RANT HERE thread

[LetItSnow]

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I have been places where the U/S probe is in Cubex/Pyxis so that you HAVE to charge if you're using it. I have some feels about how useful that is to the learning interns/students etc. Most people I know are like "pop a probe on it." but sometimes...

UMN ICU used to keep their ultrasound probe in Cubex.... I think their real reason had less to do with charging and more to do with not wanting random students playing around with an expensive probe.

It's a bit of a dilemma - those probes are so darn expensive that you don't want people just goofing around, banging it against something, dropping it on the floor, stabbing/scratching it with a needle during centesis, etc. But on the other hand - you have to learn.

That's why an ultrasound rotation is awesome.

 

[LetItSnow]

@fromthebox there really are two sides to it - on one hand yes practicing to improve is great and a goal, but there is also the cost and maintenance of the machine, the responsibility carried by the doctor and clinic to provide medical services but also keep the clinic open. I had a couple of mentors who were very against doing anything without the clients permission because they had ended up in sticky situations by doing seemingly benign things like a fast scan. Meh. That's the difference between academia and private practice (although academia definitely audits those charges of they get any hint it was done!)

Well. It kinda goes without saying that you shouldn't be doing something unless you have the discretion to do it...... I would hope nobody read my post as suggesting breaking any rules for whatever organization you work for.

I don't really think it's academic vs private, though. UMN - at least during my ER rotations - was always super happy to have students FAST scanning patients. They encouraged it. Maybe they've changed their tune, I dunno.

 

[Trilt]

I heard nothing particularly great about our ultrasound rotation as far as actual clinical skills... didn't manage to fit it into my schedule. I hounded my patients while they went through ultrasound so watched a ton, but honestly since I was going into GP practice and sooooo many do not have an ultrasound, it wasn't a high priority for me.

And then I was hired at a clinic that likes toys that they don't necessarily know how to use, and has an ultrasound. And how I end up spending my lunch break FASTing my still gorked out morning spay. 😛 (who was an extremely bloody sx and has a heart murmur, so actually a kinda fun candidate for it).

 

[Trilt]

We have a $20 ultrasound assist charge for our cystos and I've used that for previous "just poke around and look for something obvious and horrible" patients. Not confident enough to really charge for a diagnostic US.

 

[LetItSnow]

I heard nothing particularly great about our ultrasound rotation as far as actual clinical skills... didn't manage to fit it into my schedule. I hounded my patients while they went through ultrasound so watched a ton, but honestly since I was going into GP practice and sooooo many do not have an ultrasound, it wasn't a high priority for me.

And then I was hired at a clinic that likes toys that they don't necessarily know how to use, and has an ultrasound. And how I end up spending my lunch break FASTing my still gorked out morning spay. 😛 (who was an extremely bloody sx and has a heart murmur, so actually a kinda fun candidate for it).

That blows. 🙁 At UMN I <loved> our US rotation. (And you in theory had to take the didactic course in order to take the rotation.) We'd spend an hour or two in the morning learning how to image a particular organ, then we'd practice on our animals or other staff animals. Then they'd start seeing patients and the tech would scan while students restrained, then we'd get a chance to scan while the radiologist was on their way down, then we'd watch again while the radiologist scanned.... lots of repetition, lots of teaching. Honestly, I felt like it was one of the best-structured rotations at the school.

 

[wallydo]

UMN ICU used to keep their ultrasound probe in Cubex.... I think their real reason had less to do with charging and more to do with not wanting random students playing around with an expensive probe.

It's a bit of a dilemma - those probes are so darn expensive that you don't want people just goofing around, banging it against something, dropping it on the floor, stabbing/scratching it with a needle during centesis, etc. But on the other hand - you have to learn.

That's why an ultrasound rotation is awesome.

One of our duties in the ER/ICU at MSU is making sure our main triage station is good to go at all times (except for our drugs which LVTs restock every time the crash cart gets opened). But at this station is where our ultrasound for fast scanning is and sometimes I'll walk into the ER and find the probe just laying on the ground and think "ope, let's put you back where you belong little buddy".

 

[LetItSnow]

One of our duties in the ER/ICU at MSU is making sure our main triage station is good to go at all times (except for our drugs which LVTs restock every time the crash cart gets opened). But at this station is where our ultrasound for fast scanning is and sometimes I'll walk into the ER and find the probe just laying on the ground and think "ope, let's put you back where you belong little buddy".

I don't really understand why you'd ever PUT the probe on the ground, much less leave it there.

 

[jmo1012]

Well. It kinda goes without saying that you shouldn't be doing something unless you have the discretion to do it...... I would hope nobody read my post as suggesting breaking any rules for whatever organization you work for.

I don't really think it's academic vs private, though. UMN - at least during my ER rotations - was always super happy to have students FAST scanning patients. They encouraged it. Maybe they've changed their tune, I dunno.

Nah I was just warning future vets that although practicing may be accepted or encouraged at some places, to unfortunately not be surprised if it's not okay at others (because I was surprised). We too allow students to play around with our er ultrasound on whomever (similar to your academic institution) thus my comment that it's likely more accepted and encouraged at academic practices over private practices because academias goals are technically to teach whereas private places have to typically be a business first.

 

[nyanko]

I'm echoing anybody else here who said trust (most of) your techs on ER/ICU. They have seen it before, they have worked with interns before, and you want them on your side. There is nothing more valuable at 3 in the morning while you've got one dog in status and one in resp distress than a tech you trust to set up that midazolam CRI themselves when you give them a dose, or grab the ultrasound for you to scan a chest before you even ask, or help you with a difficult client, or one of the million and a half other things that are going to stress you out in August of your intern year.

 

[orca2011]

@fromthebox there really are two sides to it - on one hand yes practicing to improve is great and a goal, but there is also the cost and maintenance of the machine, the responsibility carried by the doctor and clinic to provide medical services but also keep the clinic open. I had a couple of mentors who were very against doing anything without the clients permission because they had ended up in sticky situations by doing seemingly benign things like a fast scan. Meh. That's the difference between academia and private practice (although academia definitely audits those charges of they get any hint it was done!)

We have an auditor who i swear has definitely gone through my SOAPs to find out that I did it cause I stopped writing it on my tx sheet most of the time but the charge magically appears. Part of me want so charge cause technically it is a diagnostic and it should be charged, plus it counts towards my production (only used to tell potential employers what I brought it) but considering I personally uses it like 10x a day on ER and I'm one of lime 10 day time ER drs, $65 seems a bit much to me.

 

[Devastating]

Colorado drivers are terrible but I have yet to see someone throw their car into reverse on an entrance ramp and back off of the highway, which I have seen someone do in TX before.

 

[deleted498041]

Thank you to everyone for the advice 🙂 I think I might have overstated my imposter syndrome a little bit. It flares up every now and then, but it's honestly not as bad as I've heard some classmates as suffering from (or that some people on here mention dealing with). Either way, I definitely appreciate the support and the words of wisdom. I'm really looking forward to my internship either way, and I imagine a lot of my concerns will be addressed in orientation, and I'll definitely be bringing up the possibility of doing a quick scan on whatever I can when the hospital is slow or when I'm able to and whether there are any problems with that as far as billing goes. Either way, I'm sure I'll make mistakes and I can just hope that I'll learn from them quickly so I don't turn one mistake into a habit.

I will definitely be leaning on my technicians a lot. My school really stresses the importance of treating your technicians well and trusting them (when you know you can). One of our professors constantly reiterates that a technician can do 90% of a veterinarian's job, and that we're just there for the 10% of the time that they can't diagnose a patient. My internship is pretty well known for its ECC department, so I imagine the technicians there are fairly skillful and knowledgeable, so I assume I'll be able to rely on them to recognize things a little more quickly than I am, at least for a little bit! 😉

Thank you again, to everyone, for the advice and support 🙂

 

[WildZoo]

I love John Mulaney!!

 

[LetItSnow]

My internship is pretty well known for its ECC department, so I imagine the technicians there are fairly skillful and knowledgeable, so I assume I'll be able to rely on them to recognize things a little more quickly than I am, at least for a little bit! 😉

I think most techs that work full-time ECC are pretty good. You don't last long in that environment if you don't have chops, for the most part. The ones to be a bit more wary with trusting their opinion are the new ones or the part-timers. Look for the ones that move efficiently but yawn when a crashing case comes in and have been putting catheters in dead or dying animals for 15 years. Legalities aside, they could pretty much do your job for you.

And when they say "Would you like [......]" the answer is almost always "Uh, yeah, of course."

That's their way of asking the classic co-pilot question on final approach with the gear still up: "Captain, are you happy with the position of the gear?"

 

[twelvetigers]

I thought we were in a professional program. But with the sheer amount of gossipy garbage and drama being flung around here I feel more like I'm in high school all over again. Urgh.

Uhhhhhhh yep. That's pretty universal.

Just try and avoid it.

 

[vetmedhead]

I thought we were in a professional program. But with the sheer amount of gossipy garbage and drama being flung around here I feel more like I'm in high school all over again. Urgh.

This is an unfortunately common complaint I've heard from a lot of people. Sorry you're dealing with it now though.

 

[RMulder]

I thought we were in a professional program. But with the sheer amount of gossipy garbage and drama being flung around here I feel more like I'm in high school all over again. Urgh.

I only like my mean people and drama to be on ABC tv shows.
But really, vet school is mostly 22-year olds fresh out of undergrad still trying to figure out who they are. It takes time and life experience to get past the gossip stage. Still frustrating when I overhear a Mean Girls conversation because I'd like to scold them (which wouldn't be effective).

 

[WildZoo]

I thought we were in a professional program. But with the sheer amount of gossipy garbage and drama being flung around here I feel more like I'm in high school all over again. Urgh.

I don't think humans as a whole really ever grow out of that kind of thing. Part of being social animals.

 

[aggievethopeful2021]

Some days, I just get crushed with an overwhelming feeling of loneliness. Usually, I'm perfectly fine by myself. But I've barely been home from dropping my dog off at my parents and already am getting that feeling. I know her staying with my parents was best for her mental health, but I'm realizing it might not necessarily be for mine. Add the fact that me and fiancé are struggling with figuring out what our life is going to be while waiting to hear back from schools and the fact that none of my friends are ever able to hang out (rightfully so, as two of them are in vet school), and it's just making it worse.

Sorry for the rant, just needed to get it out there and vent. Hoping tomorrow is a better day.

 

[amgoose319]

Some days, I just get crushed with an overwhelming feeling of loneliness. Usually, I'm perfectly fine by myself. But I've barely been home from dropping my dog off at my parents and already am getting that feeling. I know her staying with my parents was best for her mental health, but I'm realizing it might not necessarily be for mine. Add the fact that me and fiancé are struggling with figuring out what our life is going to be while waiting to hear back from schools and the fact that none of my friends are ever able to hang out (rightfully so, as two of them are in vet school), and it's just making it worse.

Sorry for the rant, just needed to get it out there and vent. Hoping tomorrow is a better day.

I feel you with the fiance thing. In the same boat. My school attendance decision solely relies on him finding a job at this point. It's stressful, but keep your head up! We have until April, there's still plenty of time to figure things out and turn things around.

 

[genny]

Had to turn down a job I really wanted because SO didn't want to move, and now I'm all butthurt and grumpy. Hope my interviews next week go well so I can get out of this funk.

 

[vetmedhead]

I keep having awful, abhorrent recurring nightmares that my mother has died and she's trying to send me messages that she loves me through my dreams. I've woken up sobbing for probably three or four days in a row now.

Last night was awful. I was going through a series of museum exhibits alone and kept seeing parts of exhibits that she had left behind for me to see so I would know she loves me. There were supposed to be 10 exhibits total but I only made it to five before I found an exhibit that was showing me a time she painted our nails so they matched and I just woke up gasping for breath ugly sobbing.

My whole pillow was soaked, I must have been crying the entire time I was asleep. And of course dreams like that always feel like awful premonitions so I had to spend all of this time combing through Facebook and texts and voicemails from my whole family just to make sure she actually is okay and that the core premise of my dream wasn't true.

I just don't know what to do about anxiety dreams like this. I hate just waking up shaking and with my heart hurting. 🙁

 

[WildZoo]

Oh I'm so sorry vmh, that sounds awful 🙁 I've had dreams like that before, but not recurring ones. Not sure how to make that stop. *virtual hugs*

 

[Caiter92]

Oh I'm so sorry vmh, that sounds awful 🙁 I've had dreams like that before, but not recurring ones. Not sure how to make that stop. *virtual hugs*

You're suppose to send kitty hugs to vmh. Those are the kind she likes. GOD DUBZ.

Ugh, that's awful vmh. I hate dreams like that 🙁

 

[WildZoo]

You're suppose to send kitty hugs to vmh. Those are the kind she likes. GOD DUBZ.

Ugh, that's awful vmh. I hate dreams like that 🙁

She said she'd accept virtual hugs before!

 

[Caiter92]

She said she'd accept virtual hugs before!

No. she needs Cheese hugs

 

[SkiOtter]

She said she'd accept virtual hugs before!

No. she needs Cheese hugs

 

[WildZoo]

No. she needs Cheese hugs

Cheese will just bite her!

 

[vetmedhead]

Oh I'm so sorry vmh, that sounds awful 🙁 I've had dreams like that before, but not recurring ones. Not sure how to make that stop. *virtual hugs*

You're suppose to send kitty hugs to vmh. Those are the kind she likes. GOD DUBZ.

Ugh, that's awful vmh. I hate dreams like that 🙁

She said she'd accept virtual hugs before!

I accept all non-physical hugs unless you make it weird 😉 Also any type of kitty hug is accepted.

But also the first thing I thought when I woke up today is that I need a hug. 🙁 Says a lot about that dream that it made me want physical contact with another person. 😛

 

[Caiter92]

Cheese will just bite her!

It's his way of showing love. You have to respect his life choices.

 

[Balesofhay]

Cheese will just bite her!

That's what I was thinking

 

[Caiter92]

I accept all non-physical hugs unless you make it weird 😉 Also any type of kitty hug is accepted.

But also the first thing I thought when I woke up today is that I need a hug. 🙁 Says a lot about that dream that it made me want physical contact with another person. 😛

Go walk around campus and find a stoner. I'm sure they'd give you a hug 😛

 

[vetmedhead]

It's his way of showing love. You have to respect his life choices.

Cheese got kicked out this morning for excessive daytime yodeling. Kitties don't know it but that's an automatic red card offense in my playbook. 😉

 

[vetmedhead]

Go walk around campus and find a stoner. I'm sure they'd give you a hug 😛

They smell like weed and bad choices though

 

[Caiter92]

Cheese got kicked out this morning for excessive daytime yodeling. Kitties don't know it but that's an automatic red card offense in my playbook. 😉

He's singing to you to make you feel better! Why you gotta be a jerk.

 

[Caiter92]

They smell like weed and bad choices though

That's why you shower and go to church afterwards.

 

[vetmedhead]

He's singing to you to make you feel better! Why you gotta be a jerk.

He was yelling because he heard the dog was up and wanted to chase him

 

[vetmedhead]

That's why you shower and go to church afterwards.

You can't scrub that amount of dank off your body, dude

 

[Caiter92]

You can't scrub that amount of dank off your body, dude

Wear PPE.

 

[Caiter92]

He was yelling because he heard the dog was up and wanted to chase him

No. that's just what he let you think after you kicked him out so he could pretend he wasn't hurt you didn't appreciate his gesture.

 

[vetmedhead]

No. that's just what he let you think after you kicked him out so he could pretend he wasn't hurt you didn't appreciate his gesture.

He couldn't conceal his excitement once he saw I was opening the door though. 😉

 

[Caiter92]

He couldn't conceal his excitement once he saw I was opening the door though. 😉

He's a really good actor.

 

[vetmedhead]

He's a really good actor.

This is a cat who can't even act tough at the vet lol

 

[Caiter92]

This is a cat who can't even act tough at the vet lol

He's playing a terrified cat at the vet. He's a method actor. He really gets into character.

 

[vetmedhead]

He's playing a terrified cat at the vet. He's a method actor. He really gets into character.

When did my cat become Daniel Day Lewis?

 

[cdo96]

No. she needs Cheese hugs

I don't think Cheese KNOWS how to give hugs. Cheese shows his love by trying to suffocate vmh.

 

[vetmedhead]

I don't think Cheese KNOWS how to give hugs. Cheese shows his love by trying to suffocate vmh.

I picked a cat who is very similar to me in personality.

 

[cdo96]

I picked a cat who is very similar to me in personality.

I mean. It sounds like cheese and I would get along well.

 

[Caiter92]

When did my cat become Daniel Day Lewis?

Since I said so.

 

[Caiter92]

I don't think Cheese KNOWS how to give hugs. Cheese shows his love by trying to suffocate vmh.

Yes he does. He just chooses not to hug.