So, you want to do clinical EMS at a charity practice? Good for you! It can be one of the most rewarding ways to spend time on placement. However, it has its challenges. Having done my share of charity placements, I can speak from experience. I will share what I found - the good and the bad, so you can understand what to expect.
A Run-Down of what I did on Charity Placement
In 2021, I undertook two weeks of clinical practice with a smaller charity in London. It is a long-standing animal charity focusing on feline neutering. Still, it supplies veterinary care for a range of furry friends - for which it would otherwise be inaccessible. While there, I saw (and did) both surgeries and consults. A typical day for me would be as follows:
- Help to draw up the anaesthetic agents with the vet nurse for the morning's ops.
- Undertake tasks such as cleaning and sterilising the surgical equipment while the theatre gets set up.
- Watching and assisting with more neuterings than I can count.
- Finishing with consults/watching a non-routine surgery or two.
It's Never Not Busy
Even more so than private practices, charity is busy. There is always something going on (owing to them being constantly overstretched and understaffed.) It is a place where time is of the essence, and dawdling is not appreciated. This has its pros and cons as a learning environment. On the one hand, there are tons to get involved in, but on the other, the fast pace can be unkind to the inexperienced.
Everyone (at least where I was) wanted me to get involved, but sometimes, before you know it, a job is done before you even have the chance to find out what it is. To combat this, I had to learn to be vocal and proactive about what I wanted to achieve during my placement. When you start your placement, determine which areas and skills you want to work on and make yourself available. If you find yourself doing nothing, ask if there's anything you can help with - there will likely be.
Try and Schedule Charity for Later in the Year
During my placement, I homed in on my cat castrations and did over fifty in only two weeks! However, I did not get a chance to practice spaying. I watched countless spays and talked through many, but they could not teach me this one due to my lack of experience and the high workload the vets were facing at the time. For this reason, I would suggest organising your charity placement so it’s after a non-charity clinical placement. This way, you will be more familiar with procedures, so you can use your time (and the extremely high case load) to develop existing skills, as there isn't always the time for the team to teach you complex procedures from scratch.
Get Stuck in or Risk Missing Out
The high throughput of cases gives you countless opportunities to watch and try practical skills and surgical procedures. It is important to get stuck in and approach these tasks with confidence. Don't let the time pressure intimidate you; give it your best shot. You won't get the same opportunities in private practice, so you must use your time with your charity practice well.
'Boring Jobs' are Very Much on the Table...
Due to the chronic understaffing of charity practices, spare hands are always used. I spent a lot of time on anaesthetic monitoring and recovery because there weren't enough nurses (made worse by COVID.) I am not an anaesthesia enthusiast, and I must admit that I have found this job tedious. I would spend 5-6 hours monitoring some days, meaning I could not attend consults or watch the surgery. It was easy to leave deflated on days like this, but I learned a lot from working on skills I would have otherwise likely avoided.
So, I advise you not to shy away from jobs you aren't keen on. Doing them enthusiastically will help you get the most out of the learning experience. As always, if things are getting too much and you'd like to get the chance to develop a different aspect of veterinary work, chat with the team and politely make it known. Be specific in what you want to have a hand in, and avoid coming across as if you're complaining. Be appreciative of the opportunity to do that 'boring' job.
...As are Cool Operations
Especially in smaller charities, as it is often the only option, surgeons will attempt specialist-level surgery in a last-resort setting. You learn with the surgeon as they prepare for these non-routine/emergency surgeries. During my time at the charity practice, I watched a cranial cruciate ligament repair using lateral suture placement. Working with the vet (who had no orthopaedic training beyond CPD), we researched the technique and refreshed ourselves on the relevant anatomy. Then, I watched as she put it all into practice. It was inspiring to see her use her more comprehensive knowledge and understanding to do a surgery she had never done before - and I'm pleased to report it was successful! This practice was also where I saw my first splenectomy and pyometra surgery - very cool!
Chaos is Common Place
With the increasing pressures on charity practices, things can get overwhelming quickly. Keeping a level head is necessary, so get ready to test your cool. An example of chaos from my time seeing practice was the day I overcame my fear of talking to clients. An emergency came in and scuppered the day's plan. Due to the challenging nature of the case - both vets were required for the op, and the only vet nurse was doing the anaesthetic monitoring. This left clients piling up in reception, waiting to get their kittens vaccinated. As the only person with some veterinary standing left, I was thrown into my first consults. With COVID in full swing, the consults were all done in the waiting room, and I would take the cat into the practice without the client. Now, as a vet student, I could administer vaccines but needed to do so with a qualified vet there so they could sign the paperwork. I was told to bring all the cats into the (very large) surgical suite with their documentation and a set of scales. It ended up with five kittens in crates on the floor and a dog with an open abdominal cavity on the table, me administering the vaccines and the vet un-scrubbing to sign all the paperwork. Not the way I expected my first vaccine consult(s) to go, but I left with the confidence that if I could do it there, I could do it anywhere!
The Realities Can be Difficult to Face
The lack of money in the charity sector is apparent. The veterinary team where I saw practice does their best with what they have available, but don't expect to see the 'gold standard.' Limited access to equipment meant I saw fewer intubations, more masking and more injections off the needle than catheters being placed. That doesn't mean the quality of what I learnt was lesser than in non-charity practices. I will say that the number of cases that couldn't be treated because there were not enough funds was pretty heart-breaking, as was seeing animals that were in a sorry state. Coming across neglected animals can be very difficult to process. Saying this, it's essential to lead without judgement. We, as students, will have no idea of the client's circumstances - approach with compassion and focus on caring for the animal.
The Rewards will come from the Challenges
In charity practice, the rewards are the challenges, and the challenges are the rewards - depending on how you approach them. There are endless learning opportunities, so take them into your own hands. Get involved, stay on your toes and enjoy the experience - there's nothing quite like charity placements!