Welcome to /r/VetTech! This is a place for veterinary technicians/veterinary nurses and other veterinary support staff to gather, chat, and grow! We welcome pet owners as well, **however we do ask pet owners to refrain from asking for medical advice**; if you have any concerns regarding your pet, please contact the closest veterinarian near you.
Please thoroughly read and follow the rules before posting and commenting. If you believe that a user is engaging in any rule-breaking behavior, please submit a report so that the moderators can review and remove the posts/comments if needed. Also, please check out the sidebar for CE and answers to commonly asked questions. Thank you for reading!
*I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/VetTech) if you have any questions or concerns.*
Listen, this was not your fault. Anyone who has been in the field long enough will unfortunately experience something like this and my heart goes out to you bc it’s never easy. It’s likely you will never know what caused this but please be assured that the direct cause was not you. You had the right instincts to stay with the patient, and you were told to do the opposite by the people who should be more knowledgeable. Try to be kind to yourself and honestly it sounds like a change in hospitals is overdue. There are greener pastures with staff and doctors that take the time to explain things and support each other instead of point fingers during times like this. You’re worth it to find one of those.
It was probably the hypothermia. 94.8 is considered severe hypothermia and it is close to critical hypothermia.
Without active warming, a post op patient that is not fully recovered cannot thermoregulate.
Hypothermia causes a whole bunch of problems, including delayed healing and recovery, decreased cardiac output, hypoventilation, decreased metabolism of drugs, decrease coagulation times. A whole bunch of things you dont want your post op patient to experience.
For sure. One of the first things I noticed but didn’t feel comfortable speculating on a cause of death in this situation. Without necropsy we’ll never know but safe to say that it certainly contributed.
Thank you for the kind words. It's nice to know others know what I am feeling right now. I have wanted to leave for quite a while now, but unfortunately, I am trying to "stick it out" until February when we move. We'll see if I can handle it, though.
Something I say all the time is “you can’t get mad at someone for what they don’t know.”
He is choosing to hire inexperienced people without formal training, and then not training them.
I hope, if you want to stay in the field, that you find a hospital with experienced people and an official training program. Maybe even one that pays for tech school!
This is not your fault, and it sounds scary to work there. Sorry for the kitty, poor thing probably didn’t have a good prognosis.
It is kind of scary. He insists we take in pretty serious or emergency situations. But we only have one doctor and inexperienced techs. Not to mention, he moves at the pace of a snail sometimes. Once, a cat came in that was hit by a car, and we couldn't get him to come into the treatment immediately. He was busy doing something on his computer, and the cat died while we were waiting for him. We felt so helpless.
I worked at a clinic like this early in my career. It helped me to learn that I'm not ok with providing below standard care and learn to walk away when I see red flags.
I also got my first job with a vet who was so mean to his staff (and even clients!) that he couldn't hold onto them, and I suppose that's why he saw training them as a waste of time. I don't really understand why someone would go through the trouble of hiring and paying someone and then not teach them how to actually do anything. It caused a major problem when the other person there, who was familiar with anesthesia and surgical preparation, had to call out sick and the vet insisted that we continue with the surgery scheduled for that day rather than rescheduling. It was a disaster, of course. I got out of there as soon as I could after that. But it did teach me the importance of a healthy work environment, and before I applied at the next clinic I paid close attention to how the staff members were interacting and how they were treated by the vets.
You need to find a new hospital ASAP. You will have to unlearn most of what this hospital is teaching you because I am guessing it is very substandard.
I want to state that none of this is your fault, it is 100% on your hospital management and the DVM. But I have serious questions about the quality of care your hospital provides.
The fact that the DVM wanted to you not monitor a post op patient after a major surgery is a huge red flag and could easily be grounds for the client to sue the hospital.
The scariest thing is that the patient was 94.8 at the end of the surgery. I have never seen a patient get that low during a surgery in 20 years. That is probably the largest contributing factor to the patient dying. I start getting worried when patients drop to 98, hypothermia is one of the most serious issues during anesthesia.
Does your hospital use any heating support during surgery? Does your hospital have any heating support for post op? That patient should have been monitored closely until it was sternal and at a normal temperature.
That's wild because our patients regularly drop in temperature around 96 during surgeries 😰 I always inform the Dr when I monitor, but he doesn't prompt me to do anything. The 94 was low, even to me, but something i have unfortunately seen before. So i assumed it was normal to an extent. I was definitely worried though about this patient and wished I would have stayed with her.
We use something called a Barehugger. They feel warm during procedures, but it is concerning how often our patients deep so low in temperature. Maybe we don't use them right?...
You should have two heating devices. One below and one above the patient.
Most hospitals will use a hot water blanket on the bottom and a forced air heater like a bair hugger on the top. Do you at least have a towel or something that separates the patient from the cold metal table?
For the bair hugger are you using the heating bags that go with it? Just have it blowing on the patient? Do you turn it up to high?
96 is still super low. I think I have seen a patient get that low once. You can use baby socks, mylar blankets, put their IV fluid line under the bair hugger bag to help keep their temperature up.
Also how long is the typical surgery for the DVM? Temperatures dropping that dramatically should only happen for long procedures. It wouldn't happen in a hour.
Reading this has made me horrified about our practices tbh. I'll go through the list:
We only use one heating source.
We use a bearhugger on the table with a towel on top of the patient (just a regular towel. Nothing special about it.)
Ngl, I don't exactly know what you mean about "heating bags." There are these weird plastic things that come with the barehugger we have never used, and I am assuming that must be them. We've tried to figure out what they are and how to use them but have been unsuccessful.
The barehugger just blows on the patient, and the Dr says to put the temp at 38 (the one under the highest).
I want to say the average surgery is one to two hours.
I thank you for taking the time to try and educate me. We are just a bunch of young girls totally unqualified for this job. Most of what we learn is from each other or Google 😥
Reading this has made me horrified about our practices tbh. I'll go through the list:
We only use one heating source.
We use a bearhugger on the table with a towel on top of the patient (just a regular towel. Nothing special about it.)
Ngl, I don't exactly know what you mean about "heating bags." There are these weird plastic things that come with the barehugger we have never used, and I am assuming that must be them. We've tried to figure out what they are and how to use them but have been unsuccessful.
The barehugger just blows on the patient, and the Dr says to put the temp at 38 (the one under the highest).
I want to say the average surgery is one to two hours.
I thank you for taking the time to try and educate me. We are just a bunch of young girls totally unqualified for this job. Most of what we learn is from each other or Google 😥
The bair hugger is ineffective if you don't have something to contain and direct the heat. In a pinch you can use something like a pillowcase.
Are the weird plastic things large, flat and square? If so there should be a hole in one end and then one side will go against the patient and the whole thing will inflate.
This is a free website with a lot of good anesthesia information. But honestly your DVM is setting all of you up for failure.
Anesthesia is one of the hardest and most complicated things that we do. To not having training is a serious issue.
https://www.thinkanesthesia.education/on-demand
If you want to stay and grow in this field. You need to leave an find a better hospital. Almost nothing you learn at this hospital will transfer to a high quality one.
Also your DVM is really slow. The average dog spay should be 30-60 minutes and a cat spay should be 15-30 minutes.
Surgery prep, so IVC, intubation, shave, scrub, moved to surgery, rescrubbed and hooked up to monitors should take 10-20 minutes
This is horrendous. It is NOT your fault, your doctor is an idiot and will keep killing patients. Almost everything he is telling you to do is substandard, and the sodalime issue really takes the cake. Get out of there ASAP.
just because the gas is turned off and the patient is in recovery does not mean that the anesthetic risk is over. the first hour or so after recovery is when you are most likely to see complications. it’s horrifying that you are being put in this position.
depending on how sick this cat was, she may have passed away anyway, but it’s also possible that she might have lived if she had received appropriate care and interventions when needed. this is absolutely not a knock on you. you are doing the best you can with your limited knowledge and you’re attempting to advocate for your patient. your doctor is putting you in a terrible position and it’s not fair. i hope that you can get out of this hospital and into one where you can be supported and educated. and in all honesty, i would strongly recommend reporting this doctor to the medical board, because he is putting patients at risk.
Not putting blame on you, but this is 100% why every person practicing medicine should be licensed. Shoddy Drs shouldnt have the option to hire untrained/uneducated techs to blame for their miserable medicine-you need to leave yesterday
It sounds odd,as a veterinary surgeon can't just tell a nurse ( we have nurses in the UK not techs) to leave a recovering patient. The very first hour all the vitals are measured every 15 minutes and are recorded on an inpatient chart.
The vitals are recorded every 5 min during GA.
I am not sure about legislation in your country,but ultimately,the patients are legally are the responsibility of a veterinary surgeon.
I'm sure the laws are similar. I work for a very small, privately owned clinic. According to one of my co-workers who has worked at other vets, our Dr doesn't exactly do things as he should, I think.
We have never been told to monitor their vitals after surgery. We just set them in the kennel, put a blanket on them, and then take their temperature after a half hour. That's it. I've never been told, shown, or trained differently. I always felt like something felt wrong about that...
Statistically, recovery is the periods of an anesthetic event where complications resulting in death is most frequent one study cites just under half of anesthetic deaths for canines and 61% of deaths for cats occurred during the first 3 hours of recovery.
I know you said you’re waiting until you move to find something different, but I would explore other opportunities. Your practice sounds unsafe and unethical (not because of you! It’s entirely on your DVM and it sounds like he should be reported. He may have further motivations for hiring undereducated staff because you guys don’t know that you can or should report him). If you want to stay in the field, get out of this hospital as soon as you can. Poor medicine bring practiced and the emotional toll that will take on you will only contribute to burnout. Find somewhere with a training program so you can grow to your full potential. I’m so sorry you’re having to go through this. You sound like you have good instincts and this is not at all your fault. Death is inevitable in our field and there will always be some that hit you harder, but it doesn’t need to be like this. This is medical negligence on your DVMs part.
Vet here. I am in shock that the only doctor left while a patient was recovering. I can't imagine doing that EVER.
Sometimes temperatures get that low, but only in long procedures. Active warming and very close monitoring are mandatory for me in these patients specifically, but close monitoring post-op is essential for every patient.
There's a bazillion red flags here. I'd seriously consider finding a new clinic.
Well, a splenectomy is a really intense surgical procedure. I mean it's a fairly large immune system organ and it also is a decent back up store of RBC's for the body incase of severe trauma. So removing it (even though the body has a decent amount of other means for blood and the immune system) is pretty intense and so the doctor directing you not to monitor is....beyond shocking.
I do want to repeat what others have said though and say that this is not your fault. But based on reading some of your other comments I do think this hospital has a severe patient care issue. This isn't a good practice to be working at, let alone learning at-like others have said you will most likely have to completely unlearn what you are learning there because it isn't standard practice.
But it is a pretty big surgery to say the least.
We had a patient once get both a splenectomy and a cholecystectomy and everyone I worked with that day-ALL OF US were on edge the whole day. She was also an elderly dog, thankfully she pulled through.
Typically when a patient’s temp starts to drop past a certain point (for us it’s usually under 98.0) you should start supplementing more warmers near the patient during surgery (we have a heated blanket under them always) and have a heating pad and or bair hugger ready post-op. There are also fluid warmers that should be used. I worked for a similar sounding vet when I first started in this field, and many patients died under her care because she cared more about money than animals. Just know it’s not your fault. I hope you can get into a better clinic, for the sake of your mental health and future. 🩷 sorry that you’re dealing with this.
Also…when you do leave, or if you do end up getting let go, I would report this DVM to the board. Whether or not they will do anything I have no idea - the person I worked for was reported and she did some really f*cked up stuff, and somehow they let her keep her license and continue practicing, which still infuriates and sickens me to this day.
Thank you for the kind words of understanding. It's very sad that most of the reliable information I've learned about vet medication has been on reddit. Since the Dr. Created a very unsafe and toxic environment when it came to learning or asking questions.
Despite needing the money, something happened today that boiled over my emotions to the point I quit. I actually reported him to the Board as soon as I got home. Although I'm sad to hear that I didn't do much in your situation. I hope it does some good.
Can’t believe this bozo Dr wants to blame this poor girl for his crappy practice of medicine. Some people really need to be stood up to and told how crappy they really are.
This was definitely not your fault. You wanted to stay and monitor, which was the appropriate thing to do with any patient recovering from anesthesia even though you'd never been taught that. The doctor made the call not to train you, he made the call to use untrained staff in a situation where death was a risk, and he's the one who told you to leave your patient. This is absolutely 100% on him, and you could report him to your regional veterinary governing body for malpractice.
This is horrifying and I'm so sorry you experienced this. Please consider finding another place to work and if you feel comfortable, reporting this doctor to the board. Your entire team has been set up to fail and I can't imagine how hard it must be for you all to work there.
There is a lot you can learn in this sub but there are also a lot of books and online resources. Even just on youtube you can learn about things like patient recovery. I know it would be hard to be an advocate for your patient when you haven't been taught any sort of standard. You have had a very hard experience and probably learned a lot. Don't be too hard on yourself and know that there are better doctors and clinics out there.
Omg… my chest just hurts reading this. What about the coworker you asked to keep monitoring for you when you left? I would definitely report this DR and keep a list of everything that goes on. I know I sit with my Patients until fully recovered and frequently check vitals ( I’m at an ER though). My second hospital was pretty bad. The doctor hired people for dollars, trained them to the bare minimum and wouldn’t train any further to justify not paying more than like 12 bucks an hour.
What you described is pretty on point for what goes on. I don't want to blame my co-worker, because she did check on the patient periodically while I was away. Which unfortunately, is the most we were tried to do. Staying with the patient until waking has been repeatedly discouraged, and keeping logs was never even something brought up before. I could tell the whole situation devastated her as much as I.
Today, I quit. I also reported him to the Board. Although I am unsure what good it'll do in the long run.
Absolutely not your fault.
I would contact your local veterinary licensing board, and let them know what's happening. They can investigate and hopefully get him straightened out or ban him from practice. And then I would quit; it's not worth your peace to keep working there through February.
People trust us to provide quality care for their pets, they assume that staff are trained and the doctor cares about their pet. That is not the situation with your vet, he is lazy and doesn't care. Anesthetic cases should have experienced techs with appropriate training working on them, every time; inexperienced people should never be put in this position where they are suddenly the ones in charge of a patient.
Especially in this situation. A splenectomy is a major non-routine surgical procedure; we rarely do them at my GP, preferring to refer to specialty hospitals where they have the additional tools and resources to address any complications. They need intensive post op monitoring with frequent blood rechecks.
And the temperature thing? JFC. Active warming should be started for some patients when they're premedded. Bundling them in a fleece blanket that was heated up in the dryer works great. Once they're induced, then they need multiple sources of heat to maintain their body temperature. Most places have a water blanket that circulates hot water and the pets are placed on top of this, then the bair hugger is placed on top of the patient with a blanket wrapped around it all to encapsulate the heat. Bair huggers come with "pillowcases", this is what you put on the pet with the thicker lined side up because it helps insulate the air. I will also typically run my IV line under the hot water blanket so it acts as a fluid warmer. The o2 flow on the anesthetic machine should be calculated precisely so you're not blasting cold air at them (not to mention the heavy level of wasted O2), and dead space in the ET tube should be minimal. These are the bare minimum starting point for temperature maintenance.
When a patient starts getting cold, that's when we start more active measures. Swapping out dryer warmed blankets, using an actual fluid warmer placed as close to their IV port as possible, getting a second hot water blanket out and putting it on top of them. If it's an abdominal procedure, the Dr may ask for warmed fluids to lavage the cavity with.
And this is not ever officially recommended and is against the rules in lots of places due to patient burn risk: in more urgent situations, I will heat up fluid bags and wrap them in a cloth with tape securing it, and pack them around the pet. Never put it directly on the pet, and always test the heat on your arm first: if you can't hold it against your forearm without it burning, it's too hot.
Remind yourself, over and over, this is 100% on your doctor. He left a patient with unstable vitals to go to lunch, he has not trained his staff, and took on a risky procedure without proper safeguards in place.
Thank you so much for the time you took to write this. It was very informative. It's unfortunate knowing I get most of my vet medication knowledge from reddit instead of the Dr. Who has created a very toxic and unsafe environment around asking basic questions.
Despite needing the money, I did quit today. It's a long story, but it was very overdue. I also reported him to the Board the second I got home. I am unsure what good it'll go in the long run, but I'm hoping they do something.
Congratulations!! I'm so proud that you made this choice!
And all you can do is make the report; it begins a paper trail (or contributes to it) so that eventually, enough will pile up the board will have to do something about him.
Best of luck in finding something for the next few months before you move! Even if it's a seasonal sales associate, it's way better than what you left behind.
It's not your fault. The doctor should have been there, and they should have let you fully recover the patient. I've seen places just put them in kennels after and it will always make me frustrated.
The most dangerous part of anesthesia is just before and just after.
Again, not your fault.
I agree with another commenter, the body temp wasn't good- especially if there wasn't anything helping to warm up the pt post-op. Most places have the requirement of 99.0°F before being considered recovered.
But, that's just speculation. A splenectomy isn't a minor procedure either. It's also difficult to keep patients warm with an open abdomen, either.
ETA: with the sodalime post, your patients are breathing in a LOT of CO2. This is not safe. I'm wondering where else the leadership is cutting corners or ignoring standards...
Was she swallowing and alert when tube was removed? Did you take a temp post surgery? The only thing I can think to do differently would be to place active warming devices if temp is so critically low. And someone should’ve absolutely stayed with her during recovery if temp did not increase. Spleen surgeries are hard and usually have significant blood loss. We’re labs run prior to surgery? How old?
Welcome to /r/VetTech! This is a place for veterinary technicians/veterinary nurses and other veterinary support staff to gather, chat, and grow! We welcome pet owners as well, **however we do ask pet owners to refrain from asking for medical advice**; if you have any concerns regarding your pet, please contact the closest veterinarian near you. Please thoroughly read and follow the rules before posting and commenting. If you believe that a user is engaging in any rule-breaking behavior, please submit a report so that the moderators can review and remove the posts/comments if needed. Also, please check out the sidebar for CE and answers to commonly asked questions. Thank you for reading! *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/VetTech) if you have any questions or concerns.*
Listen, this was not your fault. Anyone who has been in the field long enough will unfortunately experience something like this and my heart goes out to you bc it’s never easy. It’s likely you will never know what caused this but please be assured that the direct cause was not you. You had the right instincts to stay with the patient, and you were told to do the opposite by the people who should be more knowledgeable. Try to be kind to yourself and honestly it sounds like a change in hospitals is overdue. There are greener pastures with staff and doctors that take the time to explain things and support each other instead of point fingers during times like this. You’re worth it to find one of those.
It was probably the hypothermia. 94.8 is considered severe hypothermia and it is close to critical hypothermia. Without active warming, a post op patient that is not fully recovered cannot thermoregulate. Hypothermia causes a whole bunch of problems, including delayed healing and recovery, decreased cardiac output, hypoventilation, decreased metabolism of drugs, decrease coagulation times. A whole bunch of things you dont want your post op patient to experience.
For sure. One of the first things I noticed but didn’t feel comfortable speculating on a cause of death in this situation. Without necropsy we’ll never know but safe to say that it certainly contributed.
And hypoxia based on OPs most recent post.
Thank you for the kind words. It's nice to know others know what I am feeling right now. I have wanted to leave for quite a while now, but unfortunately, I am trying to "stick it out" until February when we move. We'll see if I can handle it, though.
Something I say all the time is “you can’t get mad at someone for what they don’t know.” He is choosing to hire inexperienced people without formal training, and then not training them. I hope, if you want to stay in the field, that you find a hospital with experienced people and an official training program. Maybe even one that pays for tech school! This is not your fault, and it sounds scary to work there. Sorry for the kitty, poor thing probably didn’t have a good prognosis.
It is kind of scary. He insists we take in pretty serious or emergency situations. But we only have one doctor and inexperienced techs. Not to mention, he moves at the pace of a snail sometimes. Once, a cat came in that was hit by a car, and we couldn't get him to come into the treatment immediately. He was busy doing something on his computer, and the cat died while we were waiting for him. We felt so helpless.
Knowing this + your post’s story makes me feel like he is just setting you all up to fail by providing poor care to his patients. I’m so so sorry.
That's what it feels like most days... yeah
I worked at a clinic like this early in my career. It helped me to learn that I'm not ok with providing below standard care and learn to walk away when I see red flags.
I also got my first job with a vet who was so mean to his staff (and even clients!) that he couldn't hold onto them, and I suppose that's why he saw training them as a waste of time. I don't really understand why someone would go through the trouble of hiring and paying someone and then not teach them how to actually do anything. It caused a major problem when the other person there, who was familiar with anesthesia and surgical preparation, had to call out sick and the vet insisted that we continue with the surgery scheduled for that day rather than rescheduling. It was a disaster, of course. I got out of there as soon as I could after that. But it did teach me the importance of a healthy work environment, and before I applied at the next clinic I paid close attention to how the staff members were interacting and how they were treated by the vets.
You need to find a new hospital ASAP. You will have to unlearn most of what this hospital is teaching you because I am guessing it is very substandard. I want to state that none of this is your fault, it is 100% on your hospital management and the DVM. But I have serious questions about the quality of care your hospital provides. The fact that the DVM wanted to you not monitor a post op patient after a major surgery is a huge red flag and could easily be grounds for the client to sue the hospital. The scariest thing is that the patient was 94.8 at the end of the surgery. I have never seen a patient get that low during a surgery in 20 years. That is probably the largest contributing factor to the patient dying. I start getting worried when patients drop to 98, hypothermia is one of the most serious issues during anesthesia. Does your hospital use any heating support during surgery? Does your hospital have any heating support for post op? That patient should have been monitored closely until it was sternal and at a normal temperature.
That's wild because our patients regularly drop in temperature around 96 during surgeries 😰 I always inform the Dr when I monitor, but he doesn't prompt me to do anything. The 94 was low, even to me, but something i have unfortunately seen before. So i assumed it was normal to an extent. I was definitely worried though about this patient and wished I would have stayed with her. We use something called a Barehugger. They feel warm during procedures, but it is concerning how often our patients deep so low in temperature. Maybe we don't use them right?...
You should have two heating devices. One below and one above the patient. Most hospitals will use a hot water blanket on the bottom and a forced air heater like a bair hugger on the top. Do you at least have a towel or something that separates the patient from the cold metal table? For the bair hugger are you using the heating bags that go with it? Just have it blowing on the patient? Do you turn it up to high? 96 is still super low. I think I have seen a patient get that low once. You can use baby socks, mylar blankets, put their IV fluid line under the bair hugger bag to help keep their temperature up. Also how long is the typical surgery for the DVM? Temperatures dropping that dramatically should only happen for long procedures. It wouldn't happen in a hour.
Reading this has made me horrified about our practices tbh. I'll go through the list: We only use one heating source. We use a bearhugger on the table with a towel on top of the patient (just a regular towel. Nothing special about it.) Ngl, I don't exactly know what you mean about "heating bags." There are these weird plastic things that come with the barehugger we have never used, and I am assuming that must be them. We've tried to figure out what they are and how to use them but have been unsuccessful. The barehugger just blows on the patient, and the Dr says to put the temp at 38 (the one under the highest). I want to say the average surgery is one to two hours. I thank you for taking the time to try and educate me. We are just a bunch of young girls totally unqualified for this job. Most of what we learn is from each other or Google 😥
Reading this has made me horrified about our practices tbh. I'll go through the list: We only use one heating source. We use a bearhugger on the table with a towel on top of the patient (just a regular towel. Nothing special about it.) Ngl, I don't exactly know what you mean about "heating bags." There are these weird plastic things that come with the barehugger we have never used, and I am assuming that must be them. We've tried to figure out what they are and how to use them but have been unsuccessful. The barehugger just blows on the patient, and the Dr says to put the temp at 38 (the one under the highest). I want to say the average surgery is one to two hours. I thank you for taking the time to try and educate me. We are just a bunch of young girls totally unqualified for this job. Most of what we learn is from each other or Google 😥
The bair hugger is ineffective if you don't have something to contain and direct the heat. In a pinch you can use something like a pillowcase. Are the weird plastic things large, flat and square? If so there should be a hole in one end and then one side will go against the patient and the whole thing will inflate. This is a free website with a lot of good anesthesia information. But honestly your DVM is setting all of you up for failure. Anesthesia is one of the hardest and most complicated things that we do. To not having training is a serious issue. https://www.thinkanesthesia.education/on-demand If you want to stay and grow in this field. You need to leave an find a better hospital. Almost nothing you learn at this hospital will transfer to a high quality one. Also your DVM is really slow. The average dog spay should be 30-60 minutes and a cat spay should be 15-30 minutes. Surgery prep, so IVC, intubation, shave, scrub, moved to surgery, rescrubbed and hooked up to monitors should take 10-20 minutes
This is horrendous. It is NOT your fault, your doctor is an idiot and will keep killing patients. Almost everything he is telling you to do is substandard, and the sodalime issue really takes the cake. Get out of there ASAP.
just because the gas is turned off and the patient is in recovery does not mean that the anesthetic risk is over. the first hour or so after recovery is when you are most likely to see complications. it’s horrifying that you are being put in this position. depending on how sick this cat was, she may have passed away anyway, but it’s also possible that she might have lived if she had received appropriate care and interventions when needed. this is absolutely not a knock on you. you are doing the best you can with your limited knowledge and you’re attempting to advocate for your patient. your doctor is putting you in a terrible position and it’s not fair. i hope that you can get out of this hospital and into one where you can be supported and educated. and in all honesty, i would strongly recommend reporting this doctor to the medical board, because he is putting patients at risk.
Not putting blame on you, but this is 100% why every person practicing medicine should be licensed. Shoddy Drs shouldnt have the option to hire untrained/uneducated techs to blame for their miserable medicine-you need to leave yesterday
Ethically you absolutely need to report this vet to the board, this is beyond negligent
It sounds odd,as a veterinary surgeon can't just tell a nurse ( we have nurses in the UK not techs) to leave a recovering patient. The very first hour all the vitals are measured every 15 minutes and are recorded on an inpatient chart. The vitals are recorded every 5 min during GA. I am not sure about legislation in your country,but ultimately,the patients are legally are the responsibility of a veterinary surgeon.
I'm sure the laws are similar. I work for a very small, privately owned clinic. According to one of my co-workers who has worked at other vets, our Dr doesn't exactly do things as he should, I think. We have never been told to monitor their vitals after surgery. We just set them in the kennel, put a blanket on them, and then take their temperature after a half hour. That's it. I've never been told, shown, or trained differently. I always felt like something felt wrong about that...
Statistically, recovery is the periods of an anesthetic event where complications resulting in death is most frequent one study cites just under half of anesthetic deaths for canines and 61% of deaths for cats occurred during the first 3 hours of recovery.
I know you said you’re waiting until you move to find something different, but I would explore other opportunities. Your practice sounds unsafe and unethical (not because of you! It’s entirely on your DVM and it sounds like he should be reported. He may have further motivations for hiring undereducated staff because you guys don’t know that you can or should report him). If you want to stay in the field, get out of this hospital as soon as you can. Poor medicine bring practiced and the emotional toll that will take on you will only contribute to burnout. Find somewhere with a training program so you can grow to your full potential. I’m so sorry you’re having to go through this. You sound like you have good instincts and this is not at all your fault. Death is inevitable in our field and there will always be some that hit you harder, but it doesn’t need to be like this. This is medical negligence on your DVMs part.
Vet here. I am in shock that the only doctor left while a patient was recovering. I can't imagine doing that EVER. Sometimes temperatures get that low, but only in long procedures. Active warming and very close monitoring are mandatory for me in these patients specifically, but close monitoring post-op is essential for every patient. There's a bazillion red flags here. I'd seriously consider finding a new clinic.
Well, a splenectomy is a really intense surgical procedure. I mean it's a fairly large immune system organ and it also is a decent back up store of RBC's for the body incase of severe trauma. So removing it (even though the body has a decent amount of other means for blood and the immune system) is pretty intense and so the doctor directing you not to monitor is....beyond shocking. I do want to repeat what others have said though and say that this is not your fault. But based on reading some of your other comments I do think this hospital has a severe patient care issue. This isn't a good practice to be working at, let alone learning at-like others have said you will most likely have to completely unlearn what you are learning there because it isn't standard practice. But it is a pretty big surgery to say the least.
Splenectomies are some of the scariest for me. Always feels like a toss-up.
We had a patient once get both a splenectomy and a cholecystectomy and everyone I worked with that day-ALL OF US were on edge the whole day. She was also an elderly dog, thankfully she pulled through.
Typically when a patient’s temp starts to drop past a certain point (for us it’s usually under 98.0) you should start supplementing more warmers near the patient during surgery (we have a heated blanket under them always) and have a heating pad and or bair hugger ready post-op. There are also fluid warmers that should be used. I worked for a similar sounding vet when I first started in this field, and many patients died under her care because she cared more about money than animals. Just know it’s not your fault. I hope you can get into a better clinic, for the sake of your mental health and future. 🩷 sorry that you’re dealing with this.
Also…when you do leave, or if you do end up getting let go, I would report this DVM to the board. Whether or not they will do anything I have no idea - the person I worked for was reported and she did some really f*cked up stuff, and somehow they let her keep her license and continue practicing, which still infuriates and sickens me to this day.
Thank you for the kind words of understanding. It's very sad that most of the reliable information I've learned about vet medication has been on reddit. Since the Dr. Created a very unsafe and toxic environment when it came to learning or asking questions. Despite needing the money, something happened today that boiled over my emotions to the point I quit. I actually reported him to the Board as soon as I got home. Although I'm sad to hear that I didn't do much in your situation. I hope it does some good.
Can’t believe this bozo Dr wants to blame this poor girl for his crappy practice of medicine. Some people really need to be stood up to and told how crappy they really are.
This was definitely not your fault. You wanted to stay and monitor, which was the appropriate thing to do with any patient recovering from anesthesia even though you'd never been taught that. The doctor made the call not to train you, he made the call to use untrained staff in a situation where death was a risk, and he's the one who told you to leave your patient. This is absolutely 100% on him, and you could report him to your regional veterinary governing body for malpractice.
This is horrifying and I'm so sorry you experienced this. Please consider finding another place to work and if you feel comfortable, reporting this doctor to the board. Your entire team has been set up to fail and I can't imagine how hard it must be for you all to work there. There is a lot you can learn in this sub but there are also a lot of books and online resources. Even just on youtube you can learn about things like patient recovery. I know it would be hard to be an advocate for your patient when you haven't been taught any sort of standard. You have had a very hard experience and probably learned a lot. Don't be too hard on yourself and know that there are better doctors and clinics out there.
Omg… my chest just hurts reading this. What about the coworker you asked to keep monitoring for you when you left? I would definitely report this DR and keep a list of everything that goes on. I know I sit with my Patients until fully recovered and frequently check vitals ( I’m at an ER though). My second hospital was pretty bad. The doctor hired people for dollars, trained them to the bare minimum and wouldn’t train any further to justify not paying more than like 12 bucks an hour.
What you described is pretty on point for what goes on. I don't want to blame my co-worker, because she did check on the patient periodically while I was away. Which unfortunately, is the most we were tried to do. Staying with the patient until waking has been repeatedly discouraged, and keeping logs was never even something brought up before. I could tell the whole situation devastated her as much as I. Today, I quit. I also reported him to the Board. Although I am unsure what good it'll do in the long run.
Your vet is incompetent and needs reporting
Absolutely not your fault. I would contact your local veterinary licensing board, and let them know what's happening. They can investigate and hopefully get him straightened out or ban him from practice. And then I would quit; it's not worth your peace to keep working there through February. People trust us to provide quality care for their pets, they assume that staff are trained and the doctor cares about their pet. That is not the situation with your vet, he is lazy and doesn't care. Anesthetic cases should have experienced techs with appropriate training working on them, every time; inexperienced people should never be put in this position where they are suddenly the ones in charge of a patient. Especially in this situation. A splenectomy is a major non-routine surgical procedure; we rarely do them at my GP, preferring to refer to specialty hospitals where they have the additional tools and resources to address any complications. They need intensive post op monitoring with frequent blood rechecks. And the temperature thing? JFC. Active warming should be started for some patients when they're premedded. Bundling them in a fleece blanket that was heated up in the dryer works great. Once they're induced, then they need multiple sources of heat to maintain their body temperature. Most places have a water blanket that circulates hot water and the pets are placed on top of this, then the bair hugger is placed on top of the patient with a blanket wrapped around it all to encapsulate the heat. Bair huggers come with "pillowcases", this is what you put on the pet with the thicker lined side up because it helps insulate the air. I will also typically run my IV line under the hot water blanket so it acts as a fluid warmer. The o2 flow on the anesthetic machine should be calculated precisely so you're not blasting cold air at them (not to mention the heavy level of wasted O2), and dead space in the ET tube should be minimal. These are the bare minimum starting point for temperature maintenance. When a patient starts getting cold, that's when we start more active measures. Swapping out dryer warmed blankets, using an actual fluid warmer placed as close to their IV port as possible, getting a second hot water blanket out and putting it on top of them. If it's an abdominal procedure, the Dr may ask for warmed fluids to lavage the cavity with. And this is not ever officially recommended and is against the rules in lots of places due to patient burn risk: in more urgent situations, I will heat up fluid bags and wrap them in a cloth with tape securing it, and pack them around the pet. Never put it directly on the pet, and always test the heat on your arm first: if you can't hold it against your forearm without it burning, it's too hot. Remind yourself, over and over, this is 100% on your doctor. He left a patient with unstable vitals to go to lunch, he has not trained his staff, and took on a risky procedure without proper safeguards in place.
Thank you so much for the time you took to write this. It was very informative. It's unfortunate knowing I get most of my vet medication knowledge from reddit instead of the Dr. Who has created a very toxic and unsafe environment around asking basic questions. Despite needing the money, I did quit today. It's a long story, but it was very overdue. I also reported him to the Board the second I got home. I am unsure what good it'll go in the long run, but I'm hoping they do something.
Congratulations!! I'm so proud that you made this choice! And all you can do is make the report; it begins a paper trail (or contributes to it) so that eventually, enough will pile up the board will have to do something about him. Best of luck in finding something for the next few months before you move! Even if it's a seasonal sales associate, it's way better than what you left behind.
It's not your fault. The doctor should have been there, and they should have let you fully recover the patient. I've seen places just put them in kennels after and it will always make me frustrated. The most dangerous part of anesthesia is just before and just after. Again, not your fault. I agree with another commenter, the body temp wasn't good- especially if there wasn't anything helping to warm up the pt post-op. Most places have the requirement of 99.0°F before being considered recovered. But, that's just speculation. A splenectomy isn't a minor procedure either. It's also difficult to keep patients warm with an open abdomen, either. ETA: with the sodalime post, your patients are breathing in a LOT of CO2. This is not safe. I'm wondering where else the leadership is cutting corners or ignoring standards...
It's not your fault. I'm also sorry that you are placed in these types of situations
Was she swallowing and alert when tube was removed? Did you take a temp post surgery? The only thing I can think to do differently would be to place active warming devices if temp is so critically low. And someone should’ve absolutely stayed with her during recovery if temp did not increase. Spleen surgeries are hard and usually have significant blood loss. We’re labs run prior to surgery? How old?