I will miss it a lot, but luckily I am doing two weeks of elective there in March. The last weekend was crazy! I was on 3-2 all week, except tonight I was on 12-10 so I could get some sleep before catching the train to Boston in the morning.
On Friday we had so many dogs come in hit by car, we ended up doing CPR on 6 dogs in one night (only one came back, but that is pretty standard odds). At one point THREE hit by cars came in within 10 minutes, two were getting CPR on different gurneys, and one was with me, very very sick, (her owners decided to euthanize in the end).
After midnight the ER tends to slow down a lot, with only about 1-2 cases an hour (the usual is 4+ cases an hour), so things get a little loopy after midnight. The last couple days were SO silly. Russell was in charge of the MP3 player and was rocking it out playing air drums, next thing I know we start our own little kareoke night with the ultrasound probe serving as our microphone, singing anything from Elvis to Britney spears, my stomach hurt from laughing so much. The jokes get MUCH more raunchy. Russell was walking around aimlessly for a while when Dr. Skovira asked him what he was doing, and he just said "conveniently crop-dusting in front of all the dog's cages". I couldn't stop laughing.
Then Travis came back from the ER conference he was at all week tonight. It is interesting when you find someone that you work well with perfectly. Travis and I just click when on clinics together, and we are the perfect pair. I took all his cases tonight, (he actually kept seeking me out to make sure I was the student on his cases). And like always we just rocked them. It's neat when you find someone that you are totally in sync with at work and the two of you can just keep trucking along, always one step ahead of the other and picking up mistakes done by the other so things work out great.
I have learned a lot in the last 3 weeks. I learned I should have more confidence in myself then I did too. And one of the neat things I learned was about client communication. In addition to learning all about medical things on ER (and belive me, the doctors at Tufts are brilliant, so they taught us lots), you get to observe the doctors in the exam rooms talking to clients about tough things. I have learned a lot about client communication that way, and know how I want to talk with clients. I respect all the doctors at Tufts, but I have noticed some are better at talking to owners then others. The best bring it down to such understandable terms and make sure to NEVER treat an owner like crap. It is kind of true that if you are good at communicating you can convince a client to do anything. Well, some of the doctors are not so good, and I was bothered that one did not even mention euthanasia on a dying dog, just came in with a $2000 estimate for owners whom she knew had little money. I felt euthanasia was a GOOD option in this dog since it had a POOR prognosis, but if the owners had lots of $ and wanted to try they could easily shell out $5000 in treatment to try to save the dog, but the chances of saving her even then were probably only 30%. I was pissed that this doctor did not tell the owners that you should euthanize if you do not want to pursue treatment. She just went in the room and told them your dog is really sick with this and needs $5000 of treatment, and when the owners started crying and said they didn't have that money, she said "well, I will leave you to think about things, and come back when you make a decision." She made them tell the doctor that they wanted to euthanize on their own, which bothered me, since it was so hard for them, I think she made them feel guilty, whereas I would of told them straight up front that euthanasia was not a bad option for their dog.
Another doctor seemed to get defensive with owners and talked down to them. The owners would get mad back and not want to pursue treatment since she did not give them options and did a poor job explaining why their pet was so sick.
But several of the other doctors were GREAT. They were compassionate, kind, smart, articulate, and explained things and ALL the options SO well. They never made an owner feel guilty for their decisions, and I think they never had to cause they did such a good job explaining the options to owners and helping them make the right decision. It is so easy to judge owners, but I truly feel they all have different situations going on in their lives, so it is not fair to tell them they are wrong if they make a decision that I wouldn't of for my pets. I hope I can communicate well with clients like these doctors in the future.
Sunday, September 21, 2008
Wednesday, September 17, 2008
what do you think?
Who would of thought that those 4 words could mean so much... "What do you think?" I tell you, I love ER for many reasons, but most importantly because for the first time ever I am feeling confident in my skills as a doctor and think I will be ready to take on vet med in 8 months. I have been showered with compliments on ER and all the doctors tell me in private how they try to work with me first since I am such a great and efficient student to work with. I have kind of become the exotics go to girl on ER, so when a exotic animal comes in the doctors consult me first. Last night a guinea pig came in with bumble foot, and Russell let me manage the case COMPLETELY on my own, I wrote up everything, handled everything, and Russell let me since he felt I knew a lot more then him about guinea pigs.
Then today I was working with Dr. Abelson (whom I absolutely adore and think is one of the BEST vets I have ever met, I want to be just like her some day)...she came and found me and asked me to work on a case that she had, a recheck on a dog with ITP. I went out to the owner's and did EVERYTHING, the physical, the blood draw, the blood smear and analysis under the microscope, the history from the owner's. And I kept waiting for Dr. Abelson to check over my shoulder and see how I was doing. When all was done I found her and brought all my results to her. She asked "What do you think?" and I told her, and afterwards she said great, checked my discharges, and sent the dog home with my medical advise and instructions. I suddenly realized that she was not going to check my work (although she did check my blood smear b.c I asked her to and she told me I knew what I was doing and not to worry). I realized that she asked me "What do you think?" not to grill me, put me on the spot, or to test my knowledge. She asked me "What do you think?" because she respected and valued my opinion, and then fulfilled that by treating me like a doctor and letting the patient go home with my medical orders. It was quite an amazing moment for me. And throughout the rest of the night Dr. Ableson continued to ask me to do things for patients I never have done before, and she always trusted my opinion (but should would double check me whenever I asked cause I was nervous).
I couldn't be happier right now, it is so comforting knowing I made the right (and fulfilling) career choice, and that I am not going to be a horrible doctor. Sure, I will make mistakes, we all will, but it will be ok. I think I can do this.
Then today I was working with Dr. Abelson (whom I absolutely adore and think is one of the BEST vets I have ever met, I want to be just like her some day)...she came and found me and asked me to work on a case that she had, a recheck on a dog with ITP. I went out to the owner's and did EVERYTHING, the physical, the blood draw, the blood smear and analysis under the microscope, the history from the owner's. And I kept waiting for Dr. Abelson to check over my shoulder and see how I was doing. When all was done I found her and brought all my results to her. She asked "What do you think?" and I told her, and afterwards she said great, checked my discharges, and sent the dog home with my medical advise and instructions. I suddenly realized that she was not going to check my work (although she did check my blood smear b.c I asked her to and she told me I knew what I was doing and not to worry). I realized that she asked me "What do you think?" not to grill me, put me on the spot, or to test my knowledge. She asked me "What do you think?" because she respected and valued my opinion, and then fulfilled that by treating me like a doctor and letting the patient go home with my medical orders. It was quite an amazing moment for me. And throughout the rest of the night Dr. Ableson continued to ask me to do things for patients I never have done before, and she always trusted my opinion (but should would double check me whenever I asked cause I was nervous).
I couldn't be happier right now, it is so comforting knowing I made the right (and fulfilling) career choice, and that I am not going to be a horrible doctor. Sure, I will make mistakes, we all will, but it will be ok. I think I can do this.
Friday, September 12, 2008
she's on fire!!!!
Why am I writing a blog at 3am do you ask? cause I just got home from school, and I am not angry or bitter at all, in fact, I love it. I have been on ER for two weeks now, and am working very odd hours, normally starting between 12-3pm, and ending between 11pm-3am. But it is SO fast paced and rewarding. I feel like I am saving lives every day. And lately I am on fire! I am rocking with my skills. I feel like no matter how nervous or hesitant I am, when the doctors ask me what I think is wrong with patients and what I want to do with them, I say what I am thinking, and they tell me I am right on the money and that is exactly what they would do.
We got slammed yesterday. Between 7-9pm 18 patients came in through the ER. It was the perfect situation for stress and chaos. Luckily, the owners were all understanding and patient. They had to wait ages, some of them over 5 hours. Yet they all talked in the lobby with each other, and got along. They even ordered pizza for themselves, it was like a pizza party in the front lobby, plus they ordered some pizzas for us in the back thanking us for our hard work. I was supposed to be on from 1-10pm, but I didn't leave until 1:30am, but it was ok, I was not upset about it at all, I loved it! I was on 3pm-2am today, and again felt like I could do no wrong. I am pairing up with the clinicians well, Dr. Lanaux and I are rock stars, and Dr. Abelson is one of the best teachers I have had on clinics yet. She loves to grill students in a nice way, and so far I have hit all her questions on the dot. I am just hoping this is not hubris on my part. I am still nervous and not cocky, but I am gaining confidence in my skills as a doctor every day.
We got slammed yesterday. Between 7-9pm 18 patients came in through the ER. It was the perfect situation for stress and chaos. Luckily, the owners were all understanding and patient. They had to wait ages, some of them over 5 hours. Yet they all talked in the lobby with each other, and got along. They even ordered pizza for themselves, it was like a pizza party in the front lobby, plus they ordered some pizzas for us in the back thanking us for our hard work. I was supposed to be on from 1-10pm, but I didn't leave until 1:30am, but it was ok, I was not upset about it at all, I loved it! I was on 3pm-2am today, and again felt like I could do no wrong. I am pairing up with the clinicians well, Dr. Lanaux and I are rock stars, and Dr. Abelson is one of the best teachers I have had on clinics yet. She loves to grill students in a nice way, and so far I have hit all her questions on the dot. I am just hoping this is not hubris on my part. I am still nervous and not cocky, but I am gaining confidence in my skills as a doctor every day.
Wednesday, September 10, 2008
183 Spring St., Medford, MA
Wow. I am scared shitless right now but excited too. I am moving to "Boston". Not really, Medford actually, but closer then ever, I can't believe I finally did it.
The story? Ryan contacted me about a week ago saying he wanted to move to Boston now (funny since I was practically begging him to this summer when he was first promoted to the Boston position). I had kind of forgotten about my dream to move closer to the city and accepted the fact that I would be in Grafton just one more year, but then when Ryan contacted me about it again, I told him I would consider it and if we found somewhere for Oct. 1 I would probably do it, but after that it would be a no go. The last week has been a rollercoaster of emotions (good ones) since I felt like every place we looked at it was Ryan and I switching places with who wanted to move, mainly me more then him.
Then on Sunday Ryan looked at a place in Medford and fell in love with it...he told me to set up a time to see it Monday night after work and if I wanted it we would take it.
So after my ER shift Monday I made it to Medford at 8pm to see the place. It was in a nice neighborhood, had a yard and front and back porch. The inside was nice, there is a huge mirror on the front wall of the living room which is a little creepy, but I could deal with it. The bedrooms were a little smaller then I would like, but the kitchen was huge and nice. It is a 1.2 mile walk to the subway. I wanted closer then that, and was instantly torn. Ryan started bombarding me with texts that we needed to take it, since it would be gone quick. My gut kept telling me that I wanted to wait and find a place closer to Boston, but then it came out that Ryan had to sign his current lease at his place in Grafton the next day or he would be out of it, so it was this place or nothing...I had a hard time sleeping, but finally decided that this was my last opportunity to move closer to Boston before graduating, and quite frankly I might not even be there after graduating, so I went for it.
Tuesday we met the broker and signed the lease. The lease starts Oct. 1 and is only 11 months. (So I should be able to summer sublet it if I need to leave before then). Even the broker made a comment about how nervous I seemed at the signing of the lease. But Mark came along too and that helped when he thought the place looked nice too.
The next 24 hours after the signing has been weird for me. I am kind of in shock, I wanted to do it, but didn't really know if I would actually be able to...and now I have to wait 2.5 weeks to move in to my new place! I am scared, it will be far away from my friends in vet school, but quite frankly I only hang out with them a couple times a year anyways. I kind of felt sick to my stomach for awhile wondering if I had made a mistake since for any left over rotations I have at tufts I will have to commute now, but then I talked to Mark awhile and felt better....he asked me to just list the reasons why I wanted to live closer to Boston, and I talked about how every 2-3 days a week that I drive to Boston from school instead of home even though it is 40 minutes longer, I feel better, I look forward to where I am going, and I feel more connected with Boston then with Grafton. And I can make the drive feel better realizing I have finished most of my cores already and with electives I don't have to be to school until 8am, so I can take the train from Boston to school those days.
I am still scared, and I think I will be until I am living at the new place for a couple weeks, but I will have a lot of friends in Boston too, and will make new ones, and will have a great support network there. I guess now I just want to get it over with and move in already!
The story? Ryan contacted me about a week ago saying he wanted to move to Boston now (funny since I was practically begging him to this summer when he was first promoted to the Boston position). I had kind of forgotten about my dream to move closer to the city and accepted the fact that I would be in Grafton just one more year, but then when Ryan contacted me about it again, I told him I would consider it and if we found somewhere for Oct. 1 I would probably do it, but after that it would be a no go. The last week has been a rollercoaster of emotions (good ones) since I felt like every place we looked at it was Ryan and I switching places with who wanted to move, mainly me more then him.
Then on Sunday Ryan looked at a place in Medford and fell in love with it...he told me to set up a time to see it Monday night after work and if I wanted it we would take it.
So after my ER shift Monday I made it to Medford at 8pm to see the place. It was in a nice neighborhood, had a yard and front and back porch. The inside was nice, there is a huge mirror on the front wall of the living room which is a little creepy, but I could deal with it. The bedrooms were a little smaller then I would like, but the kitchen was huge and nice. It is a 1.2 mile walk to the subway. I wanted closer then that, and was instantly torn. Ryan started bombarding me with texts that we needed to take it, since it would be gone quick. My gut kept telling me that I wanted to wait and find a place closer to Boston, but then it came out that Ryan had to sign his current lease at his place in Grafton the next day or he would be out of it, so it was this place or nothing...I had a hard time sleeping, but finally decided that this was my last opportunity to move closer to Boston before graduating, and quite frankly I might not even be there after graduating, so I went for it.
Tuesday we met the broker and signed the lease. The lease starts Oct. 1 and is only 11 months. (So I should be able to summer sublet it if I need to leave before then). Even the broker made a comment about how nervous I seemed at the signing of the lease. But Mark came along too and that helped when he thought the place looked nice too.
The next 24 hours after the signing has been weird for me. I am kind of in shock, I wanted to do it, but didn't really know if I would actually be able to...and now I have to wait 2.5 weeks to move in to my new place! I am scared, it will be far away from my friends in vet school, but quite frankly I only hang out with them a couple times a year anyways. I kind of felt sick to my stomach for awhile wondering if I had made a mistake since for any left over rotations I have at tufts I will have to commute now, but then I talked to Mark awhile and felt better....he asked me to just list the reasons why I wanted to live closer to Boston, and I talked about how every 2-3 days a week that I drive to Boston from school instead of home even though it is 40 minutes longer, I feel better, I look forward to where I am going, and I feel more connected with Boston then with Grafton. And I can make the drive feel better realizing I have finished most of my cores already and with electives I don't have to be to school until 8am, so I can take the train from Boston to school those days.
I am still scared, and I think I will be until I am living at the new place for a couple weeks, but I will have a lot of friends in Boston too, and will make new ones, and will have a great support network there. I guess now I just want to get it over with and move in already!
Thursday, September 4, 2008
ER Vet
Tuesday I started my new ER rotation. Of course, I had to go in at 7am and take care of my leftover neuro patients first...one of my classmates was starting neuro soon and asked how it was...I tried to be optimistic but told her it was the toughest rotation I had done yet. Then she told me that a bunch of my classmates and her were having lunch together the other week and I guess I came up and were all terrified of neuro since they had seen me running around and never leaving the hospital. yeah, I eventually admitted to her that I cried almost every day of that bloody rotation.
Before I go in to the ER details, the weekend before was a three day weekend. I had to work every morning, but only 3-6 hours each day. Mark and his mom and sister and I went to the Italian St. Anthony's festival in Little Italy. Then Sunday I came back and helped Mark move little stuff to his new apartment for 6 hours. The only rough part was when the landlord's wife came back to wax the floors and we had just started unloading the cars and she told us to hurry up, so I ran up and down the two flights of stairs with load after load and wanted to die, but I say that counts for some speed training! We went to a nice dinner, and story of my life, i got a little too drunk. I still can't decide if it was a good or bad thing that I acquired such a taste for beer 2 years ago.
Well Tuesday's ER shift was 10-8. I was terrified, typical deer in the headlights. And yet it went amazingly well. I loved it! I even got out by 9pm and had time to go see Mark at his new place.
Yesterday I was on 1-10, and it was a little more rough since I didn't actually leave until 12:40am. I really like most of the ER people. But there are a few that irk me...I met the first intern that I didn't like yesterday. One of the elective students who is visiting from NC state was overwhelmed with a case she took on. She didn't know how to manage it and get all the paperwork done, so I tried to help her out. Then the intern asked her to go get chest x-rays on the dog, and the girl admitted to me her shift had ended over an hour earlier. I offered to do the x-rays for her, and when she told the intern her shift had been over but I would do the x-rays for her the intern went off on her saying "I know your flight just got in last night, so I will let you go this one time, but I want you to know that this is the exception. Normally we expect you to stay and finish up your case no matter what. Leaving before all the tests and paperwork is not acceptable but I will let you this one time cause I am nice." All I could think is "Nice my ass, there was NO need to raise your voice and reem in to this poor visiting student who just needs to sleep."
Well, trying to be nice, I asked the intern "When does your shift get done?" (At this time it was 9:10pm). "(" she answers. Trying to be nice AGAIN (big mistake) I say "Oh, I am sorry." Well, then she reemed in to ME saying "Well, I am used to it, I never get out of here before 2am. ANd you should get used to it too. When you are on ER you never leave on time. And when you are a real vet, you will never leave at the end of your real shift either. If you think that is the case then you are in the wrong career missy." I sat there and smiled nodding, but all I wanted to say was "No, you listen hear bitch, no one calls me missy, and I think after 6 months of clinics I know better then most of my classmates that you never leave on time, and patient care should come first, but that is NO reason to make others feel like shit and to run around acting like you are god's fucking gift to veterinary medicine." Wow, it feels nice writing that, I really didn't like this intern. Luckily she is the only doctor of the 8 I have met on ER so far that I don't like.
And sure enough I was there 2.75 hours late. But it was ok. Surprisingly, as I drove home at 12:45am, instead of feeling angry at being there late, sure, I was super tired, but I felt quite content. ER is so rewarding. You stabalize some animals, save some lives, sadly send some patients to kitty or doggy heaven, deal with sweetheart as well as nasty bitch clients, but at the end of the day, it is over, and all you can do is smile at all the good work you did as a doctor and look forward to what surprises the next day in the ER will bring. This is great, maybe I can handle an internship.
Before I go in to the ER details, the weekend before was a three day weekend. I had to work every morning, but only 3-6 hours each day. Mark and his mom and sister and I went to the Italian St. Anthony's festival in Little Italy. Then Sunday I came back and helped Mark move little stuff to his new apartment for 6 hours. The only rough part was when the landlord's wife came back to wax the floors and we had just started unloading the cars and she told us to hurry up, so I ran up and down the two flights of stairs with load after load and wanted to die, but I say that counts for some speed training! We went to a nice dinner, and story of my life, i got a little too drunk. I still can't decide if it was a good or bad thing that I acquired such a taste for beer 2 years ago.
Well Tuesday's ER shift was 10-8. I was terrified, typical deer in the headlights. And yet it went amazingly well. I loved it! I even got out by 9pm and had time to go see Mark at his new place.
Yesterday I was on 1-10, and it was a little more rough since I didn't actually leave until 12:40am. I really like most of the ER people. But there are a few that irk me...I met the first intern that I didn't like yesterday. One of the elective students who is visiting from NC state was overwhelmed with a case she took on. She didn't know how to manage it and get all the paperwork done, so I tried to help her out. Then the intern asked her to go get chest x-rays on the dog, and the girl admitted to me her shift had ended over an hour earlier. I offered to do the x-rays for her, and when she told the intern her shift had been over but I would do the x-rays for her the intern went off on her saying "I know your flight just got in last night, so I will let you go this one time, but I want you to know that this is the exception. Normally we expect you to stay and finish up your case no matter what. Leaving before all the tests and paperwork is not acceptable but I will let you this one time cause I am nice." All I could think is "Nice my ass, there was NO need to raise your voice and reem in to this poor visiting student who just needs to sleep."
Well, trying to be nice, I asked the intern "When does your shift get done?" (At this time it was 9:10pm). "(" she answers. Trying to be nice AGAIN (big mistake) I say "Oh, I am sorry." Well, then she reemed in to ME saying "Well, I am used to it, I never get out of here before 2am. ANd you should get used to it too. When you are on ER you never leave on time. And when you are a real vet, you will never leave at the end of your real shift either. If you think that is the case then you are in the wrong career missy." I sat there and smiled nodding, but all I wanted to say was "No, you listen hear bitch, no one calls me missy, and I think after 6 months of clinics I know better then most of my classmates that you never leave on time, and patient care should come first, but that is NO reason to make others feel like shit and to run around acting like you are god's fucking gift to veterinary medicine." Wow, it feels nice writing that, I really didn't like this intern. Luckily she is the only doctor of the 8 I have met on ER so far that I don't like.
And sure enough I was there 2.75 hours late. But it was ok. Surprisingly, as I drove home at 12:45am, instead of feeling angry at being there late, sure, I was super tired, but I felt quite content. ER is so rewarding. You stabalize some animals, save some lives, sadly send some patients to kitty or doggy heaven, deal with sweetheart as well as nasty bitch clients, but at the end of the day, it is over, and all you can do is smile at all the good work you did as a doctor and look forward to what surprises the next day in the ER will bring. This is great, maybe I can handle an internship.
Subscribe to:
Posts (Atom)