

It’s all a sliding scale... I wouldn’t quit because of label troubles.

Just learn from your mistake and try to do better - that’s all that any of us can do!

 

[ajs513]

I worked for a clinic that autoclaved and reused needles.

It’s all a sliding scale... I wouldn’t quit because of label troubles.

Just learn from your mistake and try to do better - that’s all that any of us can do!

I feel like that clinic spent more on water and electricity using that autoclave than they would’ve spent to buy new needles...

 

[twelvetigers]

There were other things too.

Sometimes it’s about learning what *not* to do, too.

 

[Minnerbelle]

I worked for a clinic that autoclaved and reused needles.

It’s all a sliding scale... I wouldn’t quit because of label troubles.

Just learn from your mistake and try to do better - that’s all that any of us can do!

Omg the practice that I work for prior to being bought over would “grind up” sharps in this weird grinder so they wouldn’t have to pay for sharps disposal. The amount you could grind at one time was probably a quarter of the amount of sharps I use in a day...

 

[that redhead]

I worked for a clinic that autoclaved and reused needles.

Shoot, I change my needles after every puncture. I’ve been double poked with a needle and that sht hurts. There was a cool zoomed in picture on reddit I think? of a needle bevel after each puncture showing just how quickly it burrs up.

 

[ajs513]

Shoot, I change my needles after every puncture. I’ve been double poked with a needle and that sht hurts. There was a cool zoomed in picture on reddit I think? of a needle bevel after each puncture showing just how quickly it burrs up.

This. Mind you, that last photo is zoomed in a lot, but the first three are very useful.

 

[SkiOtter]

Shoot, I change my needles after every puncture. I’ve been double poked with a needle and that sht hurts. There was a cool zoomed in picture on reddit I think? of a needle bevel after each puncture showing just how quickly it burrs up.

This. Mind you, that last photo is zoomed in a lot, but the first three are very useful. View attachment 275205

But is TT talking suture needles and not syringe needles tho?

 

[that redhead]

But is TT talking suture needles and not syringe needles tho?

Oh, dunno. I assumed she meant regular needles. We autoclave and reuse non-swaged needles, though I generally prefer the swaged ones anyway.

 

[ajs513]

But is TT talking suture needles and not syringe needles tho?

I guess I was figuring syringe needles, since reusing suture needles isn’t entirely uncommon.

 

[twelvetigers]

Syringe needles.

Also syringes.

Also surgery gloves.

Like I said...

 

[JustPaws]

Syringe needles.

Also syringes.

Also surgery gloves.

Like I said...

HMB: How about IV lines? Hand washed in the sink between patients. Several techs and I would routinely cut them before tossing so they had to be replaced...

 

[twelvetigers]

Didn’t use fluids enough to find out.

 

[PrincessButterCup]

Syringe needles.

Also syringes.

Also surgery gloves.

Like I said...

My old clinic did the last two.


My boss didn't believe in catheters (too expensive ???) and instead used a rubber band to hold a needle and syringe somewhat stable. That was interesting.

 

[Minnerbelle]

Omfg what is wrong with people!?

 

[Caiter92]

My old clinic did the last two.


My boss didn't believe in catheters (too expensive ???) and instead used a rubber band to hold a needle and syringe somewhat stable. That was interesting.

I also heard a rumor she didn’t use gas anesthesia like ever...

 

[PrincessButterCup]

I also heard a rumor she didn’t use gas anesthesia like ever...

Can confirm. Though at the point I was working for her she only did dentals, cat neuters, lump removals, and laceration repairs, because she recognized her eyesight was falling and she had decided to keep procedures to a minimum. The one time she did a major surgery (orthopedic) she did use gas, but it seriously took 45 minutes to intubate, and she didn't have the staff to help so we had a completely untrained receptionist monitoring anesthesia for the surgery. It was a mess.

 

[Minnerbelle]

Can confirm. Though at the point I was working for her she only did dentals, cat neuters, lump removals, and laceration repairs, because she recognized her eyesight was falling and she had decided to keep procedures to a minimum.

I can understand cat neuters, minor lump removals and lac repairs.

But dentals!? That is not a dental that person was performing. That’s essentially “anesthesia free dentistry” that is no better than what a stupid groomer does... just with sedation... essentially malpractice.... and if she used any sort of drill, ultrasonic scaler, or extracted teeth, super dangerous anesthetically without having an ET tube to protect the airways. The prev practice owner of my clinic used to do the same. Telazol ‘n scrape. And yank out some loose teeth. **** that ****.

I dunno why there are so many horrible veterinarians out there. As a vet, there are so few places that I take my pets to. And as someone who prefers to work with the middle of the road clientele and volunteers at low income clinics, I totally get not being able to do plan A for everyone. But geez, I have standards (as does the state veterinary board... but so many people fly under the radar).

 

[KCgophervet]

I feel like there needs to be a "WTF?" reaction just for some of these posts...

 

[PrincessButterCup]

But geez, I have standards (as does the state veterinary board... but so many people fly under the radar).

The vet I worked for finally lost her license a few years ago. It was for different reasons though - she wasn't keeping medical records current after seeing appointments, and would take records home so they weren't physically present and then just never bring them back. Our regular clients were aware that records were frequently missing.

 

[that redhead]

@Minnerbelle at least at my previous/first clinic where it was not good medicine, they didn’t know it wasn’t good. They assumed everyone turned out OK (the dog’s BP was 30 throughout the procedure? Well it woke up just fine, what’s the problem?) and that was how they’d always done it. The lack of adequate analgesia was what really pushed my buttons, but there were many other things too. I think for a lot of vets, they worry about branching out into unfamiliar territory AND have no desire to improve what they see is just fine. It’s really sad. (I am loads happier at my current practice where quality of medicine is great and we actually strive to go above and beyond.)