Reflections of first job in practice

Since secondary school I’d had my sights set on becoming a vet and always felt sure it was a career I’d love, but I genuinely didn’t expect to enjoy it as much as this, which I know sounds cheesy.

This is partly because I work with such a great bunch of people, who are all supportive and want me to do well, but it’s also because I’m learning so much every day, so I feel like I’m continually improving as a vet, which is really fulfilling. 

In this respect, the job is exceeding my expectations. However, the caveat is I didn’t realise how much there is still to learn. University prepares you to a certain degree, but so many cases don’t follow the classic “textbook” presentation that you learn in lectures, and this has certainly been a reality check.

Early surprises

I’ve surprised myself at the elements of the role I’m enjoying and have become passionate about.

During university and my rotations, I always enjoyed internal medicine, and particularly anaemia cases, due to their nature and the wide range of possible causes and potential treatments, which is still the case.

Since starting in general practice, I’ve become fascinated by ultrasound imaging, which I never found particularly interesting at university. One of my colleagues is fully qualified in ultrasonography (as well as being a very good teacher), and I’ve learned so much about it in the past few months that I’m now thinking it’s another area I’d like to train in at some point.

I’m also still surprised at how much I’m enjoying the emergency and critical care (ECC) work in our 24-hour emergency hospital. At first this side of the practice felt particularly daunting, but I’m now much more forthcoming at volunteering to treat these cases.

I enjoy the thrill of not knowing what we’ll be dealing with until it arrives and the urgent nature of the work. It’s also hugely rewarding to manage something that was completely unexpected, as well as hopefully playing a part in giving both the pet and their owner a positive outcome. I recently performed an emergency pyometra, which I’m really proud of.

I’m now working on improving my AFAST and TFAST (abdominal and thoracic focused assessment with sonography for trauma, triage and tracking) abilities, and my sedation and analgesia decisions for more unstable patients.

As part of my role, soon I’ll have a rotation of night shifts, which will be another great way to increase my ECC exposure.

I’ve got ‘regulars’

Ultimately, I became a vet because I wanted to help animals and educate owners, and this is genuinely the best part of the job.

Even away from the excitement of ECC, basic consults are fun and gratifying because you build rapport with both clients and their pets, and slowly, but surely, I’m getting “regulars”. These are clients that specifically ask to see me, which is an amazing boost for my confidence.

Challenges

An early challenge I didn’t notice at first, but became aware of as the first few months in my new job flew by, was how I was going to achieve a good work-life balance.

Sometimes it can be very difficult to switch off when you get home, and this is especially true after a difficult day. There have been a few late nights where I’m either still at the practice after my working hours or I’m catching up on notes at home.

I realised I was letting work consume my life. I was getting home and re-reading my clinical notes to make sure they were coherent, then looking at my consults for the next day.  This meant I wasn’t relaxing and felt tired.

I knew I had to implement a better routine, as well as feel more confident that what I’d done that day was good, and the next day would be fine as well. So, I have put this into practice and this has helped me find a much better equilibrium. Obviously, there is still the odd day I finish late, depending on the cases that come in, or I do a bit of work at home, but it’s infrequent so I don’t mind.

The worst days

Dealing with euthanasia is the part of the job everyone finds difficult and there have been a couple I’ve struggled with. In some instances, afterwards you find yourself questioning whether there was anything else you could have done for the animal.

One example was a young dog and, looking at this patient, you wouldn’t know it was ill because it was bright and bouncy, so it had been treated symptomatically on and off for a while. By the time further investigations were pursued, the dog’s blood results showed a very extreme protein-losing enteropathy, which required treatment the owner simply couldn’t afford.

Alternative and palliative treatment was attempted, but the dog didn’t respond well and, in the end, had to be euthanised. In cases like these it’s difficult to not be hard on yourself and wish you’d done different tests or investigated certain things sooner.

Hindsight is wonderful thing, and it never gets easier. 

Unusual cases

I’ve certainly seen a few weird and wonderful cases in my first few months, but one of the strangest was a kitten on a Saturday morning with “off back legs”. Initially, I thought it could be something neurological or potentially infectious aetiology. The kitten was hardly moving and extremely bloated, and when I felt its abdomen, it appeared to be full of hard faeces, which immediately rang alarm bells.

I went to take a rectal temperature, but couldn’t fit the thermometer in, and then I realised the kitten didn’t have an anus. Unfortunately, by the time the owner brought it to us, it was septic and the only option was euthanasia. Although it was a sad case, I’ll always remember its unusual congenital defect – I’d seen it in a lamb before on extramural studies, but not in small animal practice.

Importance of being honest

Initially, when I started this job my biggest worries were making the wrong decision or a mistake with so much at stake. I’ve stepped off my perfectionist pedestal and realised at the end of the day, there is no way I can know everything.

Now, if I’m unsure on a case, I am honest with owners, presenting them with a few possibilities and what treatment or investigations I would recommend, and the majority are receptive to this. There are also occasions where I ask if the owner is happy for me to seek another vet’s opinion and again, this is usually met with enthusiasm. The lesson is don’t be afraid to be honest. If not, an educated guess expressed in a confident tone always works. 

I think my worries now are mainly in surgery. I am comfortable with routine things, but it is always daunting when you’re faced with a case that’s more difficult or if something goes wrong intraoperatively. I enjoy surgery, but it’s definitely an area I want more practice in.

Advice to other students

If I could give any advice to any final-year students looking for jobs, it would be to prioritise working at a practice that offers plenty of support. Although pay, working hours and facilities are important, at first you need somewhere that offers support spanning emotional, professional and mental health.

I noticed every employer promises a supportive workplace, which made me apprehensive about how much support I would actually receive, but I have been impressed with Pennard Vets living up to its promise.

I have a mentor for my Veterinary Graduate Development Programme and we have scheduled meetings once a week, although admittedly this doesn’t always happen if the day suddenly becomes manic.

I also have monthly meetings with my line manager and dedicated internal CPD days with our leadership team, which focus on communication skills and addressing any concerns. In addition, there’s always someone around for informal chats or quick case discussions if I am unsure of anything.

Plus, our regular reflections help me recognise how far I have come (although I still have a lot further to go), which is sometimes easy to forget.

I’ll be checking back in with Vet Times in the next few months to update you on my experiences and reveal how my life as a vet is evolving.

• This article was first published in Vet Times (Volume 53, Issue 16, Pages 18-19)