Sunday, 15 April 2018

How the profession is changing....

Corporate or Independent?

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So locuming around you certainly get to see the best and worst of practices, that's a given. However the above question seems to keep cropping up in my world. What's everyone's opinion on this one? I'd be interested to hear your views.

My career overall has seen more time spent in Independently owned practices - they are a private enterprise either with one owner or a limited number of partners, they tend to only have one or two branches. The boss is normally a vet who works at the branch, with a practice manager (quite often their other half) working there too.

Corporates by contrast are huge enterprises, with one central HR and payroll hub. They have so many branches that you lose count, the bosses you tend to never see. You do however get regular visits from area managers and such like. Things are sent down from head office, ie new protocols and products. 

I can see the pros and cons to each, and continue to do so on a daily basis. I understand the buying power that corporates can wield therefore having the ability to pass that saving on to the end client (sometimes not). They tend to have a big network of locums and staff that they can draw on in times of need, they have big hospitals with specialised skill sets. However sometimes their staff feel like just a number, not really having their individual issues listened to. Vets feel their clinical choices are being taken away from them on a daily basis - you may only suture using this cheaper alternative etc. Clients continue to get confused by product changes, one year they're sold this type of flea treatment, the next another not necessarily because it's better but 'that's now the brand we sell'.

Sometimes the personal touch is lost vs independent branches - however these branches are becoming few and far between - being bought up on a weekly basis by the corporate chains. Still some of these corporates have the ability to retain the staff and therefore the clients may not even realise.

I've got to be honest I think I will always appreciate independently owned and run practices over corporates. Too many times I have heard the staff of corporates talk of just feeling like a number, too many are staffed with under experienced vets and nurses who are just left to flounder - with no sounding board of senior staff to bounce ideas off of. Yes they may have some of the latest equipment but they've lost the ability to treat clients and staff as individuals. There will always be those clients with money issues that have been known to the practice for years and years, and who always pay their payment plans that have been set up on a local basis - where as in my experience the bigger groups have zero tolerance for this. 

Alas as more and more of these little gems are bought up and taken over I really do wonder where the profession in the coming years will take us. Will it just be all out pricing wars between the different groups, will vast areas i.e. London be owned solely by one corporate? If staff feel undervalued in any set up they will eventually leave the profession and then those vast years of experience are lost. It's a scary world when some groups think third year trainees can be head nurses, even with my coming on 14years behind me I'm still not sure I'm ready. Or when they think 2 year qualified vets are now senior ones and are running branches by themselves and teaching new grads what to do. I don't deny some vets are amazing, but lately I've met lots that haven't even completed a caesarean let alone a GDV and are already considering leaving the profession.

To retain a fair a balanced post, I have also met nurses who love working at corporate branches, I just don't think it's for me.

Further reading:

Wednesday, 7 February 2018

Not a hump day that I ever want to repeat

Today can only be described as the day from HELL.!

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Now I as you probably know by now have been nursing for more years than I can remember, I know about stress and I know just how busy and ill-equipped vet practices can be. But wow today just took the prize for the most unnecessarily stressful day yet.

So I started my shift, early as usual and stupidly put the kettle on thinking I'll set the scene for how the day may pan out....I never got to make that cuppa. For no sooner had I clicked it on the other nurse came through and said 'I've had the area manager on the phone and they may need you to go somewhere else, we've got a potential emergency in consult currently, another one on its way and oh I've got to disappear for college in 30 mins,,,,! Well, shit me joy!

And that's just how the day started and carried on from there! I'll be a bit careful here how much I say, but let's just say the place is ill-managed at the best of times and ill-equipped to boot. They have constant staffing issues and generally problematic clients. I realise this blog post is now turning into a dear diary vent/rant but hey, perhaps it's good for the general population to realise that it's not all cuddling puppies. Anyways I digress. My next blood boil moment was when the area manager phoned to speak to me, whilst I'm trying to hold an animal, comfort a meltdowning vet and answer 10 other ringing phone lines. Needless to say this phone call didn't end well, to hell were they going to pull a nurse from this practice to bulk up another (where is the sense of pulling from one to then make that one in the same boat), it ended in a very uncomfortable NO you can't have a nurse I'm sorry and to put it bluntly I am sick of having to constantly sort out your staffing issues on a daily basis when I don't even work for your company.

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Whilst I can't go into the finer details, the two emergencies were in fact admitted and needed a nurse each sat with them either delivering oxygen or administering meds or calculating dosages. I regularly feel that management at a certain level just don't understand what happens in clinics, what can go wrong on a daily basis and how you can't cover for every eventuality. Even the managers that have in the past been vets or nurses seem to forget so quickly, it's a shame.

Anyways my day from hell was topped off by an abusive client. I was speaking to him on the phone about a problem he had to register a microchip to a new owner of one of his puppies (yes he was a breeder) when I couldn't help with his query as it was now up to him to change over the details with the company in question he became increasingly agitated, started shouting at me and telling me how we'd done a very bad thing and he was going to call the police on us. This culminated in him swearing at me once to which I warned him that I'd have to hang up if he continued to be verbally abusive.... to me then hanging up when he was!

I mean you couldn't script this day really. I know I've touched on this before in other posts, but sometimes it's good to show what we have to go through on luckily rare occasions. Today I had a vet in tears because she felt unable to help clients that couldn't afford emergency treatments, area managers expecting waaaay too much, clients shouting at me, and a poor trainee thinking what on earth have a I let myself in for! I for one totally get why our profession has such a high suicide rate, it's sometimes emotionally and physically draining. Our hands are tied with regards to payments and costs and yet clients are too quick to take out their frustrations on us :(

In other news, one emergency went home feeling heaps better and unfortunately one had to be put to sleep - not a great end to an already difficult day :(

It's great that the profession & RCVS are now moving with the times and offering support for people and some mindfulness - check out the links below if you're struggling or just need someone to talk to.

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0303 040 2551 or confidential email via Vet Life.
Talking to others can help lighten the load. That’s where Vet Helpline comes in. It’s available 24/7 to listen and offer a safe, non-judgemental space for you to explore your options. It’s for VNs and students, too. All calls are confidential, and callers are referred on for specialist advice where appropriate.