The WCVM’s ICU from eyes inside
When I first walk into the small animal intensive care unit (ICU) at the WCVM Veterinary Medical Centre, there’s activity everywhere: dogs are barking, machines are beeping and clinicians are discussing the unit’s cases.
At first, the level of activity and noise is overwhelming. But it soon becomes evident that everything is organized and controlled in this high-paced environment where ICU teams care for seriously ill and injured pets around the clock, 365 days of the year.
Patients with severe pancreatitis, intervertebral disc disease and immune-mediated disease are just a few of the conditions I learn about during rounds in the ICU. As well, there are several post-surgical patients that are often hospitalized here for post-anesthetic recovery and post-operative monitoring.
I’m here during what the technical staff refers to as “rounds” that take place before every shift change. Rounds allow the nursing staff to communicate and learn about the progress or new developments with the critically ill patients in the ICU.
During my visit, animal health technologist (AHT) Kim Foster is the assigned shift leader and arrives before the shift change to do rounds with the previous overnight shift. The remaining nursing staff consists of AHTs — some of whom are working toward certification in veterinary emergency and critical care (ECC) medicine. All of the ICU technicians on the day shift are present for rounds and listen to Foster’s update of each animal.
“The goal of rounds is to get a better idea of what’s going on with the patient,” explains Melissa Underhill, an AHT who’s currently working towards her ECC certification. “Rounds give the nurses an opportunity to understand what’s occurred over the past 12 hours and what to prepare for during the rest of the day.”
Dr. Jennifer Ogeer, a WCVM associate professor and critical care clinician, manages the ICU and often joins the nurses for rounds. With Ogeer’s guidance, the AHTs learn about a patient’s history plus they often pick up some little known medical facts.
For example, one of the ICU’s patients is a vomiting female dog with a history of seizures. She’s on an oral medication called potassium bromide for seizure control, but because of her vomiting, she can’t take this medication orally. As the group discusses the issue, Ogeer points out that the drug can be administered rectally if needed.
She adds that valium, another anti-seizure drug, can be given rectally or intranasally if venous access isn’t possible. It can be administered at double the oral dose rectally or a dose similar to the oral dose when administered intranasally.
It’s all fascinating for me — an AHT-turned-veterinary student who graduated from the AHT program at the Northern Alberta Institute of Technology (NAIT) in 2003. I ask the group how cases are handled in the ICU. Generally, the ICU nurses work together to care for all the patients. “If we’re running behind, we’ll all pitch in to get everyone treated,” says Underhill.
But in some instances, each AHT will gravitate towards certain patients. “We have our favourites,” says Danielle Mierau, the ICU lead hand and an AHT with ECC certification. “If you’ve taken care of a patient since they were first admitted to the ICU, then you often continue their care throughout their stay in the unit.”
And in some cases the animal chooses its caregiver: “Many animals decide that they like one person because they’ve come to know that one person,” explains Laura Schuster, an AHT who’s been working at the VMC for four years.
I spent seven years working in a general companion animal practice before coming to the WCVM. As a back-up plan, I had considered taking up a specialty such as ECC if I didn’t get into the veterinary medicine program — but I never realized how challenging the ECC certification process could be.
“You have to work in an emergency clinic setting for at least three years. You need to submit a proposal, case log and case reports for review by a committee in order to be considered a candidate to write the certification exam,” explains Underhill. And although she’s nervous about it, Underhill is looking forward to writing her exam in September.
Working in the ICU seems to be an enjoyable and rewarding experience for this group of AHTs. According to Mierau, helping an animal return to good health is one of the best feelings in the world. “It gives you a sense of satisfaction when you see a case through,” says Mierau as she looks down at a patient with a smile.
When rounds finish, the dogs are still barking and the machines continue beeping. The nurses scatter and return to their daily routine of treatments and TLC all with a single goal in mind – to send these animals home, happy and healthy.
Robyn Thrasher of Edmonton, Alta., is a second-year veterinary student at the WCVM. Robyn produced stories about the veterinary college’s clinical services, research program and its researchers as part of her 2011 summer job in research communications.