The nursing debate

The nursing debate

Are we leveraging technician responsibilities for the betterment of patients?
Feb 01, 2006

Academy Animal Hospital, Springridge, Ohio

John Grant was closing the door to his Jeep Wrangler. In his right hand was a small bag filled with various paraphernalia of death. He looked at the door of Mrs. Jordan's small home and dreaded going in. He knew what awaited him there — a small Pekinese named Billy with multiple organ systems ebbing and clinging fitfully to life. This teetering at the border of existence is all too familiar to doctors of veterinary medicine. He was there because Mrs. Wilson had requested that he come to her house. He did this service infrequently but often felt good about providing this kind of service to a long-standing client.

Just then, his cell phone rang. It was Cathy Harmson, his registered tech at the office.

"Dr. Grant, Laura Ott just arrived with Jeeves. He was hit by a car, and his pulse is weak. He seems to be having some trouble breathing and is cyanotic but quite alert and responsive otherwise."

"OK Cathy, here is what I want you to do," he began. "Get Sarah and whoever else is there to help you. We need to get him some oxygen. First, examine the oral cavity for obstructions. Remove anything that is obstructing the airway. If nothing, then oxygenate or intubate if necessary and then get an IV line going. If the blood pressure is too low to get a good vein, then do a cut down like I have shown you in the past — use your best judgment. Once you have the IV established, follow the crash protocol listed on the wall with steroids and bicarb and call me back when all this is going ... OK?"

"OK, Dr. Grant"

DVM Newsbreak
Jeeves was an overactive Border Collie that unless leashed was more of a blur than a dog. John had thought in the past that this particular dog might be subject to road trauma because of his speedy nature and his owner's cavalier attitude toward supervision. His owner had even remarked in the past that she thought that Jeeves could outrun a car if pressed. It looks like she had been wrong.

John took a moment to reflect. This is the third time in the past six months this type of situation had occurred. During the other two times he had been up to his ears in alligators doing orthopedic procedures that had demanded his full attention. During both of these times, Cathy had come through in similar crash situations with flying colors. Even if he left right now to go back to the office, it might be too late.

John entered the Wilson home and found Billy laying in the kitchen in obvious distress. Thankfully, his end would be peaceful, and Mrs. Wilson was gracious and grateful.

As Dr. Grant entered the hospital, he could see a knot of people gathered over the treatment table behind the pharmacy. The hair raised on the back of his neck for a moment until he could see smiles on everyone's face as he closed in.

"Dr. Grant, Jeeves seems to be a lot better." Cathy cried with both emotion and restraint.

John looked the little zephyr over and smiled.

"He seems to have stabilized for the time being," he said. "Good job Cathy — now let us get him into X-ray and do some blood tests."

Bowen Animal Clinic, Springridge, Ohio

Paul Bowen, DVM, walked into the practice at 7:30 am. His one lone staff member, Jan, had arrived an hour earlier to check on the patients and clean the kennels. She was up front now answering the phone and checking in a few of the patients for the day. There were two other part-time people to help Jan with similar duties.