Sunday, 31 July 2016

Take the time.....

Not everything in Veterinary medicine has to be fast paced and glory filled. It still humbles me that sometimes just time and patience is all you need.

Recently we had a dog stay with us called Ellie, Ellie is a Shitzu. She had a gastric upset, wouldn't eat and generally was feeling very sorry herself. She has been staying with us since the weekend on fluids in an attempt to rehydrate her. Bloods had been run but these were pretty unremarkable. Even on fluids and a multitude of drugs she was continuing to have violent haemorrhagic diarrhoea and bouts of projectile vomiting.... Mmmmm.

I only joined this case on the Tuesday when it was my turn to play hospital nurse. Sometimes in veterinary medicine because the animal can't tell us what's wrong we are all guilty of looking for the glory disease, the thing that's causing all these symptoms and treat that. Rather than take a step back and just deal with the present. Ellie still wasn't eating and if it didn't happen soon she would have to be referred for tube feeding.

So on Tuesday I made it my goal to give this dog more attention than she had had in her entire 3 day stay so far. I love cases like this because from a nursing point of view you can make a real difference. So from my 8:30am start, despite this being the day from hell in so many ways I made this dog my priority. Yes this did mean snapping at a couple of vets when they tried to pull me off hospital to get dogs prepped for theatre, but sometimes like in any job you have to prioritise accordingly. I knew there were other nurses that should be on those roles, so today my little team was just me and Ellie.

It didn't get off to the best of starts, I think in the first 45mims of my shift she had approximately three explosions. When I say explosions, apologies for anyone with a weak stomach but they were up the wall style blood filled explosions. However little mercies I am pleased to report that the vomiting had subsided. Outside she seemed lack lustre and depressed probably not helped by the increasing length of her stay away from her normal routines. However I got to work, continuously cleaning her out. With the assistance of another nurse I bathed her dirty areas in an attempt to make her feel better (and clean her up). Replaced her tail bandage and gave her a groom.

So I started the arduous task of syringe feeding. I mean this dog needed energy, to not only start to repair its body but also to get that poorly gut moving again. I won't lie and say she was a fan,  and it was like aiming at a moving target. However it was vital for her recovery, and to have a little rant I was annoyed it hadn't been forced down sooner. Anyways, on wig the job in hand 10mls at a time doesn't sound like a lot but it can still create a lot of mess.

Later in the day I switched catheter placement for her intravenous fluids and I think having an hour without a drip whilst we cleaned her up actually helped no end. She was able to go out for a walk without getting clothes lined by her own drip and able to visit her mum in a consult room and get lots of untangled cuddles.

By the end of my shift at 6:30 I believe I noticed a real improvement, no she still wasn't happy at being put back again in the kennel. Yes every time I took her outside she still broke my heart by pulling me to sit beside random cars believing it was her mums. But she seemed more content, I knew she had some energy on board. I also felt satisfied that today had been a job well done.

I am pleased to report that Ellie came off fluids the next day, began to eat on her own and went home later that evening. :) see even after 10years, the job is still throwing rewarding cases at me. Ones where you just have to go back to basics to see even a slight improvement. That is very satisfying and the main reason I do it.

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