Out of hours duties as a student

Re: Out of hours duties as a student

sarah mason — Fri, 08 Jan 2010 22:55:24 GMT

I think form nursing patient care point of view i like the fact that students do overnight care in the university hospitals, i think the vast majority improve a great deal over even a short week... and most people seem to think it is of value.I agree that emergency training is probably better gained in a dedicated emergency clinic or on the job, like you say, students dont get a huge amount of exposure or involvement to these.

Re: Out of hours duties as a student

Hanna Bennett — Fri, 08 Jan 2010 16:18:47 GMT

i would agree with Gillian, just a willingness to have a go at things, but the sense to call for help when needed,. i think having good qualified nurses available helps too, as they can advise on simple things that the new vet might not feel comfortable asking a more senior vet for, and it takes the pressure off getting a catheter in when you know someone else can do it for you if need be

Re: Out of hours duties as a student

Gillian Mostyn — Fri, 08 Jan 2010 08:10:08 GMT

Actually - I don't really care. Just the fact that someone has spent X amount of weeks in an OOH setting tells you nothing - some people would have got really involved and learned loads - others would have decorated the wall. Also, apart from putting in catheters and setting up drips, a student participates very little in the emergency situation. I would have said that of all the different areas, emergency medicine is something the student needs to learn in theory but is unlikely to do until they are a vet themselves! That is why they need a first practice that is understanding of that......

Re: Out of hours duties as a student

sarah mason — Fri, 08 Jan 2010 02:52:12 GMT

For all you employers out there. what is the minimum ooh training you would like/expect your new grads to have?

Re: Out of hours duties as a student

Rebecca MacMillan — Wed, 06 Jan 2010 20:39:38 GMT

[quote user="sarah mason"]

RVC do the ooh for lots of neighbouring practices so presumably get more emergencies?

[/quote]

Yeah, we had quite a few first opinion things come in which was useful as well as emergency referrals. I saw things such as the pug caeser, ingested rat poison, collapsed dog etc. I think we had a magpie pts as well late Sunday afternoon lol! But we didn't get loads of things, most of the night in emergency critical care (ECC) was spent looking after the in patients in intensive care

Re: Out of hours duties as a student

sarah mason — Wed, 06 Jan 2010 01:55:57 GMT

It depends on the uni really-we don't get so many small animal emergencies ooh at Liverpool, 3 last weekend for example. RVC do the ooh for lots of neighbouring practices so presumably get more emergencies?

The students are here to help with patient care, checks and emergencies. when I was a student I only remember seeing 1 new emergency during my small animal ooh, and we had a few in patients develop arhythmias etc which I would consider examples of useful learning situations.

Maybe students should be advised to do a week on nights ems at vets now or equivalent to gain experience of seeing emergencies?

Re: Out of hours duties as a student

salome2001 — Tue, 05 Jan 2010 22:47:42 GMT

my experience was Sydney Uni in the early 90s so no idea if it;s still the case but I don't recall doing a lot of emergency work at all while a student. Certainly not on our work experience in private practice (small or large). Of the university hospital rota we had late nights (sometime all night) if you were on surgical or anaesthesia rota, and I remember doing the odd colic with the large animal residents, but other than that, no. Probably about 5 -10 nights in 2 years. I may be wrong, but my recollection is that the residents/ interns did the emergency shifts.

Re: Out of hours duties as a student

Gillian Mostyn — Tue, 05 Jan 2010 20:35:51 GMT

Yeah - I have noticed new grads seem to want to just give anything complicated to another vet rather than tackle it themselves, obviously with help. I am always happy to help with any procedureas as many times as needed until they are confident (our current new grad is doing brilliantly and WANTS to do as much as possible). - but it is frustrating when someone doesn't even want to try....

Re: Out of hours duties as a student

Hanna Bennett — Tue, 05 Jan 2010 20:10:12 GMT

i have absolutely no problem with being back up on call, will happily come in and help with caesars, enterotomies/enterectomies etc for the first few times as i remember how scary they were to start with, and the new grads are told to phone if they have any concerns, but sending complicated things to vets now rather than phoning me to come help them cos it's getting late and they can't be bothered to stay and sort it does my head in. emergencies present out of hours, that is the nature of them!

Re: Out of hours duties as a student

Rebecca MacMillan — Tue, 05 Jan 2010 20:03:27 GMT

As a new grad, I am willing to do new things but prefer it to be under supervision for at least the first time I do it. I think this is reasonable and not too much to ask from an employer that willingly takes on new grads. I appreciate it can be frustrating for the more experienced vets when it's busy or out of hours, and means that two vets are working on the one procedure, but it is extremely necessary otherwise how do we know we are doing it correctly? I must admit I am struggling to build up my confidence with the large animal side of things because of the lack of help whilst out on visits and the fact I don't do much of this work on a regular basis. But that's just me, and I like to have reassurance when I'm doing things for the first time

There is a difference however between point blank refusing to do something ever and doing it with a bit of help the first time/s, I'm not sure if this is what you were referring to Gillian?

Re: Out of hours duties as a student

Gillian Mostyn — Mon, 04 Jan 2010 21:10:04 GMT

I have found the same - with one new grad we had I got cheesed off with the phrase ' I can't do that because I haven't done it before'. She's left now but I never did figure out how she managed to do anything at all in that case......

Re: Out of hours duties as a student

Hanna Bennett — Mon, 04 Jan 2010 19:47:54 GMT

i also think students need to see emergencies, as our new grads have little experience with these, and while we do back them up on call it would help if they had a little more confidence in these situations. Although i have to say some of ours seem to be scared of the idea of new procedures - avoiding these if possible - where i remember wanting to get my first experience of so many emergencies out of the way as soon as possible so i had a little more confidence the next time the same thing presented.

Re: Out of hours duties as a student

Gillian Mostyn — Mon, 04 Jan 2010 15:00:49 GMT

I'd say (1) - trying to work all day and all night is pointless - you would learn nothing.

Ideally, a bit of (2) during EMS would be useful - large animal practices are very likely to do their own OOH still.

Re: Out of hours duties as a student

Hanna Bennett — Mon, 04 Jan 2010 12:09:22 GMT

suppose there are more practices these days that outsource ooh work so maybe not the same as it once was, but surely preparation for the broken nights is not a bad thing? Get used to it before you are the responsible person!

Re: Out of hours duties as a student

sarah mason — Mon, 04 Jan 2010 01:53:52 GMT

What do people think are the best ways of doing small animal ooh-in terms of preparation for future career:

1. dedicated nights, looking after emergencies/in patients-days to sleep

2. doing in patient checks overnight/weekends while on clinics during the day-with broken sleep

3. rotating days and nights

all would be for say 1-2 weeks

Re: Out of hours duties as a student

Rebecca MacMillan — Wed, 30 Dec 2009 22:17:56 GMT

At RVC we did 7 nights on equine, so looking after in-patients and helping with any surgery or emergencies that came in and four nights in small animal emergency critical care, looking after in-patients and doing ooh consults. Then during our week in the farm hospital we had to look after in-patients at night as well as stuff during the day, which shared between 5 of us in our rotation group worked out to be a few nights each. Plus we had a couple of nights on call for whatever rotation we were currently on - I only got called out once in my entire time on rotations, during anaesthesia, for a pug caesarian!

I think the worst bit was going from equine nights, completing our shift on Monday morning, and starting equine imaging, which began also on Monday morning. It was painful trying to stay awake in a darkened room! College have now changed the equine night shifts slightly, as when I did them you were expected to be there for evening rounds at 5pm, through to 10am the next morning when morning rounds finished, thus leaving just under 7 hours for sleep, food, shower etc. Equine night shifts were 17 hours long for a whole week, compared to just four nights of 12 hour shifts in the small animal department, which felt like a breeze in comparison. Now I believe rounds start later in the evening and you also don't have to stay for morning rounds, so you get to go to bed sooner! However, despite the tiredness, I really enjoyed that rotation in that it made most students really bond and work as a team, plus you had a great feeling of responsibility. The constant colic checks through the night also made me feel much more confident at examining horses than I did before.

Re: Out of hours duties as a student

Hannah Wynne Richards — Tue, 29 Dec 2009 11:23:53 GMT

We did a total of 15 weeks OOH during term time. During EMS a lot depended on practices. I stayed with the veterinary surgeons mother-in-law, and he would phone me whenever an OOH came in (foster practice ) so another 18 weeks there That was Bristol Cambridge students at that time only did 1 week on-call intra-murally, and obviously EMS would vary

Wynne

Re: Out of hours duties as a student

Noweia — Tue, 29 Dec 2009 09:41:31 GMT

In Glasgow we all did 4 weeks of hospital care - 2 2-week blocks of a week of days and a week of nights. It wasn't emergency stuff as such - if anything came in we helped the intern cover it, but it was more looking after all the in-patients in the hospital at the time.

Then if you did farm track, you did 2 weeks in the equine hospital (and shared the OOH there - usually you did about 3 nights doing on-call and in-patient treatments) and 2 weeks at a local busy farm practice (again, 3-4 nights on-call and going out with the vets when a call came in).

If you did the equine track you did 8 weeks in the equine hospital, and correspondingly more nights on call.

Maybe I was cursed and never saw an emergency come into the hospitals, maybe I was lucky - but all my on-site OOH did was teach me patient care!

Re: Out of hours duties as a student

sarah mason — Mon, 28 Dec 2009 21:18:32 GMT

How much on call/out of hours did everyone do on small animal (or overall?). In Liverpool at my time we did 1-2 weeks on small animal, a few nights on farm, and probably about 4-5 nights and a weekend on equine. Plus the on call for whatever elective you did.

Re: Out of hours duties as a student

Gillian Mostyn — Thu, 24 Dec 2009 21:16:04 GMT

I feel the most useful thing I learnt during emergency rotations was responsibility. During normal working hours you're always surrounded by other students and vets. At night time/weekends you're far more likely to have to work through a problem yourself, and if you don't know, look it up in a hurry. In other words, it's far more like being a 'real vet'.

Re: Out of hours duties as a student

Lucie Allcutt — Wed, 23 Dec 2009 23:46:58 GMT

I'm still a student :-)

I'm not sure how 'out of hours' works at all UK universities, but here at the University of Florida we don't have any specific student time as such set to receive emergencies (yet! there is talk of setting up an Emergency and Critical Care rotation that will do nothing but take in small animal emergencies). How the system works currently is that while you're on Small Animal Medicine (a month long rotation) you are on "teams" and Team A will do triage during the day and Team B will see appointments (and the students will switch around weekly), then there are on-call schedules that the students have to cover for overnights (with an intern there as well, of course).

Every other rotation will also have on-call schedules for the students, and once it's been triaged if it is applicable to a specific specialty (an ophtho emergency - the ophtho on-call student comes in, if a neuro emergency...etc.) that student will come in and take over the case.

I have found my on-call time to be terrifying (at first!), but ultimately extremely useful. :-) The only on-call I deeply resent is when on large animal anything. Those 3am colics!!! Ugh!!

I go back on clinics as of January 4th...so more on-call time is coming my way!

Re: Out of hours duties as a student

sarah mason — Wed, 23 Dec 2009 23:32:58 GMT

It would be really good to get some more feedback on this one........

Re: Out of hours duties as a student

sarah mason — Tue, 22 Dec 2009 22:51:27 GMT

I was probably a bit geeky, I used to write down the names of the medications we were giving and then go and look them up in the formulary.

I was also a student at Liverpool, 2005-2007 clinical years and we had quite a busy small animal case load by then we used to do the ooh either in vacation, so you worked 8am until all the checks were done, and then started again at 3-4pm through the night depending on how busy it was 2-4 hourly checks, so you used to get about 4 hours sleep per night and maybe 3-4 during the day if you were lucky. If you did it during term time you were on rotation all day as well which obviously was a lot more tiring.

Re: Out of hours duties as a student

Clive Ansell — Tue, 22 Dec 2009 11:04:22 GMT

Although it sometimes seemed like an endurance test at the time, 4th and final year rotations on call were on the whole good fun and I learned one heck of a lot, particularly on Equine rotations with Prof Edwards and all those surgical colics. Small animal was not so good, as non or very little case load, but we did spend a lot of time studying the indigenous prostitute population of Liverpool that used to gather on Crown street below (On a purely observational only basis of course )

Re: Out of hours duties as a student

Hannah Wynne Richards — Tue, 22 Dec 2009 10:24:51 GMT

Definitely not recently qualified, but in my time at Bristol, we were clerking, i e on call alternate weeks Very worthwhile. I learned an enormous amount, especially when on large animal medicine, as Mr Pinsent was always prepared to properly discuss patients (never cases ) with students, and the responsibility meant that I was able to discount later confidence -sapping "colleagues "

Wynne