ER for GP: 5 tips for surviving your shifts
One of the most beautiful things about veterinary medicine is the variety of different career experiences a practitioner can create for themself.
Some of us thrive on the human interaction and client education, forging bonds by doing phone updates and rechecks on a chronic atopy patient, or spending the time in behavioral counseling and developing practice literature for first-time puppy visits. Yet others of us live for the fast pace, adrenal squeeze, life-or-death moments in the ICU.
In my 10 years since graduation, I have learned that, eschewing routine and predictability in my life, I like an even mix of both those things. I tend to spend half my week in general practice and half in ER.
I feel like the varied experience and additional challenge make me a more well-rounded vet and it gives me perspective for when I do have to refer a case or when I need the advice of a specialist.
Emergency medicine for GP vets
If you are used to general practice, taking some shifts in ER can be an incredible learning experience and a worthwhile challenge. Or if you are a new grad trying to find your place, emergency medicine is often where you will find the most opportunity to see lots of different cases of varying difficulty and grow as a veterinarian.
Additionally, with the current state of the profession seeing shortages of both veterinary and nursing staff nationwide, hospitals are offering better compensation for ER shifts that are perceived as less desirable because of the long hours and heavy work load. That can be very attractive to many people that would never have considered taking ER shifts before.
As a result, it is easier than ever to find yourself in a shift for which you are underprepared. But don’t worry. If you are brave, observant and intelligent (and I know you are because you are a veterinarian), you can do this.
Here are 5 tips you can take with you into these shifts to help you get through the night.
Read more: Why I love working ER
Tip #1: Don’t panic
Breathe. Certain times can be incredibly busy, and with multiple urgent cases arriving at once, it is so easy to get overwhelmed and shut down.
Remember you will get through this. Especially when someone is being impatient, when that client with a non-emergency “emergency” is being rude to you or the staff because you took in a more urgent patient ahead of them, or when the third Maltese requiring oxygen arrives and you just set up your last oxygen cage — just remember to breathe.
I have a personal mantra that I repeat to myself to bring me back into the moment: I can’t take things personally and I can’t get into my own head because the animals need me. Find what works for you.
Repeat it to yourself, then put your head down and keep working.
Tip #2: Be kind
The ER is an emotional place for clients and staff. Never respond to anyone with anything other than kindness and compassion. People can be very cruel when their beloved pet is in a compromising position, compounded by the often unexpected huge expenses that can come with a veterinary emergency.
That rude client that I mentioned before — thank them for their patience once you do get to look at Fluffy’s ear infection 4 hours after presentation.
Remember that if it is an emergency to them, it is an emergency. Not everyone will be kind back to you, but we have to remember that we can’t let a patient suffer because their owner is unpleasant to deal with. Patient care is first.
Tip #3: Manage your time effectively
Triage cases quickly, then take your time with them. In general practice you have 15 to 30 minutes with each patient.
In ER, you will likely have all day but you will have many, many more of them at once. If you are in a setting where animals are brought into a treatment area to be evaluated, get eyes and hands on each one before putting them away.
Don’t allow patients to sit in exam rooms or cages unevaluated, even if it is just vitals and a visual assessment by a technician or assistant. Even if the history is questionable, or if you think it is not a true emergency, always look at your patient and mentally put them in order of most to least critical, then attack it methodically.
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Tip #4: Utilize your resources
This one goes hand in hand with the previous tip. You’re likely used to doing a lot of things yourself. But trust me, you do not have to take every temperature and blood pressure.
Use your staff. Ask them to take vitals and let you know when things don’t look right. If you get stuck, don’t forget all you have at your fingertips. Pull out a text book or ask another doctor if they are around.
Often daytime ER hospitals have specialist staff that are happy to help with a consult if you need it. If all else fails, ask your fellow IndeVets! I have seen some great clinical questions in via our Microsoft Teams channel. Ask for help if you get stuck
Tip #5: Never stop studying
There will be lulls and you will have moments where it seems like nothing is happening. I recommend reading up on emergency procedures and especially the RECOVER CPR guidelines during the quiet moments. Feeling prepared for what may be coming is half the battle.
What I do in the ER definitely informs the way I practice in GP, in more than just what medications to choose and when to refer (though the latter is the most important skill a general practitioner can have, in my opinion).
The time management and triage skills I have learned in emergency medicine have transformed me as a GP vet and made me into a better practitioner.
In conclusion
I hope these little tips will make you feel brave enough to take those ER shifts you have been thinking about. Pets and their people need emergency vets now more than ever. Now is the time to take the plunge and serve your community in this way. You can do it! I believe in you.
Lissette Cepero, DVM is an Associate IndeVet practicing in Florida.
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