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Originally Posted by gazoo02 
I get the point about people in the way during emergent situations, people not capable of handling the situation, or interfering with care; but I think every situation has to be taken on a case by case situation. Working in a Trauma ICU, there has been a lot research on whether or not family should be allowed to visit the patient at any hour or be present for codes (trust me, this has met much resistance). The thought process is, when people are sick; that is when they need their family the most. Why should we hold patients "hostage" and restrict visitations during this critical time. Also, we find if a family is present for a code (and capable of handling it) it brings closure. It lets them know we did everything we could or helps them to make a decision on withdrawing care.
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Like I said - the exception to the rule is very critical patients.
It is impossible to take it "case by case" in the emergency clinic - we have two treatment areas with probably about 10 wet tables and a staff large enough so that at any given time we can be working on all of them at once. It is an open area, unlike a human hospital. Multiply that 10 patients by the average 2-3 people that come with each patient and you wouldn't even be able to move! Sometimes there isn't time to find out whether or not someone can handle the situation - patients get rushed in more quickly than you can blink. It might not be ideal for everyone, but it is a rule set up for us to be able to provide the highest quality care possible, and we will not sacrifice that.
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Originally Posted by gazoo02 My point is, I think if a dog is considered too sick to go home after a surgery; than I don't understand how it can be rationalized that they are well enough to stay alone in an unfamiliar environment. My dogs are most comfortable with me and at my house. So I would insist on them coming back home before I would ever leave my dog unsupervised. |
Again, as I said earlier it is not that they are too sick to go home, it is that many owners are incapable of caring for post-surgical patients. We certainly won't make your pet stay overnight against your wishes, but you are fully informed of the risks of not following discharge instructions -- when i discuss this with people, many people actually CHOOSE to leave their pet in the hospital.
And no, personally, I wouldn't leave an animal of mine alone in a hospital overnight unattended either... If the situation required it, I would leave my pet in a 24-hour facility. But that is because *I* have a problem with it -- not because my dog would. Most pets are absolutely fine left overnight.
And believe it or not, there is a large percentage of people out there that ABSOLUTELY REFUSE to transfer their pets to 24-hour facilities. We end up leaving actually sick (not just post-routine surgery) patients in the hospital overnight alone because the owners refuse to transfer even though they are told it is against medical advice. People have refused transfer for the following reasons: cost, they have a 'hot date', they have to pick up the kids from soccer, etc. The average pet owner, sadly, has drastically different feelings about their pets than most of the people on this forum -- you are all here because you care about your pets enough to want to learn, discuss, share, etc.
The people on this forum, the people involved in the "dog world" are the creme de la creme of dog owners... I can only think of a handful of clients that are "in the know" -- I only see people involved in training/showing/working/etc maybe a few times a YEAR! The average pet owner I see has NO IDEA what the current issues in vet med are...
The average pet owner: does not notice their pet is even sick until it is close to unresponsive/suffering a massive hemorrhage/hasn't eaten in a week/has been vomiting for months/has lost 50% of its body weight, etc etc etc. The average pet owner flat out refuses to take care of basic health needs (such as high quality food, dental hygiene, exercise, mental stimulation, etc).
Therefore, it is my job to do the best for the animals no matter who the owner. Obviously when I run into an owner that is knowledgeable and truly concerned, I cater to them and we bend the rules -- but believe me, they are very few and far between.
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Originally Posted by gazoo02 Also, I wouldn't be afraid to let the owners see the ugliness of situation either, because that may help them decide on how to proceed with their animal's care.
I don't think dogs should be taken in the "back" for minor procedures without the owners.
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I agree not all people are capable of handling situations, following directions with post surgical care, or staying out of the way during the delivery of care. But when talking to people, you can usually get a sense how capable they are of following directions and base your decision from there. I just don't think it should be a hard and fast rule when it comes to this stuff. |
Why do you think back yard breeders and puppy mills are that prosperous in this country? Because a large percentage of the pet owning population really is that ill-informed to fall for the gimmicks.
Say its 3am in the morning - you rush to the e-clinic with your unconscious/bleeding/whatever pet -- you want me to take the time and talk to you to see whether or not you seem capable of coming into the back with me or do you want me to rush your pet back and start working on it immediately so there is a chance I can actually save its life? My triage for patients this critical usually consists of a "tell me what happened as quickly as possible, tell me any known health problems/allergies/medications, and do you want emergency care to stabilize your pet that could run between $300-$800?"
In less critical and outpatient situations, you don't want your pet to be taken to the back without you? Fine, I do what I can in the room, you still don't get to go in back. If owners request, I will pull blood, place catheters, give treatments, etc in the exam room. If the patient is being admitted or requires any type of surgical procedure, that's where it ends.
People are waaay more squeamish than you're giving them credit for - I've had people pass out in an exam room while taking their pet's temperature rectally! I had a football-playing 17 year old boy go ghost white when I took a DROP of blood from his dog for a BG. I'd say almost half the people I put in rooms are royally grossed out by rectal temperatures and have to turn away when vaccines are given!
And last but not least -- the rule was instituted when there was a threat of a lawsuit from a client that was bit by an animal in the outpatient treatment area. Of course they were told to keep their hands at their side, not touch anything, not to disturb any of the animals -- and what do they do?! STICK THEIR FINGERS IN THE CAGE OF AN AGGRESSIVE CAT! So what is the old adage? One rotten apple ruins the entire barrel... Thats the way it goes in our society.