DoveLewis Emergency Animal Hospital invites fourth-year students to practice their knowledge and clinical skills in one of the most highly esteemed emergency and critical care veterinary hospitals in the region. In our well-equipped 24-hour hospital, an extern can expect to learn the art of triage as well as the ability to recognize and treat certain key emergency and critical care situations such as shock, respiratory distress and GDV. In addition, DoveLewis gives students the opportunity to learn the value of a team approach while working with doctors, technicians and nurses in the management of critically ill animals. Externships are available to fourth-year veterinary students currently enrolled in an accredited college of veterinary medicine. Externs must be eligible to work in the United States. This is a 40-hours-per-week commitment. Externships are scheduled for a two-week period of time and start on every other Monday. Applications are accepted on an ongoing basis and positions are available throughout the year excluding the end of June and December.
DoveLewis Emergency Animal Hospital, established in 1973 and based in Portland, Ore., is the only nonprofit, 24-hour emergency and intensive care unit in the region. DoveLewis provides donor-funded programs to the community, including one of the United States’ largest volunteer-based animal blood banks, a nationally recognized pet loss support program, an animal-assisted therapy program, education for veterinary professionals and the animal-loving community, 24-hour stabilizing care for lost, stray and wild animals and financial assistance for qualifying low-income families and abused animals. With over 40 years of service to the community, DoveLewis has treated over 500,000 animals and has been deemed one of Oregon’s Most Admired Nonprofits by The Portland Business Journal for eight years.
Case rounds are held twice daily outside ICU – 6 am and 6 pm. One or both rounds should be attended by the externs. Additionally, the criticalist will lead short discussions on timely topics if time and hospital case load permits.
The schedule starts on a Monday and lasts two weeks. The extern rotation will be Monday through Thursday 6a-7p except the first Monday of the rotation which starts with orientation at 8am. Since weekends are usually busier, the externs are encouraged to observe on the ER hospital floor on one Saturday during their externship. This time is not directly supervised; however Dr. Lee Herold (DACVECC) is available for guidance and to answer questions. We ask that only one extern come on a Saturday for observation.
Students will have a 30-minute orientation upon arrival where they will receive a locker, key card and a hospital tour. You will receive an introductory demonstration to ezyVet and SmartFlow once you begin shadowing on the clinic floor. After your orientation you will finish the remainder of the day in ER or ICU shadowing a staff DVM. You will be provided with a toxicology quiz and a trauma quiz which you are expected to be able to complete by the conclusion of your externship. We encourage you to work on these quizzes during down time, and multiple “practice” cases and radiographs are also available to allow you to work through common emergency situations.
Below is a list of procedures that students may conduct under the assistance of the technical staff at DoveLewis. Due to safety laws, externs are not permitted to take radiographs since they are not issued a dosimeter. Keep in mind these procedures are based on the case load and number of patient admitted to the hospital during the externship at DoveLewis, and hence the availability may be quite variable. The asterisk (*) signifies that there is material available at DoveLewis’ atdove.org website that relates to the procedure, and you are highly encouraged to watch these videos to enhance your understanding.
1. Proper use of Pulse Oximeter *
2. Proper use of doppler blood pressure measurement *
3. Proper placement of EKG leads and set up *
4. Proper set up of IV fluids and additives *
5. Placement of a peripheral IV catheter *
6. Calculation of CRI *
7. Proper calculation of nutritional requirements
8. Oxygen administration techniques
9. Proper set up for oxygen cage
10. Procedure needed for proper blood transfusion administration *
11. Placement of a urinary catheter in a male dog *
12. FAST Scan
13. Intraocular pressure measurement
Students may also observe and possibly assist with the following procedures under the supervision of the veterinarians at DoveLewis pending availability of cases. Some of these procedures are performed infrequently, so it may be necessary to discuss them in a didactic setting rather than be actively involved in performing them.
1. Urinary catheter placement in a blocked male cat
2. Placement of an esophagostomy tube for feeding *
3. Minor laceration repair *
4. Abscess repair
5. CVP measurement
6. Abdominocentesis *
7. Thoracocentesis *
8. Parenteral nutrition formulation and administration
9. Collection of sample for arterial blood gas *
10. Placement of central line *
11. Placement of an NG or NE tube for feeding *
Emergency receiving
The extern’s experience on the ER floor could be variable from very slow days to very busy days. This is the unpredictable nature of ER work. Evenings and weekends are typically busier times on the ER floor. Please be proactive in getting involved in cases. Although there will be no direct client interaction, you may be permitted to observe conversations between the DVM and the client. Externs are allowed to perform a physical exam on the treatment floor or in the ICU, but not while the patient is in an examination room with the client. The externs are encouraged to:
1. Create a problem list, differentials, diagnostic/treatment plan. Discuss with the admitting doctor
2. Assist in treatments for patients
3. Follow the patient’s diagnostic work up
ICU Duty
Externs will spend 4 days shadowing in the ICU. This is a very different experience from the ER. It is the time to think critically about cases and treat the most ill of patients. There is variability in the caseload in ICU. It may be extremely busy or very slow. As in the ER, the students are encouraged to be proactive about getting involved. They are allowed to perform physical examinations and assist in treatments if time and patient temperament permits. This is a great opportunity to observe the often lengthy and intense communications process that occurs with both clients and referring veterinarians. The externs can follow patients through the day with diagnostics and procedures and discuss pertinent issues along the way.
Surgeries and Procedures
Students are encouraged to ask the surgeon if they can scrub in on emergency surgeries and assist in procedures. Factors that may preclude the students’ participation include if an intern is already assisting or if the patient is unstable. You are always welcome to offer your assistance.
Additional learning opportunities
Depending on the flow of patients through the hospital, externs may also have the opportunity to observe diagnostic ultrasounds, assist/observe blood donations and blood product processing, and observe cardiology consultations and internal medicine procedures such as endoscopies, bone marrow aspirates and joint taps. Please let us know if you have specific interests in any of these areas.
Student evaluation of DoveLewis
Your comments are greatly appreciated and will help to assess and address deficiencies in the rotation. A survey will be given to you at the start of your rotation. We love all input on your experience at DoveLewis.
Student evaluation form
If your school requires that an evaluation form be filled out, please give that to Yaicha Radonski when you begin your externship; this will be mailed to your school when your rotation is finished. The DoveLewis criticalists will be the main respondents to the institution evaluation forms.
Most important of all: HAVE FUN!!!
There are several area hotels and a local hostel that we can recommend. In addition, we have a home stay program in which students can stay with staff members for a fee of $420. Please contact Yaicha Radonski at yradonski@dovelewis.org, for more information on and accommodations.