George, Washington

Site of the Gorge, of course.  And tomorrow is Labor Dave Weekend for us.

I said I wasn’t going.  And I didn’t wanna slum on the lawn.  Because once you’ve you’ve had legit seats, toward the front, with upstanding people and clean(er) bathrooms–it’s difficult to go back.  Literally back.

I will be annoyed.  People talk, and goof around back there.  Everyone is crammed in.  And you can’t see well.  BUT, if you live in Washington state, AND you get a real 3 day weekend away from work–you have to go.  I’d be sad if I didn’t.  Once I move I would regret it if I hadn’t taken advantage of every Gorge concert I could have.  So in the interest of the future, and as a nice break from work and school–we’re going.  Horrible, stressful work.

We will hike in the middle of the state.  And hopefully see the petroglyphs and a waterfall.  We’ll have a pic-nik and pre-game tail-gaiting.  We will buy some merch.  And I’m not going to snag a good seat on the lawn and sit there holding it for 3 hours.  Because always some mofo will show up after the opening act and ask you to scoot over “just a little bit.”  And stomp on your blanket.  And that stuff infuriates me.  So, since I can’t beat them–I will join them!  I’m going to be the one that gets on the lawn 2 minutes pre-show and shames someone to scoot over “just a little.”

In preparation, we made out set-list wish-lists.  And who ever has most of the songs DMB plays get merch bought by the other.  Hopefully, I will win.  Anyway, there’s the quick run-down of the concert goings-ons.  I’ll be sure to post after we’ve seen the show!!!!

Accountability!

August. Flew by. Honestly, it went so fast I don’t even remember if I hit my goals. OK, I’ll try harder.

Flossing = A+

Water = D

It’s hard to drink water.  It makes you pee.  Which makes you have to use public bathrooms.  Or squirm around in your desk during lecture.  Or silently dance while in an exam room or polishing teeth.  I have to get the timing down so I function during the day and sleep at night. . .

Running (is this a thing?) = B-
Sure, I went, but my head wasn’t quite in the game unless I really, really primed myself. I did the minimum on most days. I did, however, shave a full 5 seconds off my 400 meter PR on one of the handful of days I tried super-hard!

Cool = A- (for me); B- (for Cool)

About every 3 months Cool’s meds just stop working.  It’s difficult for me to pinpoint when it happens because things could easily be due to external factors.  I had been stressed and crabby about work in July.  So it made sense that we started griping and being irritable.  Also, Cool just feels whatever she’s feeling and her behaviors are “normal.”  Until after an episode, then she looks back and says, “hmmm. . .  something wasn’t right.”  Anyway, so Cool was manic for at least a month, and probably the whole summer and we didn’t realize until August.  Now she’s doing the med-merry-go-round.  So things are on the climb.

Work = C

There were really bad-times, but constructive times too.  I guess it works out pretty evenly in the end.  This month, I have to remember it’s school that matters, not work.  And hopefully they are really going to change my schedule.  Soon!

Drinking = B+

I imbibed a little, but nothing too much.  And now that school is game-on, it’s out of the question.  Except on Labor Dave Weekend, obviously.

Money = A-

I jumped through the hoops to get my all-important school loans, and didn’t spend frivolously.  Too much.  I have to tighten the purse strings if my schedule changes, but during school I don’t really have time to spend a bunch anyway.  I have to do 2 more paperwork items, and work on essays for future monies.

Going to the Media

There is a story that needs to be written:

Who takes care of the trails system? The branch of the Centennial on East S. Riverton Ave (across the river from Avista and across Mission Avenue from Witter Pool) is overgrown to the point people are hiding in the shrubbery. I think some grooming is in order.

I sent this note to the Spokane Police, Spokane Transportation, Spokane Parks & Rec, and Spokane Government. Each entity deferred responsibility to someone else, so no one is doing anything.

This is right down the road from where Sharlotte McGill was stabbed to death and is marked as an official trail. To let the foilage grown to an extent that people can hide/drink/drunk/live within is dangerous for everyone that trusts a community trail should be safe.

From Parks & Rec: [Here’s the official word —– The trail between the river and South Riverton is Tuffy’s Trail and is not part of the Centennial Trail. There is an informal, unofficial dirt path that runs closer to the Riverbank where vegetation is heavier but we advise people to stay on the paved and sidewalk trail that runs on top along the street. The vegetation does not encroach on the trail in this location. —– So it looks like that part of the trail might be out of luck. Thanks for letting us know!]

From the Police:  [I believe that would be Parks and Recreation. . .  You may want to check with the street department at 232-8800. Other than that, we’re out of other options.]

“Tuffy’s trail” is the lower dirt trail demarcated by a sign and starts near Napa–well away from the Mission portion I’m speaking of. I’m talking about the Centennial Trail right on Mission, the bike branch–which has a sign saying “Centennial Bike Trail.” It is dangerous to be on the cement there as the trees and brush obscure view from the street and people are hanging out/drinking open container/living/maybe doing drugs there.

It’s unfortunate there is apathy for that part of the trail and the safety of the people on it. Someone ought to care. . . Maybe if you write a story on the issue, someone will find the motivation to do something in order to avoid another tragedy.

Aural Rehab Writing

Assignment 1: Select a disorder, disease, or syndrome in which hearing loss is a primary
component and is characterized by at least two of the following– unilateral and/or
progressive and/or fluctuating. Briefly describe the disorder/disease/syndrome and
discuss implications/considerations for intervention. Total words: 75-150 words.

–>  See other blog entry

Assignment 2: Using 75-150 words, explain to teachers, parents, and
students: 1) the differences between a hearing aid and a cochlear implant; and
2) hearing aid troubleshooting to solve the following issues: no amplification, and
feedback.

[U] When the CI users were compared with their deaf age mates who contributed to the norms of the RITLS, it was found that CI users achieved significantlybetter scores. Likewise, we found that CI users performed better than 29 deaf children who used hearing aids (HAs) with respect to English grammar achievement as indexed by the IPSyn. Additionally, we found that chronological age highly correlated with IPSyn levels only among the non-CI users, whereas length of CI experience was significantly correlated with IPSyn scores for CI users. Finally, clear differences between those with and without CI experience were found by 2 years of post-implant experience. These data provide evidence that children who receive CIs benefit in the form of improved English language comprehension and production. [U]

[T]

Acoustic Feedback and Other Audible Artifacts in Hearing Aids

[T]

Assignment 3: In a 75-150 word paragraph, offer tips for communicating with
individuals with hearing loss.

[V]

Communication with Deaf and Hard‐of‐hearing People: A Guide for Medical Education

Barnett, Steven MD

full article available online

[V]

[W]

Communicating about Health Care: Observations from Persons Who Are Deaf or Hard of Hearing

Lisa I. Iezzoni, MD, MSc; Bonnie L. O’Day, PhD; Mary Killeen, MA; and Heather Harker, MPA

[W]

[X] Communication strategies, accommodations to deafness, and perceptions of the communication environment by profoundly deaf subjects were correlated with indices of psychosocial adjustment to determine whether accommodations to deafness could play a role in the presence of psychological difficulties among deaf persons. Persons with postlingually acquired profound deafness were administered the Communication Profile for the Hearing Impaired (CPHI) and several standardized tests of psychological functioning and adjustment. Inadequate communication strategies and poor accommodations to deafness reported on the CPHI were associated with depression, social introversion, loneliness, and social anxiety. Limited communication performance at home and with friends was related to both social introversion and the experience of loneliness; perceived attitudes and behaviors of others correlated withdepression as well as loneliness. In general, the pattern of correlations obtained suggests that specific communication strategiesand accommodations to deafness, rather than deafness per se, may contribute to the presence of some psychological difficulties in individuals. [X]

Assignment 4: Visit a public place and observe a child and a caregiver interacting for a
minimum of 5 minutes. In 75-150 words, describe how this communication interaction
would have been different had the child had a bilateral, moderate hearing loss.

[Z] However, there was considerable individual variation within the SNH group. Nearly 50% of the SNH group showed phonological impairment associated with poorer expressive and receptive vocabulary and higher hearing thresholds than remaining children without phonological impairment. Nonword repetition deficits were observed in SNH subgroups with and without phonological impairment and were of a similar magnitude to those observed in children with SLI. Indeed, poorer repetition in children with SLI could only be differentiated from children with SNH on phonologically complex nonwords. Overall, findings suggested major problems in nonword repetition and phonological impairment occurred without clinically significant deficits in wider language and literacy abilities in children with mild-to-moderate sensorineural hearing loss [Z].

[Y]  A total of 1528 pre-school children (mean age 4 years and 9 months), being identified as speech or language delayed, were evaluated with respect to micro-otoscopy, nose and throat pathology, hearing function, and speech-language abilities. Subjects were classified into groups of (I) constant normal hearing, (II) fluctuating conductive hearing loss and (III) bilateral moderate to profound sensorineural hearing loss requiring hearing aids. In groups II and III, severe speech and language pathologies were found more frequently than in group I. Additionally, auditory perception skills were less in group II, even if peripheral hearing function was normalized. Group III was affected more than group II, but not significantly. The results indicate that in children having speech or language delay for severals reasons, mild fluctuating hearing loss can additionally alter language acquisition, but less than in cases of moderate or profound sensoneurinal hearing loss. The need of early detection of sensoneurinal hearing loss appears widely accepted; this study demonstrates also the necessity of early diagnosis of mild fluctuating hearing loss, especially in children with speech-language delay.[Y]

T]  http://tia.sagepub.com/content/1/2/45.extract

U]  http://jslhr.asha.org/cgi/content/abstract/42/2/497

V]  http://journals.lww.com/academicmedicine/Fulltext/2002/07000/Communication_with_Deaf_and_Hard_of_hearing.9.aspx

W]  http://annals.org/article.aspx?articleid=717256&atab=11

X]  http://jshd.asha.org/cgi/content/abstract/55/4/656

Y]  http://www.sciencedirect.com/science/article/pii/S0165587698000755

Z]  http://onlinelibrary.wiley.com/doi/10.1111/1469-7610.00726/abstract

Related articles

• Deaf Awareness: Listen Up! (allentreeservices.com)
• Stem Cell (hearinglossstemcells.wordpress.com)

 

Schedule Adjustments

After putting my original plan in practice, I realized that a couple of things will have to change.

1.  I can’t walk to my Tues/Thurs class.  The smaller reason being the heat is intense just a little later in the day when that class meets.  The bigger reason:  I have to rush to find a seat more than 40 minutes earlier then class begins.  The rooms capacity is 80, and my class is comprised of 96 students.  Today, I showed up 40 minutes early, and still had to settle for a 5th row seat.  I like to sit on an aisle in the 2nd row or at very least 3rd.  So I’ll just drive, then study the flashcards in my seat the hour before class starts.

2.  I can’t run at 6AM on the mornings I don’t work.  It’s just 60 degrees and my legs feel tight the entire time.  I also have to wear a jacket to run.  All of that slows me down.  So I’ll get up, study very first thing in the morning, and try to be at the track at 7:15AM.  If those gals are still running at 8AM, I might even have to go at 9:30AM–hopefully I won’t lose all my motivation by then.

3.  My work schedule will change!!!!!!!!!  I am so relieved and thankful.  Like, really a lot.  This is such good news, and will help me in so many ways.  I just hope the change is applied very soon.  When that happens, I’ll work every morning.  And things will go like this:

-wake up early

-study

-work

-Run? hmmm, I didn’t think about when this will fit in. . .

-Eat lunch w/Cool

-study flashcards while walking to class/fighting for a seat in class

-class

-study

-stretch

-read

-sleep

So when will I run?  Friday, Saturday, and Sunday for sure.  I may lose the other days though 😦

SLP Goal: Dysphagia-Cat Food

This needs some editing, but it’s a start.  I probably won’t use it, even though it’s a nice creative writing exercise and memorable.  It could work, I just have a better one in mind, that’s all.

Pulling the silver can from the bottom shelf with my left hand, I opened the top, silverware drawer and excavated a can-opener.  Setting the short metal on the counter-top with a clink, I then lined the teeth of the can-opener on the edge of the rounded tin and squeezed down.  There was a “pop” as a puncture bit its way through the rim, and I could instantly smell salty gravy, and see some cloudy liquid oozing out of the tiny puncture.  Twisting the white handle, of my easy-grip can-opener I scraped my way around the top of lid, making confetti of the ajoining blue, paper label covering the can.  The pungent aroma filled the kitchen with a undefined meaty, smell.  The paper bits and gravy make a slimy, brown semi-circle on the tan counter.

Disposing of the lid in the trash, I perceived the contents of the can.  A shiny, gelatinous mass, of mottled brown coloration wiggled up at me.  I got my worn, tupper-ware bowl, stained peach from a prior meal of spaghetti sauce, and turned the open can upside down over it.  After some shaking and squeezing of the sides of the aluminum sides, the circular mound of food, can rings tattooed around its periphery, landed in my container with a plopping noise.  A scooped the mass of congealed gravy that was shy to exit, with a fork.

Mashing the psuedo-can with my fork, the mushy, wet, brown food sent waves of odor to my nose.  I scooped up a small, bite of food and lifted it to my mouth.  It tastes–Wait!  Does anyone want to find out the answer of how this mystery meat tastes?  There is nothing appealing about the above description, and no person should have to resort to this food. I just described opening a can of cat food.  No one, dysphagia or not, should have to endure a meal reminiscent of this.  Food should be a family affair to cook, harken cultural traditions, look pretty, and smell good.  There should be fresh ingredients and texture.

I want to combine my veterinary experience with endoscopy and radiographs, my education in speech and hearing sciences, and my creativity to help people with swallowing disorders, because I love food and cannot imagine a sad, meal time of bland, non-discriminate slop from a can eaten alone.  I hope to imbibe my dysphagia-friendly food with some flair–help my clients regain not only confidence in a safe eating experience, but some flair and festivity to recourse.  Everyone should be able to cook, look forward to, and delight in their meals, not dread, fear, and bare them.

Related articles

• Dysphagia Awareness & Grey’s Anatomy (ualbertaslp.wordpress.com)
• Dysphagia: A Forgotten Condition (djoglobalexport.wordpress.com)
• What in the World? (dysphagiaramblings.net)

 

Hearing Disorders Paper [Possible Topics]

You know how I like getting ahead.  I have this short paper due (hopefully individually written, and not presented) at the end of the semester.  Here are some aural pathologies I found, a short description (not my own), a couple of pics, and ones I may be interested in.  It would be SUPER helpful if any of there occur in people and cats–so I could use work to look at a case, get info, and maybe take a real-life pic.  We’ll see about that. . .

-acute otitis media

is characterized by a short-lived infection (< 3 mo) that may be initially viral and then bacterial in origin.^[3] Patients generally experience pain and some hearing loss and often develop a fever. Discharge from the ear usually accompanies this infection in patients with acute suppurative otitis media [A]

***-Adhesive Otitis Media

glue ear” TM becomes wrapped upon ossicles; Results from serous otitis media

–Asteatosis

Diminished or arrested action of the sebaceous glands; eczema, old age, cleaning of EAM [E]

–>aural hematoma (feline)???

*-barotrauma 

an injury to your ear because of changes in barometric (air) or water pressure. [D]

-bullous myringitis,

–Carhart notch

sensorineural component at 2000 Hz due to stapedial fixation; occurs with otosclerosis [C]

–Cholesteatoma

Invasion of Epithelium Cells of the EAM into the middle ear. Causes damage to ossicles, facial nerve, ad can be life threatening; Results from Chronic otitis media, marginal perforation of the TM, long periods of negative pressure with infection or PE tubes insertion [E]

-eosinophilic otitis media

Eosinophilic otitis media is an intractable middle ear disease associated with bronchial asthma and nasal allergy that sometimes induces deterioration of sensorineural hearing loss. How eosinophils accumulate in the middle ear has yet to be determined; active eosinophilic inflammation may occur in the entire respiratory tract, including the middle ear, in patients with this disease. EOM often produces a yellow and highly viscous middle ear effusion and can cause symptoms that range from prolonged hearing loss and otorrhea to sudden deafness. The middle ear symptoms are unresponsive to conventional treatments for otitis media and are instead treated with steroids [A]

***-Glomus Jugulare

Dilation of the internal jugular vein impairing ossicular movement. Can hear heart beat.

–Goldenhar Syndrome

-granular myringitis,

*-Malingering

Individual is actively faking a hearing loss. [E]

*-Mastoiditis

Mastoid air cells become infected. Life threatening Meningitis [E]

**-Meniere’s disease., {pics}

could be progressive, Sx: fullness,dizziness [B]

Meniere Episodes = Rotary vertigo, tinnitus, ear fullness or pressure, nausea, and hearing loss. Can last minutes to hours. [E]

–meningitis

–mumps

–Otosclerosis.

Fixation of stapes (calcified), so increase in mass of ossicles. Conductive HL, seen in audiogram at 2000 Hz called “Carhart Notch”. Tx: stapedectomy [B]

Fixation of the foot plate of the stapes in the oval window; Autoimmune disease. Higher occuring in caucasians and women.

–>parasites (feline)???

*-Perilymphatic Fistula

Rupture of the oval or round window causing a loss in perilymph. This causes hearing and balance problems. [E]

*-Psychogenic

Individual does not have a hearing loss but they truely believe they do. Usually result of emotional trauma [E]

–stenosis

acquired– abnormal narrowing of ear canal [C]

**–>Suppurative otitis:  (feline)???

The ears of kittens and cats are liable to infection from pus producing organisms

–Swimmer’s Ear {pics}

*-Tinnitus,

a roaring in your ears, can be the result of loud noises, medicines or a variety of other causes. [D]

**-Toxoplasmosis

–Usher Syndrome

–vestibular schwannoma

An acoustic neuroma is a slow-growing tumor of the nerve that connects the ear to the brain. This nerve is called the vestibular cochlear nerve. It is behind the ear right under the brain. An acoustic neuroma is not cancerous (benign), which means it does not spread to other parts of the body.

–Waardenburg Syndrome

[A]  http://emedicine.medscape.com/article/860227-overview

[B]  http://quizlet.com/19275235/middle-ear-pathologies-flash-cards/

[C]  http://quizlet.com/8475059/common-ear-pathologies-flash-cards/

[D]  http://www.nlm.nih.gov/medlineplus/eardisorders.html

[E]  http://quizlet.com/21704867/aural-pathology-flash-cards/

Related articles

• Recurring Ear Infections (pediatrics.answers.com)

 

Who Can Concentrate on Studying, Anyway?

Not me after waking at 5AM, getting to work at 6:30AM, going to class at noon, going baaack to work at 2:30PM, and finally getting home at 5:45PM.  I can’t even focus enough to heat the dinner Cool was nice enough to make me.  So hard-core study in the morning, that’s the plan.

Today, I was able to get the power-points online.  I was not late.  I didn’t get lost.  I wasn’t in the wrong class.  I wasn’t called out as the new, unknown student by any professor.  There were no torrential rain storms or blizzards.  In short, that makes it my best first day at Riverpoint yet.

I get to take audiology-related courses this time, so I’m super excited for that.  I’m not sure how this lecture went, because the professor talked about herself for 25 minutes, so we barely got into the notes.

When I first saw her I thought my prof. looked like a lady that appeared at the all-weather track yesterday.  Normally, when anyone else comes to the track, Cool and I leave.  I never know what is the school’s classes or sports, and we don’t really belong.

BUT yesterday, I was this-close to being finished with a pyramid workout (run 1 mile, walk 200 m, run 800 m, walk 200 m, run 400 m, walk 200 m, run 400 m, walk 200 m, run 800 m, walk 200 m, run 1 mile) and some gal showed up.  But I had just finished she 2nd lap of my final 800 m, and you can see why I didn’t want to stop short after getting that far in the thing.  And the lady had a dog with her.  And you know how people that own all weather tracks have a hizzy if you wear the wrong shoes, even, so we knew she didn’t really belong there either.

Anyway, as I finished up, she sat on the bench for 3(?) of my laps.  Then her and her dog went to lane 8 and ran.  Since we were going the same direction, I didn’t get the best look at her.  I just thought she must be fighting some sort of injury, because her pace was fairly slow, and she had a limp on her right side.  She ran maybe 2 laps (dog off leash) then left.  And she left right when I finished my last mile, so if she was waiting it would have been 2 more minutes.

So when I first saw my instructor, I thought SHE looked similar to the runner.  But then I thought it probably wasn’t.  As she talked more and more though, I wondered.  She was going on and on about how she partakes in water sports.  And how she cycles.  How she did the Seattle to Portland ride and around Lake Tahoe.  So I thought, well, maybe. . .  She’s obviously active.  But when she said her husband works at the school where the track is located. . .  So maybe.  Maybe I hogged the track when my prof. wanted a jog with her dog.  Hopefully, she didn’t recognize me.

Time will tell.

Last Day of Summer

And how did it fly by so fast?

Just a short note to say I’m sorry about disappearing for the last couple of days and share some intentions.

I ran 4.5 miles this morning, went grocery shopping, fi–nally finished the choreography to my clogging dance, cooked some meals ahead, printed my outlines, printed some (not all yet) of my class lecture notes, and packed my backpack.  And there’s still more to do. . .

I feel under-prepared for school this semester–compared to last year’s ultra-preparedness at least.  Seems like while I was getting a jump on school last summer, I was trying to squeeze every last drop of fun out of this summer.  Hopefully, it will work out OK though.  I think a change in work schedule will help quite a huge amount in that endeavor.  Cross your fingers that happens for me.

I may be MIA on the posting next week, as I want to do everything right to establish a productivity-maximizing schedule for myself, and it’s the first 2 weeks that count most.  I’m going to try to walk to class, study flashcards, draw anatomy, make study sheets, run, hula-hoop, stretch, read for pleasure, and write on non-work days.  Wish me luck.

How to be Super-Fast Vet Tech

Work has been insanely busy lately.  Like off-the-heezy, can’t catch your breath, crazy.  We barely rifle through the hospitalized before surgeries, drop-offs, and emergencies are coming through the door–all simultaneously of course.  How does a good vet tech handle it?  I say good, because many vet workers, LVT or not, are just bodies, and not all that fast.  Speed is a skill.  After all you’re just one person and can only do so much and physically move so fast.  Well, obviously I don’t have all the answers–someone tell me if you find the key to keeping up the pace while upholding high standards, but here are some tricks (that I know, and attempt to do) to at least keep your head above water (in no particular order):

keep moving

First things first–you can’t TEACH motivation.  And a good tech is self-directed–we have to be.  But along with the motivation and where-with-all to do the things, it’s a good guideline to keep moving.  During a slow spot, the receptionist, for instance will come to the back to chat with you.  Instead of just standing and talking, wash some dishes while you talk, take inventory of what needs filled, clean the wall behind the trash can (there’s always blood there!), start the autoclave–do little things while you conversate.  There is never a time all day long, a good tech can afford to just stand.  If there’s a slow spot before work starts, get the laundry washed and folded, prep and stock.  And during busy times, just do things.  Pick a task (hopefully the highest priority one, and the entire thing) and do it.

prepare

Yes, this does soothe my OCD, but it’s also really important for speed.  Put things in a nice order, and exactly in the same spot all the time.  Then everyone will be able to grab what they need quickly.  It seems silly to take the time (on a super-slow day) to sit and put the lids on each Rx bottle, or create bags of to-go-home SQ fluid accessories, but when it’s busy you’ll thank yourself for having things ready to just grab.  And prep the charts–really reception should do this, but let’s be real, you’re going to do it.  Make it easy to just grab a folder and have everything filled out and right there–cage labels included.  Whatever can be done early, should be done early!

anticipate

Vets love this one.  It helps them be faster, which in turn helps everyone go faster, because they are the bottle-neck.  An abscess suddenly walks in the door, while you have 10 other things to do.  Sure, all the necessary stuff is right in the drawer or within easy reach, but it takes a couple of seconds to minutes for the doctor (always with dirty gloves on) to shuffle through a drawer searching for what they’re looking for.  Pull the stuff out ahead of time and have everything you need already out on the counter.  Which brings me to my next item,

Stock

It seems like tedious busy work, but when the syringes aren’t in the drawer, the alcohol bottle is empty, and the pill bottles aren’t in the cupboard, it just takes that much longer to retrieve items for the task at hand.  The doctor shuffles through the drawer not finding what they need, because they aren’t 100% familiar where everything is kept, they have to ask a tech to go through the drawer looking for the item.  Then, after the search, the tech finds that the item isn’t even IN the drawer where it’s supposed to be.  The tech has to walk to a further location (while evryone is held up waiting for the item) to get things to stock the drawer and hand to the doctor = valuable time wasted.

clean

Under the same track is keeping things clean.  From surgery packs to cold sterile to counter tops, everything in there needs to be cleaned right after it’s used.  It doesn’t hurt to be throwing garbage away, tossing things into the wash sink while the vet is suturing and you’re just standing there looking.  Just make sure you’re patient is stable FIRST, that’s all.  Cleaning, and keeping things clean is imperative, and everyone (doctors, LVTs, assistants, receptionists, kennel help) should be doing this all the time.  This is a hospital after all, plus, it helps with the afore-mentioned stocking and prepping.

stay organized

Honestly, I think this is the key.  I find it imperative to maintain current treatments and to-do lists on the board, on the treatment sheet, in the computer.  All of those places eventually.  Having kennels and carriers labeled immediately, labels on prescriptions, notes of doses, becomes SO helpful.  Especially when it’s overwhelming.  It’s very easy to confuse patents, and what they’ve done (eating habits, BM, etc. . .), certain numbers (vitals, how much injectable medication they’ve had, etc. . .), who needs what, and what is where.  Having a system, and sticking to it helps me be the most efficient and productive.

write things down

As sort of an extension of the above, write things.  Sometimes it’s impossible, but try to jot things on the board or treatment sheet or in the computer or file ASAP.  Too many things and too much of a time-crunch creates pressure and confusion.  Take the time to make a note.  You can fix it later, transfer it to the appropriate spot when there’s more time, but it needs to be somewhere other than in your (chaotic) brain.

communicate

On notoriously busy days, tell everyone there may be a wait when they schedule their appointment.  If you’re running behind, just keep the clients informed.  Like a slow restaurant, most people can be understanding of busy-chaos–but only if you seem very apologetic and keep them in the loop.  Also, when you need help make sure to stop and tell your co-workers.  Keep everyone in back informed–write warnings on kennel cards of fractious animals, note special diets, keep the board and treatments current so everyone knows.  Don’t let the hectic atmosphere render you silent, because it slows everyone down and makes clients angry.  It’s much faster to take time to say/write things then fix a problem later.

prioritize

Possibly the most difficult thing on the list.  When a bunch of things are needing done all at once, it’s hard to know where to start.  And even the most educated and experienced employee sometimes pick the wrong thing.  It’s very confusing.  I think my list of do now to save for last would go like this:  Critical care emergencies, surgery, drugs, writing things down, medication, diagnostics, rooming clients, processing labs, answering the phone, clean, prep, eat, chat.  I guess (as of this second, and maybe changing my mind if you asked me again later), but it depends on circumstances too.  So make your best attempt to think about what is the most imperative and what can wait.

And most of all–good luck.  Sometimes it’s just going to be crazy.

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