OOH work

RE: OOH work

Gillian Mostyn — Thu, 09 Aug 2018 06:21:09 GMT

[quote user="David Mills"]But, by your own admission, when you were the boss you worked your arse off to make your practice solvent and successful. [/quote]

You're quite right. I did more than my fair share of the clinical work on top of the management. My bad.

On the plus side, my staff turnover was low.

RE: OOH work

Michael Woodhouse — Thu, 09 Aug 2018 01:39:40 GMT

[quote user="Evelyn Barbour-Hill"]In most of my practices, the boss or senior partners always did Christmas.[/quote]

I like working Christmas. I've done 12 consecutively so far and will do this next one. I'll do 25 and consider having 1 off.

[quote user="David Mills"]it strikes me how little most employees know or appreciate how much management stuff happens whilst they're at home with their feet up[/quote]

Agree. I'm currently on holiday and I've had messages from 3 members of staff today. I really don't mind.

RE: OOH work

Lucy Fleming — Wed, 08 Aug 2018 23:36:17 GMT

[quote user="Gillian Mostyn"]1) when the boss was on call, they didn't suffer anything like the stress and anxiety I did. Thus doing less on call than us was...irritating[/quote]

ironically, one of the senior vets in my first job absolutely hated being on call, and would seemingly get very stressed about it and spend a fair amount of the week running up to an on call weekend complaining. I always told myself that if I got that stressed about the very idea of being on call, then it was going to end up ruining my free time whether I got called out or not, and that I was going to do my best to live my life around it. I have, mostly, barring a few odd superstitions I have developed, stuck to that.

RE: OOH work

Evelyn Barbour-Hill — Wed, 08 Aug 2018 22:40:03 GMT

[quote user="Gillian Mostyn"] on public holidays such as Christmas, the boss got to be at home with family between calls, with their meals prepared. I got to go home to an empty practice flat as my family wasn't nearby. I thought that was rather heartless.[/quote]

No kidding. That's a bad boss.

In most of my practices, the boss or senior partners always did Christmas. With Geoff Parkin, we took alternate years, but if I was on duty on Christmas Day i was invited to spend the day with Geoff. He was a good boss.

RE: OOH work

David Mills — Wed, 08 Aug 2018 22:10:06 GMT

[quote user="Gillian Mostyn"]These were the reasons I swore, when I was a newly qualified assistant, that I would be different when I was the boss.[/quote]

But, by your own admission, when you were the boss you worked your arse off to make your practice solvent and successful.

Having been in management for a little while, it strikes me how little most employees know or appreciate how much management stuff happens whilst they're at home with their feet up. I can't remember the last time I finished on time. I don't resent the work, but it cuts both ways (and, as it goes, I do full share of ooh and late vet finishes).

RE: OOH work

Sarah Keir — Wed, 08 Aug 2018 19:44:22 GMT

[quote user="Anthony Dennison"]

[quote user="MartinH1"]I think the appropriate hand holding is a good way to phrase that. Something that a lot of my peers were promised (anecdotally), but something they rarely had. A lot of the time the excuse was "oh sorry, my phone died" or "sorry I was out at the pub and didn't know you called"[/quote]

I find it hard to believe that the majority of new graduate vets go in to jobs like this where they're just left to sink or swim. Given that it's currently very hard to find any British new graduates that want a job with OOH work, why are they all going to these bad practices?

[/quote]

Because they are promised support at interview but until they actually work there you don't actually know if you'll get that support (reliable information second-hand - from my sister who is 6 years qualified and several bum jobs down the line).

Sarah

RE: OOH work

Anthony Todd — Wed, 08 Aug 2018 18:17:18 GMT

[quote user="Gillian Mostyn"]I got a Friday afternoon off after a full weekend on call (every 6 weeks). I make that a half day to make up for working 100+hours that week. How generous!!! [/quote]

We juggled it so that every so often the vet got Friday to Monday morning off, and dropped the evening Friday surgery at 2 sites clients could always travel 2 miles to the branch pair].

Nothing like a 3 day weekend to recharge batteries!

When I started with Uncle Clive I got a half day on Wednesday, which was little good to beast or man. [remember the days when shops on ?? Wednesday were half day and no Sundays at all]

RE: OOH work

Gillian Mostyn — Wed, 08 Aug 2018 18:12:39 GMT

[quote user="Tricia Goulden"]I feel retrospective resentment for what I have endured in the past.[/quote]

[quote user="MartinH1"]It was also pretty demoralising to see the partners do no on call, whilst letting the assistants battle it out over OoH cover. I get that they've done their fair share, and kudos to them, but times have changed.[/quote]

These were the reasons I swore, when I was a newly qualified assistant, that I would be different when I was the boss.

Two things struck me at the time.

1) when the boss was on call, they didn't suffer anything like the stress and anxiety I did. Thus doing less on call than us was...irritating

2) on public holidays such as Christmas, the boss got to be at home with family between calls, with their meals prepared. I got to go home to an empty practice flat as my family wasn't nearby. I thought that was rather heartless.

RE: OOH work

Gillian Mostyn — Wed, 08 Aug 2018 18:05:48 GMT

[quote user="Joyce Whitehead"]with a half day off per week which I rarely got.[/quote]

Lol....you were spoiled! I got a Friday afternoon off after a full weekend on call (every 6 weeks). I make that a half day to make up for working 100+hours that week. How generous!!!

RE: OOH work

Joyce Whitehead — Wed, 08 Aug 2018 15:18:54 GMT

I have always done OOH and for much of my working life this was 1:2. Now 1:4. We are equine/sa so no possibility of using an OOH provider, and also rural. I think it is important for new grads to do at least some on call, it improves decision making, and there will be the chance to see and do some stuff rarely seen in daytime. As a fairly small practice we can be very supportive (I hope) even to new grads. We have one starting later this year, and will ensure there is always another vet on the end of the phone if needed. They will always have a Nurse available too so that can often help with the straightforward. They all have a wealth of knowledge of practice protocols etc.

As a partner I do take a full share of ooh, as does my husband/other partner. We feel that it costs us a vet’s salary to do ooh, as we could manage with one less vet if we didn’t do it, and get enough time off. We have taken a deliberate decision in the past few years to be relatively over staffed but each vet gets a weekday off, and two if they are working a weekend. And a long weekend following a weekend on call. Which has made life much nicer, albeit affected our profit margins.

Our young vets have some friends who have gone straight into non ooh, and who never want to do any. In some bigger practices with apparently good graduate schemes this has meant mainly consulting and cat neuters in th first year. The interesting ops and cases get passed to the colleagues studying for certificates. That would not appeal to me as a new grad, and still wouldn’t now! I’m glad the days of no time off and mad rotas have largely gone - like many I started in 1983 in a 1:2 rota with a half day off per week which I rarely got. Weekends involved open surgeries virtually all day saturday and most of Sunday.

RE: OOH work

Lucy Fleming — Wed, 08 Aug 2018 14:35:21 GMT

[quote user="Linda Filshie"]

[quote user="Gillian Mostyn"]

I have mixed feelings about my first on call rota. There were 3 assistants and 3 partners on it, but only the assistants did the weeknights. My weeknight was Thursday. Therefore, every 6 weeks I worked solidly from Thursday morning to Monday evening. And as I worked a 5 day week, I worked 12 days straight. It was a mixed practice, so night time and early morning calls were guaranteed. Knackering is not the word!!!

[/quote]

Snap! But mine was 1 in 3 and we did every 3rd Mon so every 3rd week would be Thur am to Tue evening. And I didn't realise until I was negotiating a leaving date 2.5y later that I'd been totally screwed over by the departing vet's rota swaps for the 1st 3 months - he had had the benefit of the days off and I got to cover them . The mere thought of doing on call now is enough to raise my blood pressure and heart rate.

[/quote]

Mine was the same - my regular week night on call was a Thursday, so a normal on call weekend was Thursday to Monday and a bank holiday was through to a Tuesday. We also had two branches, and while most of the vets only covered work from one branch, myself and one of the other vets covered both when on call. The branches were a 40 minute drive from one another, and one covered a huge but sparsely populated area which meant that from one side of our area to the other (technically) was a four hour drive! However, the other vet that covered both branches was the practice owner, so I can't exactly accuse the boss of shirking his fair share. I also got a whole Friday off after a weekend on call where the other vets got a Friday afternoon, and outside of the spring calving period and the summer fishhook period, the on call work often wasn't that busy.

I'm not sure I would ever go so far as to say I enjoy the crazy nights on call when everything is trying to die on you and the phone just won't bloody stop ringing (unlike other contributers to this thread) but I do agree that they are usually few and far between, and most of the work is actually quite routine.

(As an aside, does anyone else get really annoyed with those insurance claim forms that ask "If the animal was seen out of hours, was the condition life threatening:?"... there's quite a gulf between "will die without treatment" and "ok to wait until Monday morning".)

RE: OOH work

Linda Filshie — Wed, 08 Aug 2018 13:57:01 GMT

[quote user="Gillian Mostyn"]

[/quote]

RE: OOH work

Gillian Mostyn — Wed, 08 Aug 2018 11:32:38 GMT

However, the partners did provide good back-up, with a named vet for the first 3 months. They never refused to come and help at any point, although I only asked for help with calvings. However, I did manage my first GDV (ever seen, let alone treated myself) from a text book. I remember my boss was most impressed with my description of a belt loop gastropexy!!! Dog did great.

RE: OOH work

Thomas Johnson — Wed, 08 Aug 2018 11:17:02 GMT

[quote user="Anthony Dennison"]

[/quote]

In my first job we had a first and second on-call rota, I was the only assistant and there were 3 partners on the on-call rota (a 4th partner no longer did on-call work for health reasons). When I first started I probably called for advice fairly frequently and never had a problem getting hold of them, or getting them to come and help for something like a cow caesarian or a GDV.

RE: OOH work

Anthony Dennison — Wed, 08 Aug 2018 09:34:35 GMT

RE: OOH work

Martin Hamilton — Tue, 07 Aug 2018 23:39:53 GMT

Long time since I've replied to a post, but I'll pick out each section at a time and add my input:

[quote user="Liz Barton"]

- so actually the best time to do OOH is before you have additional responsibilities... generally earlier in your career.

- BUT we do live in an age where fear of complaint and mental health are increasingly issues for young professionals

e.g. social media vet bashing never used to exist, and - whatever your take on this - mental ill health in society is increasing and our profession has a particularly bad record.

[/quote]

This isn't one I'd immediately thought of, but it did affect my out of hours. I once had a social media complaint as well as formal complaint that went through the VDS aimed at me, as a dog in resp distress turned up at the same time as an RTA (which required euthanasia as its small intestines were trailing around the place). I rushed the dog through and onto oxygen with the nurse after a quick exam, before attending the euthanasia. I explained to the resp distress dog owner why I had taken that step, apologised, and yet was faced with a complaint for "not taking appropriate care" of their dog. The dog survived, all was well, but they said it was an awful experience that caused emotional trauma. It was very demoralising to work for 36 hrs (with a 1hr nap) and the only feedback I had was a negative Facebook review and a VDS complaint

[quote user="Liz Barton"]

- I entirely agree my best shifts have been the solo nights. It's the interesting cases and the times I've pushed myself and achieved the most. So I would say it's hugely valuable to expose new graduates to OOH, with appropriate hand holding. I am also increasingly convinced by the value of resilience training to teach them how to cope with moments of uncertainty, errors and complaints without fear and stress.

[/quote]

Didn't any of you see GDV's, ruptured splenic masses, foreign bodies, pyos etc during the day? I feel like I did an equal amount of these during the day. At least then there was another vet in the building if really necessary, but otherwise I was expected to get on with it if it was my case.

I think the appropriate hand holding is a good way to phrase that. Something that a lot of my peers were promised (anecdotally), but something they rarely had. A lot of the time the excuse was "oh sorry, my phone died" or "sorry I was out at the pub and didn't know you called"

[quote user="Liz Barton"]

- On the work-life balance front, it's entirely possible to have a good work-life balance and work OOH, but it does require a sympathetic rota (not the 100+ hour weeks I started out on).

- I wonder if new grads more concerned about work-life balance or gripped by fear of getting something wrong OOH and the consequences of this? Or both??

[/quote]

It's possible, depending on the caveats. Some practices want you on site, so although you're on call and may not even get called, you're stuck on the premises.

In all honesty the reason I seeked a job without out of hours was multifactorial. Working in a practice with OoH, I worked more hours and got paid less than my friends who worked 9-5 and had no out of hours at a clinic just down the road. It was also pretty demoralising to see the partners do no on call, whilst letting the assistants battle it out over OoH cover. I get that they've done their fair share, and kudos to them, but times have changed.

RE: OOH work

Tricia Goulden — Tue, 07 Aug 2018 23:17:32 GMT

I have been in practice for over 34 years and have worked full-time for most of it. I have always taken my share of the OOH rota and accepted it as part of my vocational responsibility. My current practice has dedicated OOH nurses who are superb and provide a very high standard of care to the in-patients and the on call vets. They also employ night vets who dilute the OOH nights making the rota very fair. We get the following Friday off following a weekend on call and only work one weekend including nights in ten. This is far, far better than any conditions I have experienced before. I feel retrospective resentment for what I have endured in the past.

RE: OOH work

David Mills — Tue, 07 Aug 2018 20:22:27 GMT

I wonder whether the promotion of OOH / "emergency work" as a pseudospeciality in recent years and by some companies has led to this fear amongst new grads. Much of it is routine, just at unsociable hours. When you read and study ECC (I've done the AVP modules in them) it's just more urgent routine work- very few of us will ever work in a specialist intensive care centre.

I agree it's an important development step because it does make one think and encourages innovation and independence. Similar to others, I actively seek jobs with ooh work as I enjoy it, and that comes from my first job where it was similar to Michael where you were expected to drip and xray things by yourself, although always a second vet on call for advice and a nurse or two who would happily come in for overtime for surgery. It also taught the importance of triaging effectively and being firm with owners.

So yes, I'd be in full support of it being part of PDP.

RE: OOH work

Wren — Tue, 07 Aug 2018 10:03:13 GMT

[quote user="Evelyn Barbour-Hill"]"Work-play balance" would be fairer.[/quote]

Or simply, "balance"

RE: OOH work

Martin Atkinson — Tue, 07 Aug 2018 09:52:56 GMT

Late to the party on this one. As the regulars will recall me saying before I have been in single handed practice for nearly 40 years, the first 30 or so of which I was on call 24/7 apart from when I could arrange with a local practice to cover for me (and even before that working for someone else, right from when I qualified I was happy doing OOH on my own). If we had emergencies OOH my wife would come in and act as nurse and the children came with us it wasn't until some time into my solovet career that I employed, or even thought about, nurses who would be on call. I still managed to have a reasonable social life and train for running and bike racing albeit admittedly I took a chance on not being called out on occasions. But before someone revisits the Four Yorkshiremen sketch, none of this is the point.

I don't recall being stressed or not being able to cope in fact I relished the challenge and it wasn't until I got older when the family had grown up and I wasn't racing etc and actually had more time to do it that I started to resent the OOH work. Having outsourced my CPD now for nearly 10 years the thought of doing it again fills me with dread and I even start to panic when an emergency comes in during normal hours. Paradoxically my confidence has decreased with age not improved and unless I could rekindle my youthful enthusiasm there is no way i would do OOH again now,

RE: OOH work

Evelyn Barbour-Hill — Mon, 06 Aug 2018 22:35:05 GMT

It's too late to change phraseology now, I guess, but I'm sick of hearing about "work-life balance". Are you not alive when at work? Is work not life? Don't you do any work when not at your paid employment?

"Work-play balance" would be fairer.

RE: OOH work

Liz Barton — Mon, 06 Aug 2018 22:00:43 GMT

A few points here:

- having a family is restrictive for OOH work, unless you have childcare in place from spouse / family / OOH childcare provider. I know of excellent emergency vets who simply cannot get this childcare in place so have had to swap to jobs with no OOH.

- so actually the best time to do OOH is before you have additional responsibilities... generally earlier in your career.

- BUT we do live in an age where fear of complaint and mental health are increasingly issues for young professionals

e.g. social media vet bashing never used to exist, and - whatever your take on this - mental ill health in society is increasing and our profession has a particularly bad record.

- However, there are far more resources to aid inexperienced vets - this forum for one, but numerous groups and online resources accessible 24/7. Virtual backup has never been so good!

- On the work-life balance front, it's entirely possible to have a good work-life balance and work OOH, but it does require a sympathetic rota (not the 100+ hour weeks I started out on).

- I wonder if new grads more concerned about work-life balance or gripped by fear of getting something wrong OOH and the consequences of this? Or both??

RE: OOH work

Sammy82 — Sat, 04 Aug 2018 19:06:16 GMT

We are in the situation described by Gillian as well, my partner is a chef. No OOH work as such but his normal working days end at 10pm, sometimes later, he is usually home by 11pm. Assuming that we would find a childminder/nursery for our 1 year old that allows pick up after 7pm (my finishing time when on call), who's gonna look after our son if I was called out between 7pm and 11pm? Weekends are naturally the busiest days in a restaurant so my partner hardly ever gets a Saturday or Sunday off. We didn't have any family near my previous job. 1 in 3 rota with no option to do less/drop out OOH. This was one of the major reasons why I did not return to my job after my maternity leave but found myself a part-time position with no OOH (and closer to family) instead.

RE: OOH work

Anthony Todd — Thu, 02 Aug 2018 23:06:04 GMT

[quote user="Gillian Mostyn"]I actually think doing OOH is good for new grads[/quote]

So do I. I hope experienced vets and particularly practice owning senior vets would embrace new grad's. doing OOH calls, but where they would be available for advice, at least.

My first bosses were, and I bet most of the experienced vets on here would, ['cos they've all been through situations where they were very much in the leaky boat heading for the rocks or a hard place...]

Let's face it

1 visit and euthanasia cat 2. euthanasia cat in surgery .3 check road accident fractured canine dog 4. testicular torsion dog 5, stick injury dog 6. Pug with melting cornea 7. Graft corneal injury 8. Cat with CRF 9. HGE springer spaniel 10. Anorexic Bearded Dragon with N-stage hepatic lipidosis.

are the sort of cases that could occur during the day, not too difficult, but an experienced voice, as backup, would make an enormous difference if it is offered.

It's a confidence thing as well as an experience thing!

Nothing worse, and I well remember, being on your own and not the faintest idea of what to do next......

"Ring me if you want" [er, not a dinovet like me] would do wonders!

RE: OOH work

Gillian Mostyn — Thu, 02 Aug 2018 18:56:57 GMT

[quote user="Evelyn Barbour-Hill"]But your explanation has only been for the rather special case where a) the veterinary surgeon is married (or shacked up or whatever) and b) the spouse is also a veterinary surgeon.[/quote]

Lol...no, it really isn't. We're really not the only profession/trade that has to work evenings, weekends and be on call! I have a two friends I can think of now... a locksmith and an undertaker, who both participate in an on call rota.

I actually think doing OOH is good for new grads, and it would be beneficial for it to be included in the PDP. All I am saying is that as the demographics and expectations of the workforce are changing, it is a good thing that there are plenty of positions where doing no OOH is an option. It can be a significant barrier to working for many people.

[quote user="Evelyn Barbour-Hill"]We never counted the hours in some sort of jealous comparison, but I certainly spent a very substantial amount of time doing that. [/quote]

Another lol. Neither did we. I just meant Ian did the same job as me, both with the kids and with the practice. Many men don't do the school run/food shop/toddler group etc. ... they just do the 'quality time' thing on the weekend. Thus some Dads (obviously not yourself) never quite have the same experience of parenting, or build the same close bond, as the mum. Obviously that is fine if that is their choice....but my point is that there should be choice!!!!

I also know of two other older vet couples in Bury where the wife gave up vetting after having children, and never went back to it afterwards.

Oh....and babies are only exclusively breastfed for 4-6 months. Ian was fully able to feed them after that too!