Extern Orientation Guide & Welcome Packet
2015
Mid-Atlantic Equine Medical Center
40 Frontage Road
P.O. Box 188
Ringoes, NJ 08551
Phone (609) 397-0078
Fax (609) 397-2905
www.midatlanticequine.com
Welcome to the Mid-Atlantic Equine Medical Center!
Thank you for choosing MAEMC for an externship. We are happy you are here and want to make this an excellent learning opportunity for you. Please take a moment to read over this handout. It will provide you with helpful information regarding your externship. Feel free to ask any questions in case we left something out!
We will make every effort to include you in the care of our patients and give you the opportunity to ask questions, assist in surgery, expand your technical skills, etc. The more effort you put into the externship the more rewarding it will be. Please remember there is no such thing as a stupid question! Please contact anyone at the front desk or one of the Interns for anything you need during your stay.
The phone number here at the clinic is 609-397-0078 or toll free 800-724-5358 in case you want to provide this number to any family/friends that may need to reach you. If you are expecting a call please let the front desk know and they will make every effort to find you when the call comes in.
Our Doctors
There are 8 senior veterinarians:
Dr. Peter Bousum, V.M.D Nuclear Scintigraphy
Dr. Rodney Belgrave, D.V.M., M.S., Dip ACVIM Internal Medicine, Neonatology, Critical Care
Dr. Dean Neely, V.M.D., PhD., Dip ACT Reproduction and Ambulatory
Dr. Patty Doyle, D.V.M., Dip ACVS Surgery and Nuclear Scintigraphy
Dr. Janik Gasiorowski, D.V.M., M.S., Dip ACVS Surgery and Nuclear Scintigraphy
Dr. Florent David, D.V.M., DACVS, MSc, DAVCSMSR Surgery and Nuclear Scintigraphy
Dr. Gemma Gerardi, D.V.M. Ambulatory
Dr. Jennifer Feiner, V.M.D Ambulatory
There is 1 surgical resident:
Dr. Jessica Partlow, D.V.M.
There are 4 interns:
Dr. Nicole Finazzo, D.V.M.
Dr. Tasha Likavec, D.V.M.
Dr. Kathryn Livesey, D.V.M.
Dr. Libby Reidy, D.V.M.
The interns are here from June until the following June and during their time with us they rotate
services every two weeks: surgery, medicine, ambulatory and overnights.
General Information
Dr. Neely sees primarily reproduction cases at a separate reproduction facility located approximately five miles from the main clinic. All other cases (e.g., lameness, prepurchase, surgery, medicine cases) are seen at the main clinic. Some cases are admitted as “in-patients” and other cases are seen on an “out-patient” basis. During the first day or two of your stay, we ask that you stay in the hospital so our doctors and staff can get to know you and you get familiar with our hospital. Then you can begin to focus your externship to any area you would like to focus on, including working at the repro facility or riding with our ambulatory doctors. We will let you cater your externship to your interests, but ask that you work with the other externs that are here at that time so that everyone gets their fair share of the action.
Informal barn rounds are held during the week between 8:30-9:30 am. During foal season, separate rounds may be held in the NICU.
We have a 5 stall Surgery Barn for emergencies, a Medicine Barn with 4 intensive care stalls equipped with oxygen, a Back Barn with 7 stalls for Nuclear Scans and overflow, a 16 stall Long Barn for elective surgeries and overflow, and a 4 stall Isolation Barn. The clinic has a pharmacy, full-service clinical lab, radiology and Scintigraphy units, an emergency surgery and recovery stall as well as an elective surgery with 2 recovery stalls, and general exam rooms with stocks. There are several work stations throughout the hospital with access to the internet, and please ask if you need assistance using the internet work stations. PLEASE BE SURE TO ACCESS ONLY WORK APPROPRIATE WEBSITES WHILE HERE AT OUR CLINIC!
In addition to the digital photo of yourself that you have sent prior to the start of your externship, please be sure to have your picture taken while you are here. THIS IS VERY IMPORTANT FOR ANY STUDENTS INTERESTED IN APPLYING FOR AN INTERSHIP! We keep these photos in your record, and will sometimes post them on the kitchen bulletin board so everyone will know who you are. Please be sure to wear your school name tag AT ALL TIMES! If you have forgotten or misplaced yours, please see the front desk and we will make one for you. There is an “extern room” provided for you at the top of the stairs in the back barn. It has beds, a small kitchen area, and a phone. Please make yourself comfortable. You may also use the kitchen/lunchroom and washer and dryer located downstairs in the main building. There are 2 showers, one in the back barn below the apartment and one in the locker rooms of the new surgery building. There are two delis in Ringoes where you can get hot food, as well as grocery items. About 6 miles North on Route 202 is Flemington, a much larger town with a Shoprite, Panera, Applebees, fast food, etc. Please let us know if you need transportation. If you do have a car, please park in the parking lot on the left side of the building.
How do you work the phones?
To dial an outside phone number, press the “outgoing” button, wait for a dial tone and then dial your number with area code. To page someone within the clinic, press the “page” button, followed by the number “1,” speak clearly into the handset and hang up softly (the person you paged for will not be able to call you back if you do not hang up). Our receptionists answer all calls during regular office hours. During all other times, calls made to the main clinic number will be transferred to our answering service. You can receive phone calls after hours by having the caller press the number “9” when the message comes on. If the phone rings after hours and you feel comfortable answering, please answer it “Mid Atlantic Equine, this is (give your name). How may I help you?” If you are going to answer the phone after hours, be sure to conduct yourself professionally! If you do answer the phone after hours and have to put it on hold, please ask the client/RDVM to hold for a “moment” (not a second!) and press the red button on the phone. In order to transfer the call to another extension you must pick up the line as if you were going to speak to the individual, press the transfer button, dial the extension you want the call to go to and then hang up (the call will not be transferred until you hang up).
Responsibilities for In-Patients
Please ask for guidance from the techs and or doctors. You will be asked to assist in numerous procedures (e.g. placing catheters, giving medications, tubing, etc.). Please be aware that occasionally there may be numerous students, techs, volunteers etc. here and we may ask that you limit the number of people in a room while clients are present. We would like no more than 2 externs in a room with owners present. We would like you to participate in all areas of the hospital. If there are several vet students here, you may be asked to rotate through services (surgery, repro, medicine and farm calls) to limit the number of people in any one area. Please contact one of the interns if you have any questions, problems, concerns etc.
If you are uncomfortable or unfamiliar with how to handle horses, please let the Interns or technicians know. We do not want to have people or horses hurt. For instance, the improper handling of foals can cause damage to internal organs. Many of the horses we see for lameness are fit racehorses and can be a challenge to handle, please use caution.
Externs are asked to help perform daily physical exams including TPRs on all in-patients. If you find a serious problem with a case (e.g., a high fever, diarrhea, laminitis, colic, etc.), please immediately contact an intern, technician, or senior clinician to report your abnormal findings. We use a computer based charting system at the hospital that you will be shown how to use.
In the morning we ask that you be ready by 8am, at the latest, and arrive in the intern office to start the morning rounds. Externs are also asked to help the technicians perform patient treatments during the day and assist the overnight intern and technicians at night (including 12 midnight treatments and special treatments between 12 midnight and 6am). Due to the varying degrees of experience of our externs, shadowing of the interns and/or technicians during treatments is generally required before undertaking any treatment responsibilities unsupervised. Your clinical experience will dictate the level of responsibility assigned. If you are unfamiliar or uncomfortable with performing certain treatments such as drawing blood samples, administering IV medications, hanging IV fluids, etc. please ask a technician or intern for guidance. Externs should not place IV catheters or stomach tube horses on their own.
General Allowance for Extern Treatment Responsibility(without supervision):
1st year students: Just TPRs
2nd and 3rd year students: Oral medications and TPRs
4th year students: oral and adult horse IV medication (with catheter) and TPRs
Externs may assist interns or technicians with changing fluids, eye medications, NG intubation and gastric lavage, foal IV treatments, chest tube drainage, bandage changes and other special procedures. Depending on your comfort with the patient, you may be asked to help hand-walk/graze. Externs will not be allowed to do foal or isolation patient treatments without supervision.
Guidelines for Administering Medication to Patients
Be certain you are clear about the amount of drug to give and its route of administration. If the treatment orders are unclear, ask a clinician or technician for clarification.
Some drugs are located in the patient’s treatment box in the treatment rooms in the front of each barn or in the medicine cabinets in the treatment rooms. During foaling season, most medications for foals are kept on individual patient treatment carts located outside each stall in the NICU.
Please sign and date anything written in the medical record and be sure to put notes and your initials in the daily exam note section of inpatient records on the computer system.
When administering IV medications, always use a clean needle to draw up the medication. Turn off IV fluids if they are running. Flush the IV catheter and extension set with 8-10cc of heparinized saline flush solution, and then slowly administer your IV drug followed by another flush with heparinized saline. Flush before, between and after all medications. It is important to thoroughly flush IV lines when giving medications to prevent catheters from clogging and to prevent drugs from interacting or precipitating with one another within the IV lines.
Discard all needles and syringes (except oral catheter-tipped dose syringes) in the red plastic hazardous waster receptacles available throughout the clinic. The sharp ends of the venosets must be cut off the IV lines and discarded in the red containers. The IV lines and coils without the venosets can be discarded in the general trash.
Once you have administered a medication, please mark off the treatment on the patient’s treatment order sheet in Vetstar as being given.
If cases are critical or receiving IV fluids, please walk by and check on them as frequently as time permits in addition to those required by the treatment scheduler.
Whenever you are administering drugs through catheters, always check to be certain there is no evidence of abnormal swelling, heat, or pain at the catheter insertion site. Please notify the intern whose case it is of your findings.
Scrubbing Into Surgery
Externs are welcome to observe surgeries. Please ask the Sx Tech where to obtain a cap and mask if you are just observing. If you choose to scrub in with Drs. Doyle, Gasiorowski or David and the surgery intern/resident, clean scrubs can be provided.
Some surgeons may ask for a surgery report if you scrub in. The surgery intern will assist you with the report. Surgery reports must be entered into the computer system. Please ask one of the interns to show you how this can be done.
Dress code:
We ask that you wear professional, work appropriate attire during the week, especially when you will be interacting with clients. For example, khakis with a polo or nice shirt are professional and appropriate. You may wear more casual (yet appropriate) clothing and footwear if you are helping with evening or weekend treatments.
General Barn Care
If you are asked to turn a horse out, please be certain you know which paddock it can go into. The last paddock on the side of the building nearest the lunchroom is generally used for isolation cases. Please be certain that the horse has a bucket of clean water. When you bring horses in, please close the gates to the paddocks. If a horse should become loose, IMMEDIATELY pick up a phone and hit page saying “Please close the gates.” That will alert everyone that there is a loose horse and the two entrance gates on either side of the hospital will be closed. The entire perimeter of the hospital is fenced, so once the gates are closed the horse cannot get off the premises.