I’ve forgotten more than you’ve ever known

In school, they teach you the gold standard approach to pretty much everything. They expect perfection and set standards of care/sterility/diagnostics ridiculously high. They do this because they know that once you’re unleashed into the real world your skills will go downhill in some way. So the higher they start you at, the better chance you’ll end up still doing things pretty well.

Now, don’t get me wrong – I’m not suggesting the care your animal receives at your average general practice is somehow less than it should be. I’m sure it’s top notch, really. It would be completely unrealistic to expect a small animal general practice to operate in exactly the same way as an academic institution.  We do the best we can.

There are also things I did in school that I’m just not expected to do now – I have technicians that do it for me, because it frees up my time to see more patients. As a student I was the grunt worker, now I’m the doctor I have my own grunt workers.

There’s also the fact that I spent hours learning about cows and horses and pigs, oh my…. and these species were included on my licensing exam, which I passed. Just two years ago. I wouldn’t recommend me to deal with any farm animal now. I have the base knowledge somewhere in my brain, and I know where to look for answers . . . but I haven’t had to think about large animal medicine in almost two years, and if you don’t use it you lose it.

I used to be able to take blood from a jugular with my eyes closed… I’ve only done jugular venipuncture maybe twice since I graduated. In school we only did jugular, with a scattered hind limb – fore limbs were saved for catheters only. Now I will try all four legs before I will resort to jugular. I also used to be super confident in my ability to get an IV catheter into just about anything. Now I do it so infrequently, if one of my technicians is available I refer to them – they’re faster and more proficient. If I do one catheter placement in a week, they do one hundred.

I sometimes lament my loss of skills. I know that I’ve gained new skills to replace the ones I lost – I was a slow and nervous surgeon when I graduated, now I’m confident and fairly well paced.  And I’ve learned a lot about medicine and surgery I just didn’t absorb in school, or get a chance to really be exposed to. However, at 2am when I’m an animal’s only option for blood collection or catheter placement? I kind of wish I was as good as I used to be!

Of course, I know these skills are reclaimable. I used to work at a clinic where I did a lot of urinalysis. We learn how to do the microscopic exam at school, but we never really have to do it on rotation because the labs just down the hall. So I started to forget. Now I’m at a clinic that is short staffed as far as technicians go, so there are times in a day/week when we have no one to do urinalysis unless the doctor is comfortable doing it themselves. I have gotten myself back to that level of comfort with urinalysis, out of necessity.

The topic of “skills I’ve lost” is on my mind because at our last doctors meeting we were discussion placing IV catheters in all of our surgical patients. As I mentioned, we’re a bit short staffed. So there is a worry of the girls resisting extra work load… so it was mentioned that we, as doctors, could start placing our own catheters. I, for one, welcome the chance to rebuild my catheter placement skills. Sometimes I think it’s a sin how much I used to be able to do and am just not so good at anymore. Not even mentioning the stuff I flat out do not remember how to do. Thank goodness for the internet and instructional videos!

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About dottiemaggie

A veterinarian living and working in St John's, Newfoundland. I love my job, and I love my home. Professionally I am passionate about critical care and client education. Away from work I am passionate about enjoying life, spending time with friends, enjoying hobbies of all sorts, and exploring this wonderful province I call home.
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8 Responses to I’ve forgotten more than you’ve ever known

  1. frigginloon says:

    I would imagine the skills that you are now developing are of greater value than the skills you have lost.

    I recently had to take my 9 year old bantam BamBam to the vets after having half its back ripped off thanks to a feral cat. Should have seen the vet’s face blahahahaha. I’m guessing her poultry skills weren’t up to scratch. She had that “oh for the love of god just have the thing put down” look. Anywho, against her better judgment she gave me antibiotics and a saline solution and wished me good luck with that. A week later the vet was amazed at BamBams’s progress .

    • dottiemaggie says:

      ahahahahaha. Yeah, I’d probably have a similar reaction if presented with a chicken… I am pretty willing to see animals of all sorts, but I’m pretty honest with the bird clients that I’m looking stuff up as I go along!! There’s a lot you have to learn from experience when you’re a veterinarian… or else we’d be in school for forever learning all the different species!!

  2. Kate says:

    I could write books on things I’ve forgotten. I understand your point, but when I go to the vet, I want the “grunt workers” to do the “grunt work.” My actual vet is involved in things that the”grunt workers” aren’t qualified to do. When someone is squirting worm meds into my pets mouth it’s ok if it’s not the vet. However, when my dog has sores all over his back or needs surgery, I want the vet. So I assume if he’s not doing the “grunt work” for me, he’s doing the important things for other peoples pets. And when he’s doing important things for my pets, I want the “grunt workers” doing “grunt work” so my pets can get his specialized attention. I’m not sure this even makes sense…I’m just blathering like an idiot.
    However, when I was in the hospital I felt exactly the same way about my own care.

    • dottiemaggie says:

      no worries, you’re making sense 😉
      And there’s definitely some stuff I totally refer to my ‘grunt workers’ for. I am always quick to say to an owner that if they have a lot of questions about getting rid of fleas, they should speak to the receptionists – they get ongoing training in flea meds, I don’t. I know what worked for me and my house, the end.
      Some of the ‘grunt work’, though, is left up to me in the middle of the night because of the nature of where we are – there are no 24 hour emergency clinics with staff in the middle of the night. There’s 24 hour emergency service. And at 2am, unless I happen to have a nurse on call with me who can do the catheters or take the blood, it’s just me. So that’s a big reason, I think, for keeping up our skills with at least some of the grunt work…

      But, having had my first rabies shot given by a doctor (who never gives vaccines) and my booster done by a nurse (who does it every day)… I definitely know that having the grunt worker do the grunt work is ideal!!!! (first shot was such an ordeal and i almost cried…. i didn’t even notice the booster, she was so quick and sneaky and totally knew how to handle my fear of needles!!)

  3. linlah says:

    That lst line made me laugh. You mean if I watch enough video I can be like Peonardo in Catch Me if you Can? No? Dang.

    I hope what you want to come back to you does and sticks.

    • dottiemaggie says:

      unfortunately for you, many of the instructional videos are not very accessible to the general public 😉 but we have some wicked information networks we can be a part of to share resources on which have been LIVE SAVERS for me at times!!

  4. Audubon Ron says:

    You mean all I have to do is read the internet and I can become a vet? Cool!!!

    • dottiemaggie says:

      many of my clients seem to think so ;P I actually just this weekend had a client on the phone who was consulting Dr Google while I was speaking with him, and trying to argue with me over my diagnosis based on what he found. . .

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