Practice in the real world "Managing chaos"

Practice in the real world "Managing chaos"

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Sep 01, 2005

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Aanet Sizemore waits in the back for Carrie to come out of the room. Carrie is writing in all the particulars about Caleb, a forlorn looking Great Dane with chronic vomiting and persistent elevated white counts. Janet has seen Caleb in the past for this and an assortment of other maladies but has been able to totally stop the irregular vomiting.

Carrie finally wanders out with a rather thick chart and starts collating history and lab printouts in order to make some sense out of it all. On top she has written a rather lengthy synopsis of the current situation.

Janet moves slowly to the counter and looks over Carrie's shoulder and begins reading. Janet emits a low whistle as the job at hand moves into its final phase.

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"That is a lot of history — some of that has to be from Dr. Wilson. I had forgotten how many times Caleb has been here," Janet says.

Just then, Mary Needham, a senior technician, appears and starts complaining bitterly about Sarah who happens to be working in the front that day. She goes on about having to answer the phones because Sarah cannot seem to control the client flow in front. She laments that there are two other people working in front as well, and she still has to answer phones and be drawn away from her other duties.

Janet ignores her and walks into the exam room to see Caleb.

When the door is shut, Mary begins to bend Carrie's ear in earnest. Carrie picks up the ball and by the time Dr. Sizemore had come back out of the room, they had managed to carve out a fairly large piece of Sarah's hide.

As the banter continued, Janet stared straight ahead and didn't comment.

"I need to set up for X-rays and some blood tests to an outside laboratory," she said to anyone listening in the vicinity.

Mary jumps to the task, and Janet moves on to another room.

In about 15 minutes, Janet exits the other exam room and heads to the small office in the back.

"Dr. Smith, this is Janet Sizemore. I hope you remember me from small animal medicine classes. I would like to refer a vomiting case up to the university."

Janet listens to Dr. Smith's response, smiles, hits the side of her head and hangs up. She walks briskly into the first exam room and explains to Caleb's owner, Mrs. Johnson, that she has just talked to one of the specialists at the university. The university wanted her to try a different approach for Caleb. Within a few hours a diagnosis of megaesphagus, chronic pneumonia and hypothyroidism had been made. The client was grateful. Janet was proud. She had used the resources of the university to leverage a positive outcome for her patient. She told Mrs. Johnson that she would get on the Internet and work out a therapy plan within the next few days.

Just then, Dr. Sherry Wilson, the owner of the hospital, walked into the side door and started her usual routine of moving through the cage area checking the various conditions of her patients. She darted from small project to small project. She mostly asked the staff various questions about patients and clients that had called while she had been out for an abbreviated lunch. Dr. Wilson was a poster child for multi-tasking approach to veterinary care.