Posted: Aug 20, 2013
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That’s the phrase we hear over the pager several times a day at my hospital and it always gives my adrenals a good squeeze. It means that an emergency has come through the door that needs immediate attention from one of our 27 doctors and “all hands on deck” for necessary treatments.

I am a Senior ICU/Emergency Technician at Adobe Animal Hospital in Los Altos, California. My good friend David Liss calls us a “general practice on steroids”. We are open 24/7/365 and will see just about any pet that walks through the door for any reason: health exams, vaccines, nail trims, surgery, dental prophylaxis, emergency services, or whatever they might need. Adobe has 27 veterinarians on staff, and more than 80 support staff – we’re almost like a major regional referral hospital except that we don’t have any specialists on staff (with the exception of one Feline Practitioner). We see dogs, cats, birds, goats, sheep, pigs, small mammals, birds, and even some wildlife. On average, Adobe sees about 200 animals per day, some with appointments, some as walk-in urgent care visits, and some as emergencies.

What’s it like to work in a practice that does general practice and emergency medicine? It can definitely be hectic, chaotic and challenging. On the technician side, it’s like Forest Gump’s box of chocolates: you never know what you’re going to get. The pet that gets brought to the treatment area after emergency triage could be suffering from something as serious as cardiac arrest or as minor as a bee sting or any ailment in between. As a technician, I have to be prepared for whatever might come through that door. And since we’re not a referral facility, often there’s no warning that a major emergency is about to change your whole day. For those of us that love emergencies, that’s great! It’s what gets us through the day. But those emergent and sometimes scary interruptions can wreak havoc on members of the staff that thrive on routine and structure – doctors and techs included.

To help minimize the impact on staff, Adobe has doctors assigned to see urgent care/emergency patients (we call them Squeezes since we “squeeze” them into the schedule) at different times during the day. That way vets don’t have to see appointments and try to take care of emergencies at the same time. Given the size of our staff, this is a luxury we can afford: we have 8-12 doctors in the hospital most days which leaves a lot of vets seeing regular appointments. We even have some doctors that only see Squeezes: those are the real adrenaline junkies on staff!

As is the case in most clinics, we have an awesome Customer Service Representative team responsible for checking clients in and out and making sure that everyone is taken care of (most definitely the hardest job in the hospital!). We are lucky to have a full-service Pharmacy, staffed by pharmacy technicians so it’s pretty rare that a technician from another department will have to fill a prescription (except on the overnight shift). In addition, we have an in-house laboratory with its own full-time staff of techs and assistants.

Technicians and assistants are organized by department throughout the hospital. The Outpatient Services department manages all the regularly scheduled appointments, along with the Squeezes, and what we call “tech appointments”: nail trims, vaccines for current clients, SQ fluid administration, anal gland expression – you get the drift. OPS also does most of the heavy lifting on emergency triage during the day. We have a full service Dentistry department for routine cleanings and more advanced endodontic services (like root canals, tooth reconstruction, etc.). Our Surgery department takes care of both scheduled and emergency surgeries. These departments operate from 7a to 10p every day.

What happens between 10pm and 7am you ask? Well, that’s where the ICU department comes in! We are the only department staffed 24/7/365. During the day, we take care of the hospitalized patients which can range from post-op monitoring to intensive care. We even have a critical care respirator we can use to ventilate patients in the ICU (as well as a surgical ventilator for short-term use). At night, we do ALL the jobs: customer service, pharmacy, laboratory, outpatient, surgery, all the while keeping up with treatments for our hospitalized patients in the ICU.

What I like most about doing both regular treatments in the ICU and treating emergencies is the variety of skills and knowledge I get to use throughout the day. I can go from changing the litterbox in a cage to placing a central line in a dog to triaging a blocked cat in the blink of an eye. Then I can go up front and cuddle the 16-week puppy after its vaccinations. It doesn’t get any better than that!

[Editor's Note: This is Liz's first blog post as an On the Floor @Dove contributor. Read her background story here.]



Ron  Morgan's picture

Thank you for contributing to On the Floor @Dove Liz. I enjoyed your post.

Bonnie Miller's picture

Liz great job, can you share what it's like to be an open practice!

Liz Hughston's picture

Being in an open practice can be challenging in many ways, as well as rewarding. Look for an Open Practice blog entry soon ;) In the meantime, you can watch my chat with Megan Brashear about working in an open practice...

Megan Varble's picture

I feel you here! I would have to say our hospital is a "general practice on steroids". It's always fun when one second you're holding a cat for a routine blood draw and in comes a HBC in arrest and it's all hands on deck!