I'm ready for some minions

Since returning from my externship at LIAH, I've been unusually annoyed by the many varied intricacies of trying to get simple tasks done at the VTH.

On my current Dentistry & Oral Surgery rotation, I am the only student. There is also only one clinician -- both of which are a little unusual. Generally the DOS service has 2 clinicians and 2 senior students to handle a full caseload (which can consist of up to 8 appointments on consult days and up to 4 procedures on procedure days). We still have that busy schedule, but since I'm the only senior student, I get to do all the busy work.

I think the "busy work" aspect of it is really catching up to me because I greatly enjoyed a full 2 weeks at LIAH with an extremely skilled, competent, and independently functioning technical staff. Don't get me wrong, the technical staff at the VTH are highly educated and extraordinarily capable in their jobs -- but their job description doesn't include a lot of the nitty-gritty things that technicians take care of in private practice.

Let's compare, for instance, how you get a CBC and chemistry panel sent to the lab at the VTH compared to LIAH.

At the VTH: I fetch the patient from the exam room at the south end of the building and bring him to the treatment area at the north end of the building. I gather alcohol, syringes, needles, blood collection tubes, and a Clinical Pathology submission form. If the treatment area is out of syringes, needles, or blood tubes, I walk to Central Supply at the north end of the building to request more supplies. I fill out the Clin Path form, including placing patient ID stickers on both of the carbon copy pages. If I don't have enough stickers, I walk to the east end of the building where I can use the computer program to print more stickers, then to the west end of the building to pick up the stickers from the printer, then I go back to the treatment area at the north end. If the sticker printer is out of paper, I walk over to Medical Records at the east end to request more paper. If the treatment area is out of Clin Path forms, I walk up to the southeast corner of the building and hope there are extra forms in the cabinet. I wait until the dentistry technician is off the phone or the dentistry clinician has finished whatever she is doing, so one of them can restrain the patient for me. I draw the blood myself. I fill out 2 of the smaller patient ID stickers for the 2 blood tubes. I walk the patient back to his owner in an exam room in the south end of the building (or try to convince the technician or clinician to hold the patient for me, or place the patient in a cage, which requires writing up a cage card and getting a blanket for the cage), then go back to the north end to pick up my blood samples and form from the treatment area, then take the samples and form to the Clinical Pathology department (which is about a 4-5 minute walk away, in another building), time stamp the form, and turn in the blood samples, then walk back to the treatment area in time to start the next appointment.

When you've got 4 appointments in 4 hours, and every one of them needs blood submitted, you can see how this gets tedious. It is tedious just to think about it.

Let's compare to how I get my blood submitted at LIAH: I let the owner know that I'm going to collect some blood, and walk about 10 feet from the exam room to the treatment area with the patient. I place the patient in a cage. I write his name on the whiteboard on the wall, along with what tests I want run. In about 5-10 minutes, the team of technicians has drawn the blood, returned the patient to his owner, and gotten everything ready to go to the lab. In that time, I've been doing doctor-type things, like seeing the next appointment, writing up charts, researching a case on VIN, or scrubbing into a surgery.

Now let's see how I submit a urine sample at the VTH: Again, I walk the patient from the exam room (south end) to the treatment area (north end). I wake up my computer, spend a couple minutes logging into the radiology request website, and another 2 minutes filling out an online request for an ultrasound-guided cystocentesis (collecting a sterile urine sample by placing a needle directly into the bladder). I gather a syringe, 2 needles, a sterile tube, a Clin Path form, and 2 large and 2 small patient ID stickers. If any of those supplies aren't in the treatment area, I proceed to Central Supply (north end), the forms cabinet (southeast), and/or the label printer (east and west ends) to gather them. My patient and I walk over to Ultrasound (east end) where we wait for an open ultrasound machine, another person to restrain, and someone to collect the urine sample. Once collected, I walk the patient back to his owner (south end), drop off a tube of urine in the fridge in the Medicine pit (southwest), and again hike to Clin Path in another building to time stamp my form and turn in the urine.

At LIAH: I let the owner know that I'm going to collect some urine, and walk about 10 feet from the exam room to the treatment area with the patient. I place the patient in a cage. I write his name on the whiteboard on the wall, along with what sample I want collected and why. In about 5-10 minutes, the team of technicians has collected the urine, returned the patient to his owner, and gotten everything ready to go to the lab.

I'm sure this post sounds whiny, and it kind of is. And in no way do I mean to speak unkindly of the wonderful technical staff at the VTH, or to imply that me having to do all of the above steps means somehow that the technicians at the VTH aren't doing their jobs. I fully believe that a capable, dedicated, responsible technician is worth his or her weight in gold. Veterinary technical staff are too frequently undervalued, underrecognized, and underpaid for the often unpleasant, exhausting, and behind-the-scenes work that they do. And certainly any veterinarian who is a true team player is happy to do some of the busy work on occasion.

However, since I'll have the letters "DVM" after my name 3 weeks from tomorrow, I'd rather be treated more like a doctor at this point than a technician.