Surviving out-of-hours emergencies: non-clinical tips for recent graduates

Posted on October 05, 2016 by Aoife O’Sullivan

A vet treating a dogThe majority of UK new graduates entering veterinary practice are required to provide out-of-hours (OOH) cover as part of their first role and many vets can find this a stressful and lonely experience, depending on their situation.

Often support is provided for new graduates during the day but when faced with sole charge on call, the decision-making process can seem ten times more difficult. This is because:

  • Most cases are sick and require emergency treatment, such as road traffic accidents or Gastric Dilatation and Volvulus (GDV)
  • Most clients are distressed due to the nature of the situation
  • You mentors are probably asleep
  • The night/weekend shift seems to stretch on forever

So how can these problems be tackled?

Practise your approach to emergency cases

In day practice a large proportion of the cases seen present for elective reasons such as vaccinations, elective neutering, dentals, and so on. However, emergencies do occur during the daytime and this is an ideal time to practise your approach, whilst the full vet team are in place. Rather than standing back and allowing more experienced colleagues to manage these cases, it may be even better to lead the case under the supervision of a more experienced colleague.

Empathise with distressed clients

The majority of clients presenting to the vet with an emergency did not plan to do so. Something unexpected has happened, otherwise they would have made a daytime appointment. We need to be mindful of this and use this as an opportunity to work on our client care and consulting room skills.

In an emergency situation, one of the most important things we can do is simply listen to our clients. Demonstrating warmth and compassion will also help build trust within the client relationship. Ultimately, these clients are often justifiably very upset by what has happened and as vets no matter what our experience level is, we should all be able to empathise with their situation. A cup of tea and a sympathetic ear will often go a long way towards helping our distressed clients.

Mentors are there to support you – don’t be afraid to call them

Many vet practices will have a back-up system in place, such as a second-on-call or practice partner/senior colleague that you can contact if you feel out of your depth. It can be nerve-racking calling a colleague in the middle of the night, but remember the majority of senior vets would prefer you to get in touch than see you struggle especially if this is part of your support system.

You’re not superhuman but you can super nap

This is a fact: an overnight shift is usually much longer than a daytime shift so you are not imagining things! Many vets can feel isolated in the darkest hours of the night, especially if they are dealing with a difficult case. It is helpful to remember that the rest of the team will join you in a matter of hours and they will be fresh and ready to help you.

Sleep deprivation can be a contributing factor for vets that work a full day shift followed by a night/weekend duty. The effects of this can be both short term or long term. In the short term sleep deprivation can cause decreased mental sharpness, decreased emotional balance and decrease empathy for others and lower self-regard. This will often explain why night or weekend duties can sometimes feel like a real struggle at the time whilst in hindsight we can’t really explain why we felt the way we did.

It may be worth speaking to your senior vet regarding rest times as unfortunately none of us are superhuman and we all need adequate rest to function. Real-time solutions include what is referred to as the 'Super nap'! Super naps have been shown to be more effective than a nap or coffee alone. This can be done prior to a night duty or on down time as your duty progresses. Simply have a strong cup of coffee and then lie down to rest/sleep for 20-30 minutes. This will allow you to rest before the caffeine kicks in. It may not be a perfect solution but if you are flagging and feel exhausted, a super nap may help.

See the second part of this series for clinical tips on getting through the night.

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Aoife O’Sullivan

Written by Aoife O’Sullivan

MVB, Cert AVP (ECC) MRCVS

Aoife has worked in equine, mixed and small animal practice. She was introduced to the world of small animal emergency medicine in 2006 and has worked in emergency practice ever since. She is Head of Edge Programmes at Vets Now, and is an RCVS Advanced Veterinary Practitioner in ECC.