Virginia Regulatory Town Hall
Agency
Department of Health Professions
 
Board
Board of Veterinary Medicine
 
chapter
Regulations Governing the Practice of Veterinary Medicine [18 VAC 150 ‑ 20]
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3/13/14  5:17 pm
Commenter: Dena Picken

additional practical training, + intern vs doctor--letting the patient know your level of experience
 

I would like to see as much practical experience given to vet students as possible. As a very experienced pet owner, and also re: Jennifer Barret's comment, I feel I almost have more experience, and I'm still learning, than the intern that "treated" my dog during an emergency situation at around midnight on a Saturday about 1 1/2 years ago. He never even introduced himself as an intern, which I've never experienced at a teaching clinic before as well. At every teaching hospital I've been to, every doctor with an intern shadowing them, have introduced the intern appropriately, or the intern themselves have introduced themselves appropriately, and have assured me they would go over everything with a senior vet, and that vet would always accompany the intern back to the exam room to discuss everything. That did not happen in this case, so I assumed he was a senior vet. Apparently this hospital does not feel this is necessary after speaking several times to the manager after my dog died.

My dog became so sick so quickly after a simple eye surgery, and I was so distrissed, I never noticed this intern (calling himself Dr.) never even gave me her exit paper work, which he emailed to me at my work email (they have both home and work), 24 hours later on Sunday, with no reference to her on the subject line--just initials of the clinic which made me suspicious, having to be wary of emails at work from people we don't know. Because there were two, I kept them wondering if they might be something important for us.

It was several days later I realized what they were, but by that time, and after chasing down several other vets to try to figure out what was happening to her, she was, by then, in their critical care unit. They thought, as I was, she was experiencing more than just post-surgical healing, and even her surgeon that Monday morning realized she was severly dehydrated and hehydrated her which helped somewhat. By around 1-2am Tuesday morning she was worsening again, and I called that same hospital, and they swore it would be alright for me to wait for me to go to my regular vet in the morning--I should have listened to my gut and just taken her back there then, but at that point I had been up for 5 days with her, and after watching her for a little while after I spoke with them, wondering if I should just take her, I accidentally fell asleep.

I rushed her in to my regular vet when they opened, for bloods, didn't even wait for results and ran out to get her back to the hospital, where she was admitted to critical care for approx. 2 weeks. As I was pulling into the parking lot, my vet called to tell me she was in severe renal failure.

This person never treated her as he claimed on his exit exam forms, nor did he discuss with me any of the things he said could be wrong with her--basically lying on a legal document. Had he actually treated her when I brought her in Saturday, I truly believe she would be alive today. He just took her in the back, doing who knows what--taking her temp?, petting her on her head?--came out with her about 20 minutes later, simply telling me to stop her antibiotics (she had started throwing up and just before I rushed her up there, she started to scream before she vomited, which I later learned is a sure sign of renal failure), to see if that would help, and he left. No senior vet ever did that there--they are wonderful. I have also never had an experience there where the senior vets never just drew bloods, so I expected he had done so. He claimed on his paperwork I denied diagnostics, which I never would have done!!! To be honest, I wonder if I was his last patient for the day and he simply wanted to go home!

Her head had started jerking on the Sunday afternoon after that intern had seen her. I thought it might be a result of her eye surgery which started all this--a very simple procedure. I've had many dogs with eye problems and who have had head jerking problems, but when she started to do it when nothing passed in front of her line of sight late in the afternoon, I really became concerned, made that emergency appt with her surgeon Monday morning. At first he, too, thought it was from the healing from the surgery, until she jerked her head while he was sitting still and giving notes to his assistant. That's when he realized she was grossly dehydrated, became concerned, and gave her 2 sq boluses to see if that would help. It did for a while, she took a long nap, but, as I stated before, she worsened by that early Tuesday morning.  

Even while I was admitting her to the hospital, this person came out into the lobby, saw me, and didn't say a word to me--he met some clients and turned and walked away. I was furious. The wonderful senior vet that stayed with her for an additional 2 shifts to stabalize her told me the head jerks were actually seizures. The manager even agreed with me at one point that had this intern done appropriate tests, she probably would have been admitted that night, to start treatments that much earlier, and it might not have gotten that bad/severe.

I'd like to add that the same wonderful vet that was there to treat her upon admission, and whom I believe worked 3 straight shifts (I think she was going home when I got there and she stayed another 16+ hours with my dog to be sure she was stable), and she the next vet, also wonderful, who took over both told me to be prepared to put her to sleep that night. I told them they didn't know her, she was a fighter, and to wait and see what she would show them--that they would be surprised. Her BUN was triple digits, and within about 2-3 days, from what I remember, her bloods were in the normal ranges--they couldn't believe it, but I told them I could! I told the second one "see, didn't I tell you she'd show you?", and she replied "yes you did!" They were amazed!! Her BUN alone had gone down substantially just that first night. My little girl was an amazing little survivor and such a love--she had spent 10 years in a puppy mill just to have this happen to her. By chance, I had to go in at that moment and have her treated by that intern, unfortunately.

My only complaint about any of the senior vets there--not all, but including the one that released her, is that many of them never go over exit paper work, which I have also never experienced any where else but there. I think this is very important, especially when an owner is very distressed. Say anything you want, but go over what you've written, and if a follow up appt is needed, you walk them to the appt book and make the appt with them. She just told me to give her a call in about a week to tell me how she was doing--nothing about making a follow up appt. with her. I only happened to notice it after my dog had died. This vet had even called about a week later to check up on my dog and simply told me I could ween her off the sq's to see how she would do, since my dog ran from me every time I set up the bag. She said nothing about bringing her in, which I think she should have to have done follow up bloods to be sure she was still okay. After her last IV dose, I was just going to make a follow up appt, though she did seem okay but I wanted to have a re-check done, when we woke up from a nap, and something was very wrong. I will say, however, after all of this, she did seem somewhat brain damaged by the way she acted. I loved her even more, if that was possible, but I think that was possibly a result of all the seizures--they were like these little micro seizures, just little head jerks.

Again, I rushed her back to the er, but they feared she had a brain bleed by her symptoms, bp and bloods. I bet it was from that day or so of seizures. I can't remember the name of the drug I asked them to try, but it started to work, but then it didn't, and I spent 7 1/2 hours the next day holding her as she drifted away into a coma, and I then put her to sleep.

I spoke with the MD state's vet board about this intern. They asked me to file a complaint, and it is still so painful, but I am getting ready to do it. Not just because of what happened to her, but I don't want him to do this to another family and their beloved pet. I don't care that the manager said he did well under his rotation under him, which I told him. I told the manager I didn't think he was prepared by the lack of treatment my dog received, and by the fact he lied on his exit paper work. And if the interns are supposed to be supervised by a senior vet there, why did he send the paperwork to me 24 hours later. Was there even a senior vet working that night--the manager would not answer me, and by this time he told me he had called their hq that had advised him not to speak to me. I also had told him I remembered watching him take notes as I was telling him her symptoms during the visit on that Saturday, and that he seemed to be having trouble writing them down, which seemed odd. I told the manager, looking back, it seemed then he either didn't know what he was doing, or he was already trying to prepare false notes, such as saying I denied diagnostics so he could go home maybe. At first, before he, the manager, had spoken with their hq, he said it did seem unlikely that someone who would have eye surgery done for their pet would turn down simple bloods. I even added, why would I also be there at midnight on a Saturday after a surgery if I was going to turn down treatment. I had also been there late the night before on Friday with her because she wouldn't stop screaming, and she needed more pain support. I also let him know I had spent close to $10k on a surgery for her the previous year, and about 8k on another of my dogs just a few months before this when she had a stroke, and they expect people to believe I would turn down $100 blood work? How would that sound to you? I've never been back there, and I'm not done with this.

I was especially shocked when this manager told me that being a vet is not like being a human doctor. Once you finish school, you're a vet vet, not like with humans, where internship is a requirment before you can call yourself DR. I found this unbelievable if not shocking. So, as I think this case shows, the more practical experience you get, the better. I actually think it should be like with people, where an internship is required before the word DR. can be used before your name!!! It might weed out the ones that are better suited to be greeters at Walmart.

CommentID: 31310