strategies for sanity

Re: strategies for sanity

Mark Holmes — Fri, 12 Oct 2012 11:17:26 GMT

[quote user="Hannah Wynne Richards"]

I must confess I have rather strong opinions-and am not scared to voice them

[/quote]

What a confession, next thing we will hear Jonny Vagas confessing to eating pies.

Re: strategies for sanity

james herriot lied — Fri, 12 Oct 2012 11:02:35 GMT

[quote user="Hannah Wynne Richards"]

I must confess I have rather strong opinions-and am not scared to voice them

Wynne

[/quote]

Re: strategies for sanity

Hannah Wynne Richards — Fri, 12 Oct 2012 09:28:26 GMT

Thanks to those who appreciate that I care about my patients-and yes I doget lots of chocolates-not just at Christmas-there's usually chocilates or biscuits available with coffee-and I don't buy them

I must confess I have rather strong opinions-and am not scared to voice them

Wynne

Re: strategies for sanity

Martin Atkinson — Fri, 12 Oct 2012 09:17:46 GMT

[quote user="Gillian Mostyn"] I even got a blood sample from and put an Addisonian dog on a drip on my own last weekend before I decided that the level of continued nursing it required was not possible under the circumstances and it went off to the RVC anyway. [/quote] At the time of first consultation it was not clear what was required so i did what I could and when it became clear that it required more intensive nursing than I could provide it was referred, as it may have been on any normal working day. And the client happily did the transporting - I don't see an issue in any of this.

[quote user="Gillian Mostyn"]You can pick and choose which OOH calls you want to turn out to and which ones you don't. I suspect your convenience and the finances of the client play a big part in this decision. As to whether this is to be something to be proud of........ [/quote] Does not convenience play a part in everyone's decision to use an OOH provider? - otherwise we'd all do our own OOH all of time. I'll admit finances occasionally play a part but not it in the way you infer, indeed I'm more likely to see the pet of the impecunious because I know the OOH service will charge a lot more than me. As for those who have no money and/or are benefit spongers they're directed to the RSPCA Putney Hospital anyway. I don't believe I suggested I was proud of this, just that I was fortunate having the choice.

[quote user="Gillian Mostyn"] Regardless, this situation means you can basically do whatever you want as OOH duties are never going to be something you HAVE to do. IMHO this removes all the stress of OOH, which is great[/quote] True which is why I feel so fortunate to have this flexibility.

[quote user="Gillian Mostyn"]but you cannot really compare your situation to the average person doing OOH duties.[/quote] erm...I don't believe I did.

Re: strategies for sanity

James Laidlaw — Fri, 12 Oct 2012 08:15:07 GMT

Where was the sniping? Did I miss something?

I think there's a range of what everyone does and we all do what we can that allows us to sleep at night. You can do after hours and make basic triage assessments with people over the phone, and you can send your patients to an OOH service without being worried they are all going to die. Suggesting what one clinic or colleague does over another is right or wrong is where people are tripping up here.

Also I think there's a massive difference between refusal to see and deciding that something will be fine to wait until the morning. I've seen people who I didn't think needed to be seen because they insisted they wanted an appointment. I've never refused an appointment.

Re: strategies for sanity

james herriot lied — Fri, 12 Oct 2012 07:37:54 GMT

[quote user="Robin Grimmer"]

[quote user="james herriot lied"]

but you couldn't ever accuse her [Wynne] of not caring.

[/quote]

I didn't.

[/quote]

I'm not implying for one moment that you did, Robin - perhaps just a mangled phraseology. My point is that everybody has their own baggage to deal with - who knows, even you might have some issues - but Wynne has always struck me as being very, very focussed on her patients, and that's why I turn a deaf ear to some of her choicer phrases - such as an implication that going home at night makes me a monster.

If you're that worried about my pseudonym, by the way, feel free to PM me. Name to a voice and all that. There are a couple of good reasons why I don't use my real name in the general forums, but I'm all for accountability; it'd help the atmosphere somewhat if you just stopped sniping, though.

Re: strategies for sanity

Robin Grimmer — Fri, 12 Oct 2012 07:13:51 GMT

[quote user="james herriot lied"]

but you couldn't ever accuse her [Wynne] of not caring.

[/quote]

I didn't.

Re: strategies for sanity

james herriot lied — Fri, 12 Oct 2012 00:30:44 GMT

[quote user="Robin Grimmer"]

Maybe that's why there's so many of them on here because they don't get the normal interaction with their colleagues?

[/quote]

Or perhaps they're pretty conscientious, and like the rest of us, want to keep on top of stuff. When you're a one-person outfit, there's nobody else in the practice to palm stuff off on, or abdicate responsibility to; you really do need omnicompetence - and a support network like this helps soothe the voices in one's head, I guess.

Wynne says this stuff because she's Wynne, not because she's a sole practitioner. You should hear her bang on about unqualified staff and delegation of tasks, or benefit cheats. But I'm willing to bet she gets a lot more chocolates around Xmas than do I, because she's giving clients a service they want. Some of what David said is probably true, but you couldn't ever accuse her of not caring.

Re: strategies for sanity

Robin Grimmer — Fri, 12 Oct 2012 00:19:15 GMT

[quote user="David Mills"]

[quote user="Evelyn Barbour-Hill"]

[quote user="David Mills"]

[quote user="Hannah Wynne Richards"]

those of us who are single handed and do OOH are so happy in our work is simply that we have clear concsiences

[/quote]

Or, eminently more likely, simply lack the confidence of their convictions.

[/quote]

I know, I'm extremely stupid and I may get a sort of sigh and a reply in words of one syllable, but could you explain what you mean by that?

[/quote]

The implication in Ms Richards' post, as Ms Mostyn pointed out, is that those who don't do their own OOH (and are single handed practitioners) are somehow inferior in not possessing this 'clear conscience' aspect. In my experience those who obsess over their cases, don't trust anyone else with them (not even specialist OOH coverers), and in the diagnostic process often cost the client a hell of a lot of money, do so because they lack confidence in their clinical decision making or in a clinical path where all the information is not available or the work up has not been as close to textbook as possible. We all have to clear our consciences somehow, and usually the means are different. Harking back to another OOH thread most would be in the sensible camp, and Ms Richards is somewhat on her own with insisting on seeing everything that phones; that's fine, no judgements passed, each to their own, but the conflation of this into somehow a morally superior way of working is arrogant, patronising, judgemental, unjustified and derogatory to the rest of the profession who choose to have a life outside veterinary work and can apply some common sense to OOH calls such as those exampled by others above.

[/quote]

Bang on and very eloquently put. I would also add that this type of practicioner behaves like this because they are professionally isolated so always do xyz with a case because it's what they've always done. Maybe that's why there's so many of them on here because they don't get the normal interaction with their colleagues?

Re: strategies for sanity

David Mills — Thu, 11 Oct 2012 23:48:50 GMT

[quote user="Evelyn Barbour-Hill"]

[quote user="David Mills"]

[quote user="Hannah Wynne Richards"]

those of us who are single handed and do OOH are so happy in our work is simply that we have clear concsiences

[/quote]

Or, eminently more likely, simply lack the confidence of their convictions.

[/quote]

I know, I'm extremely stupid and I may get a sort of sigh and a reply in words of one syllable, but could you explain what you mean by that?

[/quote]

Re: strategies for sanity

Gillian Mostyn — Thu, 11 Oct 2012 21:58:11 GMT

[quote user="Martin Atkinson"] I even got a blood sample from and put an Addisonian dog on a drip on my own last weekend before I decided that the level of continued nursing it required was not possible under the circumstances and it went off to the RVC anyway. [/quote]

Could it be possible that the welfare of this dog would have been better served by going to the OOH immediately and therefore avoiding the added journey from your practice to the RVC? Who did the transporting?

You can pick and choose which OOH calls you want to turn out to and which ones you don't. I suspect your convenience and the finances of the client play a big part in this decision. As to whether this is to be something to be proud of........ Regardless, this situation means you can basically do whatever you want as OOH duties are never going to be something you HAVE to do. IMHO this removes all the stress of OOH, which is great, but you cannot really compare your situation to the average person doing OOH duties.

Re: strategies for sanity

Evelyn Barbour-Hill — Thu, 11 Oct 2012 18:57:05 GMT

[quote user="David Mills"]

[quote user="Hannah Wynne Richards"]

those of us who are single handed and do OOH are so happy in our work is simply that we have clear concsiences

[/quote]

Or, eminently more likely, simply lack the confidence of their convictions.

[/quote]

I know, I'm extremely stupid and I may get a sort of sigh and a reply in words of one syllable, but could you explain what you mean by that?

Re: strategies for sanity

David Mills — Thu, 11 Oct 2012 18:26:55 GMT

[quote user="Hannah Wynne Richards"]

those of us who are single handed and do OOH are so happy in our work is simply that we have clear concsiences

[/quote]

Or, eminently more likely, simply lack the confidence of their convictions.

Re: strategies for sanity

Martin Atkinson — Thu, 11 Oct 2012 18:05:18 GMT

[quote user="Hannah Wynne Richards"]

Martin Actually sounds like the best of both worlds-the only flaw is what if you think it needs surgery-you'll also have to have a nurse on call

Wynne

[/quote] That is the flaw although a nurse is theoretically on back-up if it was her evening/weekend shift, they are called in so infrequently that they shall we say 'forget this' and they always seem to have an excuse why they can't come in so potentially complicated surgical problems would be in the category of 'something I can't deal with goes to the OOH provider'. In extremis Mrs A or one of the Misses A could help however I have long become adept at doing many things by myself: stitch ups under Torb/Dom are easy, I even got a blood sample from and put an Addisonian dog on a drip on my own last weekend before I decided that the level of continued nursing it required was not possible under the circumstances and it went off to the RVC anyway. Clients seem to appreciate me telephone triaging things even if they ultimately have to go to the OOH centre.

Re: strategies for sanity

Hannah Wynne Richards — Thu, 11 Oct 2012 17:35:37 GMT

Martin Actually sounds like the best of both worlds-the only flaw is what if you think it needs surgery-you'll also have to have a nurse on call

Wynne

Re: strategies for sanity

Hannah Wynne Richards — Thu, 11 Oct 2012 17:33:29 GMT

I'd be far far more stressed lying there wondering if I'd guessed wrong than just getting up, going to the surgery and seeing the animal To those who think it possible to guess-Vets Now guessed wrong- the dog died-so I voted with my feet-and left them

Wynne

Re: strategies for sanity

Martin Atkinson — Thu, 11 Oct 2012 17:21:43 GMT

[quote user="Gillian Mostyn"]Oh, and Mr Atkinson does not do his own OOH.[/quote] Not strictly true, I am in the (possibly) enviable position of picking and choosing what OOH I do. My answer machine gives out my mobile number, If I'm in the mood I answer my phone, if I'm not or I'm out/drunk/busy I don't and it transfers to the OOH provider. If I answer it and I don't feel it is something I can deal with or its an idiot who is not one of my clients who still insists on being seen I direct them to the OOH provider who will charge them appropriately. It works well for both of us. Don't know if I'll now be called irresponsible or be the envy of others.

Re: strategies for sanity

Gillian Mostyn — Thu, 11 Oct 2012 17:09:49 GMT

[quote user="Hannah Wynne Richards"] Maybe part of the reason those of us who are single handed and do OOH are so happy in our work is simply that we have clear concsiences[/quote]

Ouch!

Whereas the rest of us apparently neglect our patients dreadfully. Or can make a better judgement call. You choose.

Oh, and Mr Atkinson does not do his own OOH, he just insinuates differently sometimes in order to play devils advocate. Apparently.

Re: strategies for sanity

Gillian Mostyn — Thu, 11 Oct 2012 17:07:47 GMT

owner "my dog is collapsed and unable to move"

vet "pick up its lead. What is it doing?"

owner "it has stood up and gone to the door"

vet "see you tomorrow morning."

Re: strategies for sanity

Hannah Wynne Richards — Thu, 11 Oct 2012 17:06:35 GMT

Malcolm Not unless it comes with a 100% guarantee of efficacy

Mark Sounds fine until the case occurs (which it will ) when you leave something too alte I couldn't live with myself if I guessed-and guessed wrongly without seeing the animal Maybe part of the reason those of us who are single handed and do OOH are so happy in our work is simply that we have clear concsiences

Wynne

Re: strategies for sanity

Anthony Dennison — Thu, 11 Oct 2012 17:05:56 GMT

[quote user="Mark Holmes"]

No ball of any description needed.

[/quote]

'Does it want to play with it's ball?' 'Yes'

Technically......

Re: strategies for sanity

Mark Holmes — Thu, 11 Oct 2012 16:56:42 GMT

[quote user="Hannah Wynne Richards"]

How do you know unless you've seen it ? Do you own a crystal ball which I haven't got?

Wynne

[/quote]

"My dog has been vomiting/has diarrhoea"

"Is it eating"

"Yes"

"Its not an emergency"

"My dog is shaking"

"Is it eating walking keen to go out if you pick up the lead"

"Yes"

"Its not an emergency"

No ball of any description needed.

Re: strategies for sanity

James Laidlaw — Thu, 11 Oct 2012 16:55:49 GMT

I'd like to point out that I said I was NOT an advocate for heavy drinking... I will assume no responsibility for the fishbowl tangent,

Re: strategies for sanity

Anthony Dennison — Thu, 11 Oct 2012 16:45:00 GMT

I once saw a fish in it, then lo and behold, that afternoon I saw a fish!

*In the aforementioned empty fishbowl before it was empty.

Re: strategies for sanity

Malcolm Ness — Thu, 11 Oct 2012 16:44:54 GMT

[quote user="Anthony Dennison"]I'll sell you mine if you want. To the untrained eye it looks like an empty fish bowl... It's not I promise[/quote]

Is she going to buy it??