Ten Tips to Thrive in Veterinary Emergency Medicine

Ten Tips to Thrive in Veterinary Emergency Medicine

Veterinary emergency medicine is in crisis.  According to the AVMA’s 2019 economic report, emergency and critical care has grown faster than any other private practice veterinary sector (almost 200% in the 10 years between 2008 and 2018).  With the pandemic, the pressure on emergency medicine veterinarians and veterinary nurses increased further.

Staffing has not grown to meet the need.  Training programs for veterinary technicians are in short supply and some schools are very expensive.  At the same time, state rules regulating alternate training pathways are tight.  For veterinarians, it has become less economically feasible to do an internship. Veterinarians graduating from veterinary school often do not have the skills needed to work in a fast-paced multispecialty emergency and ICU at graduation.

Despite this crisis, after 20 years, I still believe that veterinary emergency and critical care is an awesome part of the profession.  I love coming to work and not knowing what I am going to see.  I love the days when the team comes together to save a life or we diagnose a crazy disease. I love the nutty stories clients tell us about their pets.  I love getting to know clients and their pets.

I believe the difference between feeling crushed and being invigorated comes down to these ten things.

Ten Tips to Thrive

Veterinary emergency medicine is a team sport

To do ER well, you have to have a team of doctors, technicians, assistants, client care representatives, and janitorial staff who all work together to save lives.   Acknowledge that it is a team sport, work to build that team, and thank your team every day.

Listen to Veterinary Technicians

I can’t count the number of times a technician has told me something that has directly changed the trajectory of a pet’s care.  These hard-working professionals are on the front line of safety and often have a “spidey” sense about how pets are doing.  Make sure you really listen when a technician has a concern and THANK them when they give you input.  This is an easy way to save more lives AND have more fun at work.

View each case as an opportunity to learn

It is hard to lose patients.  We want to save all of them.  However, if we can learn something from every pet we work with, we will continuously improve the care we are able to provide.  Be thankful for the opportunity to learn and realize that no matter how skilled we are, we won’t save every animal.  If we share case learning as a team, we multiply the benefits and are able to improve outcomes for all the doctors in our practice.

Laughter matters

There are crazy things that come into the ER.  The Standard Poodle who always wore dark goggles when he came into our hospital.  The Bernese with 17 pacifiers in its stomach (the owner wasn’t sure how her baby kept losing them).  The chihuahua with wounds the owner thought might be from a large bird trying to carry him off. If you can find humor in the stories, it makes the day more fun.

Acknowledge the pebbles in your shoe and work to get rid of them

Emergency medicine is full of difficult cases.  It is made more difficult if your equipment doesn’t work, your EMR is slow, or your phone triage system leads to communication failures.  Problem solving how to fix these things makes your shifts go smoother with less frustration.

Build systems for fast information retrieval

If it takes you 30 minutes to find information one time, figure out where to put it so it only takes you 2 minutes the next time.  For example, I occasionally treat bad pneumonia with gentocin nebulization but can never remember the dose. I also can never remember the oxygen rates to create the right FiO2 for different size pets.  I got tired of trying to remember where I last found the dose or the chart so I created a pneumonia protocol and added it there.   My list of personalized protocols and discharges saves me a ton of time on every shift.

Spend effort on systematic training

You might not be in charge of training.  However, if there is not a clear and specific way to train new employees in your hospital, you are likely to be endlessly frustrated, especially if you have high turnover.  Think about the things that are most important to you and then help make sure your staff is trained to do them.  Developing training often seems very time consuming.  However, effort spent on proper new employee orientation (including for doctors!) and training always pays off.

Acknowledge the humanity of your clients

It can be easy on a busy shift to get mad at agitated clients or to want to focus solely on the pet.  However, that client could be your friend or your relative.  Treat them the way you hope your mom would be treated at a different practice. Clients might be agitated because their day has been as busy as yours, their bank account is not flush, and they love this dog. Understanding the inherent stress for clients and acknowledging it directly often quickly gets clients to trust you so that you can have a heartfelt conversation.

Accept that not everyone will like you

 I’m a pretty strong communicator and can work with lots of different people.  However, every once in a while, someone comes in who leaves me flabbergasted.  No matter what I try, they don’t get what I am saying.  In those situations, find help.  I’ve often found that another doctor, a technician or client care representative can help me figure out the right words or the right approach. Don’t take it personally, it is going to happen to all of us.

Work hard, play hard

The best ER vets I know put their all into their cases. However,  when they are off, they are off doing different things to fulfill their adrenaline junkie needs.  The best thing about veterinary emergency medicine is that you don’t work a regular schedule.  So go skiing mid week.  Get into the mountains or onto a river or down to the beach.  Play hard so you are recharged for your next shift.

I can’t use these ten tips to thrive where I work

If you work somewhere and these things aren’t possible, don’t leave the profession, leave your job.  Emergency veterinarians are in high demand.  There are great workplaces with well trained staff and processes that support veterinarians.  Don’t stay somewhere you are not appreciated and not allowed to build the systems and teams that will allow you to be successful.

Can’t find a job that will let you do this?  Build your own. The best hospitals I know were created by frustrated people looking to do it differently.