To visit or not to visit...???

RE: To visit or not to visit...???

Anthony Todd — Thu, 01 Jul 2021 22:10:08 GMT

Refer to the "new" TIPP [Transport Injured Pet Protocol} on another thread........

Extreme example I know, but a possible alternative solution? [double bed blanket, probably]

RE: To visit or not to visit...???

Clive Ansell — Fri, 18 Jun 2021 16:14:27 GMT

[quote userid="11308" url="~/001/veterinary-clinical/small-animal/f/misc-clinical-discussions/29887/to-visit-or-not-to-visit/230873#230873"]I can understand that, but owners of large breed dogs who have tried everything to get the animal to the surgery (or elderly and housebound owners), not going is a severe compromise of animal welfare.[/quote]

yes, I get that, and in these cases where all other options are not possible I would probably do the same and carry out the visit (Covid restrictions permitting of course) if possible.

Ultimately though, we can help all we can, but the animals welfare is the responsibility of the client. If they own a large breed dog they should have the means in place to be able to move it and transport it. There are many situations and many practices where home visits are just not possible, covid or not.

RE: To visit or not to visit...???

Anthony Dennison — Fri, 18 Jun 2021 15:55:16 GMT

[quote userid="5012" url="~/001/veterinary-clinical/small-animal/f/misc-clinical-discussions/29887/to-visit-or-not-to-visit/230838#230838"]I would refuse during a national pandemic, unless there was a very good reason not too. Going into peoples homes has to be a no-no during covid. [/quote]

I can understand that, but owners of large breed dogs who have tried everything to get the animal to the surgery (or elderly and housebound owners), not going is a severe compromise of animal welfare. When we've gone we've used full PPE, changed out of it after the house and put fresh on to travel in the ambulance back to the surgery (we lost 2 members of staff with test and trace because one tested positive and the other wasn't in full PPE).

Always checked COVID status of the household, didn't go with a positive test or if people self isolating. In severe cases animal was left outside with owners inside. Animal left in one room, owners another, can come back in afterwards.

RE: To visit or not to visit...???

Clive Ansell — Fri, 18 Jun 2021 14:51:58 GMT

[quote userid="6297" url="~/001/veterinary-clinical/small-animal/f/misc-clinical-discussions/29887/to-visit-or-not-to-visit/230864#230864"]the couple I've done have been where we could do the euthanasia in their garden and there was access to the garden without going through the house.[/quote]

Yes, I would go along with that.

Social distancing and covid safety are not the only considerations though. In the 3 practices I have worked during covid, we have been short staffed with heavy work loads too, so the time just isn't there to allocate to home visits, although in an exceptional circumstance we would. Not had too though.

RE: To visit or not to visit...???

Thomas Johnson — Fri, 18 Jun 2021 14:46:29 GMT

[quote userid="5012" url="~/001/veterinary-clinical/small-animal/f/misc-clinical-discussions/29887/to-visit-or-not-to-visit/230838#230838"]

I would refuse during a national pandemic, unless there was a very good reason not too. Going into peoples homes has to be a no-no during covid.

The 3 practices I have worked in during the pandemic have not been doing home visits at all. They have all said they would if there were extenuating circumstances, and covid safety and social distancing can be maintained. There are very very few cases that cannot be brought to the surgery, the only examples I can think of are very large collapsed animals or entrapment.

[/quote]

We have generally been saying no to home visits during the pandemic, the couple I've done have been where we could do the euthanasia in their garden and there was access to the garden without going through the house.

RE: To visit or not to visit...???

Dinu Catilina — Thu, 17 Jun 2021 18:38:25 GMT

I would go but I would not like my female staff to go unless they know the client well and are comfortable.

For some of our clients I banned them for doing any home visits on their own.

RE: To visit or not to visit...???

Clive Ansell — Thu, 17 Jun 2021 17:39:32 GMT

[quote userid="11308" url="~/001/veterinary-clinical/small-animal/f/misc-clinical-discussions/29887/to-visit-or-not-to-visit/230837#230837"]We've being doing home visits throughout, with measures in place, lots of non clients where their practice has refused, only on welfare grounds for PTS though. [/quote]

I would refuse during a national pandemic, unless there was a very good reason not too. Going into peoples homes has to be a no-no during covid.

RE: To visit or not to visit...???

Anthony Dennison — Thu, 17 Jun 2021 16:06:57 GMT

We've being doing home visits throughout, with measures in place, lots of non clients where their practice has refused, only on welfare grounds for PTS though.

RE: To visit or not to visit...???

Jill Butterworth — Wed, 16 Jun 2021 20:53:23 GMT

I guess it depends on your anxiety level and how much you feel the fear. It's different for a 6ft fella than a 5ft female. I've been worried , but never so much that I wouldn't attend.

RE: To visit or not to visit...???

Clive Ansell — Wed, 16 Jun 2021 20:11:40 GMT

[quote userid="8858" url="~/001/veterinary-clinical/small-animal/f/misc-clinical-discussions/29887/to-visit-or-not-to-visit/230816#230816"]If you are really worried, you can ask for a police escort [/quote]

If we are that concerned about our safety, that we feel we need a police escort to attend, why not just decline. Personal safety has to be the overriding factor on every occasion, and trumps the well being of the patient. Non negotiable, end of.

Ultimately, the responsibility rests with the client, not us.

That said, in > 99% of cases I would carry out the visit and deal with it, just as long I was able too and felt safe to do so.

RE: To visit or not to visit...???

Charlotte Marshall — Wed, 16 Jun 2021 18:26:44 GMT

Haven't done OOH for quite a few years but did then go out for similar sort of things though 25 miles would be well out of my zone being as I am in a city. Only alternative I would see would, potentially to see if any sort of pain relief could be given by the owner to keep the animal comfortable until the morning.

RE: To visit or not to visit...???

Jill Butterworth — Wed, 16 Jun 2021 18:25:15 GMT

I've had this exact situation in a poor area, and I went, being more scared of RCVS retribution than the client.

If you are really worried, you can ask for a police escort I always feel you might as well get on and go, if there are no real reasons not to. There's no way I'd get back to sleep anyway, wondering if the client would call back, or if it had died and I would be complained about. Other options are to take a partner/nurse/send an animal ambulance. I've observed a similar long discussion on FB: a surprising number of vets don't want to attend in these circumstances, they don't seem to trust chemical restraint and don't seem to have lot in their toolbox for dealing with unpredictable situations.

RE: To visit or not to visit...???

Michael Woodhouse — Wed, 16 Jun 2021 14:41:38 GMT

[quote userid="5012" url="~/001/veterinary-clinical/small-animal/f/misc-clinical-discussions/29887/to-visit-or-not-to-visit/230806#230806"]But placed in the situation how can one evaluate or quantify safety easily and quickly? [/quote]

In the same way that we will send (generally) a single person from the ambulance service, gas company, Tesco delivery to the house. I'm a first responder for the ambulance service and we get sent by ourselves and could wait over an hour for back up. I do appreciate I'm lucky in a rural area, but there's volenters responding for the ambulance service in London and Birmingham.

[quote userid="5012" url="~/001/veterinary-clinical/small-animal/f/misc-clinical-discussions/29887/to-visit-or-not-to-visit/230806#230806"]What perspective do managers and employers take on this, where you have to do all you reasonably can to ensure employee safety? [/quote]

Calls entered on diary so we know where people are. Happy doing welfare checks etc on the phone if needed. If really worried I'd do the call myself (not happened yet).

RE: To visit or not to visit...???

Clive Ansell — Wed, 16 Jun 2021 14:19:17 GMT

[quote userid="3169" url="~/001/veterinary-clinical/small-animal/f/misc-clinical-discussions/29887/to-visit-or-not-to-visit/230802#230802"]I think the safety issue has to be a real and genuine concern, not a nominal one.[/quote]

But placed in the situation how can one evaluate or quantify safety easily and quickly?

When I used to work in OOH centres it was not that unusual to get drunk abusive clients threatening to use violence.

There are areas in parts of Birmingham where ambulance and fire crews will not visit unless accompanied by the police. Police patrol in fours with dogs and guns. Would it be safe for a lone veterinary surgeon? I wouldn't risk it.

What perspective do managers and employers take on this, where you have to do all you reasonably can to ensure employee safety?

What happens in an OOH centre where there is only one vet, and they cannot leave the building? that could be because of case load, practice protocol, no vehicle etc. I think under the RCVS PSS there has to be a vet on premises all of the time in ECC centres?

RE: To visit or not to visit...???

Julie Innes — Wed, 16 Jun 2021 13:12:25 GMT

We don't do our own OOH, and don't do visits either, but I have made exceptions in cases like this. However, after previous experiences, I would have insisted on having someone else with me, even if that meant it had to wait a little.

RE: To visit or not to visit...???

Michael Woodhouse — Wed, 16 Jun 2021 13:12:19 GMT

[quote userid="11249" url="~/001/veterinary-clinical/small-animal/f/misc-clinical-discussions/29887/to-visit-or-not-to-visit"]Just interested in others thoughts please.[/quote]

100% attend, remember my constant endeavour will be to ensure the welfare of the animals committed to my care....

As long as in the practice area. If you're doing something else then people have to wait - I could be 25 miles in another direction starting a cow caeser or a GDV. Don't think you can turn anything down with the vague possibility of something else coming in.

I think the safety issue has to be a real and genuine concern, not a nominal one. I would be much more concerned by a towerblock in a run down part of town. I would generally attend alone and size up the situation when I go there. I don't think you can legitimately refuse just because you don't want to go - the chances of harm happening are miniscule. I do agree taking a partner or friend with you is handy - especially if you then need to extricate the body!

RE: To visit or not to visit...???

Derek Lyon — Wed, 16 Jun 2021 11:50:38 GMT

I had similar with Guinea Pig. Never got paid!!!!

RE: To visit or not to visit...???

Beats — Wed, 16 Jun 2021 10:26:57 GMT

I remember doing a 50minute drive to euthanase a Guinea Pig once at 2am. It took it 30minutes to pass away after my intra-abdominal pentobarbitone. 50minutes back again. over 2 hour round trip in middle of night.

Obviously never got paid.

Thankfully though these things are the exception rather than the rule. I don't mind the odd eccentric thing as an exception, but wouldn't want it to be a regular occurrence!

RE: To visit or not to visit...???

Clive Ansell — Wed, 16 Jun 2021 09:48:42 GMT

If I thought the case was genuine and a welfare concern, the animal was in distress, there were no other emergencies in progress, and there were no obvious concerns about safety, I would probably have visited as you did. I would take an assistant though, not necessarily a nurse, just another pair of hands and a witness. I would not go alone, nor expect anyone else too.

If the client was registered elsewhere, I would redirect them to their own vet or their OOH provider, certainly at 0400!

Safety has to be at the nub of any risk assessment, and if one is concerned about their personal safety or wellbeing then they should decline to do it, making sure comprehensive and contemporaneous notes are made.

This visit was 25 miles away, was there not a vet closer? what would happen should another emergency present and you're 25 miles away and unable to deal with it/

If I did decline the visit, I would try and come up with other options; advise on how to lift and transport to the surgery, animal ambulances or pet friendly taxi's.

Ultimately, the responsibility lies with the client.

[quote userid="11249" url="~/001/veterinary-clinical/small-animal/f/misc-clinical-discussions/29887/to-visit-or-not-to-visit"]what's the likely RCVS position had I refused?[/quote]

Anyone's guess, and given the Chokoski fiasco in the past who knows.

One would hope that you would be supported, as long as there are valid reasons which are documented at the time, and evidenced where possible. My gut feeling is you probably would be.

RE: To visit or not to visit...???

Nicola Cole — Wed, 16 Jun 2021 08:11:09 GMT

If you’re concerned about a situation then you don’t have to attend-but I’m not sure how far that has been tested with regards to what is deemed acceptable.

Personally I would have attended from an animal welfare point of view.