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NStarz said:
I wish it were so 🙁 Apparently I sucked so much they want me to come for another week. There goes any hopes I have of an internship. My life is officially over. Might as well just drop out now 🙁 🙁 🙁
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this is so not true - pm if you want a recap of the nasty things said to me from seniors who didnt think i'd succeed. well guess what, i got my top pick internship and i'm doing just fine as a doctor no thanks to them.
 
NStarz said:
I wish it were so 🙁 Apparently I sucked so much they want me to come for another week. There goes any hopes I have of an internship. My life is officially over. Might as well just drop out now 🙁 🙁 🙁
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Internship (or residency) does not a life make. I didn't match, am doing something completely different than I ever imagined, and my life is not over. People have overcome worse, and you certainly can too :luck:
 
My family and I have been invited to my neighbor's wedding. It is their second wedding, but their first legally recognized wedding, as they are a gay couple. My mom is refusing to go, because even though she likes them, and considers them friends, she has religious conflicts with their marriage. She told me she hopes they aren't offended that she's not coming, and I told her if her reason for not coming was because she believed marriage was between a man and a woman and therefore she felt she was unable to attend, then they have every right to be offended. I also told her she could hold her beliefs and still attend the wedding, besides it wouldn't be the first wedding she ever attended that she felt shouldn't happen for whatever reason. I'm really upset with her about this, and what am I supposed to say when they ask me why she didn't come?
 
Jilary said:
My family and I have been invited to my neighbor's wedding. It is their second wedding, but their first legally recognized wedding, as they are a gay couple. My mom is refusing to go, because even though she likes them, and considers them friends, she has religious conflicts with their marriage. She told me she hopes they aren't offended that she's not coming, and I told her if her reason for not coming was because she believed marriage was between a man and a woman and therefore she felt she was unable to attend, then they have every right to be offended. I also told her she could hold her beliefs and still attend the wedding, besides it wouldn't be the first wedding she ever attended that she felt shouldn't happen for whatever reason. I'm really upset with her about this, and what am I supposed to say when they ask me why she didn't come?
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I would hope she would explain it in person, not leave it up to you at the wedding. If she did in fact not broach the subject and you get asked, I guess you would be best saying that they would need to ask her. Bummer either way though. 🙁
 
Jilary said:
My family and I have been invited to my neighbor's wedding. It is their second wedding, but their first legally recognized wedding, as they are a gay couple. My mom is refusing to go, because even though she likes them, and considers them friends, she has religious conflicts with their marriage. She told me she hopes they aren't offended that she's not coming, and I told her if her reason for not coming was because she believed marriage was between a man and a woman and therefore she felt she was unable to attend, then they have every right to be offended. I also told her she could hold her beliefs and still attend the wedding, besides it wouldn't be the first wedding she ever attended that she felt shouldn't happen for whatever reason. I'm really upset with her about this, and what am I supposed to say when they ask me why she didn't come?
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That's tough, and it imposes a lot on you. If you did tell the truth, your mom realizes that whatever civility and relationship she has with them now may effectively end immediately? And it'll likely carry over into how they feel about you as well, even though it shouldn't. She's entitled to her opinion, but I think for the greater good of the community and the future dynamic between your family and your neighbors', she should just go and keep her mouth shut.
 
Jilary said:
My family and I have been invited to my neighbor's wedding. It is their second wedding, but their first legally recognized wedding, as they are a gay couple. My mom is refusing to go, because even though she likes them, and considers them friends, she has religious conflicts with their marriage. She told me she hopes they aren't offended that she's not coming, and I told her if her reason for not coming was because she believed marriage was between a man and a woman and therefore she felt she was unable to attend, then they have every right to be offended. I also told her she could hold her beliefs and still attend the wedding, besides it wouldn't be the first wedding she ever attended that she felt shouldn't happen for whatever reason. I'm really upset with her about this, and what am I supposed to say when they ask me why she didn't come?
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Honestly, they don't need to know why she isn't attending. Their wedding isn't about her or her beliefs. You don't have to offer any further explanation other than "my mother couldn't attend." You're attending and participating in their celebration and that's all you need to do.

If she's really worried about how this couple will perceive her absence, she can tell them herself in whatever holier-than-thou, self-righteous, condescending way she wants. That's not on you and you shouldn't feel compelled to be her messenger.
 
NStarz said:
Lost a kitten...A KITTEN...under anesthesia today. And I had a big role in it (didn't recognize that it had arrested until the dr had come in and told us). RIP <3

And my surgical skills are getting worse, not better (made the same mistake today that I made at the wayyy beginning of this rotation despite having done it a billion times since without incident). I just want to push papers all day 🙁
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That sucks, I'm sorry. But if you were the surgeon at the time it shouldn't even be your primary responsibility to monitor the patient's circulatory status. I hope nobody suggested it was your fault for not noticing. The anesthetist should have been monitoring.
 
Doktor Timo said:
That sucks, I'm sorry. But if you were the surgeon at the time it shouldn't even be your primary responsibility to monitor the patient's circulatory status. I hope nobody suggested it was your fault for not noticing. The anesthetist should have been monitoring.
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That's maybe technically true, but in most private practice contexts (outside of, say, ivory tower medicine or referral medicine), you're going to be primarily responsible for your patient - period. And there is a wide range in competency and comfort for technicians handling patients under anesthesia.

If I'm cutting anything (even just some simply laceration repair), I will have a technician dedicated to monitoring the patient, but if things go south .... it's ultimately my responsibility. I'm lucky to have techs with advanced training and experience, but that's not ubiquitous in private practice.

Maybe it's just because I'm paranoid, but... I think it's a really, really good habit to get into as a SA DVM that you keep one eye on the monitoring gear the entire time you're cutting. Trust your techs ... but don't trust your techs.
 
LetItSnow said:
That's maybe technically true, but in most private practice contexts (outside of, say, ivory tower medicine or referral medicine), you're going to be primarily responsible for your patient - period. And there is a wide range in competency and comfort for technicians handling patients under anesthesia.

If I'm cutting anything (even just some simply laceration repair), I will have a technician dedicated to monitoring the patient, but if things go south .... it's ultimately my responsibility. I'm lucky to have techs with advanced training and experience, but that's not ubiquitous in private practice.

Maybe it's just because I'm paranoid, but... I think it's a really, really good habit to get into as a SA DVM that you keep one eye on the monitoring gear the entire time you're cutting. Trust your techs ... but don't trust your techs.
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You're right about private practice; my response was based on the assumption that they were working in an academic setting where they should have a fellow student running anesthesia (which is how they do it here at TN, at least). In that case the primary responsibility for monitoring would fall on the anesthesia student, not the surgery student.

I get that when something goes wrong the entire team is responsible to an extent because patient care is everybody's responsibility. I just hope they weren't placing undue pressure on the surgery student for something that went wrong under anesthesia.
 
Doktor Timo said:
You're right about private practice; my response was based on the assumption that they were working in an academic setting where they should have a fellow student running anesthesia (which is how they do it here at TN, at least). In that case the primary responsibility for monitoring would fall on the anesthesia student, not the surgery student.

I get that when something goes wrong the entire team is responsible to an extent because patient care is everybody's responsibility. I just hope they weren't placing undue pressure on the surgery student for something that went wrong under anesthesia.
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Sorta. In NStarz' case, sure, it's academic ivory-tower medicine and there's a larger team. And yeah, patient care is everybody's responsibility. But once you get out ... it's still sorta everybody's responsibility, but you the DVM are the only one that's actually likely to have anything major at stake, like a license. So while it's everybody's responsibility, it's REALLY your responsibility. And if the patient dies, you're the one who is going to have to call the owner, not the technician you had monitoring the patient under anesthesia.

I'm just saying don't get in the habit, even as a student in ivory tower academic medicine where anesthesia might be its own service and you have nothing to do with it for a given surgical case, of thinking "I'm the surgeon, anesthesia isn't my problem." It will come as a slap in the face when you get out and have to give at least <some> attention to anesthesia, even if you do have a dedicated person monitoring it. Better to just keep it in your head from the get-go. You've got your hands in the patient, so it's relatively easy to assess perfusion. You can keep the last BP in your head. You can usually hear some sort of heart rate. And you can glance at the ECG/ETCO2/etc (i.e. whatever monitoring you are using) .... every 5 minutes or so.

It's just a good habit.
 
I certainly don't disagree, I just hate to see somebody shoulder blame that shouldn't be on them. My point was not that surgeons can't or shouldn't keep an eye on their patient in general, I was just trying to speak to nstarz specific case. Outside the ivory tower things are different obviously, but on the inside we have anesthesiologists and anesthesia students specifically so the surgeons can focus primarily on the actual surgery.

ETA: I worked full-time this summer in Anesthesia here at Tennessee, and most of the time the surgeons can't even see the monitoring equipment. So the most they could do is listen to the ECG. But even in that case, if a patient arrests and the surgeon has to be the first person to notice it, then I majorly screwed up on my end and I bear 90% of the blame.
 
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Doktor Timo said:
I certainly don't disagree, I just hate to see somebody shoulder blame that shouldn't be on them. My point was not that surgeons can't or shouldn't keep an eye on their patient in general, I was just trying to speak to nstarz specific case. Outside the ivory tower things are different obviously, but on the inside we have anesthesiologists and anesthesia students specifically so the surgeons can focus primarily on the actual surgery.

ETA: I worked full-time this summer in Anesthesia here at Tennessee, and most of the time the surgeons can't even see the monitoring equipment. So the most they could do is listen to the ECG. But even in that case, if a patient arrests and the surgeon has to be the first person to notice it, then I majorly screwed up on my end and I bear 90% of the blame.
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Yes. But surgeons in ivory tower are staying there (for the most part). The vast majority of students aren't. So it's a good idea to start forming good habits now that will help make it less stressful later. It's not about placing blame, and I'm not saying the surgeon should be the first person to notice it: it's about creating processes that give you the best chance of breaking the chain of error, and it's about learning from unfortunate incidents. Don't focus on it as a mistake; focus on it as a learning opportunity. I think Nstarz's day just plain sucked and the universe decided to take a crap on her and her team that day - but there's still the chance to learn something from it!

To some degree students already have their head full and you don't want to overload them and actually reduce learning. That's true. So I'm not saying the student should overload themselves.

But there's also the saying "practice like you play" - and there's a lot of truth to it. Way better - in my opinion, and I recognize there are others - to start from the get-go keeping it in your head that at some point you're going to have to manage both cutting the patient and keeping at least somewhat in the loop on the patient status. So start now while you have time to practice.

Now that I've been on both sides (student with a full-on team of people, and dvm elbows deep in a crashing patient with just me and a tech), I wish they had pushed me harder in school to focus on both cutting and monitoring my patient at the same time. But in general, because there was always someone 100% focused on anesthesia, we didn't really do that. We just assumed the anesthesia people had it covered. Then you get out and ... oops, you actually have to pay attention to your patient. Might as well just start getting used to that multi-tasking now (to the degree a student can do so without detracting from the learning goal). That's coming from my experience. Whether you think it's worth listening to .... all depends on your future goals, I guess.
 
I constantly get labeled as mediocre by others. What they don't realize is my school has been so much tougher than theirs has been. I held a 3.7 at 21 credits. Got a 4.0 in both semesters of honors level ochem. Have a hefty amount of clinical experience. All my rec letters are from vets. I've never had anything below an A in a 3000+ level science. I also have extracirriculars. I put on my own campus wide event. I'm on the board of directors of a non profit organization. I volunteer. Oh and I'm a liberal arts major in an thesis bachelor's honors program. I don't make everything about vet med, but I'm well rounded. I messed up when I was young, that's why my cGPA is lower than yours. The only thing that's completely awful on my app is my GRE (300 v+q). I already count myself out enough, but I don't need others around me doing it, too. This is why I haven't shared my applying with everyone.
 
Doktor Timo said:
I certainly don't disagree, I just hate to see somebody shoulder blame that shouldn't be on them. My point was not that surgeons can't or shouldn't keep an eye on their patient in general, I was just trying to speak to nstarz specific case. Outside the ivory tower things are different obviously, but on the inside we have anesthesiologists and anesthesia students specifically so the surgeons can focus primarily on the actual surgery.

ETA: I worked full-time this summer in Anesthesia here at Tennessee, and most of the time the surgeons can't even see the monitoring equipment. So the most they could do is listen to the ECG. But even in that case, if a patient arrests and the surgeon has to be the first person to notice it, then I majorly screwed up on my end and I bear 90% of the blame.
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maybe it's changed but when I was there we were always encouraged to pay attention to anesthesia or ask for updates.
 
dyachei said:
maybe it's changed but when I was there we were always encouraged to pay attention to anesthesia or ask for updates.
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I'm on my surgery and anesthesia rotation at the moment and had my first case as primary surgeon today. I asked for an update about every 10 minutes or if it was a moment I wanted to stop and get the surgeon's advice on something. When I was the anesthetist, I updated my surgeons every once in awhile to let them know their patient was fine.
 
dyachei said:
maybe it's changed but when I was there we were always encouraged to pay attention to anesthesia or ask for updates.
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Yeah that definitely happens occasionally. I would have surgeons ask me about pressures periodically. I didn't mean to imply that wasn't the case, just that most of the time the surgeons aren't monitoring in any active way.
 
Today was the first day that I felt really, totally overwhelmed at work. Like hang on, I just need a mixture to scream. I really hope I did right by heart dog and I actually heard what I heard, and I hope the awkward phone conversation guy doesn't tell the main doc that I seem like a bit of a derp. I wouldn't argue anyway...
 
twelvetigers said:
And how long does it take to keep all the names of all the drugs straight, and to know doses without having to clamber for plumbs/notes/the Internet? Blah.
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for the really common stuff? ~6 months. I still refer to plumbs for some stuff
 
twelvetigers said:
And how long does it take to keep all the names of all the drugs straight, and to know doses without having to clamber for plumbs/notes/the Internet? Blah.
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Several Dr's I've worked with keep a notebook for drug doses. Easy stuff like benedryl you can remember quickly, but there is no shame is looking things up.
 
This summer I've been working 40+ hours a week, teaching myself stats, studying for the GRE, AND applying to vet school. I can't wait for it to be over! Applying is so tedious! I want this so badly but there's so much pressure and the deadline is approaching and ahhh. How are you all coping with/how did you cope with the application stress??
 
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olive. said:
This summer I've been working 40+ hours a week, teaching myself stats, studying for the GRE, AND applying to vet school. I can't wait for it to be over! Applying is so tedious! I want this so badly but there's so much pressure and the deadline is approaching and ahhh. How are you all coping with/how did you cope with the application stress??
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Procrastination. That's also how I cope with vet school stress...
 
Doktor Timo said:
Procrastination. That's also how I cope with vet school stress...
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That was going to be my suggestion!

Though I probably wouldn't advise having a friend help you revise your PS the night before the app is due, finishing your last supplemental that same night, and submitting everything 2 hours before the deadline :whistle:
 
twelvetigers said:
Today was the first day that I felt really, totally overwhelmed at work. Like hang on, I just need a mixture to scream. I really hope I did right by heart dog and I actually heard what I heard, and I hope the awkward phone conversation guy doesn't tell the main doc that I seem like a bit of a derp. I wouldn't argue anyway...
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It's ok. We are all new at this and will get better in time. I had not one, but two panic attacks on Friday on a client's farm (working with another doc who has a tendency to not pay great attention to things who ended up trying to urge the students to step into dangerous situations multiple times). Now I can't get a hold of the client to make sure all the castrated animals are alive and well.
 
olive. said:
This summer I've been working 40+ hours a week, teaching myself stats, studying for the GRE, AND applying to vet school. I can't wait for it to be over! Applying is so tedious! I want this so badly but there's so much pressure and the deadline is approaching and ahhh. How are you all coping with/how did you cope with the application stress??
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Everyone copes differently, but what helped me the most was not telling everyone about it or blasting it on Facebook. Don't get me wrong, talking about it can be very therapeutic for some. I just hate talking about anything relating to applying, interviewing, or heading to vet school. Not sure why....just me. Could be because I really dislike talking about myself or being focused on. I could not stand hearing "When will you know? Have you heard back yet?" over and over again. Talking about it on SDN was helpful, though. Everyone already understands what you're dealing with. Plus, it was easier to tell only a few people that I was flat out rejected my first try:smack: . I'm sure that won't happen to you though!

Remember to do your best on the applications, but also have fun before summer ends!! Try to do the application in small sections so it's not so overwhelming. Or set one day aside for each supplemental and crank them out so they get done. Whatever you feel comfortable with. Best of luck!
 
pinkpuppy9 said:
Everyone copes differently, but what helped me the most was not telling everyone about it or blasting it on Facebook. Don't get me wrong, talking about it can be very therapeutic for some. I just hate talking about anything relating to applying, interviewing, or heading to vet school. Not sure why....just me.
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That's good practice, because once you start school you'll quickly get tired of talking about vet school all day every day. I'm grateful that I have a non-scientifically inclined wife who doesn't get excited about medicine because it forces me to talk about other things around her. When I'm with my classmates, even if we're out having a beer or whatever, we always just end up talking about school and it's just obnoxious after a while.
 
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Doktor Timo said:
That's good practice, because once you start school you'll quickly get tired of talking about vet school all day every day. I'm grateful that I have a non-scientifically inclined wife who doesn't get excited about medicine because it forces me to talk about other things around her. When I'm with my classmates, even if we're out having a beer or whatever, we always just end up talking about school and it's just obnoxious after a while.
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My boyfriend is a mechanical engineer...other than being interested in learning how drugs work or how body systems operate, he doesn't grill me too much. My parents seem faint at some of the things I have to say haha.
 
scb44f said:
It's ok. We are all new at this and will get better in time. I had not one, but two panic attacks on Friday on a client's farm (working with another doc who has a tendency to not pay great attention to things who ended up trying to urge the students to step into dangerous situations multiple times). Now I can't get a hold of the client to make sure all the castrated animals are alive and well.
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Yuck. Everyone says it gets easier, so I guess it does.

I guess I need an official notebook to fill with things I want to try and remember...
 
It gets easier. First year out is hell but you just have to go through it.
I had a mini notebook where I kept common drug doses organized into antibiotics, dewormers, etc. I'm a little over a year out and I don't even know where it is now.
 
In all seriousness, I've put off my application nearly all summer, and now I'm really working hard. I see Facebook statuses about submitted applications to medical school, pharmacy school, vet school, and it makes me turn colors. I ought to stay off social media until I know if I get an interview or not...
 
Also, good luck @olive. If you haven't taken your GRE yet! We are almost there. By sept 15th, most of the hard parts of applying will be over. I forgot where you're applying but if it's LSU or Miss st maybe we will meet one day.
 
bunnity said:
It gets easier. First year out is hell but you just have to go through it.
I had a mini notebook where I kept common drug doses organized into antibiotics, dewormers, etc. I'm a little over a year out and I don't even know where it is now.
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My (perhaps weird) approach is that I have a little notebook (really little - fits in my scrub pants pocket). I never write in the notebook itself - I just put sticky notes on each page with things I feel like I need to remember. Then when I realize I just 'know' it, I take the sticky note out and free up that page for something else.

When I started, the first page was drug dosing for crash drugs. About a week and 4-5 CPR attempts later I realized that we had sufficient signs all over the room that I didn't need to know it. And anyway, my techs figure it out for me; all I do is say "<drug name> now, please". So out that went. Second page was my preferred dosing for allergic reactions since we get that pretty commonly. That lasted a week and 2-3 cases. I've still got a neuro exam cheat sheet post-it in there, because neuro. A few tox post-its for some toxins I see frequently enough to matter, but not enough that I have their whole work-up, toxic doses, and tx memorized. Etc. I've probably got 20 post-it notes going at any one time, and I just add new ones as needed and get rid of them once comfortable.

It's a weird system, but it seems to work for me. I think what might be better is for me to start making a list of "LeTitsNow's preferred dosing" for my techs. There's been some doctor turnover where I'm at, and you can tell it stresses them all out because they knew all the previous docs' dosing and whatnot, and now they feel like they don't. I do SID famotidine dosing, for instance, whereas most docs do BID. I like my fentanyl separate on a syringe pump; the other docs like to put it in a bag of fluids through the normal pump. Etc. I should put together my list of "this is the treatment for these top-10 things we see" just to make their life easier. 🙂
 
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I have a little laminated card from UTK with doses for pain meds, anesthetic meds, and emergency meds. It was given to us on our anesthetic rotation. Multiple other vets have taken and made copies of this pocket sized "book". Otherwise, I have memorized allergy meds, common antibiotics, and most of my pre-meds. I also have NSAID and pain control (particularly for arthritis) down.
 
dyachei said:
I have a little laminated card from UTK with doses for pain meds, anesthetic meds, and emergency meds. It was given to us on our anesthetic rotation. Multiple other vets have taken and made copies of this pocket sized "book". Otherwise, I have memorized allergy meds, common antibiotics, and most of my pre-meds. I also have NSAID and pain control (particularly for arthritis) down.
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It's a pretty sweet little card. I still keep my copy close at hand. (I need to laminate it, though). A few dosages on there I find are kinda weird, but no surprise there - we all have things we do differently. All in all, it's a really handy little reference.
 
Thanks @rockatiel and everyone else!! I am not applying to LSU or Miss, but good luck to you tooo 🙂
I'm glad to hear others have procrastinated as well haha. Makes me feel a lot better.
 
dyachei said:
I have a little laminated card from UTK with doses for pain meds, anesthetic meds, and emergency meds. It was given to us on our anesthetic rotation. Multiple other vets have taken and made copies of this pocket sized "book". Otherwise, I have memorized allergy meds, common antibiotics, and most of my pre-meds. I also have NSAID and pain control (particularly for arthritis) down.
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I love that little card. They actually updated it this year with even more meds. I probably referenced it twenty times a day this summer in anesthesia.
 
Doktor Timo said:
I love that little card. They actually updated it this year with even more meds. I probably referenced it twenty times a day this summer in anesthesia.
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Do they have it in PDF format, by any chance? Or can you beg/borrow it in PDF format? I'd love a newer copy.
 
Doktor Timo said:
I'm not sure, I'll try to find out who I should ask about that. In the meantime I could try scanning my copy if you like.
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I would also appreciate an update. Though I may just go visit one day and harass anesthesia for a new one
 
dyachei said:
I would also appreciate an update. Though I may just go visit one day and harass anesthesia for a new one
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That's right, I was supposed to get you a copy of mine. I have clinics brain, sorry.
 
Decided to celebrate the end of the first week of clinics and was rewarded by having my credit card, debit card, and license stolen 🙁 Florida DMV recommends filing a police report and filling out some paperwork and taking it with you to the DMV to get a new license... which would be fine if I didn't live in California and didn't want a California license.
 
Now out $370 because UIUC automatically charges you for student health insurance. Tried to find out about waiving/refunding that, but apparently I needed to have done that by June 12, before any of this was even billed to me. Not sure if automatic insurance is a UIUC thing or a veterinary/grad school thing, but maybe informing me about it would have been nice. :yeahright:
 
pinkpuppy9 said:
Now out $370 because UIUC automatically charges you for student health insurance. Tried to find out about waiving/refunding that, but apparently I needed to have done that by June 12, before any of this was even billed to me. Not sure if automatic insurance is a UIUC thing or a veterinary/grad school thing, but maybe informing me about it would have been nice. :yeahright:
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You have to opt out of it here and have a plan approved otherwise you get the school plan for $3200/year.
 
Your young neutered male cat does not have a history of recurrent UTIs, your male cat does not have a history of recurrent UTIs, YOUR MALE CAT DOES NOT HAVE A HISTORY OF RECURRENT UTIs!!!!!!!!

If he didn't have UTIs, then why was he put on antibiotics (quinolones to be exact) every time he started having bloody urine, you ask?

How about your vet is a douche who really wants to cause antibiotic resistance in this world?

Oh no no, my bad. I'm the dumb one. Clearly I don't know what I'm talking about. Cause you know, if your cat seriously had 10 UTIs over the past 3 years, I would have had an ultrasound/rads done on your cat at least 2 years ago to rule out cancer or stones or something. Has your cat ever even had a urine culture ever? No? But only stupid vets need diagnostics. Good ole smart antibiotic vet just KNOWS, and can tell by looking at the cat that he has an infection. The antibiotics clear it up right away each time...

Graaaawwewrrrrrr
 
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