Home visit

Re: Home visit

Clare Tapsfield-Wright — Mon, 28 Jul 2014 23:37:29 GMT

Couldn't agree more with the grumpy brigade. It isn't what RCVS Prof con say, it's what you as a professional person know you ought to do. The owners may have lived in what you consider poor conditions but they cared enough to phone your practice and ask for help and that's what you should give if it is in your power . I have a niggling suspicion that you are spinning a tale here to see what the reaction .

Re: Home visit

Stephen Courtney — Wed, 23 Jul 2014 18:15:24 GMT

I used to have to visit the local quarantine kennel after Saturday morning surgery. i once had an issue where an irate client phoned up demanding a home visit after I had left for the kennels. she seemed to think i would have to drop everything to visit her because she wanted me to - and of course this was not a genuine emergency in any eyes except her own.

arrived at the kennels and had to deal with her demands - i offered to visit her as soon as I was done - even though that would have made me very late for starting my weekend - but that wasn't good enough and she went to another practice. good riddance - but that was the only time i have ever had conflicting demands while I was out of the building on a visit.

Anon's situation seems mainly based on a bad reaction to hassle and inconvenience, perhaps made worse by being in an area with an unpleasant clientele. not the animal's fault, and after my own dog's illness i will never ever try to talk an owner out of a home visit for PTS because it is not convenient for me. these visits are never convenient, but they are so much nicer for the animal and the client.

Re: Home visit

Will McMullan — Wed, 23 Jul 2014 11:33:12 GMT

I find it really strange that the recent high profile disciplinary case which was essentially due to a refusal to visit seems to have made people even more wary of making house visits. I don't recall ever seeing a DC case that concerned a vet being out of the practice on a visit (or otherwise come to think of it) and so unable to treat an animal that turned up as an emergency. Problems arise when you refuse to do something, not when you are actively getting on with your work.

Re: Home visit

Jo Dyer — Wed, 23 Jul 2014 09:12:08 GMT

Visits, in the vast majority of cases, are a client care issue. The pet probably doesn't mind either way, especially if he is in extremis. I would like a visit for euthanasia of my pets if I was a client.

Your practice is clearly happy to provide them on request, as are many practices. As an employee, your job is not to argue, unless you have a clear health and safety reason to do so, but to get out there and do the work that the practice needs doing.

If you disagree with any practice policy, then at a later, mutually convenient time, you need to raise your objections with management. If they stick with their (apparently very reasonable in this case) present policy then you have to decide whether to move to a practice with a different policy, or to set up/buy your own.

That's the reality of being an employee.

Re: Home visit

Braden Collins — Wed, 23 Jul 2014 06:13:19 GMT

Another for the "should have done the visit" group. For a client we don't know we will make them prepay for the procedure and charge a house visit fee. This covers the extra time and effort to do the visit. If we go with the "can't leave just in case" logic you would need to insist on the vet not leaving the clinic for lunch breaks or other reasons.

You of course would schedule it for a convenient time, but in reality how many times does a single vet practice have a "drop everything" emergency come rushing through the door? How is animal welfare better served by not doing a house call PTS on the very small chance that a dog gets hit by a car?

As was said above, we are in a service industry. I am a practice owner and a vet, and would happily do a call like this myself. If one of my staff refused to do it I would give a similar response to your manager. If the RCVS would discipline you because you did a PTS at home in the interest of animal welfare and client care I would be very surprised.

A client that pays their bills (as I said, they would have to prepay for a house call) is worth as much as any other, no matter how they live their lives. We have some very rough "working class" clients, bikies and all sorts as clients and I find they are often the best clients to work with. If you are working for someone else you are responsible for helping pay the bills and earning your own pay, so it is not up to you who is worth having as a client.

I'm quite surprised by the strength of your feelings on this. Is there something else going on in the background that is relevant to how you feel about this?

Re: Home visit

Nicola Cole — Tue, 22 Jul 2014 23:43:56 GMT

Grumpy young(-ish!) woman here-no question, just do the visit (I know you already have but just adding my thoughts)!

Re: Home visit

rjhvet — Tue, 22 Jul 2014 23:03:29 GMT

I agree with Michael, stop making excuses, there is no requirement to have a vet on a premises at all times. Think sensibly and logically, following your rationale you would need lots of vets present at all times. What if an emergency arrives when vet 1 is operating, what if vet 2 is in the loo, what if aliens arrive and kidnap vet3 .........

I agree just get on do the visit !

Re: Home visit

Cat Henstridge — Tue, 22 Jul 2014 22:49:11 GMT

Anon,

You can't really draw comparisons between a vet working during the day at a single handed practice, backed up by other branches and an OOH vet working alone covering the patients of upwards of 20 of their colleagues.

It is a reasonable argument (I feel but some feel differently!) that leaving to do an OOH visit does leave you open to the possibility of an emergency arriving but the chances of it happening in your situation and then there being NOBODY else to be able to help said animal are vanishingly small and the risk is not comparable to the need of the pet who is the subject of your post.

Yes, you should have gone on the visit without any argument (sorry). You would have been quite right to schedule it at a time convenient for the rest of your work but there should have been no discussion about going.

I can only assume all the recent drama about visits has made you concerned about leaving a practice at any time. I hope this thread has put your mind to rest. This is the sort of situation that will arise from all the scaremongering around the visit issue and the only ones to lose out are the animals themselves.

Re: Home visit

Louise6732 — Tue, 22 Jul 2014 21:35:04 GMT

[quote user="An On MRCVS"] I can guarantee you would not want this client to be bonded to your practice. The house was in a complete mess, cluttered with stuff, dirt and damp. There was very little space for me and my nurse to move around the dog. As soon as we went in, we felt the need to leave the place, and I have seen other awful places. That house was not safe to live in, to keep a dog in, and carry a clinical procedure there.[/quote]

Perhaps I have missed something, but why does the fact that the client's home is a mess mean you don't want their business, or can't do your job? Did you feel unsafe in their company or their house? I can understand this, but as a profession I really feel that it is not up to us to judge how people live, our interest is the welfare of the animal and we get on with our job focussing on that. I've been to places that were jumping with fleas, smelly, etc, but it didn't stop me doing my job. I completely understand if you felt threatened and that is a situation where you do not want that client, especially on a home visit.

I would've gone on the visit, to add my thoughts on the original question.

Louise

Re: Home visit

Anthony Todd — Tue, 22 Jul 2014 19:48:00 GMT

[quote user="An On MRCVS"]I hope no animal will die in your practice, while you are out on home visit.[/quote]

At least the animal I visited would have received attention rather than the animal that never appeared 'cos there wasn't one....

Re: Home visit

Martin Atkinson — Tue, 22 Jul 2014 19:01:24 GMT

It is a long time since I posted this but I think now is the time for it again:

Re: Home visit

CatherineThomas — Tue, 22 Jul 2014 18:55:20 GMT

[quote user="An On MRCVS"]

[quote user="Anthony Todd"]

But hold on An on, you're laying yourself wide open!

What about, having arranged cover, off you go to this euthanasia and another "emergency" comes in whilst your backup vet is dealing with the first......

Better, therefore, have two vets on site before you go, oh no, another emergency just called, better make it three vets, just in case......

[/quote]

Having a back-up plan does not mean being stupid. And I was taught that having a Plan A, B and C is actually a good thing.

I hope no animal will die in your practice, while you are out on home visit.

[/quote]

I don't think you are helping yourself with this comment.

I don't think any reasonable person would expect you to be available at every minute of the day to respond to emergencies immediately. How is being on a visit different to being at home while on-call where it might take you 20 minutes to get dressed and into the practice? Or what about if you are the only vet and you are operating and in the middle of a bitch spay, you can't drop what you are doing and see to every emergency that walks through the door (most of what owners call emergencies are not really time critical anyway). If you are in a one vet practice the chance of having an emergency turn up is low. This is different to an out of hours centre where you could reasonably expect there to be a large number of emergencies turning up at any time and therefore a vet is required to be on the premises.

Re: Home visit

Michael Woodhouse — Tue, 22 Jul 2014 18:52:49 GMT

[quote user="An On MRCVS"]I hope no animal will die in your practice, while you are out on home visit. [/quote]

How many animals will die in the whole country in a year if vet care was delayed 30 mins?

I know of lots of people having waited 1hr+ for an ambulance.

Almost nothing can't wait a few minutes.

Re: Home visit

Neil Wheadon — Tue, 22 Jul 2014 18:38:59 GMT

[quote user="CatherineThomas"]I read that as meaning anon would go on the visit once the OOH vet was there to take over and hence he or she would stay behind to do the visit. Not that he or she would leave it to the OOH vet to do the visit.[/quote]

Maybe, however multibranch practice, presumably not a dedicated OOH vet, so would be (secretly) hoping for a bit of a break in the evening and then faced with this one? In either case, I stand by it's unreasonable to whoever is on call.

Neil

Re: Home visit

Martin Atkinson — Tue, 22 Jul 2014 18:37:53 GMT

[quote user="An On MRCVS"]I hope no animal will die in your practice, while you are out on home visit.[/quote] Anon I was going to say that however much anyone disagrees with you there was no excuse for red starring your earlier long post. However this post smacks of vindictiveness, your apparent excuses for getting out of a home visit appeared to be looking for justification, your response to the client's home (we all see situations like that) and your whole attitude make me think you deserved it and more, I wonder why you became a vet. I thought I was cynical enough but you take the prize. I think you should be big enough to reveal yourself. This is not the sort of thread one should be allowed to hide behind as anon.

Re: Home visit

Malcolm Ness — Tue, 22 Jul 2014 18:33:48 GMT

[quote user="An On MRCVS"]The advise was that the home visit should be arranged once a cover for me would be provided, and if that is not possible then the home visit can be delayed until the OOH service starts the cover.[/quote]

If that is really what they said, specifically "should" and not "could" or "might", then somebody in Belgravia House should be relieved of their duties.

How do you cope when you are operating and therefore unable to deal with an emergency should one appear??

Re: Home visit

Rob Loxley — Tue, 22 Jul 2014 18:28:06 GMT

[quote user="Linda Filshie"]If I was in the middle of ops or consults when the call came in[/quote]

Maybe you shouldn't have started ops without someone to cover for any walk-in emergencies?

Seriously, I'm all for placing the onus of getting care to the dog on the owner and allowing vets to refuse visits where unnecessary as per the new RCVS guidance (which is surely due to be published soon?), but equally we are running a service business and need to understand that. Maybe your manager would rather you were out earning some money than sitting doing nothing?

So far today I've been out on 2 visits, and received a bottle of wine, a cabbage, tomatoes, beans and some potatoes for going the extra mile for another client.

Re: Home visit

CatherineThomas — Tue, 22 Jul 2014 18:25:53 GMT

[quote user="Neil Wheadon"]

[quote user="An On MRCVS"] the home visit can be delayed until the OOH service starts the cover. [/quote]

To be absolutely frank this is a dreadful statement.

OOH providers are in place to treat emergencies that occur out of hours, they are NOT there to clear up in regards to staff shortages or a refusal to do the right thing during the day.

Quite cross now, and not hiding behind an ANON

Neil

[/quote]

I read that as meaning anon would go on the visit once the OOH vet was there to take over and hence he or she would stay behind to do the visit. Not that he or she would leave it to the OOH vet to do the visit.

Re: Home visit

Neil Wheadon — Tue, 22 Jul 2014 18:21:20 GMT

[quote user="An On MRCVS"] the home visit can be delayed until the OOH service starts the cover. [/quote]

To be absolutely frank this is a dreadful statement.

OOH providers are in place to treat emergencies that occur out of hours, they are NOT there to clear up in regards to staff shortages or a refusal to do the right thing during the day.

Quite cross now, and not hiding behind an ANON

Neil

Re: Home visit

Linda Filshie — Tue, 22 Jul 2014 18:13:20 GMT

[quote user="emma_j"]

I am an employee but completely share the views of the grumpy old people.

[/quote]

Yep, likewise.

If I was in the middle of ops or consults when the call came in (and it wasn't an emergency) the owner would be told that and given an ETA for after I was finished ops/consults, but otherwise just get on and do it.

Slightly irrelevant perhaps, but I'd love to know when you qualified Anon.

Re: Home visit

Hannah Wynne Richards — Tue, 22 Jul 2014 17:43:11 GMT

Hear hear Bob. Home visits come with the territory.

Wynne

Re: Home visit

emma_j — Tue, 22 Jul 2014 17:36:04 GMT

I am an employee but completely share the views of the grumpy old people.

Re: Home visit

An On MRCVS — Tue, 22 Jul 2014 17:32:00 GMT

[quote user="Anthony Todd"]

But hold on An on, you're laying yourself wide open!

What about, having arranged cover, off you go to this euthanasia and another "emergency" comes in whilst your backup vet is dealing with the first......

Better, therefore, have two vets on site before you go, oh no, another emergency just called, better make it three vets, just in case......

[/quote]

Having a back-up plan does not mean being stupid. And I was taught that having a Plan A, B and C is actually a good thing.

I hope no animal will die in your practice, while you are out on home visit.

Re: Home visit

Bob Russell — Tue, 22 Jul 2014 17:15:13 GMT

Anon - you did what you should have done. The condition of the homes people live in can be a shock to the system and make you pleased you live your life and not theirs!

It looks as if your manager had opinions broadly in line with the majority of posters here! If you are on a visit and an emergency comes in there is little or nothing the RCVS could do - you cannot be in two places at once.

Sometimes we have to do things that are unwelcome and unpleasant. They come with the job!

"I also appreciate most of your point of views are so because you are either sole charge and owner, or owner of the practice."

My point of view is not because I am sole charge and owner (but am) or owner (but am), it is because I am a vet and it is part of my job!

Re: Home visit

Anthony Todd — Tue, 22 Jul 2014 17:04:40 GMT

See what I mean.... though good to see that the environment was of more relevance than the state of the dog.

But hold on An on, you're laying yourself wide open!

What about, having arranged cover, off you go to this euthanasia and another "emergency" comes in whilst your backup vet is dealing with the first......

Better, therefore, have two vets on site before you go, oh no, another emergency just called, better make it three vets, just in case......