One of my main problems that I come across is that I want to make notes (in whatever format, but writing stuff down helps me focus on it, and it seems to make it stick better) and then I end up with about ten different ways of storing them. I have a lot of my lecture slides in course folders, and all of my notes from those lectures are in books, but then I have a bunch of extra stuff that's saved in random places where I've tried to pigeonhole it into existing folders, or written notes based on a specific textbook, etc.
I've hit upon a more question-based approach which I think might help focus my information on what's useful and relevant, where I've split vet nursing in total up into seventeen categories which hopefully cover most things I'll need to know, and has the added benefit of being separate to courses and specific books and such, so I should be able to keep each section up to date and separate, without too much blending.
So far my list of topics is:
-Anaesthetics
-Anatomy
-Avian/Reptile
-Behaviour
-Clinical/Diagnostic
-Emergency
-Geriatric Care
-Laboratory
-Medical/Intensive Care
-Paediatric Care
-Pathology
-Pharmacology
-Preventative Care/Product Knowledge
-Radiology/Imaging
-Reception/Computer Skills
-Small Animal Care
-Surgery
As far as definitions go, I'm still working on wording them exactly right because most of them are still a bit iffy in my head. The categories look like they should be reasonably easy to define though, so it's the bones of a project I intend to work on for basically my entire vet nursing career.
The way I'm planning to set things up is that within each of the above categories, there'll be a bunch of questions which I'll think up whenever I find something I'm uncertain about or wish to learn more information on, which will be under each category. That way, when I want to do some learning, I can pick a section, and have definite questions to find an answer to, like "what do the atria and ventricles of the heart appear as on an ultrasound?" "what are some abnormal heart sounds and what do they signify?", as opposed to the slightly more vague "wanting to know more about the heart". The questions will all be stuff that's relevant (like in my external clinic the other day, we had a cat with saddle thrombus that had been there a few days, and I wasn't sure what that was, so the associated question would be something like "what is a saddle thrombus, how is it formed, and how does it affect the animal physiologically?" I've since found out that it's a clot in the aorta that often forms when there's associated cardiac problems causing uneven blood flow, which breaks off and then partially or completely blocks blood flow to the hind limbs, causing paralysis and tissue death, which may or may not be able to be reversed, and if it's not reversed within a few days then it's best to euthanize before gangrene sets in. Treatment being blood thinners, fluids, and hope. This cat unfortunately didn't make it (she died really suddenly when we were trying to feed her) but she didn't really have a positive prognosis either.
It's just things like this - specific diseases and such - that we haven't been taught much about yet that I come across and feel like I don't know enough about yet. From what everyone else is telling me, a lot of it is experience and I know that seeing an animal with saddle thrombus really drove it home more than words on a page will ever be able to, but I...basically want to know everything I can cram into my head about vet nursing and animal pathology and surgery and general care, and I need to know more about emergency situations and such. Really the only thing I can't focus on yet is reception, and that's only because each clinic I go to uses a different system and I don't spend enough time on reception anywhere to need a complete how-to guide. It's something I'm confident I'll pick up on my own once I start regularly using a single system.
Overall I'm hopeful for this system of organisation, but we'll have to wait and see how it goes.
Saturday 23 July 2011
Friday 22 July 2011
PHC Assessment and General End Of Semester Ramblings
I think I've officially impressed people (but at the same time I don't want to get complacent and stuff it up). I'm not entirely sure if I've talked about this before, but at the start of the year, one of my lecturers put my first-year case report in to a journal publication. There were some minor things to change, but they were mainly just a few clumsy sentences and removing specific times and such from the report. That came out about two weeks ago, and my report came out really nicely.
About a week ago, the same lecturer emailed me about an assessment that we need to do later on in the year, which is basically a preventative health clinic (PHC) where we look at people's pets that are either well and getting a yearly checkup, or their owners are just starting to notice that their animal's doing something kinda weird. What we need to do is take the history, examine the animal, talk with the vet, collect samples for diagnostics where appropriate (eg we'll do a blood draw but not a cystocentesis), analyze those samples, and then talk with the vet about the case, with some basic recommendations about what we need to do to confirm or deny likely possibilities. We're not expected to diagnose the animal ourselves, and it is completely up to the veterinarian to say what gets done, but obviously the more knowledge you have, the better. After that we'll need to talk to the client, explain the findings and the recommendations, give them a sample bag of select goodies that are relevant to their case, and follow through with sending off lab samples etc if it's needed. This is all supposed to be done in September, and I think we also need to do a bunch of advertising and stuff on the clinic to drum up our customers.
Well, this lecturer's cat was starting to look a bit poorly NOW, as opposed to in September, and she also got the go-ahead to choose her very own student to do their PHC assessment early, on her cat. She chose me, which is rather flattering, and told me that she didn't think it'd affect my marks if I did the assessment early, but that it'd probably be easier to do it early as well, seeing as it'd just be me in the clinic, rather than me and twelve other people and twelve other clients and twelve other pets. There was also the plus that she'd be holding and I'd trust her to properly restrain just about anything. She also knows what I SHOULD be doing, but wouldn't construe things completely wrong, either. She sent me a marking schedule, and it all looked reasonably do-able, so I went for it. I was in VSG on Tuesday, at my external clinic on Wednesday, and then did the assessment, so I got to do a practice blood draw on a cat at my external clinic which was good, since before this, I'd only drawn blood from one dog (the total is now one dog and two cats and one nonproductive stab).
Basically I met my lecturer at the clinic, and examined her cat. I didn't take an awesome history (I got most of the basics, but did miss some important stuff) and my examination was also a bit more patchy than it should have been (I missed some bald patches from fur-pulling, a small sore in her mouth, a rather large heart murmur which was probably present when I listened, but may not have been as loud, and soreness in the hips and left forearm) which was a bit frustrating. I didn't have a sheet, so I was doing things completely from memory, but I should still have picked up on at least some of those. I did manage to do the blood pressure monitoring quite well, and figured out that the cat did better with her head covered so she didn't have to look. We gave her a few breaks because she was a really timid cat, and then came back to get blood samples and a urine sample if we could. It worked pretty well - her collar had rubbed a ring of fur off most of her neck, so I didn't have to clip, and her jugular was large and easy to find. I drew one sample pretty well but slightly fumbled the syringe and couldn't get all the volume out at once, so had a second try and didn't quite get it, so the vet drew up the remaining volume from the other jugular. Apparently the right side is usually larger, too. The lab tests went quite smoothly, though my blood smears were rather shabby. The cat had elevated ALT and creatinine, so we asked the lab to include a CBC in with the T4 test they were already doing( (we actually JUST missed the lab courier, which is annoying, but the forms did say to hold the other samples, so it should be fine - they'll just get told with the afternoon pickup.My explanation was okay (I did get some time to read through a five-minute consult book that gave information about each thing on the biochemistry test, and about what an increase paired with other increases meant, etc. ) and they actually started asking me harder questions as well, to see if I could answer them. We tried again for a cystocentesis sample but her bladder was still too small, so we weren't able to get a urine sample. The vet seemed to be impressed with me overall, and told me that the extra work I was putting in was really showing, which made me pretty happy. I'm glad to do the extra, and I enjoy learning about stuff, but it is nice to see that other people have noticed it too.
About a week ago, the same lecturer emailed me about an assessment that we need to do later on in the year, which is basically a preventative health clinic (PHC) where we look at people's pets that are either well and getting a yearly checkup, or their owners are just starting to notice that their animal's doing something kinda weird. What we need to do is take the history, examine the animal, talk with the vet, collect samples for diagnostics where appropriate (eg we'll do a blood draw but not a cystocentesis), analyze those samples, and then talk with the vet about the case, with some basic recommendations about what we need to do to confirm or deny likely possibilities. We're not expected to diagnose the animal ourselves, and it is completely up to the veterinarian to say what gets done, but obviously the more knowledge you have, the better. After that we'll need to talk to the client, explain the findings and the recommendations, give them a sample bag of select goodies that are relevant to their case, and follow through with sending off lab samples etc if it's needed. This is all supposed to be done in September, and I think we also need to do a bunch of advertising and stuff on the clinic to drum up our customers.
Well, this lecturer's cat was starting to look a bit poorly NOW, as opposed to in September, and she also got the go-ahead to choose her very own student to do their PHC assessment early, on her cat. She chose me, which is rather flattering, and told me that she didn't think it'd affect my marks if I did the assessment early, but that it'd probably be easier to do it early as well, seeing as it'd just be me in the clinic, rather than me and twelve other people and twelve other clients and twelve other pets. There was also the plus that she'd be holding and I'd trust her to properly restrain just about anything. She also knows what I SHOULD be doing, but wouldn't construe things completely wrong, either. She sent me a marking schedule, and it all looked reasonably do-able, so I went for it. I was in VSG on Tuesday, at my external clinic on Wednesday, and then did the assessment, so I got to do a practice blood draw on a cat at my external clinic which was good, since before this, I'd only drawn blood from one dog (the total is now one dog and two cats and one nonproductive stab).
Basically I met my lecturer at the clinic, and examined her cat. I didn't take an awesome history (I got most of the basics, but did miss some important stuff) and my examination was also a bit more patchy than it should have been (I missed some bald patches from fur-pulling, a small sore in her mouth, a rather large heart murmur which was probably present when I listened, but may not have been as loud, and soreness in the hips and left forearm) which was a bit frustrating. I didn't have a sheet, so I was doing things completely from memory, but I should still have picked up on at least some of those. I did manage to do the blood pressure monitoring quite well, and figured out that the cat did better with her head covered so she didn't have to look. We gave her a few breaks because she was a really timid cat, and then came back to get blood samples and a urine sample if we could. It worked pretty well - her collar had rubbed a ring of fur off most of her neck, so I didn't have to clip, and her jugular was large and easy to find. I drew one sample pretty well but slightly fumbled the syringe and couldn't get all the volume out at once, so had a second try and didn't quite get it, so the vet drew up the remaining volume from the other jugular. Apparently the right side is usually larger, too. The lab tests went quite smoothly, though my blood smears were rather shabby. The cat had elevated ALT and creatinine, so we asked the lab to include a CBC in with the T4 test they were already doing( (we actually JUST missed the lab courier, which is annoying, but the forms did say to hold the other samples, so it should be fine - they'll just get told with the afternoon pickup.My explanation was okay (I did get some time to read through a five-minute consult book that gave information about each thing on the biochemistry test, and about what an increase paired with other increases meant, etc. ) and they actually started asking me harder questions as well, to see if I could answer them. We tried again for a cystocentesis sample but her bladder was still too small, so we weren't able to get a urine sample. The vet seemed to be impressed with me overall, and told me that the extra work I was putting in was really showing, which made me pretty happy. I'm glad to do the extra, and I enjoy learning about stuff, but it is nice to see that other people have noticed it too.
Saturday 9 July 2011
Work Experience At The Zoo
Today I got to go to a nearby zoo & wildlife center with a friend from vet nursing (for transport) and spend 8 hours there to fulfil course requirements for my study. It. Was. AMAZING.
We started off at 6.30am, and drove down, getting lost on the way and ending up 20 minutes past where we needed to be - luckily we'd left in such good time that we weren't that late in the end. Filled out some forms, then went around on the morning monkey feeds, which included cotton top tamarins, lemurs, capuchin monkeys, a lone spider monkey, Barda, (who lived next to the main capuchin monkey cage), and others. One of the lemurs was feeling poorly, so we got quite a good look at her because she was comparatively still, and we also got to have quite a lot of time with Barda, as he was very attached to his keeper (who was showing us round) and would come right up to the bars to say hello. After that was some veggie chopping for the emus.
After that, we had morning tea, and went on the monkey/elephant talk, which involved a little more about the monkeys, then we went to see Mila, who is the ex-circus elephant that they rescued, and have been since rehabilitating with tremendous success. Mila's an African elephant who was wild-caught and then kept in zoos and circuses for thirty years, so it was amazing to see how far she'd come. She was genuinely caring with her main keeper, and they obviously had a very special relationship. Positive reinforcement really has done wonders for her - it's so cool to see her showing natural behaviours when she used to rock stereotypically for nearly 20 hours a day.
Then we got to go around all the red-eared slider (turtle) cages, and check all the turtles. They're hibernating over winter so they don't get fed, but we did pick them all up and checked their shells for scratches, chips, or other damage. Most of them only had a few bashed-up bits, but one did have a small sore on it leg. We iodined up any damage, and had a lot of fun with the turtles, as turning them on to their backs basically stopped them from attempting to leave, not that they were having much luck!
After cleaning up the turtles it was time for lunch, and one of the zoo cats made sure to get in all the cuddle time/food stealing he wanted, which was cute. There are three cats that roam around the zoo (which is somewhat bad in terms of healthcare, but the main keeper is a fully qualified vet with a second degree in nutrition, so she tests their feces regularly for things like toxoplasma gondii, which can reproduce inside any mammals or birds.
After lunch, we did an otter talk, then got to see Mila in her outside enclosure - there were a few more people, so this one wasn't held in the barn - and then got to see Ruby, the lioness, fed, as well as the bobcats. That was really neat, even if it did start raining quite heavily at times. Ruby was very friendly towards her keeper as well, rubbing up against the cage for (careful) scratches, and following her around - although that was probably just for the food benefit! We also got to hear Ruby roaring quite a bit as we were running slightly late, which was pretty cool, too.
After the talks, we helped the main keeper do a soak of a sick chicken's badly infected feet, which was kind of gross but necessary, and also got to see a fledgling woodpigeon which was being cared for. Then we stopped by Mila again to give her some browse, although we were quite preoccupied by the two zebras, which were shamelessly cadging food (we were given bags of duck/chicken/emu/zebra/deer/peacock/pigeon/sparrow food, which we scattered around with us through the day, more or less tripping over the animals in the process) and then sorted out some kea enrichment, which was us stuffing muesli bars, unbuttered popcorn, and sunflower seeds into a roll-along treat ball, and a length of bamboo with the divider portion in the middle of a ten-inch tube, which we then put in with the keas, and got to watch them having a go at getting the food out. They were actually really clever about it too - the male kea was dunking his muesli bar in the water bowl to soften it up, and he would pick the stick up and drop it a few times if he thought he could dislodge some more muesli from the inside. We didn't get to see them finding the treat ball though, because it was time to sort out some more monkey food.
One thing that really surprised me (although it makes sense looking back) is how much food that zoos go through in a day. The elephant would eat 110kg of leaves, branches (thick as my wrist branches too, not twigs) and fruits and veggies, the lion went through 3-5kg of meat per meal, the bobcats were a kilo between them, the monkey cages would have been about four large buckets stuffed with fruits, and the emus went through another bucket of carrots and muesli bars and the like, and that was just the feeds we saw - maybe half the diets. It was pretty cute though, because one of the other zoo cats (domestic ones) was meandering around the kitchen chasing the fledgling pigeons that have adopted the place, which was a spotted bengal named Spots, who was "not very clever". She was really talkative though, and friendly, and stood on my shoulders for a while when I picked her up.
We gave the capuchins and Barda some more fruit, and tried to have another look at the cut that Barda had on his hand. There were two main groups of capuchins - a big group of twelve that had two cages connected by a wire walkway over the path (Barda's cage had a walkway that mirrored theirs, and a second enclosure down the bottom) which were quite stable and harmonious, and a smaller group of three (two girls and a boy) who were the misfits of the capuchin world, with a low-rank female, a low-rank female with no monkey social skills, and a large but low-rank male. By putting them separately, it stopped them getting bullied by the other group members, and they're apparently really shining for it. They certainly seemed very content when we went to feed them, with Jungle coming right up to the front of the cage (she was raised mostly by humans though, so her behaviour isn't typical of capuchins).
Next was probably one of the most awesome parts of the day - we got to hand-feed mealworms to some cotton-top tamarins. That was singularly awesome, because they're so much more delicate up close. It was the coolest feeling ever to feel them grabbing stuff off my hand, and I don't think I'll forget how solemn and gray their faces were - a little incongruous with the wild hairdos though!
After feeding the tamarins, we also got to feed the center's ageing one-eyed otter, who was also a bit of an oddball, in that he was mostly blind, old, and small for his species, so it was very difficult to get him into a group. However, it does mean that he can be hand fed as well, which meant scooping up bits of mince, and holding them out for him to delicately grab with his mouth (doing very well for someone not able to see much).
The center really did have a bit of an odds-and-sods animal collection, but that's mostly because they don't really aim to be a popular zoo because they've got amazing animals, but because the animals they do have are all there on other reasons, and the education benefit comes second to the welfare of the animals. A lot of them are animals that didn't get along with others, they had a lot of ex-circus animals that needed extensive rehabilitation, or they're animals that just aren't wanted anywhere else. The fact that they put so much effort into keeping everything running, and that they still had constant improvements they were making, and wanting to make, and plans for future years - it's just stunning, the amount of work they put in for the animals. I have nothing but the highest esteem for the main keeper, because she obviously knew her stuff, but every action showed how much she cared about her animals. Not only that, but the fact that she lives on site, and wakes up whenever Mila needs a friend, no matter how little sleep she's had...it makes me feel very small, when I think about her dedication. What's more, on a day where she was short staffed, and had four other young students in for captive wildlife courses (either current or planned) she still made as much of an effort as possible to make our day interesting and fun, going out of her way to make sure that we got to do things like feed the cotton tops, and things like that.
One day just wasn't enough time there, which makes me really glad that we may be going back for another day there.
We started off at 6.30am, and drove down, getting lost on the way and ending up 20 minutes past where we needed to be - luckily we'd left in such good time that we weren't that late in the end. Filled out some forms, then went around on the morning monkey feeds, which included cotton top tamarins, lemurs, capuchin monkeys, a lone spider monkey, Barda, (who lived next to the main capuchin monkey cage), and others. One of the lemurs was feeling poorly, so we got quite a good look at her because she was comparatively still, and we also got to have quite a lot of time with Barda, as he was very attached to his keeper (who was showing us round) and would come right up to the bars to say hello. After that was some veggie chopping for the emus.
After that, we had morning tea, and went on the monkey/elephant talk, which involved a little more about the monkeys, then we went to see Mila, who is the ex-circus elephant that they rescued, and have been since rehabilitating with tremendous success. Mila's an African elephant who was wild-caught and then kept in zoos and circuses for thirty years, so it was amazing to see how far she'd come. She was genuinely caring with her main keeper, and they obviously had a very special relationship. Positive reinforcement really has done wonders for her - it's so cool to see her showing natural behaviours when she used to rock stereotypically for nearly 20 hours a day.
Then we got to go around all the red-eared slider (turtle) cages, and check all the turtles. They're hibernating over winter so they don't get fed, but we did pick them all up and checked their shells for scratches, chips, or other damage. Most of them only had a few bashed-up bits, but one did have a small sore on it leg. We iodined up any damage, and had a lot of fun with the turtles, as turning them on to their backs basically stopped them from attempting to leave, not that they were having much luck!
After cleaning up the turtles it was time for lunch, and one of the zoo cats made sure to get in all the cuddle time/food stealing he wanted, which was cute. There are three cats that roam around the zoo (which is somewhat bad in terms of healthcare, but the main keeper is a fully qualified vet with a second degree in nutrition, so she tests their feces regularly for things like toxoplasma gondii, which can reproduce inside any mammals or birds.
After lunch, we did an otter talk, then got to see Mila in her outside enclosure - there were a few more people, so this one wasn't held in the barn - and then got to see Ruby, the lioness, fed, as well as the bobcats. That was really neat, even if it did start raining quite heavily at times. Ruby was very friendly towards her keeper as well, rubbing up against the cage for (careful) scratches, and following her around - although that was probably just for the food benefit! We also got to hear Ruby roaring quite a bit as we were running slightly late, which was pretty cool, too.
After the talks, we helped the main keeper do a soak of a sick chicken's badly infected feet, which was kind of gross but necessary, and also got to see a fledgling woodpigeon which was being cared for. Then we stopped by Mila again to give her some browse, although we were quite preoccupied by the two zebras, which were shamelessly cadging food (we were given bags of duck/chicken/emu/zebra/deer/peacock/pigeon/sparrow food, which we scattered around with us through the day, more or less tripping over the animals in the process) and then sorted out some kea enrichment, which was us stuffing muesli bars, unbuttered popcorn, and sunflower seeds into a roll-along treat ball, and a length of bamboo with the divider portion in the middle of a ten-inch tube, which we then put in with the keas, and got to watch them having a go at getting the food out. They were actually really clever about it too - the male kea was dunking his muesli bar in the water bowl to soften it up, and he would pick the stick up and drop it a few times if he thought he could dislodge some more muesli from the inside. We didn't get to see them finding the treat ball though, because it was time to sort out some more monkey food.
One thing that really surprised me (although it makes sense looking back) is how much food that zoos go through in a day. The elephant would eat 110kg of leaves, branches (thick as my wrist branches too, not twigs) and fruits and veggies, the lion went through 3-5kg of meat per meal, the bobcats were a kilo between them, the monkey cages would have been about four large buckets stuffed with fruits, and the emus went through another bucket of carrots and muesli bars and the like, and that was just the feeds we saw - maybe half the diets. It was pretty cute though, because one of the other zoo cats (domestic ones) was meandering around the kitchen chasing the fledgling pigeons that have adopted the place, which was a spotted bengal named Spots, who was "not very clever". She was really talkative though, and friendly, and stood on my shoulders for a while when I picked her up.
We gave the capuchins and Barda some more fruit, and tried to have another look at the cut that Barda had on his hand. There were two main groups of capuchins - a big group of twelve that had two cages connected by a wire walkway over the path (Barda's cage had a walkway that mirrored theirs, and a second enclosure down the bottom) which were quite stable and harmonious, and a smaller group of three (two girls and a boy) who were the misfits of the capuchin world, with a low-rank female, a low-rank female with no monkey social skills, and a large but low-rank male. By putting them separately, it stopped them getting bullied by the other group members, and they're apparently really shining for it. They certainly seemed very content when we went to feed them, with Jungle coming right up to the front of the cage (she was raised mostly by humans though, so her behaviour isn't typical of capuchins).
Next was probably one of the most awesome parts of the day - we got to hand-feed mealworms to some cotton-top tamarins. That was singularly awesome, because they're so much more delicate up close. It was the coolest feeling ever to feel them grabbing stuff off my hand, and I don't think I'll forget how solemn and gray their faces were - a little incongruous with the wild hairdos though!
After feeding the tamarins, we also got to feed the center's ageing one-eyed otter, who was also a bit of an oddball, in that he was mostly blind, old, and small for his species, so it was very difficult to get him into a group. However, it does mean that he can be hand fed as well, which meant scooping up bits of mince, and holding them out for him to delicately grab with his mouth (doing very well for someone not able to see much).
The center really did have a bit of an odds-and-sods animal collection, but that's mostly because they don't really aim to be a popular zoo because they've got amazing animals, but because the animals they do have are all there on other reasons, and the education benefit comes second to the welfare of the animals. A lot of them are animals that didn't get along with others, they had a lot of ex-circus animals that needed extensive rehabilitation, or they're animals that just aren't wanted anywhere else. The fact that they put so much effort into keeping everything running, and that they still had constant improvements they were making, and wanting to make, and plans for future years - it's just stunning, the amount of work they put in for the animals. I have nothing but the highest esteem for the main keeper, because she obviously knew her stuff, but every action showed how much she cared about her animals. Not only that, but the fact that she lives on site, and wakes up whenever Mila needs a friend, no matter how little sleep she's had...it makes me feel very small, when I think about her dedication. What's more, on a day where she was short staffed, and had four other young students in for captive wildlife courses (either current or planned) she still made as much of an effort as possible to make our day interesting and fun, going out of her way to make sure that we got to do things like feed the cotton tops, and things like that.
One day just wasn't enough time there, which makes me really glad that we may be going back for another day there.
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