Hindsight

Re: Hindsight

Martin Atkinson — Mon, 18 Feb 2013 09:24:30 GMT

As all said, shit happens.The trouble is that we get so used to making the right decisions and everything turning out rosy that we get disappointed when it doesn't, we're not God and we can't make everything immortal. You can't win here, if you'd done the bloods and they were all normal you may have had the owner on your back for wasting their money. Unless you know that you made a mistake by deliberately cutting corners then you made a call at the time and it may have been wrong in the end but you made it because it seemed the right one at the time. Even if you cocked something up don't beat yourself up about it just learn from it and don't make the same mistake again but if the same set of circumstances arise again you've still got to make that call. You do get older and wiser but I still occasionally make the wrong call even with 38 years of experience. You are a better vet for being concerned, believe me there are plenty out there who don't give a shit about their mistakes or even realise they are wrong which is even worse. You're a better person for being concerned for the consequences of your actions, that makes you a good vet so don't ever forget it, be proud of it, the profession needs people like you so don't let it get to you

Re: Hindsight

Bibs — Sun, 17 Feb 2013 21:01:04 GMT

When I was working in a locum job when i was newly qualified, a wise vet once said to me, "it's not our fault that they are ill".

Re: Hindsight

Laurence Webb — Sat, 16 Feb 2013 23:38:59 GMT

[quote user="Dagmar Steele"]Shit just happens [/quote]

That ^

Re: Hindsight

Bob Russell — Sat, 16 Feb 2013 10:56:20 GMT

We had a 2½ yr old cat with odd incisors which were clearly painful so booked in for removal. After 15 minutes stopped breathing and did not restart spontaneous respiration for 45 minutes after that!

Came round completely out to lunch, unable to stand, extensor rigidity, the works. The owners were much more forgiving of me than I was myself!

Decided to persevere as it managed to eat a little on its own that night and a week later almost back to normal! This happened only last week and we questioned everything we did (decided to call it a clinical audit!).

These things happen. Learn lessons if you can but often however hard you beat yourself up there is not much you can learn other than sh*t happens!

Re: Hindsight

Dagmar Steele — Sat, 16 Feb 2013 10:42:15 GMT

I beat myself up regularly about things like that, but I wouldn't in this case. I wouldn't have done bloods again after 4 weeks if first results had been clear. Shit just happens and in this case it just may have been a coincidence, not the GA itself. Nothing to beat yourself up about (although I know the feeling very well!)

Re: Hindsight

Michael Woodhouse — Fri, 15 Feb 2013 23:42:16 GMT

Human NICE guidelines do not recommend routine bloods in healthy individuals undergoing surgery.

What would you have done differently if you had known - quite possibly nothing.

All our patients are going to die of something at some point.

It doesn't sound like you were negligent or missed anything. If you beat yourself up about this and get stressed and no sleep you cannot do your best for your other patients. They are the ones that matter.

Join me in a whisky (or tipple of your choice)

mmmm smoky............

Re: Hindsight

Utlendigur — Fri, 15 Feb 2013 23:06:50 GMT

[quote user="Mark Holmes"]I don't think you made a mistake, I wouldn't check bloods before many ops. Particularly if bloods had been done in the last 4 weeks [/quote]

Ditto.

If we all graduated with crystal balls veterinary work would be so easy (and we'd all be lottery millionaires) - but we don't, so we just have to make the best decision we can based on the information we have available.

Re: Hindsight

An On MRCVS — Fri, 15 Feb 2013 22:41:18 GMT

The dog had a chronic disease, then 2 separate injuries/illnesses. The dog had started to go off it's food, but I had just been suspicious of pain due to it's injuries/illnesses.

Been in practice a few years, but now and then these things just make you think don't they.

Re: Hindsight

Julie Innes — Fri, 15 Feb 2013 22:34:37 GMT

Comiserations, but, as others have said, don't beat yourself up over it. I personally would probably not have repeated bloods if they were fine 4 weeks ago and the dog appeared clinically well. Look at it this way- every op carries a risk. It may well be that even without the anaesthetic this dog would have gone exactly the same way- IME it takes more than a GA to send an animal into multiple organ failure. I've had to make the decision to operate on animals with less than ideal bloods and they've generally been fine afterwards. Sounds llike there was something else going on with this guy, another reason for the deterioration. But I know how easy it is to say so from the outside, and equally how easy it is to think it's your fault when it's you! How would you feel if it was your boss/ a colleague who had done the same?

Re: Hindsight

Evelyn Barbour-Hill — Fri, 15 Feb 2013 22:33:24 GMT

[quote user="An On MRCVS"]I guess I only felt that way as I made the decision to not do the bloods[/quote]

You didn't just rush in without thinking though, did you? You gave it some thought and made a judgment.

Veterinary surgeons can be so hard on themselves. As a wise nurse said to me many many years ago when I was agonising because something died: "Well, It's not as if you bashed it over the head with a hammer. Stop brooding".

Re: Hindsight

Mark Holmes — Fri, 15 Feb 2013 22:31:33 GMT

I don't think you made a mistake, I wouldn't check bloods before many ops. Particularly if bloods had been done in the last 4 weeks and I don't think a different set of decisions are necessarily required if faced with similar circumstances in future. A bad outcome isn't necessarily the result of bad decisions. I don't know how long you have been in practice but this is something you need to accept. I have been in practice long enough to know better but still need reminding myself sometimes.

Re: Hindsight

An On MRCVS — Fri, 15 Feb 2013 22:26:15 GMT

Thank you Emily, that has really helped.

I guess I only felt that way as I made the decision to not do the bloods before the most recent anaesthetic.

Re: Hindsight

Evelyn Barbour-Hill — Fri, 15 Feb 2013 22:22:48 GMT

[quote user="An On MRCVS"]Feel like I have let down the dog and clients[/quote]

Don't be ridiculous.

Re: Hindsight

Emily Nightingale — Fri, 15 Feb 2013 22:18:42 GMT

I often say hindsight is SUCH a bugger!!!!!!! Sometimes you are damned if you do and damned if you don't in this profession. It sounds like (at 10.15pm on a Friday night) you are really giving this issue a lot of your thinking time, and fair enough! It's never nice to doubt yourself, but whichever way you look at it, you can learn something from this case. Life's life that. The crappy times leave you reeling, but when the storms blown over you'll feel better about things- I promise. In five years time, will this really matter? Like you said (and without knowing anything about your case), the patient already had lot's of other things going on. Do you have anyone you can talk to? A colleague or partner?? Or even your dog or cat??? Sometimes writing it all down on a piece of paper and shredding it helps. Honestly, please don't dwell on this, you have no doubt had the dogs absolute best interests at heart and things happen that are out of our control. Stop going over it all again and again. Done is done. Accept, learn from the mistakes you feel have been made and move on. You'll be a better vet for it.. after all experience is the name we all give our mistakes..isn't it??? Big virtual hugs from the Essex outback.