Welcome to the December edition of BLOG blog, Bored Surfer!

The end of 2020 lies just beyond the dark depths of the upcoming weeks.

In the meantime, please enjoy some festivities during this most wonderful time of the year (McRib season).

You won’t hear it coming, but the 5th (the Day of the Ninja) is sneaking up on you.

December 8 is known as Bodhi Day. This is in reference to Buddha attaining enlightenment, not the bank robbing surfer played by Patrick Swayze.

Feel free to round up your felines on National Cat Herders Day (Dec 15); just don’t expect them to cooperate every day.

Dec 18 marks National Wear a Plunger on your Head Day. This holiday has yet to catch on, presumably because revelers don’t want to buy a new plunger every year, and don’t dare use last year’s…

On the shortest day of the year in the Northern hemisphere (Dec 21), you can celebrate Look on the Bright Side Day by singing along to the Monty Python song. Another option is to simply take quiet comfort in the knowledge that the sun will return in the coming months.

Dec 29 is Still Need to Do Day, presumably for us procrastinating types who undoubtedly have some loose ends to tie up before year’s end. Personally, I will be celebrating by working on the first BLOG blog of 2021.

In hindsight, 2020 has been an unusually challenging year for many people. As the year draws to a close, let us pause and reflect on the important lessons this year has provided. In particular, we should recognize that our lives (as well as the comfortable lifestyle many of us in the US enjoy) depend on the hard work and dedication of other human beings. Many of these people are not adequately appreciated; they are often taken for granted. I can only hope that people (especially Americans) have gained a greater appreciation for the workers who keep society functioning.

I would now like to take the opportunity to give thanks for (and to, if any of them are reading this) the incredible people that work at Best Care. Warning – this BLOG blog definitely has the potential to turn excruciatingly sappy at any moment. I shall do my best to refrain from sounding like someone who has over- imbibed and just rambles on about how much they love you, man, but I cannot guarantee it. I will attempt to give you a glimpse of the responsibilities of the various roles within our clinic. This is not an inclusive list, and many of the fantastic Best Care employees are cross-trained to perform a large array of tasks that fall outside the confines of their job description.

A well trained and managed support staff allows the veterinarian to focus on their primary objective – using their education (4 years of undergrad + 4 years veterinary school, often resulting in an undesirable debt: income ratio) to diagnose and treat your beloved pet to the best possible extent. Please note, that while I will wax poetic specifically about the virtues of the Best Care staff, there are most certainly other wonderful employees at other veterinary facilities. So please feel free to substitute the staff at your local vet clinic and show them some appreciation for the job they do every day.

Client Service Representatives

Your first point of contact at the vet clinic is usually the front desk staff. They have been traditionally referred to as ‘receptionists’, but ‘client service representatives’ is a more accurate description of the multi-faceted nature of their job. After all, they are not hosting wedding celebrations, catching footballs or obtaining TV signals. They are seeing to the needs of a multitude of pet owners, often several at any given time.

You are undoubtedly aware that they answer the phone. The needs of the person on the other end of the line are as individual as the person themselves. You should not be surprised that people call to make appointments or request medication refills. They call (or return a missed call) to discuss test results or be updated on a hospitalized pet’s condition. Other vet clinics call for vaccination records or other pertinent health history of patients. And, like phones everywhere, ours are subject to sales calls from both humans and robots.

In other instances, people call for advice on any number of animal (or even vaguely animal related) topics. These calls range from the not unexpected cases of pets ingesting taboo substances to more unusual, sometimes amusing and occasionally bizarre descriptions of situations involving the behavior of pets, parasites, wild animals, people and various combination thereof. I do not recommend trying to prank call the front desk, because they have already heard almost any absurd scenario you can dream up. In the midst of the cacophony of ringing phones, there are clients who need to be checked in and escorted to an exam room and clients in other rooms who need to be checked out.

People also come to the veterinary hospital to purchase medications (including flea/tick and heartworm preventatives) pet food and other supplies. If they need assistance with their purchases (up to and including carry-out service) our staff will cheerfully oblige.

Cashiering is another important function of the position. In a veterinary setting, this means they have the unenviable job of collecting payments from clients who are in every conceivable state of mind. They are occasionally called upon to assist a client in the process of applying for Care Credit. And at the end of every day, some light bookkeeping is needed to reconcile receipts and reports.

The front desk staff also aids in some sensitive steps surrounding the euthanasia of a beloved pet. They provide necessary paperwork for signature and discuss the cremation options with the client. They also contact the cremation service to make arrangements for pick up and call owners when the ashes are returned to the clinic.

In the moments when no clients are present, there is paperwork to be done. This includes such tasks as sending rabies certificates to the Nebraska Humane Society, inputting client information and preparing reminder postcards. There is also paperwork to be scanned into the computer; that which doesn’t getdone on a daily basis adds to the backlog that our part-time file clerk is working on. There are also shelves to stock and pet foods (including prescription diets) to be ordered.

As if the above duties aren’t enough, there is a lobby to be kept clean. This includes the restroom facilities (which, in turn, includes the designated restrooms for humans and various spots on the floor that dogs use from time to time). There are other duties, as required, but you should have a general idea of the demands placed upon these essential workers.

The presence of Covid-19 has put additional stress on the front desk staff. To minimize the interaction between clients, we ask that you call upon arrival to make sure an exam room is available. Clients are then escorted directly to the room instead of loitering in the lobby. This decreases the number of people in the vicinity of the front desk, but it also increases the number of phone calls to be answered. This, in turn, increases the odds that the client service rep will be on the phone at any given moment, which may result in increased wait times. Upon entering the building, clients are also expected to wear a mask, and it falls on the client services reps to enforce this policy. We also ask that, whenever possible, only one person accompany the pet into the vet hospital. Euthanasias are the obvious exception, but allowances are also made for small children and elderly or disabled persons who could not be left alone either at home or in the car. These measures, meant to protect everyone from exposure to infectious disease, are admittedly inconvenient. Many people tolerate these safeguards and maintain their good humor (thank you!). There are, however, some people who do not take kindly to the situation. Unfortunately, it is the front desk staff who bear the brunt of displaced frustration.

Please note – While they have also sold many a pet license in years past, there will be a very different protocol for the upcoming pet license season. Stay tuned for more details…

Assistants

Here at Best Care, we have veterinary assistants in various stages of training and performing a variety of job duties. As assistants receive training and demonstrate proficiency in particular areas, their responsibilities expand to incorporate the new knowledge. Among our assistants are some students who are currently enrolled in a veterinary technician education program. They are receiving vital hands-on training while providing valuable assistance to the clinic as a whole.

Their extent of contact with clients varies with the particular duties they are performing, which can vary from day to day. Some assistants primarily help with appointments. They check patients in, weigh them and gather information about the reason for the visit. They help appointments flow more smoothly by briefing the vet, gathering supplies and holding the patient for exams and vaccinations. If needed, they escort the patient for administration of tests or treatments or for samples to be collected. Between appointments, they keep the exam rooms cleaned and stocked. They also fill in at the front desk when needed, and perform call backs (checking on patients, not requesting another audition).

Other assistants work primarily in the treatment area (aka “the back”) and focus on direct patient care. This means feeding and cleaning up after hospitalized patients, restraining animals, and assisting the technicians in a multitude of ways. They provide for the comfort of hospitalized patients (and the resident cats) during their stay. They make sure patients have a clean, comfortable resting spot, food, water and exercise. But cleaning kennels, walking dogs and washing dishes and laundry is only one aspect of their occupation. Once they have been properly trained, they can also trim nails, clean ears, collect biological samples, operate the blood analyzer, administer subcutaneous fluids, prepare fecal samples, assist with x-rays, help prepare patients for surgery, wrap surgery packs, get samples ready to send to the lab, clean and wrap wounds and administer laser therapy treatments. They even provide aftercare of euthanized patients, which includes making paw prints and preparing the pet for cremation.

Technicians

Most states require graduation from an accredited veterinary technician program (2 years of intense education, both books and hands-on clinical) and passing a board exam (the Veterinary Technician National Exam) to get a Vet Tech license. The amount of Continuing Education required to maintain your license depends on your place of residence (16 hours every 2 years in Nebraska).

In some places Veterinary Technicians are referred to as “nurses”. I will be the first to admit that nurses, with the obvious exception of Annie Wilkes, are incredibly wonderful, dedicated professionals and worthy of great esteem. I must also express great admiration for the nursing assistants, especially those tending to the needs of people in long term care facilities. The title of “nurse”, however, does not adequately convey the scope of the duties performed in the veterinary hospital.

The job of Licensed Veterinary Technicians, aka Registered Veterinary Technicians (LVT or RVT for short) entails a large array of duties. You will notice there is a lot of overlap between the duties of Veterinary Technicians and veterinary assistants. Techs can delegate many tasks to properly trained assistants, but certain ones require certification to perform (for example performing anesthesia, giving drugs IV, performing radiologic exams and giving controlled drugs).

For starters, Vet Techs routinely provide standard nursing care such as: checking vital signs, drawing blood, placing IVs and keeping patients clean and comfortable. They administer medications via various routes, including oral, parenteral (injections) and respiratory. They calculate doses for sedation and keep track of controlled substances. They also carry out such unglamorous tasks as giving enemas, expressing anal glands and removing fecal mats (aka performing dingleberriectomies).

Vet Techs also perform duties associated with a Laboratory Tech, such as preparing samples (feces, blood, urine, skin scrapes, ear swabs etc.) and examining them under a microscope.

They perform the primary X-ray Tech function of taking radiographs. As a bonus, they may have to sedate the patient first.

They assist before, during and after surgery; this includes serving as both Surgery Tech and Anesthetist. They sedate and intubate the patient, shave and cleanse the surgery site, maintain surgery packs to ensure the proper sterile equipment is available, keep the patient at the proper depth of anesthesia throughout the procedure and wake them back up when the operation is completed. After recovery, they discharge the patients and provide post-op instructions.

If all these duties are not enough, they also perform dental cleanings. They scale and polish teeth, like your Dental Hygienist does to you – except that veterinary patients need to be anesthetized (for obvious reasons).

One final note about the awesome skills of vet techs – they do all these tasks (and more) on patients of vastly different sizes, shapes, species and temperaments.

Management

Even with a tremendous technical staff, an animal hospital cannot stay in business without someone to handle the business aspects. At Best Care, we rely on a Practice Manager and a Director of Technical Services to keep our doors open. They work behind the scenes on a variety of fronts to keep things running as smoothly as possible.

There are Human Resources issues like hiring staff, providing benefits for full time employees and making sure shifts are covered. There is also training for new hires, Continuing Education and Fear Free training for everyone (hooray!). A monthly employee newsletter is produced to make everyone aware of any protocol changes and keep everyone on the same page.

There is inventory to be maintained. Maintaining good relationships with vendors and drug reps help ensure our shelves are stocked with the food, medications and supplies sold to clients. There are also a multitude of supplies used during daily operations that need to be replenished frequently. It would be very bad for business, not to mention patient care, if the clinic ran out of needles or vaccines or anesthetic gas or rubber gloves or poo bags or any of the dozens of items necessary for a successful vet visit.

There are multiple agencies and a plethora of regulations with which a veterinary facility must remain compliant. This includes general workplace safety (think OSHA) and radiation safety as well as AAHA standards of care. There are also mandatory daily reports of controlled substances dispensed.

Someone needs to make sure all the bills get paid. It is crucial to keep accounts up-to-date with payroll, vendors, utility bills, maintenance, insurance and the taxman.

In this day and age, there are also duties related to the virtual world. This means ensuring the proper functioning of our website, online pharmacy and preventing Skynet from becoming self-aware. There are also emails requiring a response, social media outlets to feed and a blog to be edited (for grammar and the most egregious off-colour humour) and posted.

I would be remiss if I did not mention that we also have two groomers on staff. They bathe and clip dogs of various breeds and varying dispositions. They also perform one of the most dreaded (by humans and dogs alike) of canine procedures – the nail trim.

This is but a sampling of the myriad of duties performed by the remarkable team at Best Care. All of these people working together on these (and other duties) are required for smooth operation of the facility. Hopefully this provides an appreciation for the work they perform on a daily basis.

I must now take a moment to direct your attention to a bit of financial reality. Occupations in the ‘helping’ professions in general tend to be undervalued. These underappreciated and underpaid occupations are also staffed predominantly by women. Approximately 51% of the population can tell you this is not a coincidence. Taking good care of a vulnerable population is physically and emotionally demanding; people who perform these jobs deserve significant respect, not to mention a living wage. Cleaning bedpans may not be as exciting as being the CEO of an aerospace company who decides that short-term profits are more important than safety, but it is definitely more honorable. Perhaps someday our society will reconsider its priorities, but probably not any time soon.

While people employed in the veterinary field do indeed love animals and often enjoy what they do, they have their own bills to pay and families to feed. Comparable positions in the human healthcare field often pay noticeably more. Working with animals can be rather difficult at times; working with pets and their people can be even more so. It is important to note that many pets are not their happy cooperative selves when they come to the clinic and may require special handling or restraint. This is a far cry from the image of the vet staff playing with puppies and kittens all day. I am very fortunate to work with a fantastic group of people devoted to providing the best possible care of your beloved pets, even under adverse circumstances.

With that, Bored Surfer, I must bid you adieu. Until next time, be excellent to each other and to all the essential workers you encounter.

Dr. Debbie Appleby