Forum Netiquette

Re: Forum Netiquette

Arlo Guthrie — Fri, 14 Oct 2011 08:43:58 GMT

[quote user="Martin Jones"] Sorry to be putting flies in the ointment, Arlo - the three strike rule is a good one (although would it be possible to let the strikes drop after a certain period of 'good behaviour' - as with penalty points on a driving licence). But what of anon posters who are doing the same kind of stuff: how would you yellow card that individual?

Does it show on the profile, or perhaps as a signature?[/quote]

Hi Martin,

Not sure about letting the strikes drop after a period of time. I think the two strikes, then suspension, then out is probably enough chances.

Fair point about Anon posters, and I think the solution to that one is just to enforce the existing rules more rigourously.

The rule says that the anon account is for seeking advice from colleagues. I have allowed some anon posts which were not used for that purpose in recent days, because by the time I saw them, others had replied, with good answers.

From now on, any post by the anon account which is not for the purpose of seeking advice will be deleted, regardless of subsequent posts.

It would help me enormously if a) you (by which I mean everyone) see an anon post which is not asking advice, you ignore it. DO NOT REPLY. It makes it harder for me to delete it later if doing so renders subsequent posts meaningless. b) you alert me to any anon posts which break that rule.

Re: Forum Netiquette

Simon Neuhoff — Fri, 14 Oct 2011 07:39:38 GMT

You must admit though Anthony you have a much better chance of achieiving good results with the correct setup and the corrrect euipment and procedures. This obviously needs to be coupled with the right knowhow and expertise but if your starting point is shoddy your results will always be shoddy.

Re: Forum Netiquette

Anthony Todd — Fri, 14 Oct 2011 02:45:12 GMT

[quote user="Bob Russell"]We should be improving standards not finding out what level they can drop to that we can get away with.[/quote]

Well, to a point.

What we really should be aiming for is to improve results which implies, in most cases, an improvement of, or the best, standards.

Trouble is that the two measurements are not interchangeable nor necessarily related and just because you operate in a state of the art theatre with all the kit and hot and cold running nurses doesn't mean your results, which after all is the true criterion, will be better.

Sometimes, some people forget this.

Re: Forum Netiquette

Mark Hedberg — Thu, 13 Oct 2011 20:37:41 GMT

I'd give that last post six stars if I could.

Re: Forum Netiquette

Edward Jones — Thu, 13 Oct 2011 20:33:41 GMT

[quote user="Bob Russell"]We should be improving standards not finding out what level they can drop to that we can get away with.[/quote]

This should apply to the netiquette between professionals also. Why shouldn't it?

Re: Forum Netiquette

Martin Jones — Thu, 13 Oct 2011 19:54:33 GMT

Sorry to be putting flies in the ointment, Arlo - the three strike rule is a good one (although would it be possible to let the strikes drop after a certain period of 'good behaviour' - as with penalty points on a driving licence). But what of anon posters who are doing the same kind of stuff: how would you yellow card that individual?

Does it show on the profile, or perhaps as a signature?

Re: Forum Netiquette

Arlo Guthrie — Thu, 13 Oct 2011 18:35:28 GMT

OK - having given the whole thing an enormous amount of thought (and worry), I have posted updated forum rules, which are now linked to from the top of the forum home page.

The purpose of the rules is to try and ensure the site retains (or should I say regains) the welcoming, collegiate atmosphere that is so vital to the site.

The most substantive change to the rules is the introduction of a 'three strikes' rule for any posts which are unkind, discourteous, impolite, belittling, condascending, you get the picture.

I stress, the purpose is NOT to stifle debate in any sense, but rather to ensure the highest standards of professional courtesy.

Any objections, speak now, or forever ...

Dives for cover.

Re: Forum Netiquette

Gerry Henry — Wed, 12 Oct 2011 14:48:34 GMT

[quote user="Bob Russell"]

We should be improving standards not finding out what level they can drop to that we can get away with.

[/quote].

In a nutshell.

Exactly.

Re: Forum Netiquette

Hannah Wynne Richards — Tue, 11 Oct 2011 13:56:24 GMT

I agree Amanda

Wynne

Re: Forum Netiquette

Amanda Nicholls — Mon, 10 Oct 2011 16:04:54 GMT

Not having read the original thread I might not be aware of all the facts, however, the way I see it is that surgery in more basic conditions such as on a kitchen table may not carry a much greater risk for the patient than if performed in a veterinary hospital, the point is if gold standard care is readily available (as it is in the UK) it should be used.

I have operated on dogs in Africa under sedation and local, on the kitchen table, with instruments boiled in a saucepan because without me doing my best under the circumstances they would have been PTS, I have not had any post op complications but would I want that for my own dog - heck no! I want an ET tube, gas anaesthetic, continuous monitoring (human and machine), sterile kit etc etc.

The risks may be small but why take them if a better standard of care is available? I fully support mobile clinics for vaccinations and PTS to reduce stress for the patient but absolutely not for sedations or operations. I

Re: Forum Netiquette

Hannah Wynne Richards — Mon, 10 Oct 2011 13:23:01 GMT

Total agreement Bob

Wynne

Re: Forum Netiquette

Bob Russell — Mon, 10 Oct 2011 12:32:50 GMT

As the main culprit I apologise for the tone of my posts in response to the original post. I do not, however apologise for my views and stand by my opinion that operating on the kitchen table except in the most dire of emergencies is not acceptable in 21st century Britain.

The comments I made relating to spelling were not acceptable and I again apologise for that. I do expect a vet to know how to spell oxygen. I have worked with and refer to a number of first class foreign vets for whom I have nothing but respect.

It may be the done thing to operate on the kitchen table in some other European countries. I accept that injectable anaesthetics are quite acceptable, infection is probably not a particularly increased risk. Our clients trust us to make judgments about risk and how procedures are to be carried out but they make basic assumptions (sometimes wrong) about our competence.

If someone is saying should we allow third world practices to become established in the UK then my response is No!

Would VDS defend surgery on a kitchen table? I very much doubt it.

'Dog dies on kitchen table during routine surgery at home!' - sounds like a good Daily Mail headline. Bringing the veterinary profession into disrepute? I think so.

Mobile clinics are an interesting idea and one I am happy to support but not like this. All staff members here were horrified and the subject was discussed in great depth.

We should be improving standards not finding out what level they can drop to that we can get away with.

Re: Forum Netiquette

Clive Ansell — Mon, 10 Oct 2011 10:51:18 GMT

[quote user="mariette asselbergs"]

No sterile conditions on a kitchen table? Certainly no operation theatre microbial flora!

No inhalation anaesthesia? Many surigical procedures on healthy animals can be safely and legally done with injectable anaesthesia.

No demand for home surgery? I have removed terrible huge mammary tumours from old (14 year old) farm dogs on the farm ("kitchen table) under deep sedation and local anaesthesia with good results. The dogs would otherwise have been put to sleep (or shot) or left to linger until ulceration and general debility would have forces euthanasia.

I have also castrated and neutered cats at home, without the stress of transport, waiting rooms, surgery kennels etc. Falling asleep on the owner's lap, waking up at home.

It is not impossible to work carefully and conscientiously and create good sterile conditions and acceptable safe anaesthesia in healthy animals at home or on farm. Having worked many years in Africa or rural conditions have given me the confidence to defend this. And yes, do some voluntary work in the middle East or greece or Spain and see how well vets can work under modest conditions instead of rubbishing somebody as if that is barbarian.

Mariette

[/quote]

I don't think there is, or should, be a place for this within small animal surgery in the UK.

Yes, sometimes injectable only anaesthesia is fine, I have castrated 3 cats this morning using just that. I would however only carry this out at the surgery and not in someones home, as I would want the back up and support of the necessary drugs, oxygen, equipment and trained staff in the event of an anaesthetic or surgical emergency.

what would you have done if the 14 year old mastectomy case had suffered cardiac or respiratory arrest, or severe haemorrage on the kitchen table and you didn't have adequate support? would the VDS defend it? what would the RCVS say in the event of a client complaint if things went wrong?

Re: Forum Netiquette

Clive Ansell — Mon, 10 Oct 2011 10:38:10 GMT

[quote user="James Laidlaw"]

Having worked in a variety of clinics in the UK I think I can safely say that some peoples' kitchens are a fair site more sterile than a number of operating theatres... I don't condone the practice, I also won't flame anyone for the post, but there is some fairly shady practice going on in vet clinics across the UK with or without people operating in peoples houses as it is.

[/quote]

I agree. I have worked in a few practices where an upward progression to a kitchen table would be a huge leap forward. I have worked in places with no bottled oxygen or inhalation anaesthesia, one used ether in an old glass Boyle's bottle, a butchers bench for an operating table with a single light bulb above it, and another that had no autoclave with instruments being boiled in an old saucepan. Maybe they should be marketed as working museums?

Re: Forum Netiquette

Mark Holmes — Sun, 09 Oct 2011 20:49:59 GMT

It's only a few months ago that I saw a UK vet performing a cystotomy on a blocked cat in what could only be described as an "office" . The cat must have recieved DTK or similar. Had no tube and no ga monitoring other than the vet performing the op. It was on a TV Program. Cannot recall which and it wasn't specifically about the vet if I recall. I wish I could remember more details but I remember my eyebrows raising considerably. To be honest I wasn't that worried about the minor ops bit in the post. She didn't say what type of surgery was proposed. I had assumed the odd stitch up, which can be successfully done with local and sedation. I did not think - Bitch Spey on the kitchen table.

Re: Forum Netiquette

Tim Cheyne — Sun, 09 Oct 2011 20:34:13 GMT

When I was a schoolboy 'assisting' the local vet I saw many SA ops done on the consulting room table (equivalent to the kitchen table but a more comfortable height) under IV anaesthesia (sodium thiopentone for short duration procedures, pentobarbitone sodium for longer ones). Apart from ether for SA and chloroform for horses, gaseous anaesthesia was uncommon. Operating gowns were conventional white coats (to prevent spurts of blood spoiling the shirt); drapes and instruments were boiled, hands were scrubbed but gloves were rarely worn.' Antibiotics were primitive even if available.

It was explained to me that rather than attempt the impossibility of a sterile environment, the aim was a sterile 'field' where the operation site was as clean as possible and anything entering that zone was either clean or sterilised. The surgery was careful and meticulous.Recovery rates were good and mostly uneventful and many animals lived that otherwise would have died. I do not consider that animal welfare was compromised in any way.

Working overseas for many years I have, of necessity, used that concept successfully in large animals and seen many others do the same in small animals. Although in terms of client expectation it might be necessary in UK to appear to re-enact a scene from Holby Hospital, it is possible to achieve successful results with fairly basic (old-fashioned?) techniques and I hesitate to criticise a veterinarian that chooses to follow them competently.

Tim.

Re: Forum Netiquette

Arlo Guthrie — Sun, 09 Oct 2011 19:58:05 GMT

[quote user="Mark Hedberg"]

Because anonymity is useful for saying whatever you like without fear, retribution, or ridicule. I do feel this isn't what Arlo intended the Anon MRCVS for, but that's my own personal opinion.

[/quote] One I share with you, as it happens. The only reason I have not deleted those posts by Anon is that the responses have been so robust. But Anon, that's enough of that please. It does say in the rules that the Anon account is categorically NOT for having a pop at another member.

Re: Forum Netiquette

Mark Hedberg — Sun, 09 Oct 2011 17:36:06 GMT

[quote user="Evelyn Barbour-Hill"]

[quote user="Mark Hedberg"]

[quote user="robloxley"]

[quote user="An On MRCVS"]

Firstly, there are no degrees of sterility. Something is either sterile or not.

But the cleanliness of the environment is not the point. One can hardly create a sterileoperating field in a kitchen...but more importantly, one cannot use proper anaesthetic techniques. She mentioned gaseous oxygen, but apparently only for use in emergencies. It would appear that she wasn't planning on using gaseous anaesthesia. God I don't know why I'm bothering arguing this. Operating on a kitchen table in the 21st Century....

[/quote]

Sorry, in what way does this reply need use of an anonymous log-in?

Or indeed the following?

[/quote]

Because anonymity is useful for saying whatever you like without fear, retribution, or ridicule. I do feel this isn't what Arlo intended the Anon MRCVS for, but that's my own personal opinion.

[/quote]

Well, just remember that if you choose to employ the anonymity facility, all your readers will be wondering and assessing why you wished to hide your name, and their conclusions may well influence subconsciously their assessment of your arguments.

[/quote]

True...plus, if right before a post like that, we have a member asking how to use the anonymity feature, one could accidentally suspect an innocent member of being the anonymous poster!

Re: Forum Netiquette

Evelyn Barbour-Hill — Sun, 09 Oct 2011 16:57:34 GMT

[quote user="Mark Hedberg"]

[quote user="robloxley"]

[quote user="An On MRCVS"]

Firstly, there are no degrees of sterility. Something is either sterile or not.

[/quote]

Sorry, in what way does this reply need use of an anonymous log-in?

Or indeed the following?

[/quote]

Because anonymity is useful for saying whatever you like without fear, retribution, or ridicule. I do feel this isn't what Arlo intended the Anon MRCVS for, but that's my own personal opinion.

[/quote]

Re: Forum Netiquette

mariette asselbergs — Sun, 09 Oct 2011 16:44:08 GMT

No sterile conditions on a kitchentable? Certainly no operation theater microbial flora!

No inhalation anaesthesy? Many surigical procedures on healthy animals can be safely and legally done with injectable anaesthesia.

I have also castrated and neutered cats at home, without the stress of transport, waiting rooms, surgery kennels etc. Falling asleep on the owner's lap, waking up at home.

Mariette

Re: Forum Netiquette

Mark Hedberg — Sun, 09 Oct 2011 14:00:34 GMT

[quote user="robloxley"]

[quote user="An On MRCVS"]

Firstly, there are no degrees of sterility. Something is either sterile or not.

[/quote]

Sorry, in what way does this reply need use of an anonymous log-in?

Or indeed the following?

[/quote]

Because anonymity is useful for saying whatever you like without fear, retribution, or ridicule. I do feel this isn't what Arlo intended the Anon MRCVS for, but that's my own personal opinion.

Re: Forum Netiquette

Rob Loxley — Sun, 09 Oct 2011 13:07:30 GMT

[quote user="An On MRCVS"]

Firstly, there are no degrees of sterility. Something is either sterile or not.

[/quote]

Sorry, in what way does this reply need use of an anonymous log-in?

Or indeed the following?

Re: Forum Netiquette

An On MRCVS — Sun, 09 Oct 2011 12:59:32 GMT

[quote user="Mark Hedberg"]

Now we have not only insulted a colleague, she'll be sure to warn all her friends what an awful bunch of people we are.

[/quote]

I repeat, she is no colleague of mine. And if she warns her friends who want to come to the UK and do bitch spays on kitchen tables that they will get a frosty response, well, good.

Re: Forum Netiquette

Mark Hedberg — Sun, 09 Oct 2011 12:47:42 GMT

[quote user="An On MRCVS"]

Firstly, there are no degrees of sterility. Something is either sterile or not.

[/quote]

Good question. Why are you arguing this? Ever been on a neutering clinic in the Middle East or Asia? Hell yes it's not UK standard operating rooms. Fold-up card table on cinder blocks (I'm tall) and no nurses, just a bunch of good hearted volunteers.

Gas? Only if you had the 5 bean chili for dinner!

When there's nobody else and no other way, you can do a lot with very little. The UK can support a better way…so I agree kitchen table surgery isn't the way here. But she wasn't proposing heresy. Just a method inappropriate for the UK's requirements.

All we had to do was reply " listen, due to health and safety, and the fact that your target market expects more in terms of anesthetic safety and drug security, this isn't a good idea. Nice that you are trying to supply a perceived need, but this is not a correct solution".

Now we have not only insulted a colleague, she'll be sure to warn all her friends what an awful bunch of people we are.

Let me be clear. I think her business idea was a bad one for the UK. i also think the 24 hour provision is an important part of our duty as veterinary surgeons. I am not in any way supporting what I feel is a poorly thought out plan. But she deserved a courteous, scientific answer.

Re: Forum Netiquette

James Laidlaw — Sun, 09 Oct 2011 11:54:42 GMT

There are a large number of vets who do spays in prep areas under injectable anaesthesia. There are a large number of vets that don't scrub properly. There are a large number of vets that don't factor sterility into their clinical procedures. I had a boss step in and put their hands into an op without scrubbing after coming back from a farm visit during a spleenectomy.

I'm not condoning kitchen surgery, in fact I don't think it should be considered either, I just think you need to realise how much poor practice goes on in clinics across the UK and around the world before you can judge others. All you can do is practice the best medicine and surgery you can and try to encourage those around you to do the same if they don't already. I think slamming someone for not knowing or doing the "right" thing is not the way to either get your view across in a way that might change their mind or encourage others to practice better.