What a fantastic rotation to start off with at the hospital! The environment in the service has this ambience of low stress. The doctors are extremely low-key and patient with you. On average, each student is getting only one case a day, so you don’t feel like your insides are turning to mush with the burden of keeping up with multiple tasks. If you are like me, I love to slowly inch my way in the water before submerging into its depths. Baby steps is my safe haven before I’m thrown out in the wild to defend for myself.
I also am glad I took this rotation first because I can appreciate heart and respiration sounds better and apply it to future physical exams. Now, instead of just finding the heart and getting only the heart rate, I am patiently listening to all the chambers and areas within the heart on the right and left side of the body. I am also taking the time to feel for the pulse (usually the femoral arteries in both hind limbs) while at the same time listening to the heart to see if the pulse is synchronous with each heartbeat.
A senior student who was working in my rotation said something that was very insightful, and I would love to share it with you:
Think of every rotation like a cycle. The first week, the doctor will ask you questions, and you will struggle answering them (just make sure to review later). The second week, you’ve now got your hands dirty and have a better understanding for the given specialty you are currently involved with. Third week, you are more confident with your answers and techniques. Then BAM. A new rotation commences, and the cycle repeats itself.
It’s a cool way of approaching a new rotation because it forces you to have more humility.
A new heartworm treatment protocol is now available for veterinarians to use, and it’s found here: http://www.heartwormtoolkit.com/
Here were other great websites to use while on this rotation that helped me:
http://www.rvc.ac.uk/Review/cardiocases/ (just one case though…)
Here’s what other people had to say about it!
(What was Orientation Day like?)
-Our time to arrive was nice (8:30am). We had instructions emailed to us 3 days before orientation day, and attached to the email was an orientation packet and 17 articles to look over (common things you will see in these patients). All we needed to bring was our stethoscope, pen, and a small notebook. The appointment schedule will be on the board. The discharge instructions for these cases are located in the box just below the board. You are asked to go ahead and sign up for a case on the first day. You are also asked to write your phone numbers on the larger board in the upper right-hand corner.
-The doctors chose to have juniors shadow seniors for the first day (won’t be like that when the seniors leave). You go do your Hx first then a tech comes in to do the patient’s BP. Then you present to the resident, she comes with you and does another Hx and gives potential dx test costs before taking the patient back for further exams.
(Average Daily hours on duty?)
(What is the attire? When do you change into scrubs?)
-First Day- One of the seniors told me this. “Usually, on ‘Receiving’ days, where you see appointments and greet the clients, you are supposed to wear business casual with a white coat. On ‘Surgery’ days, where you go to the OR or do procedures, you are supposed to wear scrubs with a white coat. Cardiology is mostly a “receiving” type of rotation, therefore ideally you should wear business casual with a white coat and deal with it if you get peed on.
-Doctors didn’t seem to care in this rotation/ didn’t bring it up
(What do doctors/residents/techs constantly harp on?)
-Know where to place the leads! For an Echocardiogram- “white on right” on right side (placed on the footpad) & “smoke over fire” where the black lead is on the left footpad of the forelimb and red on left footpad of the hindlimb
-ECG leads- placed distally to the elbow on both forelimbs are the “newspaper” leads (white on right & black on the left)/ placed distally to the stifles are “Christmas colors”. Patient is placed in right recumbency and the two leads placed on that side on the ground are “snow on the grass” (white on forelimb & green on the hind limb)
(What are some struggles to watch out for?)
-When tapping a patient during pericardial effusion, designate someone to always watch the ECG. Any sign of VPCs (ventricular premature complex) running in couplets, triplets, or more, inform the doctor (they will then inject lidocaine via IV). Patient can go into sudden V-tach and die! VERY IMPORTANT!
-If you had the Cardio elective, keep the ECG sheets. They will give you another ECG packet to work on, so review them
(Words of encouragement)
-These doctors/residents/techs are wonderful! Super easygoing and chill. The material of the heart is dense, but they are great teachers who are patient and will do their best to help you get through it.
(Difficulty Level (1-3)? 1= It’s a breeze/ 3= really difficult workload)
(1)- had 1 case a day, and sometimes had to pair up
“Taste and see that the LORD is good; blessed is the one who takes refuge in him”