My frustration cup once again runneth over. That didn't take long. Ha.
Without getting into specifics, I will try and explain. Being an emergency veterinarian is a lot like being a goldfish. You exist in your own little bowl. Unfortunately, the whole world can see into your bowl all the time. You have to deal with clients who have never met you and automatically don't trust you. Those clients come with their own veterinarians, who go over the records with a fine tooth comb to determine if everything was done perfectly "right" (as if there is such a thing). If you have to send a complicated case to the referral/specialty hospital, you have those specialty doctors and technicians poring over the records and everything you did.
Why is that a bad thing, you wonder?
In and of itself, it's not. There are many checks and balances as an ER doctor. Mistakes are much more visible, and it makes it easier not to repeat them - especially when everyone else sees them.
On the other hand, it opens us up to nit-picking from other veterinarians, other clinics, and clients. How I handle one emergency might not be how another veterinarian would have handled it and vice versa. Does this make me (or them) wrong? No. Does everyone see it that way? No.
I am beyond frustrated at the moment because I am still trying to learn balance. Keep in mind, I have only been out of veterinary school for 2.5 years. I work in a poor area in North Carolina, thus I see many people with very limited means. As a result, I am striving to find the ground between malpractice and "Ivory Tower" medicine. I still want to do everything exactly "right" - I want to check serial blood pressures on hospitalized patients, I want to monitor electrolytes, PCV/TS, and blood glucose at least once a day on sick patients, I want to make sure my diabetic ketoacidotic patients get exactly the kind of TLC and monitoring they need (which is expensive and involved). On the other hand, many people can't afford this.
I am afraid I have alienated some local veterinarians because I am doing the best medicine that I know how to do and that is not always a cheap thing.
It's so hard to learn balance - balance between doing what is "right" as I was taught in school and in textbooks and what is "best" for the patient (sometimes what is best for the patient is what is best for the owner's wallet). On top of that, I put enormous pressure on myself to be perfect. From the simplest dislocated elbow to the most complex polytrauma post-hit-by-car...I constantly question myself, my medicine, my abilities. I go back, review cases again and again, looking for the key that would unlock the mystery, give me answers, help me treat better. I spend hours on the Veterinary Internetwork (VIN), posting about cases I've seen, questions I've thought of. I read my journals. I talk to colleagues. I work when I'm not at work. I love my job. Yet I feel like I'm constantly failing...all the time, every day.
In short, I do everything I can to be better, and yet every day, I feel like a quack. My best friend told me that if you don't feel like a quack at least once a week, you're not doing your job well.
Sometimes I tell myself to just lighten the hell up, and don't take it all so seriously. Then I think of the anguished owners, the emotional euthanasias, the animals I couldn't save, and the look in their owners' eyes when I told them, and I realize that lightening up would be doing a grave disservice to my clients, my patients, and myself.
I need to find a bit of work/life balance. I'm joining the gym tomorrow. Sometimes I'm very afraid that my time in the veterinary field will be limited, because how can I keep going at this pace and not just burn out?
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