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Leave it to the locum

by
01 June 2013, at 12:00am

MARION McCULLAGH begins a series in which she describes the life of a locum veterinary surgeon, the challenges it involves, its joys and disadvantages, and the need for adaptability

BEING a locum, I assume that everyone knows what a locum is or, indeed, what they do, so I was surprised when our American veterinary student, who appeared to know a great deal about everything, asked for a definition.

I explained that the term “locum tenens” applies to a person who stands in for someone else when they cannot do their job.

So why do I do it? Australians used to do it to fund their world tours, coming to Europe, broadening their experience by working here and then disappearing into the blue of travelling. Now they are better paid at home.

Working for a practice on a regular basis seems to have all the advantages: you have security of tenure, continuity, career progression and a regular income. Living in one place makes developing a social life outside work highly possible.

A nomad

So who on earth would choose to be a locum? Being a locum is being a nomad. Its joys are much the same as its disadvantages. It all depends on how you see the situation.

Novelty, adventure, meeting new people can be seen as a permanent state of stress but working in the same place, day in, day out, debating about rotas and holidays and playing the inevitable power games may not be so wonderful.

Change is a challenge, in all its forms. Every new job involves coming to terms with a new computer system. It is not so much the IT itself – the pattern of how the computer tackles things is logical; the person I want to strangle is the one who buried the simple list of tasks that describe my work into such an obscure code.

One might think that “consult” would be listed under “C” or at least under “E” for “examine” and vaccination would have a “v” in it somewhere, but life is not so easy. Navigating the system gives an interesting perspective on the thought processes of the founding fathers of the practice. On the principle of DIY wallpapering, by the time I am coming to terms with the complexity and getting comfortable with the system, my locum has reached its conclusion.

The fun really starts outside the safe haven of the practice premises. Either I have to transfer my equipment into the practice vehicle or I have to make myself a kit from their drugs and instruments. Usually, it’s a bit of both.

It can be easy or hair-raising depending on how familiar the practice is with the needs of a locum. A good car, equipped with in-date drugs appropriate for the work ahead, clean gear and a tank full of fuel is what I need and do not always get. Then I need to find the farm.

Navigation

My best friend is my OS map: tricky when the practice spans two or three separate sheets, otherwise good. Google maps can be a trial, great in towns but misleading where I need surface details to orientate myself.

Practice members can be very helpful, some people are brilliant at directions. They draw sketch maps that work and use landmarks that I can find. Others just see the world in a different way from the way that I do.

My next helper is my satnav. It is good except when the chosen route is blocked by flooding and my gadget just brings me back to where it thinks I have strayed from; and it needs to have a new destination put in before we can make an effective diversion.

When all else fails in darkness and pouring rain, I resort to asking a human for directions. She won’t be aware of it, but the lady in the hi-vis jacket who gave me a way out of the maze, and the man walking his beagle who kept me going have my eternal gratitude. Finally there is my mobile phone, which is great as long as there’s a signal.

In an ideal situation it is best to talk to the client and get directions from him or her before setting out on the call. At least we will both be heading for the same part of the property.

Obliging horse owners often agree to meet me at a landmark, such as a pub or a filling station: this is a great help especially when the horse’s field has no distinguishing features. The “third white gate on the left” can be very hard to pin down.

Variations

The most locum-friendly practices have a list of all the clients with names, phone numbers, DEFRA numbers, OS references and directions for the final approach as well.

One day I arrived at a fairly remote farm to be greeted with “You’re early” as the farmer explained how he was used to watching stray vets following their satnavs which took them to the other side of his valley.

The variation in protocols between different practices is truly amazing. What one practice believes is risktaking to the point of fatality is standard practice in another.

This is tricky if you leave the first practice on Friday and join the other on Monday.

Different techniques

Anaesthetic induction is a good example of diverging techniques. As far as possible, I stick to the view that the safest anaesthetic is the most familiar one and go along with practice policy. Favourite pharmaceuticals vary between practices so I always carry my compendium for reference, though generally the core products are fairly constant.

Adaptability is the key word. I find that fixed attitudes are unhelpful; after all, whatever it is has worked for this practice through the years and will continue to be used next week when I am a distant memory.

As a locum I am indeed migratory but returning to a friendly practice on a regular basis is a great pleasure. Someday I might even find one where I put down roots!