The trouble with new graduates...

01 August 2015, at 12:00am

Dr DAVID WILLIAMS examines the challenges faced by those entering the profession who, once qualified, may find themselves thrown in at the deep end, especially when dealing with euthanasia

“THE trouble with new graduates,” said Steve, one of my previous students, when we met for lunch a few days ago, “is that they aren’t used to failing at anything.”

They will have had three As or better at A level, leading to a place on a really sought-after course in a top university. Then with any luck there will have been a flurry of exam successes through the years at vet school, all leading to that wonderful day when they get to promise that their prime endeavour will be the welfare of animals under their care.

Now they are MRCVS! And this year for the first time Dr as well. That’s what they had always wanted, what they had been aiming for since before they can remember! What can go wrong now?

Well the answer is a lot, as those of us with a few years of experience know all too well. Let’s take Jill as an example. In her first week of practice she is brought a collapsed diarrhoeic rabbit that couldn’t be resuscitated. The next day a cat is presented by an inconsolable young couple following a road traffic accident. It has a ruptured diaphragm with its abdominal contents filling its thorax.

They just can’t afford the required surgery so Lethobarb is the only option. And that evening a Flat Coat Retriever arrives; the oral tumour which the previous veterinary assistant had referred for specialist treatment has recurred. Euthanasia again is probably the best course of action. Suddenly the student life where everything went according to plan has turned into a professional career where there seem to be many more failures than successes.

This isn’t at all what Jill was expecting. Nobody at vet school gave much in the way of instruction on coping with such a negative first week. There the aim of the referral hospital of the vet school was succeeding whatever the cost, or so it seemed.

And yet were those cases of Jill’s first week actually failures? None of them was cured for sure. Each of them ended with euthanasia. And yet if you asked the owners in each case they would say that Jill seemed genuinely upset at the situation (well she was) and she really empathised with their grief. Well she did – she went home and cried herself to sleep each night wondering what she was doing wrong.

But of course she wasn’t doing anything wrong. In none of the cases did the owners blame her for the death of the animal. Rather they were grateful for the care they received. They realised that Jill was completely new to the job but were pleased with the way she did everything she could. The trouble is that Jill simply didn’t know that. How could she?

Actually the head nurse was aware of how those owners felt – she had known each family for years, an advantage Jill just didn’t have. And when she found Jill crumpled in a corner after an evening surgery at the end of the week she could help by explaining that these weren’t failures; they were, in a strange way, successes.

Was the welfare of the animals compromised by euthanasia? Not really. And her care and attention meant that the owners were really helped by Jill’s attitude.

Our prime focus must surely be the welfare of the animals under our care but that mustn’t stop us from seeing the welfare of their owners is key as well.

There will be times when the two are in conflict: the owner who wants to euthanase the animal that is no longer wanted but is fit and well; or the owner who wants to keep going with treatment where euthanasia would be the much better option to stop pain and suffering.

But most of the time animal welfare and owner welfare go hand in hand, and it is at those times when I realise I couldn’t be in a better job. To have an animal fit and healthy again and owners overjoyed is great, but to ease the saying goodbye to an ill or old beloved animal, to have owners who feel their pet has had a peaceful end can be just as worthwhile.

We need to make sure that new graduates understand that and aren’t left in the position Jill found herself in at the end of her first week. We need to teach students that before they start their careers, and I guess EMS is just where they are going to see that in action.

The trouble is that a number of my students seeing practice seem to find themselves excluded for those tricky consultations where euthanasia is on the cards. This is just the place where they need to see how an experienced vet deals with the conversation at the end of life. And while communication skills workshops with actors playing the part of distressed owners can be useful, there is nothing quite like seeing it in real life.

Certainly, it is just about the most difficult part of our job, and one where it can be difficult to have a student in with us, but that difficulty is exactly why students need to see the euthanasia consultation as often as they can and have time to reflect on it and discuss it with us afterwards.

Thank goodness that students here in the UK are required to see EMS; I cannot imagine what that first week in practice must be like for new graduates in other countries where what we used to call seeing practice is not a key part of the course.

Even with those 26 weeks though, we need to recognise how much help and support a new graduate needs as they start out.

If you have a newly qualified vet beginning their career with you this summer, please make sure they get as much care and help as you can give them, won’t you? I’m sure you will.