My god, I am working at Sketchy Vets.
When I worked at Bedford Vet, I had a running joke going with my co-worker Megan that we were going to start our own clinic which we could call "Sketchy Vets". It was our way of complaining about clients who seemed to put money ahead of their pet's well being - owners who complained that our high quality food was far too expensive for them, or who didn't want to pay 50 dollars for half an hour of the vet's undivided attention. At Sketchy Vets, I would be the veterinarian and Megan would be the tech. We would only charge 10 dollars for an exam, where I would look at the animal but not actually take a temperature or palpate it or anything. We would sell Friskies and Eagle Pak, and when people's cats developed severe urinary infections which blocked their urethra from the bad food, we would simply tell them "Well, it'll cost a 1000 bucks to fix it, but at least you saved that 3 dollars a month on pet food!" We wouldn't waste money on sterilizing instruments or running blood work on an animal, and we certainly wouldn't bother with fluids, so we could do spays and neuters for very cheap. Of course, we could spread infection through our non-sterile equipment and some of our patients would get sick or die, but at least people would have saved 50 dollars on the cost of their spay.
But it was all a joke.
Then I started work on Tuesday.
This clinic is... awful. Actually, the vets seem nice enough, and probably WANT to practice good medicine, but they have become accustomed to the fact that things like organized patient care, swift medical treatment, and careful monitoring of their patients simply won't happen. The clinic is extremely busy, especially on my first day - every single cage was filled, probably amounting to thirty animals. The clinic has NO method of listing the animals in clinic and the procedures that need to be done. Nor are there any attempts at labelling the cages themselves. Which means there were 30 animals stuffed into various cages, and no one had any idea who the animals were, why they were there, or what we were supposed to be doing with them. At one point, they actually spayed the wrong dog. That is, they grabbed the file for a dog that needed to be spayed, and grabbed a dog that needed to be spayed, which was not the dog that the file referred to. Later on, they discovered another dog, and when they started asking people who the dog was, it turned out to be the dog that they thought they had already spayed. Can you imagine if the dog that they spayed first had had an allergy to the drugs they used? Or a vastly different body weight? Or if it had not been in to be spayed at all, but was a show-dog needing x-rays? Can you IMAGINE?
The tech who showed me around (I have not had the guts to ask her, but guessing from the blank looks she gives me some times, I don't think she's an actual tech, but instead is a trained-up layperson) is a foul-mouthed, irritable and bossy little woman whom we will call BCW for Bitchy Co-Worker. BCW has been nice enough to me -mostly- but spends a lot of her time swearing and complaining about things like the fact that someone has written on the dry erase board with a black dry erase marker, the fact that some idiot who only works one day a week actually THREW AWAY some bottle that they like to re-use, the fact that the vet has removed an incontinent and paralyzed old dog from its cage because it has soiled itself and because she wants to examine it (because BCW finds the dog difficult to put back into its cage) and so on. She talks to me like I am an idiot a lot of the time, probably because she has never been to tech school and therefore has no idea what I have learned, or possibly because she thinks she is the only competant person on the planet.
BCW disturbed me on the first day by refusing to get me some rubbing alcohol when I requested it before poking an animal with a needle. She disturbed me more on the second day by complaining about how the orthopedic specialty surgeon who was coming to do a TPLO (complicated bone surgery on dogs who have torn their cruciate ligament) insists on having a well-cleaned surgical suite (she was complaining about this while reluctantly removing a large blood stain from the floor). When I pointed out that bone infections are really hard to deal with, she didn't answer me. She appalled me on the third day by telling me to feed "whatever" to a cat that we had unblocked the day before. I went to the cupboard and while I was looking for some dissolution or s/d, she hauled out some hypogastro and said "there. feed it that. It doesn't matter, he doesn't have crystals". So what blocked him then? A CORK? I noticed that the veterinarian told me to force feed it some s/d today. The vet seems to think the blocked cat should be on s/d. But the tech who has worked there for 13 years seems to think it a waste of time.
She is openly insulting and rude to one of the younger vets who has the unreasonable tendency to want xrays to be readable. On my first day, BCW openly refused to repeat a radiograph, saying that she didn't have time for things like that. So I did the repeats. And the repeats after that. And the next set of xrays needed. And those repeats. And so on. In fact, despite the fact that I don't have a dosimeter yet, I seem to have become radiography bitch, because I am the only person who agrees with the veterinarians that it is important to have a high quality picture so you can, oh, I don't know, DIAGNOSE. Unfortunately, I have to repeat the xrays again and again because I am not allowed to touch two of the most important settings on the machine.
TIme out for vet tech talk - Ridgetown and Bedford girls, read away. Other folks, you might find this confusing, but you can read this part of the rant if you want.
Okay, so I am not allowed to touch the mA dial OR the time dial. Whenever I had tried I have been stopped and told "We ALWAYS leave those at those settings". Which means that ALL radiographs are taken at 10 mAs. Which means that the settings are great for taking pictures of bone, but if you want a low contrast picture, we're pretty much out of luck. There is a technique chart on the wall which can only have been made by someone who had either never taken radiography, or never paid attention during it. I should really list the things wrong with the technique chart in order:
1. The chart has the following categories: Abdomen and extremities, thorax, skull and spine. That's right, Abdomen and extremities are ONE category. Because, you know, extremities are bone shots that should have a low kvp and a high mAs, while abdomen shots should be LCR and therefore HIGH kvp and LOW mAs. Those are the same, right? Why not group them together?
2. All the categories use the same mAs in increments. Yes, INCREMENTS. For table top shots, apparently, we only use 10 mAs. For Bucky shots we are apparently supposed to up it to 30 mAs. I'm not sure why. And for the really big animals, you know, that need a high kvp to penetrate through, it recommends an mAs of 60 - so one can melt the machine and never have to deal with radiography again, I guess.
Gee, I wonder why the staff soon found that leaving the dials at 10 mAs worked better than following that part of the technique chart?
3. Focal film distance does not change according to whether you are using table top or bucky.
Staff have found that by adjusting KvP back and forth, they can relieve the intense darkness which is brought on by the high mAs. Of course, that means that you don't get a lot of detail on thorax shots, but at least you can kind of see the lungs. Lung shots are the worst, because the high mA means that I have a lot of trouble getting the detail that the veterinarian wants, and have to redo them again, and again, and again. I was sent in to do MORE lung shots today and as soon as the door closed, I turned to the kennel girl who was helping me and asked her if the whole not-touching-the-mA-dial thing was a hazing ritual. Maybe they were all sniggering at me, watching me trying to get a high detail shot with an mA that made things so dark that I needed to turn the kvp WAY down in order to compensate for it, and therefore losing the detail that the vet wanted. It was the only thing that made sense. Kennel girl was sympathetic, but assured me that no one ever touches those dials.
So they really DO use 10 mAs for everything. I believe the book recommends like 1-3 mAs for abdomen, 5-6 for thorax and 8-12 for bones. I just KNOW that if they would let me touch those dials I could make a technique chart that actually WORKS in a matter of days, and then people (i.e. myself) wouldn't need to spend an entire day wrestling the same poor critter onto a table again, and again, and again. But I just know that if I messed with the dial, and it didn't come out, people would say "see? It doesn't work. Leave it the way it is." Never mind that it takes trial and error to make a technique chart, and that all their xrays are taken using trial and error anyway. The one time I asked BCW if I could try a different mA setting, and she testily told me that this setting had worked for HER for 13 years, so to just leave it alone. Oh yeah. You have to retake every single xray. Works GREAT.
Seriously, after my first day, I came home (two hours late because people kept getting me to do stuff so I couldn't leave at 3:30 like I was scheduled to) and was on the verge of quitting. Actually, I'm STILL on the verge of quitting. This job makes me cry. I miss working at Bedford. I miss joking with Megan and Lyndsay and Robin and Colleen. I miss Cheryl's rules and protocols and things. This clinic doesn't have protocols. I asked the official boss person, who is sort of administrative but works in reception and is nice but not around me much, if there was a book with their procedures in it that I could study and she said they were working on getting one. I said I just wanted to know basic things, like how often they vaccinate and the dewormers they recommend and stuff and she said they didn't have anything like that written down anywhere. So I can't answer the phone because I can't answer the most basic of questions.
I miss Ridgetown. If I brought my teachers to this clinic and showed them how the "techs" just scrub willy nilly over the shaved area, bringing dirt and stuff over the incision site, and how they do all their surgeries using forceps and a scalpel handle that they keep in cold sterile, and how I have been pronounced "done" monitoring an animal when the IT tube is out - never mind that it is still unconscious, let alone sternal... I think they would freak out, and I would enjoy watching that.
The only reason that I haven't quit is that I emailed the guy who hired me - the guy in Alberta who owns the company that hired me and that just bought this clinic. Basically, I asked if he was planning any changes. He responded with an email that was surprisingly understanding, given that I hadn't actually complained. He encouraged me to "hang in there" and that they have significant changes planned, and that he really believed that the clinicians were great and that once certain things were improved that it would emerge as one of Vancouver's leading veterinary facilities. He said he hoped that my being new there would bring an objective view to the place, and that he would be installing a lead clinician soon (thank Gawd. As far as I can tell, no one is boss. Sure, BCW bosses everyone around and is actively rude to people, but she has an authority based on seniority, not authoritative power. No vet is boss over the other vets, and it means that everyone just runs around doing their own thing with no one to answer to), and that he and the regional manager Dr. Arora would welcome my ideas on how to improve the clinic.
I hope they're willing to listen to a long list. I will stick it out for a while, because my visa is maxed out from bills and groceries, and I need rent money, but I am already dreading getting up in the morning to go to work. I am miserable and mentally ranting the whole time that I am there, and I am so homesick for an environment that actually resembles... health care. If we were a restaurant, we'd be a low quality fast food chain, where people drop burgers on the ground, then put them on the burner to cook anyway, or sneeze on the food before serving it. I am used to the kind of kitchen where people wear gloves and wash their hands, you know?
I turned down Vancouver Emergency Clinic, because they would want me to work over Christmas, but in January I will write the VTNE and become an actual registered tech. Part of my agreement in coming to work for Associate Vets was that my wages (much lower than what emerge offered me) would be reviewed when I became registered. If they don't meet my expectations, or if things are not changing noticeable at this place, I'm out of here. Emergency sounded pretty disappointed when I turned down their job offer.
In the mean time...
I hate my job.
But it was all a joke.
Then I started work on Tuesday.
This clinic is... awful. Actually, the vets seem nice enough, and probably WANT to practice good medicine, but they have become accustomed to the fact that things like organized patient care, swift medical treatment, and careful monitoring of their patients simply won't happen. The clinic is extremely busy, especially on my first day - every single cage was filled, probably amounting to thirty animals. The clinic has NO method of listing the animals in clinic and the procedures that need to be done. Nor are there any attempts at labelling the cages themselves. Which means there were 30 animals stuffed into various cages, and no one had any idea who the animals were, why they were there, or what we were supposed to be doing with them. At one point, they actually spayed the wrong dog. That is, they grabbed the file for a dog that needed to be spayed, and grabbed a dog that needed to be spayed, which was not the dog that the file referred to. Later on, they discovered another dog, and when they started asking people who the dog was, it turned out to be the dog that they thought they had already spayed. Can you imagine if the dog that they spayed first had had an allergy to the drugs they used? Or a vastly different body weight? Or if it had not been in to be spayed at all, but was a show-dog needing x-rays? Can you IMAGINE?
The tech who showed me around (I have not had the guts to ask her, but guessing from the blank looks she gives me some times, I don't think she's an actual tech, but instead is a trained-up layperson) is a foul-mouthed, irritable and bossy little woman whom we will call BCW for Bitchy Co-Worker. BCW has been nice enough to me -mostly- but spends a lot of her time swearing and complaining about things like the fact that someone has written on the dry erase board with a black dry erase marker, the fact that some idiot who only works one day a week actually THREW AWAY some bottle that they like to re-use, the fact that the vet has removed an incontinent and paralyzed old dog from its cage because it has soiled itself and because she wants to examine it (because BCW finds the dog difficult to put back into its cage) and so on. She talks to me like I am an idiot a lot of the time, probably because she has never been to tech school and therefore has no idea what I have learned, or possibly because she thinks she is the only competant person on the planet.
BCW disturbed me on the first day by refusing to get me some rubbing alcohol when I requested it before poking an animal with a needle. She disturbed me more on the second day by complaining about how the orthopedic specialty surgeon who was coming to do a TPLO (complicated bone surgery on dogs who have torn their cruciate ligament) insists on having a well-cleaned surgical suite (she was complaining about this while reluctantly removing a large blood stain from the floor). When I pointed out that bone infections are really hard to deal with, she didn't answer me. She appalled me on the third day by telling me to feed "whatever" to a cat that we had unblocked the day before. I went to the cupboard and while I was looking for some dissolution or s/d, she hauled out some hypogastro and said "there. feed it that. It doesn't matter, he doesn't have crystals". So what blocked him then? A CORK? I noticed that the veterinarian told me to force feed it some s/d today. The vet seems to think the blocked cat should be on s/d. But the tech who has worked there for 13 years seems to think it a waste of time.
She is openly insulting and rude to one of the younger vets who has the unreasonable tendency to want xrays to be readable. On my first day, BCW openly refused to repeat a radiograph, saying that she didn't have time for things like that. So I did the repeats. And the repeats after that. And the next set of xrays needed. And those repeats. And so on. In fact, despite the fact that I don't have a dosimeter yet, I seem to have become radiography bitch, because I am the only person who agrees with the veterinarians that it is important to have a high quality picture so you can, oh, I don't know, DIAGNOSE. Unfortunately, I have to repeat the xrays again and again because I am not allowed to touch two of the most important settings on the machine.
TIme out for vet tech talk - Ridgetown and Bedford girls, read away. Other folks, you might find this confusing, but you can read this part of the rant if you want.
Okay, so I am not allowed to touch the mA dial OR the time dial. Whenever I had tried I have been stopped and told "We ALWAYS leave those at those settings". Which means that ALL radiographs are taken at 10 mAs. Which means that the settings are great for taking pictures of bone, but if you want a low contrast picture, we're pretty much out of luck. There is a technique chart on the wall which can only have been made by someone who had either never taken radiography, or never paid attention during it. I should really list the things wrong with the technique chart in order:
1. The chart has the following categories: Abdomen and extremities, thorax, skull and spine. That's right, Abdomen and extremities are ONE category. Because, you know, extremities are bone shots that should have a low kvp and a high mAs, while abdomen shots should be LCR and therefore HIGH kvp and LOW mAs. Those are the same, right? Why not group them together?
2. All the categories use the same mAs in increments. Yes, INCREMENTS. For table top shots, apparently, we only use 10 mAs. For Bucky shots we are apparently supposed to up it to 30 mAs. I'm not sure why. And for the really big animals, you know, that need a high kvp to penetrate through, it recommends an mAs of 60 - so one can melt the machine and never have to deal with radiography again, I guess.
Gee, I wonder why the staff soon found that leaving the dials at 10 mAs worked better than following that part of the technique chart?
3. Focal film distance does not change according to whether you are using table top or bucky.
Staff have found that by adjusting KvP back and forth, they can relieve the intense darkness which is brought on by the high mAs. Of course, that means that you don't get a lot of detail on thorax shots, but at least you can kind of see the lungs. Lung shots are the worst, because the high mA means that I have a lot of trouble getting the detail that the veterinarian wants, and have to redo them again, and again, and again. I was sent in to do MORE lung shots today and as soon as the door closed, I turned to the kennel girl who was helping me and asked her if the whole not-touching-the-mA-dial thing was a hazing ritual. Maybe they were all sniggering at me, watching me trying to get a high detail shot with an mA that made things so dark that I needed to turn the kvp WAY down in order to compensate for it, and therefore losing the detail that the vet wanted. It was the only thing that made sense. Kennel girl was sympathetic, but assured me that no one ever touches those dials.
So they really DO use 10 mAs for everything. I believe the book recommends like 1-3 mAs for abdomen, 5-6 for thorax and 8-12 for bones. I just KNOW that if they would let me touch those dials I could make a technique chart that actually WORKS in a matter of days, and then people (i.e. myself) wouldn't need to spend an entire day wrestling the same poor critter onto a table again, and again, and again. But I just know that if I messed with the dial, and it didn't come out, people would say "see? It doesn't work. Leave it the way it is." Never mind that it takes trial and error to make a technique chart, and that all their xrays are taken using trial and error anyway. The one time I asked BCW if I could try a different mA setting, and she testily told me that this setting had worked for HER for 13 years, so to just leave it alone. Oh yeah. You have to retake every single xray. Works GREAT.
Seriously, after my first day, I came home (two hours late because people kept getting me to do stuff so I couldn't leave at 3:30 like I was scheduled to) and was on the verge of quitting. Actually, I'm STILL on the verge of quitting. This job makes me cry. I miss working at Bedford. I miss joking with Megan and Lyndsay and Robin and Colleen. I miss Cheryl's rules and protocols and things. This clinic doesn't have protocols. I asked the official boss person, who is sort of administrative but works in reception and is nice but not around me much, if there was a book with their procedures in it that I could study and she said they were working on getting one. I said I just wanted to know basic things, like how often they vaccinate and the dewormers they recommend and stuff and she said they didn't have anything like that written down anywhere. So I can't answer the phone because I can't answer the most basic of questions.
I miss Ridgetown. If I brought my teachers to this clinic and showed them how the "techs" just scrub willy nilly over the shaved area, bringing dirt and stuff over the incision site, and how they do all their surgeries using forceps and a scalpel handle that they keep in cold sterile, and how I have been pronounced "done" monitoring an animal when the IT tube is out - never mind that it is still unconscious, let alone sternal... I think they would freak out, and I would enjoy watching that.
The only reason that I haven't quit is that I emailed the guy who hired me - the guy in Alberta who owns the company that hired me and that just bought this clinic. Basically, I asked if he was planning any changes. He responded with an email that was surprisingly understanding, given that I hadn't actually complained. He encouraged me to "hang in there" and that they have significant changes planned, and that he really believed that the clinicians were great and that once certain things were improved that it would emerge as one of Vancouver's leading veterinary facilities. He said he hoped that my being new there would bring an objective view to the place, and that he would be installing a lead clinician soon (thank Gawd. As far as I can tell, no one is boss. Sure, BCW bosses everyone around and is actively rude to people, but she has an authority based on seniority, not authoritative power. No vet is boss over the other vets, and it means that everyone just runs around doing their own thing with no one to answer to), and that he and the regional manager Dr. Arora would welcome my ideas on how to improve the clinic.
I hope they're willing to listen to a long list. I will stick it out for a while, because my visa is maxed out from bills and groceries, and I need rent money, but I am already dreading getting up in the morning to go to work. I am miserable and mentally ranting the whole time that I am there, and I am so homesick for an environment that actually resembles... health care. If we were a restaurant, we'd be a low quality fast food chain, where people drop burgers on the ground, then put them on the burner to cook anyway, or sneeze on the food before serving it. I am used to the kind of kitchen where people wear gloves and wash their hands, you know?
I turned down Vancouver Emergency Clinic, because they would want me to work over Christmas, but in January I will write the VTNE and become an actual registered tech. Part of my agreement in coming to work for Associate Vets was that my wages (much lower than what emerge offered me) would be reviewed when I became registered. If they don't meet my expectations, or if things are not changing noticeable at this place, I'm out of here. Emergency sounded pretty disappointed when I turned down their job offer.
In the mean time...
I hate my job.