Well, it seems crazy that we are in exam term once again. A stressful time for students and staff. Maybe I’m looking back with rose-tinted spectacles, but 40 years ago when I started as a vet student, things didn’t seem to be anything like as tense come the little tests. If you passed, it was all well and good but if you failed, well, hey, there were always resits! Nobody was pushing to get a first, which was just as well because I never got one! I did have a first-class life which was the main thing!
But these days it seems that it’s the students who are pushing themselves quite as much as we, the lecturers, are causing the problem. So, the question then is how best to support them. Should I be telling them to relax or pushing them to work as hard as they can? One thing I do tell them is that failing is not the end of the world. By no means. One of the problems that new graduates have these days, as far as I can see, is that they have never failed. To get into vet school they need to have excelled in their A levels. And then, because we’ve chosen the best, they do well in university as well. True, here in Cambridge having been at the top of the class most of them suddenly find that they aren’t the absolute best in the year, but even so the vast majority work their way through and pass the exams they are set.
One of the problems that new graduates have these days, as far as I can see, is that they have never failed
So, if in their first week in practice a gastric dilatation volvulus (GDV) patient dies before it even gets to the table, or with an elderly polydipsic/polyuric cat it’s kinder to say goodbye than to put it through yet more tests, these may be the first failures these young people have come across which can be completely crushing for them. So maybe to have failed some pharmacology theory test or a multiple-choice exam in public health and hygiene is actually a good lesson in how to cope when things don’t go quite as you hoped they would.
But if not, it’s up to us to support these new graduates when something does go wrong. That feline euthanasia – was it the failure you thought it was? The owners were singing your praises as they left saying how kind you had been in such a troubled time. They knew it was probably the end, but you explained things so well and cared for the cat as the lethal injection was given, they feel really well supported in their loss. It’s just that you never saw how they felt as they left the consulting room and you closed the door.
And that GDV? Looking back was there anything we could have done better? The animal had already been in a shocked state for a couple of hours before being brought to the clinic. You had done just the right thing, calling for support from a senior vet from the get-go and instigating fluids as soon as possible. A quick Google Scholar search on GDV shows that, according to recent research, the overall mortality is between 10 and 20 percent and one survey showed that the survival rates of patients operated on by general surgeons and specialists was 81.7 percent and 88.7 percent, respectively (Song et al., 2020). Time from first signs being noted to the time of surgery was a major factor in the survival rate, so this death is not all that out of the ordinary. Interestingly, cardiac abnormalities were also a significant factor in prognosis so maybe we should include an ECG in our preoperative work-up of these cases in the future. Now, having this sort of a metaphorical post-mortem, more perhaps than the results of a physical examination of the deceased animal, is important in helping vets and particularly new graduates cope with the death of an animal.
Having this sort of a metaphorical post-mortem, more perhaps than the results of a physical examination of the deceased animal, is important in helping vets and particularly new graduates cope with the death of an animal
Back to the students we started this little reflection with. I’m not sure we teach them enough about coping with failure or dealing with euthanasia cases. Hopefully at vet school they don’t see that many animals where an unexpected end occurs. And while they are given lectures about how to approach euthanasia, the chances of them seeing one in the referral clinics are small. It’s when they are doing EMS that they are likely to see pets euthanised. Obviously, you’ll want to ask owners if they are happy with a student observing, but most realise that this is an important learning experience and are quite willing to have them involved. Talk with the student before and after the consultation about what went well and what could have been better. But why am I telling you this – hopefully, that’s the way you help students get the most out of EMS at every opportunity!