hey vets in practice... advice? thoughts?
I've been working Saturdays for the past month at a practice up in Escondido. Initially I really liked the practice (I still do, actually), but today I was hit with the full force of a normal Saturday for this place, and there are some things upsetting me.
The only places I've worked thus far were relatively slow-paced, which was fine for someone that was a relatively recent grad. This place sees 15 minute appointments. That's fine when it's a wellness package, etc. It is not fine when it's a 16 year old cat with history of on and off vomiting/inappetance for the last few years, vomited 4 times the past 24 hours, mildly elevated liver enzymes with nothing else worriesome on bloodwork, salivating, but not clinically dehydrated. X-rays seemed to show a mass effect in the caudal right abdomen. I thought I palpated a mass, but am still unsure. I recommended ultrasound, but the owner decided to wait and see what the bloodwork showed that we sent out. This case keeps nagging me, and I wonder to myself whether I should have sent him to the ER for monitoring. I worry that there's a blockage, even though there was nothing obvious on radiographs. The cat still wants to eat, but there was food in the stomach 4 hours after he had eaten. There's so much more I'd have liked to have done. But I had 5 other appointments stacking up on top of it.
I'm worried about him. I don't like this feeling, and I don't like the feeling that I'm doing a shitty job because I'm too overextended with cases at all times. This isn't the way I'd choose to run a hospital; I feel as though I'm gipping clients like this. You folks that have been in practice for a while -- have you ever felt this way??? It's the first time I've gotten to experience a busy full-service practice, and I'm finding that it leaves me really dissatisfied. I'm also unhappy with the cursory write-ups I did for these cases because it's all I had time to do. I don't know whether this is just the norm for most general practitioners or whether I really am just doing as crappy a job as I feel like I'm doing.
The only places I've worked thus far were relatively slow-paced, which was fine for someone that was a relatively recent grad. This place sees 15 minute appointments. That's fine when it's a wellness package, etc. It is not fine when it's a 16 year old cat with history of on and off vomiting/inappetance for the last few years, vomited 4 times the past 24 hours, mildly elevated liver enzymes with nothing else worriesome on bloodwork, salivating, but not clinically dehydrated. X-rays seemed to show a mass effect in the caudal right abdomen. I thought I palpated a mass, but am still unsure. I recommended ultrasound, but the owner decided to wait and see what the bloodwork showed that we sent out. This case keeps nagging me, and I wonder to myself whether I should have sent him to the ER for monitoring. I worry that there's a blockage, even though there was nothing obvious on radiographs. The cat still wants to eat, but there was food in the stomach 4 hours after he had eaten. There's so much more I'd have liked to have done. But I had 5 other appointments stacking up on top of it.
I'm worried about him. I don't like this feeling, and I don't like the feeling that I'm doing a shitty job because I'm too overextended with cases at all times. This isn't the way I'd choose to run a hospital; I feel as though I'm gipping clients like this. You folks that have been in practice for a while -- have you ever felt this way??? It's the first time I've gotten to experience a busy full-service practice, and I'm finding that it leaves me really dissatisfied. I'm also unhappy with the cursory write-ups I did for these cases because it's all I had time to do. I don't know whether this is just the norm for most general practitioners or whether I really am just doing as crappy a job as I feel like I'm doing.