What do you do when you feel like you just can’t win? I just had my third work day in a row where I felt constantly behind. I let myself get overwhelmed by the stack of charts with blood work to review, messages to return, estimates to put together, reports to write up and phone calls to make. I like to be efficient at work. I’m known as the doctor that has all of that “extra stuff” taken care of by 10 or 11am, only needing to tackle an occasional message or blood work throughout the rest of the day. All of my exam notes generally get written and signed before I move on to the next appointment. I almost never miss an entire lunch break, nor do I usually leave more than 15 minutes past the end of a shift. I almost never leave any charts in my mailbox for the next day, unless I’ve already left a message but really want to be sure the owner gets it and want to remind myself to follow up.
My last three days have been nothing like that. I’ve left 30-45 late every day. Friday, I left a chart in my mailbox with exam notes and lab work from another vet hospital that I just didn’t have time to review. Today, I left one chart with lab results that are stable from 3 months ago, but I know it’s going to be a half hour phone call. At 1:45pm, I need lunch when I ate a bowl of Cheerios at 7:30am. The fact that I left that one chart weighs on me, and I hate it. It seems that every animal is dying and/or complicated, and if one happens to not fit into those categories, I don’t have time or energy for anything more than the basics for those patients or their owners right now. I feel like a terrible doctor when they walk out the door.
My brain is mush when I get home. On Tuesdays, I only work a half day (after having a 3 day weekend most weeks). Last week, Thursday and Friday lasted an entire week each, I’m convinced. I had my 3 days off and feel like I didn’t have any days off at all. Today, I came home, did a half hour of yoga followed by 15 minutes of meditation meant for “deep relaxation.” During this meditation, I was creating imaginary patients with problems in my head. You could say that it was not as relaxing as intended.
I read lab results for one of my receptionists the other day and somehow added an extra “0” onto her dogs’ lymphocyte count in my head, which I would be a little concerned about if that were true. Thankfully, the count is not 10,000, but 1,000, and I am not actually worried about that. Also thankfully, she works with me, knows me well and knows how stressed we’ve all been when I texted her back later to say, “I’m an idiot; don’t mind me.” Then today, I went to leave a voicemail for a client about her cat’s blood pressure and potentially changing the medication dose. I started to leave instructions at least 3 times, but kept getting distracted by a dog having its blood drawn in the background and forgot what exactly I had said/was pretty certain that I had reversed what I meant to say and then promptly said the same thing again. Eventually, I simply said, “This was probably the most confusing voicemail ever. Please just disregard it, and I’m going to text you what I want you to do.” Way to instill confidence that you know what you’re doing to your clients, right?
This morning alone, I saw a dog that I’m fairly certain has lymphoma, and the owner is not prepared for that diagnosis. Two appointments later, I saw a cat for a quality of life discussion that has a large abdominal mass. I spoke with a long time client near the end of my shift who has a very complicated dog that was diagnosed with kidney failure, on top of all of her other pre-existing problems, a couple of weeks ago. She is dying, and her family is devastated. I ended my day last Thursday with a little 8 year old dog that came in with a very odd presentation. The more of a work up I do on this dog, the more confusing it seems to get. I called the owner today to recommend some additional diagnostics, but apparently, she had already gone back to the ER that did a big work up on the little guy two months ago. He was diagnosed with an inoperable tumor behind his eye. That option was not on my differential list… at all.
I’ve left each of my last 3 shifts feeling parched because, even though I try to drink something between appointments, it’s just not enough for the amount of talking I’m doing with each of these cases and/or phone calls. I’m grumpy every day because I can’t get through my pile of charts in the amount of time I’m used to. Today, I was extra fired up because I learned that we didn’t have any of our core cat vaccines stocked in the fridge in the building I was working in, and my tech was having to go next door for every cat vaccine appointment. I learned this when I had to go next door to get a vaccine myself because he busy was holding a cat that was angry after its blood draw. How am I supposed to do my job efficiently when I don’t even have basic tools handy? Someone please explain this to me. It’s hard enough when it’s just one technician with me in this particular building to get everything done in a timely fashion. Sometimes, we can enlist the surgical recovery tech for something quick, but sometimes she’s plenty busy with her own tasks and patients.
There are, unfortunately, no easy solutions here. (Although I do intend to ask my practice manager why we ran out of our feline rabies vaccine again and point out how inappropriate that is in the hopes that we can stock more than one tray of vaccine in the hospital at a time. Screw corporate’s “budget;” I need this to do my job and take care of patients. It is not negotiable.) Mostly, I just need to suck it up and hope that things settle back down to the “new normal” level of chaos and unpleasantness or that my run of particularly crazy days comes to a close sooner rather than later. There’s always going to be an occasional day that gets out of hand. It gets very old and very draining very quickly when it bleeds from one day right into the next.
As a side note- please, Dr. Andy Roark, don’t make me feel bad about not wanting to answer anyone’s pet related question when I am not at work right now because as you can see from this post, I am at my limit and can barely function while at work. Saying in your latest article to, “Help people out. Or don’t. Don’t feel bad about your choice either way,” is in no way beneficial to me right now, especially after talking about how you have let your boundaries slip because you don’t want to be seen as hiding behind a pay wall. It’s not about the money. It’s about my brain needs to not think about vet med for a little while sometimes.
That is the end of my venting session. *Deep breaths*
“Anxiety’s like a rocking chair. It gives you something to do, but it doesn’t get you very far.” ~ Jodi Picoult
