Tuesday, October 22, 2013

Good help is hard to find

I have the decidedly unpleasurable job of working with someone I actively hate. This is very weird for me. First of all, I generally do not HATE people. Yes, there are people that I like more than I like other people, but usually I like everyone I work with. On rare occasion, I dislike someone I have to work with, and that is of course unfortunate but part of life. These days, well - actually feeling hatred for someone is so disturbing. I pull into the parking lot, see her car, and start bubbling with rage and wondering how I will get through the day. I hope she will fall ill and have to leave. I fantasize about sending her home and just working on my own. It's terrible, just terrible. I don't know what to do with this feeling.

She's not only has a generally unpleasant demeanor (she babytalks constantly, she never shuts up, she has no conception of personal space) but she is ignorant and incompetent and sadly, I am not The Big Boss, so I cannot fire her.

We call her BTT (babytalk tech) for short around here. None of the other docs let her do any patient care while not being directly supervised, none of us let her calculate drug doses, none of us let her administer medications we haven't handed her directly - she can't be trusted to do these things. Despite having to supervise her so heavily and having restricted her duties as much as possible, she still continues to drive me UP THE FUCKING WALL. Ahem. Sorry for the outburst.

So, yeah. In recent past:

A giant-breed dog presented with a laceration of a toepad. My intent was to sedate him, infuse a local anesthetic, & repair it with just two stitches. I asked her to hold off a vein for me and she started to do so but then let go of his leg JUST as I was about to inject, telling me she needed a tourniquet. I felt that a tourniquet was (a) not needed and (b) going to be a problem as she would then need to release it without his leg moving/dislodging my needle, & told her so, but she (in baby talk) told me that her thumb was just getting TOO TIRED and she refused to proceed without the tourniquet, which she was trying to apply as I was sitting there on my haunches in front of the dog telling her to stop it. The dog freaked out because she pinched his skin with the tourniquet and started attacking us, requiring muzzling and then IM sedation with very high doses to overcome his catecholamine surge. So then of course he took forever to recover. I was outraged. Frankly I am still outraged.

A client came in for "I think I pulled my cat's nipple off!" and apparently she did not, in fact, pull the cat's nipple off. I was in my office typing up charts when BTT came in and said "good news! your next patient doesn't need to see you, she thought she pulled off a nipple but it was just some waxy debris stuck to the fur." I said "is that all it was in for? you can send it home if it doesn't need to see me," because I was backed up with my charting anyway. She said "ok" and and walked out. Then she came back THIRTY MINUTES LATER and asked me when I was going in to the exam room to see that patient. The two other staff members and the boss, who had witnessed our previous interaction, were all completely gobsmacked. We thought she had sent that patient home! She denied having said anything about me not having to see it.

We had a Scottie whose calculated dose of dexdomitor was 0.07 ml, and BTT gave her 0.7 ml. As if that isn't bad enough, it was the third time we know if that she was off by a decimal point in that way, but it was the first time she'd actually ADMINISTERED it before being stopped by a supervising doctor. She has also been known to put the wrong size of pills in bottles to go home with patients. Now, with the dexdom overdose, she DID realize AFTER she did it that there was a problem, and the patient was successfully treated and went home none the worse for wear. But these incidents are so disturbing to everyone, yet she has not been fired. It's mindboggling. Meanwhile, she points fingers at everyone else.

One time, a puppy came in for a first visit, whose owner had registered him as being 12 weeks old. Upon review of the paperwork the owner brought, BTT found that the puppy was actually 14 weeks old. She had a huge hissy fit, yelling at our blameless receptionist that she needed to be more careful about putting dates into the record. Of course the receptionist had put in the birthdate the owner had given her. The owner had made the mistake and freely admitted it. BTT ranted and raved over this "dangerous error" for a good hour and a half. It was really unnecessary.

My diagnosis is that this person has a PITF deficiency. But, the boss says, "good help is hard to find," so we're stuck with her. I say, "some kind of help is the kind of help that helping's all about, and some kind of help is the kind of help we all can do without!"
 

27 comments:

  1. Not that my opinion matters but she sounds dangerous. Clients expect you to hire people they can trust. They are trusting the "boss" to do the right thing. What else do they have to go by? I , personally, think its wrong not to fire this person. What if she kills someones pet with the wrong dose? Is that what its going to take? How would you feel is your childs doctor kept someone on staff who was incompetent and they gave your kid the wrong dose? Just something to think about.

    ReplyDelete
  2. This person will kill an animal sooner or later. I don't know why it is hard for some people to fire bad employees. Sounds like there is plenty of evidence in this case.

    ReplyDelete
  3. I had a tech like this on emergency. Not a situation you want to have to constantly supervise. I caught multiple errors that could have killed a patient (like trying to make a fentanyl CRI with KCl instead of fentanyl!) and hated working with her. But the boss wouldn't do anything about it. I finally wrote a list of all the errors I had caught, put it in writing and refused to work with her. I demanded that she not be scheduled on any of my shifts because it was my license on the line when she inevitably caused a death. That seemed to open their eyes. She was put back into training, which didn't help, and eventually fired when she didn't show any improvement.

    ReplyDelete
    Replies
    1. That sounds like an excellent way to get the people higher up to realize that they aren't actually helpful. I wonder if it would work in this case?

      Delete
  4. Tell your boss that NO BJ is worth a lawsuit for a patient's death...

    ReplyDelete
  5. Tell your boss that NO BJ is worth a lawsuit for a patient's death...

    ReplyDelete
  6. Is there any sort of licensing agency that she can be reported to? Her annoying mannerisms aside, a person who puts the well being of the patients in danger cannot be trusted. Ultimately, it will drive business away from the clinic.

    ReplyDelete
  7. I had to work with a totally incompetent person once too - she didn't know how to do anything right - once she was supposed to be monitoring anesthesia while I spayed a cat - before I started, I asked her if she had any questions about what she was supposed to be doing (are you confident you can tell if the cat is breathing, etc.). She said sure (like it was a stupid question). I monitored the patient myself because I had no confidence in her but, just to check her, I asked her how the cat was doing in the middle of the surgery and got complete silence from her. I then asked, "Is she breathing OK?" Again, complete silence - at that point, I looked up at her and she was like a deer caught in the headlights - she had no clue whether the cat was even alive. Another time, a puppy came in with an obviously broken leg and I needed her to hold the pup on the table for an exam - she actually grabbed the broken leg to restrain the poor thing, causing the pup to scream and I actually had to pry her hand off the leg that was broken and tell her that you don't touch the leg that is obviously broken when you restrain an animal. Meanwhile, the owner is looking at her like she's insane. She just had no common sense at all. I told my boss, but he refused to get rid of her and actually defended her (he of course never worked with her). Finally, I get fed up and took a week of my vacation time, knowing that, in my absence, he would be forced to work with her. By the time I got back, he had fired her :-) But he wouldn't do anything until he was forced to experience her himself. I've never worked anywhere that actually had trained assistants or technicians - they have all been high school kids trained on the job. A few have been wonderful, but most, quite frankly, are just not very swift, and the practice owners still insist they be referred to as technicians. I know most of the clients think these kids have some type of formal education in the field because of this title and I just feel like it's lying to clients to call these people technicians. If you're a client, ask the "techs" at your practice where they got their vet tech degrees - you might be in for a surprise.

    ReplyDelete
    Replies
    1. YES!! One of my biggest pet peeves... there is nothing wrong with calling an unlicensed assistant an "assistant" - that's not a demeaning term. But a "technician" should be a licensed professional. Misuse of the technician title is a huge problem and one seen in many practices.

      Delete
  8. I have worked with such a tech. She one day flushed a catheter with straight heparin. Then the powers that be finally got rid of her. Sad thing she passed her boards.

    ReplyDelete
  9. I worked with one girl who had great intentions, but was a HORRIBLE tech. She was put on a monitoring system where other techs or doctors had to sign off on EVERYTHING she did. She was fired after I reported a mistake that I found - she tried to pull up injectable metronidazole, but only pulled up air. I walked by in time to find 30 mls of air being pumped into the line. I was able to disconnect before the air hit the bloodstream, but it was close.

    ReplyDelete
  10. Gaaaaaah, I feel for the patient she winds up killing! :( If you're in the SF bay area, I know a great RVT with 13 years of experience who is looking for a new clinic.

    I've been thinking that I need to tell my vet when I see him on Monday that his new RVT came across to me as a total idiot. We've been battling chronic GI inflammation with my cat and when I was in a few days ago the tech actually told me "The GOOD news is that he has only lost a pound". As though a pound off of a 7.5lb cat was somehow a good thing.

    ReplyDelete
  11. Please tell me this person is a "tech" and not someone who made it through school and some sort of licensing/certification/registration process. Please?

    ReplyDelete
  12. We had a technician that actually did go through school and was in the process of going through boards... and she was just, well, her heart was in the right place!

    We finally had to let her go because despite months of trying and teaching, she just was not improving at all. Yet she graduated from a licensed tech school, and was in the process of trying to pass boards. I don't know if she did or didn't, as she left before she took her boards. Just goes to show that just because someone is licensed doesn't mean they're any good!

    ReplyDelete
  13. I have worked with such a tech. She one day flushed a catheter with straight heparin

    Do you have to mix it with saline? Im not a vet tech but I'm guessing just straight heparin will cause profuse bleeding and cause lowered bp etc?


    Also

    tried to pull up injectable metronidazole, but only pulled up air. I walked by in time to find 30 mls of air being pumped into the line

    Is this where you can cause something like the bends effect?

    ReplyDelete
    Replies
    1. the bends is actually more like nitrogen in your blood - air in the bloodstream leads to an air embolism and death.

      Delete
    2. Ahh thank you that's what I initially thought either way not good

      Delete
  14. This is scary for me to read as a pet owner... I would tell the practice owner that the cost of replacing this girl is NOTHING compared to the cost of the lawsuit I would bring on his head if she killed or irreparably harmed one of my dogs.

    ReplyDelete
  15. I'm on your side OP, but your attitude reveals flaws in the way you think too. You hope she gets ill? Really? I wouldn't want to work with a doctor who ever thought that about any of our technicians.

    1. Try talking to her, after any episode one on one. It's called direct communication, if you haven't.

    2. Have you tried to teach her? Again, one on one. Help her with her math? Some people need coaching, others do not. Try to work with her, not around her.

    3. Document the mistakes and show her. Honestly, most of the time this might not go well, but it may get her thinking. If it continues, show the documentation to your boss.

    Good luck.

    ReplyDelete
  16. Reminds me of one of the assitents at the last place I worked, only she would show up hung over (the boss knew about it) and stoned (again, he knew about it) and made some the most insane mistakes. I don't care what planet you live on, a 8 week old pug puppy with a broken toe would never be given 0.7mL buprenex (thankfully he lived even though we had no naloxone on hand) and you don't place a water bottle on top the chest of a 3 pound anesthetized chihuahua.
    Somehow I was always the bad guy in these situations, even when I wasn't in the building. Her showing up to work hungover and almost killing a patient was my fault since I wouldn't come in and work her shift for her. Never mind that she was a 23 year old adult who, in theory, should have some concept of personal responsibility.

    Part of what I love about the practice I currently work for is that such behavior would never be tolerated. It also amazes me to see people who have passed their tech boards not have the first clue how to restrain, collect blood samples or even fill a prescription. I never went to school or took the boards, I've learned everything I know on the job and I here I am teaching, teaching LVTs how to do the job they went to school for. *sigh*

    I agree with the above commenters, document the errors in full so you can hand the list of horrors over to the boss, refuse to work with this tech. It is not worth your license.

    ReplyDelete
  17. This makes me terribly sad. I count on my vet to protect my pet in their care. Allowing this person to continue to work there is no different than not sterilizing surgical equipment, or reusing needles to save money.
    Either the boss is being blackmailed, or the practice has very low standards for quality. Either way, I would think you would want to find a new place to work.

    ReplyDelete
    Replies
    1. Or veterinarians tend to be nonconfrontational.

      Delete
  18. Bad techs are the worst. For a lot of reason obviously. Shame the practice owner will wait until she kills something to fire her.

    ReplyDelete
  19. Lols Gag is the the Best Lol Network Ever, where you can every thing is lol and Funny, Troll Images, Prank Peoples, Funny Peoples, funny planet, funny facts, funny cartoons, funny movies pics, iphone funny, funny jokes, Prank Images, Fail Pictures, Epic Pictures, Lols and Gags, Lol Pictures, Funny Pictures, Lol is the Laugh out of Laugh where you can Fun Unlimited and Laughing Unlimited.
    lolsgag.com

    ReplyDelete
  20. Scary to think my dogs could be subjected to someone so dangerous under my Vet's watch. I completely respect my Vet but would find it hard to do so if I he employed someone so inept.

    ReplyDelete