Veterinary Practice 101
There can surely be few more stressful episodes in a veterinary career than day one, first case.
In the thousands of alternative scenarios I had conjured up whilst lying in my little cot at the veterinary school not one was even remotely like the way my first case actually turned out…
Driving into the Thompson’s dairy farm there were no grateful, smiling farmers waving with relief, no music, no flags, just an uncaring laneway leading in. My dreams had lacked the hollow, empty sense of dread that fear and an overwhelming sensation of loneliness injected into that moment. I contemplated turning back at this point to tell my bosses that I had developed some incapacitating disease such as, say, malaria, and needed to start again some other day – any day – just not now. Instead, I drove in.
In the weeks and months that followed I eventually became used to being welcomed to farms with clever one-liners such as: “Does your mother know you’re out?” but that was still in the future. So, on this first visit, the elder Thompson brother floored me with his opening gambit:
“How long have you been out, son?” It was days later that I eventually came up with a great riposte. Sadly on that actual day I could only mumble something about it seeming a lifetime since I was a student.
Nevertheless I eventually got through this, my first case! It should actually have been something of an anticlimax if all had gone as my employers anticipated because I only had to vaccinate two calves. This should really have taken about five minutes. It didn’t.
Forty minutes after arriving (but now filled with elation at having signed my name on an official form appended, for the very first time, with the letters “BVSc”) I gave a friendly wave to the grinning Thompson brothers and backed straight into their tractor. I suspect eventually they would have helped me, when they got over being convulsed with laughter, but I wasn’t waiting. A quick three-point turn and I was gone.
Of necessity, I soon worked out quite a few ‘strategies’ to get me out of other troubles and embarrassments. One of the first was to find ways of not looking so brand new. After being asked: “Are you as green as your overalls, son?” I learned that before wearing overalls in practice you cycled them a dozen times through the washing machine to produce that well used and experienced look. My new gum boots went into storage and my tatty, old ones re-emerged.
I learned some face saving replies. For example: “You look so young!” Reply: “Thank you.” The two practice principals, Peter and Wes, also offered up a few suggestions, so between the three of us I was able to wriggle out of many potentially awkward situations.
When farmers (quite understandably) indicated, as I descended from my car, that they would rather have had Peter or Wes come, I would appeal to their Australian sense of fair play. My opening speech varied a little with the occasion but basically went as follows: “Fair enough. I know you would prefer Peter or Wes – and so would I, if I were in your position. However, as I’m here, let me have a look and if I can’t help you then maybe one of the other boys can drop in later for a second opinion.” I never had a knock-back. Every single one of these farmers was prepared to give me a go as long as I wasn’t going to be “a young, smart-arse from the Uni.”
Many of my other survival strategies were simple but effective. The first suggestion for new players, from Wes and Peter, was to always park the car a little bit away from the dairy, milking shed, barn or whatever – preferably facing towards the scene of the action. This meant that when said young player (me) got into trouble I could suddenly claim to have forgotten my thermometer, stethoscope, plastic gloves or whatever which gave me the excuse to return to the car. Once back at the car the next move was to lean over to the back seat and consult one or both of the two textbooks cleverly left open on the floor – in my case The Merck Veterinary Manual (everything you ever wanted to know about veterinary science in a Reader’s Digest condensed book format) and the Veterinary Physicians’ Handbook (drugs: their indication and, more importantly, their correct dose rates). These days you could use your iPad or smartphone.
If this didn’t work, I went to Plan B. My two-way radio handset had a cord that was long enough to reach over the back where I could not, I hoped, be seen or heard. With any luck either Peter or Wes would be available and in reception range for some more, quick, get-out-of-jail advice, over the radio.
If neither of these strategies solved the current dilemma then Plan C came into play – buy time.
Buying time in small animal practice is easy. You just have to take a sample – it doesn’t really matter of what: blood, urine or faeces will do. Then, simply tell the client: “The results will be in tomorrow,” and Hey Presto! you now have 24 hours of research time.
Unfortunately, it’s a lot more difficult in large animal practice. If, for example, you are standing with your left arm inserted up to the shoulder in a dairyman’s prize milker, with not the slightest idea of what is amiss with her and the farmer is standing at the other end demanding to know what’s wrong with her, then you have to come up with SOMETHING. There is always the stethoscope!
Stick the stethoscope in your ears, mutter a lot and claim deafness: “Won’t be long. Mutter, mutter, hmmm …” then bow your head and think hard. Of course you can hear everything that is said even with a stethoscope in your ears. You just hope the farmer doesn’t know that.
I had many adventures that first year. Of the hundreds of mistakes I have made in my career around 95 per cent of them were made then. One of my biggest mistakes was driving around the Strzelecki Ranges on cheap tyres. That was nearly my last. The only award I gleaned was the local panel beaters’ “New Client of The Year”. I did however get through. That I did was largely down to Peter Carter and Wes Southgate to whom I will be eternally grateful.
My parting advice to everyone new in veterinary practice, whether as a nurse, a vet, practice manager or receptionist is to ask for advice often and be prepared to take it. As it says in the airline pilots’ manual: “Learn from the mistakes of others. You won’t live long enough to make them all yourself.”
This essay was an entry in the In The Black Essay Competition for 2012.
Eric Allan is an author and the director of Turn Right Consulting – a business with the mission of assisting young vets to acquire the skills and knowledge they need for practice and life.
John Heath of Boehringer Ingelheim, Mark Amott of Southern Animal Referral Centre and the AVBA and Susan Halloran of In The Black judged the competition.
Visit www.avba.com.au for information about the In The Black Essay Competition for 2013.