Why I love working ER shifts
By Marie Keith, DVM
I recently had a somewhat obvious but simultaneously eye-opening realization. As an ER veterinarian, every client I meet is experiencing their worst day…of their week, their year or even sometimes their life.
Whether I’m telling them that despite our best efforts and resources we couldn’t get their best friend back, or I’m breaking bad news about their new puppy after they witnessed the trauma of that puppy being hit by a car, or that this new sudden limp in their beloved old golden is due to a cancerous lesion that has spread all over his body… the best news I can deliver is that their perceived emergency is in fact all fine and they just spent many hours and a few hundred dollars and a lot of stress…it’s never been a good day for any one of my clients.
Now that might sound like an odd way to start an article titled “Why I love working ER shifts.” However, in the midst of the pandemic era chaos we have all been experiencing in the veterinary industry, this moment of realization made me fall back in love with my job.
A change in perspective
Early this summer, I came home from a long day at work to a horrific scene. My own cat, Linus (an unplanned addition to my home during a weak and vulnerable ER moment of my intern year), didn’t greet me at the door for the first time ever.
After a few panicked minutes of searching for him, I found him hiding on top of a cabinet, a limp bradycardic dishrag with weak pulses. I then found the pile of vomit, the largest pile I had ever seen come out of a cat. I rushed him right back to work and a friend/colleague stepped in swiftly getting diagnostics and stabilization going. The next day he underwent a gastrotomy for a stubborn hairball that wouldn’t pass.
He recovered uneventfully and has returned to manically playing parkour around my apartment and his other usual shenanigans. Linus and I were lucky with a fixable problem with a great prognosis (and pet insurance to take financial stress out of the equation). Still, that day was the worst day of my year and one of the worst in my life.
It has been awhile since I’d been on “the other side” of this job and what we do. It was freshly terrifying. But also renewed my sense of pride and respect for what we do; the comfort I felt knowing my baby was in the capable and compassionate hands of incredible nurses and clinicians was the only way I got through that horrible day. What we do is truly incredible!
This can be so easy to forget on the days with body bags piling up in the ER, the days when I feel like I can’t catch a win or figure out what’s wrong with a patient, or I can but the client has such limited financial resources that I agonize over creative ways to try to give that pet and family any chance, any hope.
A client-centered approach to veterinary ER care
Approaching clients in the ER with the conscious thought that it’s probably their worst day has helped me remember that what we do is incredible. It has also helped me remember that what we do is really hard and it’s ok to feel that burden. And finally it has helped me put some of the tougher encounters in a better perspective so that when I go home after my shift I leave more of that burden behind me.
Whether it’s due to the gradually increasing general public awareness of the insanity of the veterinary world these days or whether it’s just my renewed perspective, I’ve noticed a lot more clients taking the time to thank me—not just generically, but genuinely.
I am more frequently hearing comments acknowledging how busy and hard our days are and that what we do and the compassion with which we do it is so appreciated. Those comments help to drown out the negative ones. And I also now make it a point to let every one of those grateful clients know that their words go a long way on a hard day for our veterinary teams.
A lot of people get into ER for the adrenaline rush. But if your tank runs on adrenaline alone, it will deplete fast and you’ll burn out quickly. You might run 3 codes in one shift and then for the next week see nothing but diarrhea cases. You have to be ready for the codes. You have to be ready for the gruesome traumas. You have to be ready for the absurd. But that’s not what will keep you going.
Why I love vet med
I grew up reading the James Herriot book series and watching the old BBC show on VHS tapes at my grandparents’ house. When people ask me why I wanted to be a veterinarian I have always given various professional sounding responses. But if I’m being honest, it’s probably because of James Herriot.
While the 2021 day of an urban ER small animal veterinarian could not look outwardly more different than that of a 1930s Yorkshire farm veterinarian, the heart of what we do is the same. I recently started watching the new PBS series on James Herriot after an ordinary July ER swing shift. I don’t remember anything particular about the shift. But I remember the following scene and the tears it brought.
Herriot, freshly graduated from veterinary school is out on his first farm call with his new boss Siegfried. Siegfried asks him “so where did it all start for you, wanting to be a vet?” Herriot tells him he “developed a real love for the animals” at a small city farm near his school. Siegfried responds “ahh, well you see, the animals are the easy part. It’s the people cause all the bother.”
Almost 100 years later and there might be more beeping machines and syringe pumps and understanding of the glycocalyx…. but the heart of veterinary medicine is still the same.
I do ER for the medicine, the challenge, the puzzle. I’m not someone who seeks and loves unpredictability. I tolerate it in the ER because I love the rest of it. I get that adrenaline rush from a well run exciting code as much as the next ER lover. But I have found what keeps me going, what makes me fall back in love with this job when I think I want to quit at the end of a really hard day, what makes me stay amidst the chaos and the hardship.
It’s recognizing that every one of my patients’ families is having their worst day. Sometimes I get to turn that worst day into a good day. Other times, all I can do is make that worst day a little less terrifying, agonizing or painful. But that still is incredible. This is why I love ER.
Marie Keith, DVM is an Associate IndeVet practicing in Pennsylvania.