Extern Schedule/Expectations
Week 1:
Monday 6 pm - 2 am ER
Tuesday 6 pm - 2 am ER
Wednesday 6 pm - 2am ER
Thursday 6pm - 2am ER
Friday - OFF
Saturday 10am - 6pm
Sunday 10am - 6pm
Week 2:
Monday: 8 am - 6pm ICU Day (ER)
Tuesday: 8 am - 6pm ICU Day (ER)
Wednesday: 8 am – 6 pm Surgery
Thursday: 8 am – 6 pm Surgery
Friday: 8am - 6pm ER (CASE PRESENTATION)
Saturday: OFF
Sunday: OFF
At RIVER, We want you to feel welcome and valued at all times. In order to make your
experience as enjoyable as possible, please see a veterinary technician for
questions/concerns about logistics or if you’re not sure where/what you need to be
doing. They will also help us evaluate your progress during your time at RIVER. See
below for the assigned technician on each shift/service.
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VETERINARY TECHNICIAN SHIFT SUPERVISORS:
Becky Howell, LVT is the head technician for
RIVER's weeknight/weekend ER service as well as the
ER department head. She earned a B.S in Animal
Science at UK, while working as a pathologist's
assistant for the UK Livestock Disease Diagnostic
Center. She moved to AL with her husband after
receiving her B.S., and continued working in
veterinary medicine in a rural AL practice while she
pursued her veterinary technician license. She joined
the RIVER team in 2008, and has been an asset to
our team ever since. She enjoys teaching, gardening,
canning, and raising her 3 young sons with the help
of her husband and her dog, cats, and chickens
Patricia Senestrari, MVZ is the head technician for
RIVER’s weekend day shift ER service
Patricia was born in Bogota, Colombia from a
Colombo-Argentinean family. She graduated in 2000
from Fundacion Universitaria San Martin as Doctor in
Veterinary Medicine and Zootechnics as top 3 in her
class. She did her internship in Exotic fauna and Zoo
practice and management in the Santacruz Zoo two
hours outside Bogota. She moved to Chattanooga in
2001 while finishing her requirements for a license to
practice veterinary medicine in the United States.
Patricia is fluent in both English and Spanish. She has
2 Great Pyrenees, who are part of the RIVER Canine
Blood Donor Program. Some of her interests are
international travel, veterinary emergency and wild
life.
Taylor Wilkey, LVMT is the head technician for
RIVER’s weekend night shift ER service
Taylor completed her veterinary technician license in
2011 and has worked at RIVER ever since. She and her
husband love spending time together with their young
sons, Jax and Jace. Taylor loves baking sweets and
favorite recipe is pumpkin bread. Her husband is a police
officer! Taylor lives at home with her goats, a horse, a
rabbit, 2 dogs, and 2 cats.
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Magen Stevenson is the head technician for RIVER’s
weeknight ovenight ER service.
Magen finished her BS in Biology in 2014 and has
been working here at RIVER for 5 years. Magen is our
in-house laboratory manager. She enjoys working out,
rock climbing, and anything outdoors (kayaking,
hiking, etc). On Friday mornings after her shift is over,
you can find her at Aretha Frankenstein’s eating
pancakes and getting ready to enjoy the weekend off.
Liz Olley, Internal Medicine Head Technician
Elizabeth has been in the veterinary field for 16 years
and a team member at RIVER for over 10 years. Her
interests in Veterinary medicine include oncology,
endocrinology and advanced imaging. Currently, Liz is
continuing her education focusing her studies toward
becoming a licensed technician. After which, she plans
to concentrate her studies in Internal Medicine and sit
for the American College of Veterinary Internal Medicine
for Technicians boards. Outside of RIVER Liz enjoys
spending time with her daughter exploring downtown
Chattanooga. In her down time she also loves to read,
decorate and spend time with her family and friends.
Blake Tutton, LVMT Surgery Head Technician
Bio pending
During your time at RIVER, you will have the opportunity of working alongside
some of our Veterinary Emergency Doctors, Specialists, and Interns. Please visit
our website for their photographs and complete bios.
http://www.rivervetemergency.com
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Case Presentations:
Please select a case you assisted with and found interesting during your externship. You will
present your case on Friday morning to the daytime emergency veterinarian(s).
Presentations should be no more than 15-20 minutes and will be informal/sit down roundstyle. A hand-out should be provided to all listening. Presentations will end with discussion and
questions. Use the following format:
 Signalment
 History
 Physical Exam Abnormalities
 Laboratory/Clinical Findings
 Differential Diagnosis
 Treatment (hospitalization vs. out-patient care)
 Outcome
 Discussion/Questions
*EXAMPLE CASES WILL BE GIVEN DURING ORIENTATION
Extern Responsibilities:
In general, you are here to interact/observe and understand the flow of a 24 hour
emergency and critical care private practice. Many 24 hour facilities exist, but not all are
AHAA approved specialty practices during the day like RIVER. Specialty services are
available from 8-6 Mon-Fri. Rotating through all services will help you develop an
appreciation for the quality of veterinary medicine we offer and maybe help you determine
if a rotating internship is the right path for you. We select our interns through the match
program and it really helps to know who you are and your skill level/personalities when
ranking our candidates.
During your rotating externship, you may take part in any of the following:
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Patient Triage
o Weigh patients and put them into examination rooms
o Take vitals (TPR) and the patient weight and learn how to enter them
into the computer system
o Take a concise but thorough history and be able to present it to the DVM
and answer any additional questions they may have
Laboratory
o Drawing blood from the jugulars, or lateral saphenous veins
o Placing IV catheters
o Running blood glucose, lactate, EPOC, or PCV/TS in-house
o Submitting blood work to the Antech lab in our building
o Performing in-house cytology (fecal, skin scrapes, or aspirates)
o Interpreting lab work results and coming up with differential diagnosis
with the DVM
Radiology
o Assisting with taking radiographs
o Interpreting radiographs with the DVM
o Submitting a history and case summaries to the radiologist for
consultation (online submission)
Client Communication
Going over discharges and medications with clients
Answering questions for clients over the phone and giving patient
updates
YOU be the Doctor!
o Taking in cases, performing a physical exam, and presenting the
information to the DVM
o Selecting lab work to perform and other diagnostics (ok with DVM)
o Present approved estimates to clients
o Going over test results with owners
o Coming up with a treatment plan for your patient
 In-Patient (hospitalization)
 Out-Patient Therapy
 Always come up with Plan A,B, and C if the owners can’t afford
your first option
o Writing SOAP’s for patients
Surgery: If possible, on ER we will have you be the primary surgeon on basic
lacerations repairs. On your Surgery or ER rotations, you will be able to scrub in
and assist with surgical cases.
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TIPS FOR SUCCESS:
1 ) Keep in mind that this is an emergency room and the priorities may be different
than those you might have on another rotation. The mission of RIVER is RIGHT
CARE – RIGHT NOW. In other words, we need to effectively triage and treat all
patients in an efficient manner and get every case stabilized, treated or transferred
as quickly and thoroughly as possible. Write down questions you may have
regarding cases if there was not time for discussion, and when the time is
appropriate (usually at the end of the shift), you can discuss the cases with your
senior veterinarian. Please don’t refrain from asking questions at any point in time!
2) Navigating our computer system can be challenging at first. You may be asked to
generate a medical record (SOAP) in INFINITY which will need to be reviewed by
the DVM. Remember, all medical records will be under their name and they will be
liable for the medical record. Sometimes, if there is not time for you to write a
record on a patient, the veterinarian may complete the medical record themselves.
In this instance, if you are involved in a case but are not responsible for the SOAP,
you should still come up with a differential diagnosis and treatment plan for the
patient on your own. This can be written down in a personal notebook and then
discussed with your senior veterinarian when time allows. It will be your
responsibility to try and do this for each patient when possible.
3) You will be expected to assist and participate in all aspects of the suggested
diagnostics such as drawing the blood, placing catheters, initiating fluid therapy,
obtaining blood pressure, monitoring ECGs, ordering lab work, ordering and taking
radiographs, obtaining urine via cystocentesis, setting up kennels and filling out
treatment plan sheets. Technical skills are vital in your learning and a part of grading,
so please don’t be offended if we ask you to help the nursing staff when needed
instead of shadowing the doctor in an exam room from time to time.
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COMMUNICATION PITFALLS TO AVOID:
1) Check yourself! If you ever find yourself in a situation that you feel uncomfortable
with, or if you feel that you have not been adequately trained to manage the
situation, please notify the attending DVM on duty immediately. Part of being a
good doctor is knowing your limitations- Experience varies GREATLY from
student to student and we rely on YOU to tell us what you feel comfortable doing.
Do not put yourself or a patient at risk because you feel embarrassed to admit your
limitations. We are here to help you learn, and will NOT criticize you for not being
able to answer a question or perform a procedure, but you will be expected to look
up information (we have a full library and VIN online) and report back for
discussion.
2) CAUTION: Placing yourself, clients, our staff members, or the patient at
unnecessary risk will result in immediate suspension with further investigation.
Other causes for suspension include (but are not limited to) frequent tardiness or
not showing up when scheduled, inappropriate conduct/professionalism, or an
overall poor attitude or work ethic. If any of these behaviors are noted, a sit-down
discussion with our program director and a representative from your school will take
place. The result will be either dismissal or reinstatement.
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