I went to tech school. I think I went to a pretty good program; we had lots of large and small animals on site and I got plenty of hands-on experience. I monitored anesthesia on multiple species, looked at endless poop and blood samples, and even pulled a calf at the dairy barn. I worked during school in a veterinary clinic that encouraged my learning, so I was able to see what I was learning. But when I hit the treatment floor at DoveLewis, I felt like I didn’t know a darn thing.
I was armed with book knowledge, I kind of had a grasp of anatomy and physiology, but putting it all together in a fast-paced emergency situation was overwhelming. As I scrambled to fill in the gaps of my knowledge, I realized that I didn’t need to be reading advanced journal articles and graduate level textbooks. I needed to be reading the basics.
If you can get a grasp on the basics, you can understand the advanced. All of this knowledge builds on itself. Getting back to basics also helps with practical knowledge. Reading advanced textbooks may allow you to spout off really impressive words, but can you put that knowledge to practice? What does that mean for your patient? To me, that’s what matters. I’ve worked with brilliant residents and interns who can recite chapters about the chemistry and physiology of shock, but when a hypovolemic dog is doing poorly on the treatment table, they need help translating that smarty-pants knowledge into practice. Get back to the basics and treat from there.
I did a LOT of studying for my VTS exam in 2003 and was surprised at how much basic information I learned while studying. I never connected the reason of tachycardia and hypovolemia. Makes total sense. It’s awesome how fluids can correct tachycardia. Anesthesia? Don’t even get me started. Vasodilation and hypotension, hypothermia and bradycardia, positive pressure ventilation and decreased cardiac output. I had to work hard to build up that basic knowledge and was surprised at what I didn’t know. I like to attend fundamentals lectures at veterinary conferences because I often learn little tips that someone went over my head the first time. I’m still learning!
In quizzing tech students and new employees, I find that they tend to skip over the basics and try to think really advanced because that MUST be what I’m looking for. When I ask them, “What isoflurane percentage is too low during an abdominal surgery?” they start doing MAC math in their head, or when I want to know when we need to start treating those VPCs in the post-op bloat they’re trying to make a Lidocaine CRI. Think simple, think basic, think practical.
The other trait I look for in super-techs is critical thinking. If you know the basics and can critically think, you can often get yourself to the right answer. Use what you know, what you’ve experienced and a dash of common sense and you’ll often arrive at the right place. But without the right base of practical understanding you’ll struggle through and end up doing something simply because you were told to do it. To me, understanding why is just as important as understanding how and that’s the attitude I want all technicians to have. Don’t do it simply because you were told, do it because you know why, and you know the effects on your patient.
I have the opportunity to train new staff in our ER and ICU and see the struggle as new employees try to match the pace of a tenured technician. They want to skip over the first 3 years of employment and be awesome efficient technicians overnight. That only comes when you can really focus on building a good base. Ask questions even if you think they’re embarrassingly easy. Watch how those awesome efficient technicians draw blood, tape in an IV catheter, or multitask through a busy shift. You become awesome when you really understand the basics.
At this stage in my career I am looking for the tough cases, I am reading advanced articles and studies and challenging myself to learn more. But I didn’t get here overnight, and neither will anyone else. It’s not only my personal philosophy; it’s the philosophy of all of us here at atdove.org. Build on the basics, focus on the practical, and share what you know to improve your standards of care.