It’s a marathon, not a sprint

Welcome to 2021! I hope you all had a lovely Christmas and new year despite the current climate.

It was definitely a different festive period for us all and it presented its own challenges to each of us, but I sincerely hope everyone managed some sort of downtime and relaxation.

Finally, a thank you to all of our amazing profession who held the fort for copious amounts of mince pie-ingesting dogs, all of the “oh, well he’s not been quite right for two months…” and the genuine life-threatening emergencies that, undoubtedly, we all faced.

As well, a thank you to all the other members of our profession who don’t work within the small animal world. It’s safe to say I have minimal experience or knowledge of the challenges you face, but you’re all appreciated and are doing a vital job.

I still can’t believe how fast this residency is going. We are already at the time of new intern and resident applications, and it is incredibly weird being on this side of the job applications. I can vividly remember how stressful I found that situation and am definitely not envious of those going through it themselves. I wish everyone applying to their various positions the best of luck.

What I wanted to touch on today was the saying “It’s a marathon, not a sprint”. I was very lucky to have a substantial block of time off clinics over Christmas and I really did not realise how much I needed it.

Taking holiday time

The past 12 months have obviously been a little different to usual. For both my internship and residency, I have been allowed 20 days of annual leave inclusive of bank holidays. It’s not much – I definitely had more in practice – but it’s surprising how difficult it is to ensure you actually take holiday.

I’m sure I’m not the only one who struggles with this. When holiday time seems so precious, you feel like you need a really good reason to take it.

Although I had to self-isolate for a decent chunk of time at the end of my internship, I didn’t really have much time away from everything. I’d planned for all my holiday to be in June, as my first block where I could take annual leave was in December – right around residency application times.

Obviously, that was not a good idea, regardless of the pandemic. I realise that now.

Essentially, I had to cover shifts for other colleagues during my block of time off – I can’t really complain given how much time away from the hospital I had, but it meant I didn’t really get a chance to fully disconnect for the entire year.

Fast-forward to the end of the internship, and I had 10 days between finishing the internship and starting the residency, including a house move. Far from ideal, but you’d think the sensible me would have had a plan for the next time off.

My brother was supposed to be getting married in September 2020 so I had a week off for his wedding and stag do, but after that got cancelled, I cancelled my annual leave. “Ah I’ll be three months into the residency, that’s fine. I can’t waste one of my four weeks of holiday for nothing, I’ll crack on until Christmas.”

Well, I definitely underestimated how much I needed my time off at Christmas. I can’t remember the last time I was able to sleep 9 to 10 hours a night and actually be okay with doing nothing. I’m such a busy person in general and try to cram in as much as I can, but I was truly exhausted, and it was pretty much my own doing.

We get our rota requests quite far in advance, so it’s up to me to decide how I want to manage my holiday time – and boy did I manage it poorly in the first six months.

We have so many weeks of outrotations to complete that it can often be difficult to separate when we are off clinics from ECC, and when we are going to take actual holiday. I tried to cram in outrotations wherever I could, meaning I would often do 10 to 14 days in a row consisting of long 12 to14‑hour shifts in intensive care units and emergency rooms, and outrotations with slightly less intense hours.

“Oh if I can get all my outrotations done in the first two years, third year will be a dream.” That’d be if I made it to third year.

Realising how much I needed that time off at Christmas has made me think very critically about when I’m taking my holiday. I have a much nicer rota for the next six months and am able to take a further three weeks of holiday, which are nicely spread out.

Going forward, I’m definitely going to arrange a holiday or something to look forward to every three months or so. Unfortunately, my brother’s wedding has been pushed back again, but I’m certainly not cancelling this time.

I don’t need weeks and weeks off at a time; just to make sure I have some time to disconnect.

Residencies are tough, there’s no doubt about that, but how we manage ourselves during them is going to be the major factor as to whether we survive or thrive.

It’s a marathon, not a sprint.

Looking back

It’s always good to sit back and reflect on where we are in life, what we are achieving and what we want to accomplish.

Over the past few weeks I’ve definitely had time to think about how far I’ve come in such a short period of time. Something as simple as talking through cases with my old practice has been mind-boggling. How am I in a position where I can offer advice to my old friends and colleagues?

There’s definitely a component of impostor syndrome in there, but I also don’t feel like I’m giving the wrong advice so I must be improving somehow.

When I think about how I felt at the start of the residency and how nervous I was, it’s really great to see how much my confidence has come on. I definitely have peaks and troughs in confidence, and I’m sure I’m just waiting for the next confidence hit, but currently I’m feeling really good about where I am in my career.

I’m at the point now where I look forward to my night shifts because I get to push my comfort zones, they’re not scary now (the majority of the time) and they afford me the opportunity to get involved in practices that I thrive on.

Highlight of the month: focus on cardiopulmonary resuscitation

Cardiopulmonary resuscitation (CPR) has been an area of interest for a long time. Communication is crucial to the successful running of CPR, and I would like to think I have my own calm and collected way of running a crash.

For example, I recently worked a twilight/night shift where we had back-to-back cardiopulmonary arrests – I was finishing dealing with one case when the next was being brought to the crash table.

As you could imagine, this was quite a traditionally stressful event. Lots of people were involved, lots of crucial tasks needed completing, and me and another resident were left to organise everything. I had actually been covering the first opinion service due to staffing shortages, so my colleague knew all of the intensive care cases and was contacting each of the owners during the crashes, which left me to run them.

I vividly remember saying “Okay, everyone quiet down. Let’s get some order and work through this” – and actually, we had two very slick crashes. They were calm and we achieved return of spontaneous circulation in both cases, and I feel a large part of that was due to the communication of the entire team. A team that communicates well is a team that performs well.

I am so proud of our team for that night. As you could imagine, we are all being hit hard by COVID-19 and people are pulling in extra shifts here and there. It’s affecting us all in the profession – and although it feels like an end is finally in sight, it’s still been a gruelling time and we have to make a real effort to stay motivated.

I can only imagine how tough it is for everyone on the front line in first opinion practice, dealing with the logistics of a busy first opinion practice with minimal staff and demanding clients. I cannot praise you all enough for your commitment and sacrifice to animal welfare; I am honestly so proud to be part of our profession right now.

The night of the back-to-back crashes will be one I remember for a while, I’m sure. Not because it was stressful, or even because we ran successful CPR, but because of the communication and trust we had among the team that night. More than 90 minutes of back-to-back CPR and post‑resuscitation care was exhausting, but I felt like we did right by our patients.

I’m not saying this is something to aim for – I really hope no one has to do 90 minutes of CPR – but recognising that the key to us working together is to be honest and communicate, that’s the real message here.

That’s all folks!

If at any point you have a question, or want to discuss a topic from ECC Endeavours, please feel free to drop me an email at [email protected] and I will try get back to you ASAP.

Until next time, take care.