Showing posts with label anesthesia. Show all posts
Showing posts with label anesthesia. Show all posts

Saturday, April 20, 2013

You Might Ask: Why Do I Need to Hire a Trainer?


Why do you need to hire a trainer?  Maybe the truth is; you don't! And if that is the case...I want to take this time to congratulate you.  The ability to practice medicine; whether as a veterinarian or a technician, or to manage a veterinary practice AND to stay abreast of new ideas and best practices while maintaining any semblance of a life is a challenge.  

My experience, even in my clinical practice is that we decide we are going to add a service, how we are going to communicate that service, what we are going to charge for it, and who is responsible for it.  We commence to provide that new service and we adjust everything we originally thought or decided, based on feedback.  Trail and error.  Then once we work it out to the point that we no longer have any problems with it and everyone is comfortable, we will do it every day, the same way and we will never question it again until we are forced to.

I will give you an example. For years, feline patients would come into the practice, be admitted for a procedure and be gently and lovingly placed in a cage with a blanket, a kitty litter pan and a catnip pillow.  A few hours later, it would be time to work with some of these cats and it would seem as though "Lovey" was having an allergic reaction to stainless steel.  Some of these cats would go from a lovely little purr bucket to a whirling dervish of teeth and nails.


We would mutter a curse word, don a pair of welders gloves, lock the doors, grab the biggest quilt we could find, call the employee that has earned the title "cat wrangler" and add a little more sedative to the injection or a cancel the procedure due to it no longer being a safe or atraumatic experience. 

Result:  More curse words, one escapee cat, four employees running wildly trying to apprehend the patient and eventually, one very injured employee, a trip to the ER, one completed worker's comp form and a cat that doesn't sedate well due to an extreme catacholamine flood.




Then an outsider came in and witnessed said experience.  She had experienced many of the same type problems before and she realized that the same cat was a doll baby in the exam room for her vaccines.  She suggested that we identify and schedule these patients as a "Do First" experience and sedate them, on the baby scale in the room with the owner.  A no-brainer some may think...but it took an outsider to show us the way out of our rut.  And, the clients love it.  They feel we are taking special care of their baby...and we are!

So, what ruts do you find yourself in?  Are dentistries the bane of everyone's existence?  Are your client service representatives getting yelled at because the client doesn't understand the bill?  Is the surgeon frustrated because they have to fit in carnasseal tooth extractions between surgeries?  Is it frustrating to do be expected to clean teeth and perform anesthesia at the same time?    if so, please know you are not alone.  



You might ask then ,what does the typical in-house dentistry training look like?  For larger practices, we divide the staff in half.  One half of the vets and techs work in a 3 hour wet lab concentrating on proper cleaning, charting, and honing their radiographic skills so that they can offer a full mouth series efficiently.  The other half of the professional staff is running appointments so that the day is not a total loss.

During lunch, we do a communication lecture.  There is no sense learning how to do a skill if you can't get the client to understand its importance enough to comply with your recommendations.  

Then the staff switches roles and the half that ran appointments, now gets to experience the wet lab. 

By the time the day is complete, we also have created a wish list.  This is a list of equipment that will help you provide this new or upgraded service efficiently.  Change also can seem overwhelming and the trainers can set expected timelines for change and equipment purchases.

The anesthesia training day looks slightly different.  The first half of the day is the trainer will observe anesthetic cases to see where the staff strengths are.  She will then provide a lecture over lunch and in the afternoon, a wet lab tailored specifically for your practice based on her observations and a PetED pre-visit survey the practice provides returns to her.

In closing, a trainer provides great opportunities for the staff:
  • to think and troubleshoot with "outside-of-the-rut" thinking
  • to be able to tweak protocols and procedures to fit within your practice
  • to work with your own equipment and environment
  • for the entire staff to get the same education at the same time instead of relying on one staff member to return and share all of the information to which they were exposed 
  • to provide RACE CE credits* to all staff members simultaneously without the travel, lodging and registration fees for each staff member.
  • PetED also has a Willow Grove, PA site where wet labs can be scheduled for small groups.  This enables practices to send employees for training without the need to amend appointments or their surgery schedules.
If you think that your practice could benefit from a  PetED Veterinary Education and Training Resource experience, contact us through the website at www.PetEDVeterinaryTraining.com or we can schedule a free Skype consultation (Skype name: Vickie.Byard). 

*RACE CE credits have only been submitted and approved for the dentistry experiences.  Anesthesia is pending approval.




Monday, March 11, 2013

To the Heart of the Matter



To me this is the saddest of cases!

A very nice man brought his 8 year old, female spayed, King Charles Spaniel to our practice. The history was that he previously lost a King Charles to cardiac issues, a problem that commonly effects this breed.  That experienced devastated him and he vowed to do everything in his power to avoid cardiac issues in this next dog if at all possible.

We had been providing care for this dog for a number of years and early on the veterinarian heard an innocent systolic click when listening to the heart.  It was mentioned and this client  sought a cardiac consult and an echocardiogram immediately and spend upwards of $400 on that evaluation annually by a cardiologist.  All was well.  He wanted the best for his baby and he went to any lengths to provide that.

We recommended dentistry for his dog and this brought up a whole host of fears about anesthesia. He was afraid he may lose his dog.  We tried to assure him that with frequent professional care, we could provide the shortest and ultimately safest anesthetic experiences for his sweet baby.  We showed him how we have state-of-the-art monitors and that we have a dedicated anesthetist for the procedure.

He said he would consider this carefully.  

What he did, in an attempt to safe guard his beloved was to seek a second opinion.  He went to another practice.  They witnessed his concern and they offered to provide anesthesia-free dentistry and told him that that would be ultimately safest.  He provided this level of care for his dog twice.  The second time, they told him that they got most of the work done but that Nala was not allowing all of it.

Fast forward to a couple weeks ago.  This client came in for his annual exam.  He related to our veterinarian that his baby was dropping food and was eating very carefully.  This very compliant, gentle dog allowed us to show him that there were multiple mobile teeth and that his baby needed to have a deep cleaning and full mouth radiographs.  

Once we anesthetized this patient and obtained a full set of diagnostic X-rays, we identified 27 teeth that we needed to be extracted because of either greater than 50% bone loss or tooth root abscessation.  This man was horrified.  The work was provided and the pet is doing wonderfully.






What breaks my heart is that this man wanted the best for his dog.  He was not stingy with his money in relation to this dog.  He was misled that providing anesthesia-free dentistry would provide the same care for the dog as we would provide with the aid and expense of anesthesia.  In the long run, this King Charles Spaniel experienced long term periodontal infection and we know that that can negatively affect the heart...the organ he was so worried about in the first place.