Anesthesia week 1

My classmates said not to worry because the first day on anesthesia is spent shadowing others.
Good thing I studied anyway because that was a big fat lie!
It was ridiculously busy today - maybe because Friday all the residents have an all-day meeting so they're trying to squish everything into 4 days? Anyway, around noon the scheduler says "I have a case for you. The induction time is 45 minutes from now."

Here's what I had to do in those 45 minutes:
- Find the dog and the student from the surgical service
- Look through the dog's chart for weight, key physical examination findings, and history from the referring veterinarian
- Wait for the bloodwork results to show up from our lab, check those, and record the abnormalities/reasons for them/any changes to the anesthetic plan because of them
- Write up the anesthetic plan: premedication, induction, maintenance, monitoring, and post-operative analgesia
- Get the anesthetic plan approved by faculty
- Find an anesthetic machine, set it up, and pressure check it
- Set up everything to place an IV catheter and run fluids
- Set up everything to intubate the dog
- Premedicate the dog
- Tell the surgical service that the dog is premedicated and that I'm ready when they are
- Place a catheter in the dog

Just writing that down makes me want a beer. Unfortunately we have rounds at 7 am, and my next case is induced at 8 am.
It's been a long week already!

Community surgery, week 2

This week so far I've done another dog spay, another dog neuter, and a combination spay + front leg amputation on a kitten.
Crazy!
I've also been learning a lot more about anesthesia. For example, the dog spay required a lot more advance planning because she had complications during her last anesthetic event, and the kitten amputation required special nerve blocks that I got to place (and they worked!)
Tomorrow I do another cat neuter on a red tabby that looks a lot like my Billy cat.
I'm going to miss this rotation a lot, but fortunately I have a couple more weeks coming up soon! On to anesthesia next week - good thing I got a refresher course during this rotation.

Perfectionism?

Here's the thing. A lot of (maybe most) vet students have a highly developed sense of perfectionism. It's what drives us to work so hard to get good grades, get enough experience, and persevere through a really hard curriculum.
It also makes us very hard on ourselves when things don't go perfectly.

My surgery today was an enucleation (eye removal) on a middle-aged dog with chronic glaucoma in that eye which had progressed to blindness. This particular surgery is known for causing a fair amount of bleeding because you have to cut through a lot of muscles holding the eye in the socket. In addition there's a big vein running along the inner corner of the eye that you have to try not to hit.
No, I didn't hit that vein - thank goodness! However, the muscles bled a LOT - which made it hard to see what I was doing and, to be honest, freaked me out a little bit (despite having seen that amount of bleeding in my enucleation surgery a couple of weeks ago). It's much higher pressure when you are the ONLY person scrubbed in!
Anyway, the rest of the surgery went fine and the dog recovered from anesthesia well. However, when I went to take her for a walk a few hours later the surgery site oozed a bunch of semi-clotted blood. This freaked me out again. The techs were awesome and reassured me that this sometimes happens, helped me clean her up and cold compress the incision site to stop the oozing, and told me to make sure she gets a lot of rest tonight. Her mucous membranes were still pink and her CRT was still < 1 second, which made me feel a little better.
I don't think I was freaking out outwardly but I sure was on the inside - and now I'm trying not to obsessively worry about her. I'm going in to check her later tonight and hope she will be ok.

UPDATE: She's doing okay. Her poor little face is pretty swollen but she is resting quietly.

Surgery!!

Started the Community Surgery rotation yesterday. I have 4 weeks total, broken into a couple of 2-week chunks. Today I did a dog neuter and a dog spay. This rotation is nice because there's a clinician there if you need it, but if you don't need them you can just keep on truckin' and you don't have to check every little move with them.
It made me feel good to have one of the clinicians say "Have you been volunteering at spay/neuter clinics?" and when I said yes, they said "It shows." It also made me feel good to have both of my anesthetists comment on my (relative) speed. I still feel pretty slow honestly (1 hour 15 minutes for a spay, much of which was spent doing simple interrupted closure on the body wall, and 30 minutes for the neuter) but it was nice to hear that I don't suck.
Also - I got to try testicular blocks today for my neuter. It's where you inject a small volume of a local anesthetic into the testicles before removing them. The idea is to make the patient less painful. Let me just say that they are THE BOMB. My patient was bouncing around 2 hours later as if nothing happened!
Thursday I might get to take an eyeball out. Stay tuned.

Interview #1

Yesterday I had my interview with the big corporation. I think it went really well. I will be doing a site visit next month at one of the hospitals near my home (permanent home, not school home) during my week off. That makes 2 site visit interview-type days filled so far that week - not bad. I'm hoping to line up a couple more visits before then, but we'll see.
Today was my last day on ophthalmology. I really liked that rotation and learned a lot on it. I still struggle a little with the fundic examination (looking at the back of the eye using a bright light and a hand lens) but even that has improved. And - best of all - most eyeball things no longer give me the heebie-jeebies!
Monday I start community surgery. I absolutely cannot wait!

Job hunting

I'm working on the job search in my spare (haha) time. So far I have spoken with my old clinic, another local clinic, and will be interviewing with a big veterinary corporation later this week. I've applied to a couple other positions where I've received no response.
Here's what I've done so far:
- While externing at my old clinic, I'd answer "Yes, I'd love to!" whenever anyone asked if I wanted to come back to work there as a veterinarian. I also spoke with the practice manager expressing my interest. I'll likely follow up with them again in a couple of months to see if they are in a position to hire (right now is the slower season so they can't say).
- Emailed my resume to another local clinic looking for an associate and received a response (yay)! They are willing to consider a new grad if it's a good fit so I will be visiting there in about a month.
- Applied online to the big veterinary corporation. I know - a lot of people knock corporate practice. Honestly, I've worked for corporations for 10 years before vet school so I think the corporate aspect might be less irritating for me than for others. My main concerns are how many appointments I'd be expected to see per day and how soon they throw new grads into the hospital with no senior doctors available onsite.
- I'm also looking at classified ads on several websites (the state veterinary medical association, the AVMA, and VIN, among others) 1-2 times per week. Pickings are slim for new grads, but you never know.
Here's what I still plan to do:
- Ask a couple of people in my network of contacts if they are hiring or if they know of anyone who is
- Use my week of vacation in a couple of months to visit practices. Hopefully I can line up enough of them in advance so I won't be cold calling (makes me nervous and brings me back to the days of selling Girl Scout cookies door-to-door).
- Be open to part-time opportunities
- Possibly follow up with the shelter where I worked to see if they need any part-time help (or heck, even volunteer surgeons). I say possibly because it was a tough place to work back in the day and I'm not sure I want to go back to that particular environment.
- Consider working as a relief vet

Less lost

As my classmates who have been through ophtho predicted, I felt a lot more comfortable after a couple of days on the service because - let's be honest - there are only so many things that can go wrong in one cubic inch of the body!
I had emergency duty today (and am still on call overnight). It was a pretty busy day but I got to see some good cases.

Switching topics - I am grateful to have enough spare time to keep going to Crossfit. Doing the workouts (even if I have to scale things like using an assistance band for pull-ups) is a great stress reliever. It also feels pretty badass to be able to flip over a huge tractor tire by myself multiple times! I decided to keep going through the remainder of the school year and then play it by ear once I move back home. First I need to get a job to pay for the membership at home. More on the job search later!