Megan Sprinkle: [00:00:00] Today we are talking veterinary career changes, veterinary education, shakeups, and groundbreaking research on medical futility. A term you need to know. Welcome to Vet Life Reimagined. If you listened to the fabulous episode with Nicole Dickerson, you will have heard the name of our guest today, Kelly Foulds.
a veterinary technician and BTS in emergency and critical care. Kelly has worked in emergency practices at three different veterinary universities and is now in a leadership position as a regional nursing partner at Blue Pearl. We talk about career changes. Not because something is wrong, but because you're ready for something different.
We discuss opportunities for change in education for both veterinarians and veterinary technicians that could help enhance our ability to work in teams. We also talk about a research project that Kelly is a co author on around medical futility. If you haven't heard of that term, neither had I. But it's very important.
It's contributing to losing people in our clinics. Kelly [00:01:00] describes what it is and how we can address it well. Fun fact, Kelly has three pit bull terriers, a leopard tortoise, and a quarter horse gelding named Billy. Let's get to this great conversation.
When did you know you wanted to get into veterinary medicine?
Kelly Foltz: I think like most of us, the initial desire comes in childhood. So I can remember just being a very animal-crazy child, bugs in jars, you know, scooping things out of the swimming pool. You know, to save them always trending more toward like, animals. Then people, we had a Congress manual and a. Series of cats when I was small, obviously I had a horse crazy period, but I didn't live in an area that would enable that.
So I didn't really get into horses until I was in my late 20s, but I would say probably like the 1st exposure is in [00:02:00] childhood, like in kindergarten and you want to be a veterinarian and then kind of the 2nd round. That really drove me into the career was much later after, after I had a bachelor's degree and after undergrad, so mid, late twenties.
So what about getting into veterinary technician work? This is such a ridiculous story, uh, like when you tell it, but I was an English major in college. I was going to get my bachelor's degree and then I was going to go to grad school and get a Master of Fine Arts, an MFA in creative writing, and then probably potentially a PhD.
And then I wanted to be a professor of English. I wanted to be Dr. Foltz and I wanted to have a small sunny office on a liberal arts campus that was full of. Plants and books and squishy chairs. And I just wanted to read books and talk about writing for the rest of my life. And I graduated from [00:03:00] undergrad.
At the time it was 1999, and so I was very obsessed with the animal ER show on Animal Planet, the one that was filmed at Alameda East, and I never missed an episode, I would record the holiday marathons on VHS, that's how old I am, and so I really did not know before then that That level of medicine existed for animals, and I had never heard of a veterinary technician before then, right?
You could either be a groomer or you could be the doctor, was kind of my conception of, of vet med. It was super eye opening that there's such a thing as emergency and critical care for animals in specialty medicine. And so I went. I did my gap year. I was working in bookstores at the time. I needed a second job and I actually answered an ad in the paper that's also dating me [00:04:00] for a really large multi specialty 24 7 365 ER in Marietta, Georgia, Cobb Emergency Veterinary Clinic, and took a job there as a CSR, CSC, like what we would call a receptionist.
And I was working like 6 p. m. to 4 a. m. in the ER and. was just eating it up. I loved it. And I, I would get in trouble a lot because I would, in the wee hours of the morning, I would wander away from the desk and be kind of lurking around in the treatment area. And I was so excited to be in my own like Alameda East experience in real life.
But what really impressed me the most were the technicians. Yeah, it was, it was cool to work with veterinarians. It was amazing to see the variety of cases, but what really turned me on were. The technicians and how intelligent they were and the impact they were able to make in these animals’ [00:05:00] lives. And again, it's what, like, 2000.
I am in my mid-twenties, I. Did not ever really know there was such a thing as veterinary technology. So, I went on to grad school and I did the first year of an MFA program. And I was really bored and not engaged. I was not enjoying it and sort of reevaluating this right plan that I had had for myself for over a decade and getting from point A to point B.
And I decided that I, I wanted to go back to school and get an associate's degree, a two-year degree in veterinary technology. And I asked my veterinarian at the time what he felt the best program was in the state, because I was in Georgia at the time, I was living in Milledgeville. And at that time, there were only three programs in the state.
There was one in Atlanta, there was one in Athens, and then there was one in Fort Valley. And he guided me toward the [00:06:00] program in Athens. And so I had to have that conversation with my parents and be like, Hey, I have half of an MFA and I want to go back and get an associate's degree and completely change careers.
And they were lovely. I think there was a certain element of dear God, please let this be the last degree, right? Let's find a direction in our life. But yeah, that's how that went. And then I always knew that I wanted to specialize. I think I came to it in a little bit of a different way than some people, because I think a lot of people work in general practice and then.
when they get a little restless, come to specialty medicine. And I'm the inverse of that. I have never worked in GP before school. I worked as a kennel attendant, and obviously I worked reception. But in terms of my career as a veterinary technician, once I got my degree and got registered as an RVT in the state of Georgia in 2006, I immediately went Back into the and I see you and I've actually never [00:07:00] had a paying job as a veterinary technician in general practice in years.
So I knew I wanted to specialize. I learned about the VTS when I was in school and became very focused on that. And so that. Was the trajectory
Megan Sprinkle: and did you feel that they provided a lot of information on different career paths for veterinary technicians when you were going through your training?
Kelly Foltz: Yeah, I, I'm probably biased, but I feel like I had the most incredible training.
That it's possible to have the unique thing about the program at Athens Tech is that they work very closely with UGA and there are other veterinary technician programs that are actually embedded in vet schools. But at that time, there weren't that many. And so we actually used UGA facilities. In the first year for anatomy, we use their gross anatomy lab, which had a lot of embalmed and plastinated and fresh specimens.
We use their dairy facility, their swine facility, [00:08:00] you know, a lot of those things that some technician programs have a hard time sourcing animals for, especially large animal. We were able UGA. And then our second year, basically our senior year, we rotated through the vet school on the same schedule as.
That's students. So you would be on radiology for three weeks. You would be on anesthesia for three weeks. You would be in, you know, the ICU for three weeks. And so I think they did a very good job of making sure that we understood there are a whole lot of options. You had an elective that you could basically choose where you wanted to go.
I had a classmate that went to a horse farm in Ocala. But yeah, I think they, they did an incredible job of showing us the breadth and depth of the profession. And when you said you followed the same rotation of the veterinary students, were you with the veterinary students? So, I mean, we were overlapping all the time.
We had our program, people would come check on us at the vet school. They would drop in in person about once a week, but we, [00:09:00] you know, we're expected to show up. at 8 a. m. You're there from like 8 until 12. You were with vet students, so if you were on anesthesia, you would be paired with vet students for cases and using the same monitoring sheets.
Be right there beside them as they were having those conversations about the drugs or the procedure. When you were on surgery, you were in the O. R. So yeah, we were all together.
Megan Sprinkle: The reason why I dig in a little bit there is because I've heard and had conversations around how could we have a better end goal of where all the different people that are in a clinic setting They know how to work together because most of the time a lot of our trainings are completely separate and so then we're put into the setting and we don't always know the best way for us to all work together and one of the ideas.
I don't want to steal it if it wasn't my idea, but. One of the ideas was, what about if they were actually trained [00:10:00] together? So, not only are you getting the technical training, but you're also learning how to work in a team. And so, you're the first person I've heard where I kind of heard that format, and it sounds like you, you appreciated it.
Do you have any thoughts about that as well?
Kelly Foltz: Oh, I have tons of thoughts about this. Um, as, as someone who, You know, like I, I have been an adjunct instructor and an educator in accredited veterinary technology programs and, and been on the accrediting body for technician programs and done some work on task forces and stuff with the ABMA.
I think that getting us all together early in our training is really essential because if you think about it right now, you and I know each other from Auburn University, right? From 2012. Yeah. So if you think about that, we technicians are working, right. Caring for your animals. You're like cramming all this stuff in your brain, trying to learn how to be a veterinarian at really no point in your [00:11:00] curriculum, probably.
Did anybody break down the practice act and break down the roles and say, here's a technician's education and training, here's an assistant's education and training, here's how you can leverage each. Here's what's legal. Here's what's illegal. You know, no one probably spoke to you about. Like trust issues and how to have those crucial conversations about what if this goes wrong and liability and I'm working under your license and all this kind of stuff.
Right. So I think I have a lot of feelings about this in the vet schools. We need to add that kind of stuff into the curriculum. We need to add the concept of the veterinary healthcare team way sooner because for you at Auburn, right, you went into the clinic your senior year and then all of a sudden there's kind of technicians everywhere and you're trying to cope with case responsibility.
And clinical interpretation and time management and interacting with clients and interacting with faculty and interacting with technicians and trying to learn right who everyone is and what you can delegate and who to trust and [00:12:00] trying to understand what you need to do yourself and what you can delegate to others.
So I think that's huge. It needs to be in the curriculum somewhere. And then I also. It is my wish, if you gave me a genie lamp and I could rub it, I, I would really love there to be a technician program in every college of veterinary medicine, or at least partnered in some way. I think sharing that time.
At a critical point in, in all of our training when I was a baby technician and they were baby doctors, you, you learn that that students are people and the doctor sort of isn't God. Right? It's been so revelatory for me in my career to see how y'all are trained and. And I worked in the vet schools for a really long time, almost 12 years, if you add it all up.
I jokingly say that I'm like a serial monogamist, like, right, when it comes to vet schools, because I've worked at UGA and Auburn and UF, and now I work for Blue Pearl. But it shows you, like, the humanity, and you begin to see that the [00:13:00] training of clinicians is also not perfect. And it's so overwhelming. So it gave me A lot more empathy and sympathy and understanding that there's a relatability there.
We're all human beings in an imperfect system trying to do science and save lives. And I think that has been really helpful for me in my career. So I would love to see y'all learn more about us, and I would love to see us learn more about y'all.
Megan Sprinkle: Ditto. Oh. I can't say any better. That's awesome. Speaking of getting into a university setting for your career, you got the love of emergency medicine.
You became a specialist. How did you get from a clinic setting into university?
Kelly Foltz: Oh, gosh, so this was kind of interesting. When I graduated from school in 2006, I went to work for a hospital that was owned by [00:14:00] multiple shareholders in the area, and it was open on nights and weekends, and so it was, I would say, By today's standards, it was primarily in ER and doing, you know, a fair amount of urgent care, right?
Like itchy, poopy, you know, those kinds of things. But then every once in a while, we would have something really in depth, like gunshot wounds or GDV. And so, by nature of the business model, a lot of those things would go back to You know, if, if their reg vet was one of the shareholders, when the clinic closed in the morning, it would go back to the reg vet, and then it might come back again that night when we reopened, but it wasn't like sustained critical care, and I worked in that environment for about a year, and then I was like, okay, I feel like I have a solid skill set with ER.
But now I really want some critical care. And so at the time, I, I'm not sure how UGA is structured now, but at the time, everything was pretty much [00:15:00] based on seniority. And so I wanted to get my foot in the door and kind of the only opening they had was overnights. And so I started working there on overnights and it was really overwhelming to be.
In the tertiary referral hospital ICU, as someone who was one year out of school, the morbidity and the mortality was way different than I had seen in like the ER. And that was my first exposure to animals that stay for weeks, animals that are in multi organ failure. animals on ventilators. That was my first exposure to feeding tubes and arterial catheters.
You hear about these things conceptually, but then you're actually working with them. So that was a difficult transition. That's also, unfortunately, when I discovered that overnights are not for me. From a mental health and circadian rhythm [00:16:00] standpoint, I really struggled. It was a very difficult transition.
I could not sleep. I tried staying awake for days, hoping that I would just collapse from exhaustion. I Tried taking cough medicine that would make me sleepy. I got pulled over right for leaving. Cause I was driving home from work and I was exhausted. I had blackout curtains. I lived in a neighborhood and everybody was mowing their lawn or riding their four wheelers during the day when I was trying to sleep.
So it was very challenging. So that was my first exposure to that. Complexity and intensity of ICU and it was so challenging, but I loved it and I was in a relationship at the time and I moved to Pensacola, Florida and went back into an E. R. referral setting with some critical care, but not at that level, and I tipped my hat to the tertiary ICU and was like, I'll be back.
We're not done with this. And so I was in Pensacola for about four years [00:17:00] and struggling in the relationship. Very restless. In my career, I had started working on my technician specialist application for emergency and critical care, and had to come to Jesus meeting with the partner at the time, and he was like, you're miserable to live with, and you need to get a different job, and I was like, all right, so I applied at Auburn, even though I was living in Pensacola, which is about 272 miles away.
And I didn't really tell him, not a good partner. I didn't really tell him until after I had interviewed and gotten the job. And then I sat him down and I was like, you told me I'm miserable to live with. And I need to find a job. I love that provides health insurance. So I did. And it was like, wait, what?
And so I commuted actually. For two years, I rented a house and I would drive up on Thursday, I would work Friday, Saturday, Sunday, 13 hour shifts, and then I would drive home on Monday morning. [00:18:00] And that's when you and I met, actually, even though we didn't really realize it at the time. My partner and I broke up and I moved to Auburn full time.
And so I was about two years in at that point and then was there until 2020 and just loved every minute of it. I love high level ICU. I am a weirdo. A lot of people are like, Oh, critical care is like watching the grass grow or watching paint dry. Uh, I, I love it. Gosh, it's one of my favorite things.
Megan Sprinkle: See, I wouldn't have called it boring.
Kelly Foltz: Well, or if you want, you know, if you want to be like a bovine veterinarian, It probably is like watching paint dry, you know what I mean? Cause you're inside and clients have all these crazy expectations, right? Of survivability and, and outcomes. Yeah. I can definitely see how some people would be like, never again.
The short version is I wanted the highest and the best. I found my way to the university because I wanted the sickest [00:19:00] animals. I wanted that challenge. I wanted all the toys. I wanted. to do the advanced things that you hear about, like direct blood pressure and central venous catheters. And I really wanted to fling myself against this high wall and see if I could scale it, is the short version.
Megan Sprinkle: Yeah. You talked about how much you loved, the challenge of the different types of cases and tools that you had in university, but you also mentioned, you're now at Blue Pearl. So what was the transition from crazy University challenging cases to moving into a blue pearl setting?
Kelly Foltz: It was challenging because of what I imposed on myself, not anything externally.
So I, I had kind of gotten to the point where I felt like as a, as a technician and as a VTS. I [00:20:00] felt like I was pretty clinically competent, right? I had been in the vet schools for a decade, I had been to BTS for a decade. I had gotten to the point where I could handle a lot with confidence and with calm.
And so I had started to feel that itch of like, what's next? Like, what's the next challenge, right? Having gone from like ER into, into the tertiary ICU, you know, gotten the VTS, had hit a lot of milestones for myself. And I had started to wonder like, what is next? What does the second half of your career look like?
Like you're, you're 15, 16 years in, you know, you're 46 years old, 45 years old. Are you going to be 55 years old and on the floor somewhere? Not that that's bad. Not that there's anything wrong with that, but I'd started to feel the itch and. I have a mentor that I worked with at Auburn, a couple of them [00:21:00] actually, and they were both with the company at the time, one of them still is, and they reached out to me and they were like, this position's coming open, we think it would be perfect for you.
And initially I was diametrically opposed, and I will be very candid about that. I was like, I could never. I could never go corporate. I could never leave the floor, right? Because the role that I'm in is not patient facing. It takes advantage of everything I know and everything I've done and all my education and experience, but it is not a hands on patient's job.
And so initially I was like, absolutely not. Thanks for thinking of me, but And then they kind of kept pinging me and picking at me. And I just had a few days in the clinic where I, I think knowing that something different was out there made me really look at my life and say, like, is this [00:22:00] really what you most want to be doing?
You know, what is left for you? Not that I'm perfect and not that I know everything, but in terms of personal clinical goals, there were only a couple of things left. And so I started to consider it and entertain the idea and, and then what really blew me away was, you know, I, I started the interview process because it is a regional leadership role and staged interviews, right?
First, you talk to a recruiter. And then you interview with a couple of people, , and then there were, I think seven candidates. Right? And so by the end I, I feel like I interviewed with like five or six people virtually. And what really blew me away was the interview process because the kind of questions they were asking were so fascinating and so probing.
I was really intrigued. And then do you have like an example or They asked me about a time that I [00:23:00] needed to. Get buy in for a new idea or a change and how that went and I remember talking about fecal catheters. I remember talking about being at UF and trying to work with my boss at the time to devise a protocol and do some change management and introduce that as instrumentation.
And get people trained and take feedback and troubleshoot. And I remember feeling at the time that was just a really dumb example, but obviously maybe it wasn't because I got the job, but the challenges of the role really appealed to me. It fascinated me. Here's this role, everything technician and assistant related in the region comes across your desk.
And so you're a professional advocate, you're a subject matter expert on kind of the technician and Assistant experience, right? You have a role [00:24:00] in medical quality, patient safety, like updating protocols, helping hospitals with. Efficiency and workflow, really being in the vanguard of like some of the stuff that we've already talked about today, right?
Making sure that both sides understand each other and helping everyone see what can be delegated. So, it, the role just seemed fascinating. And when the offer came, I remember sitting, I was so nervous and. It was like being asked to prom. It was so dumb. The DACVAC, who's now my boss, you know, sent me a text and was like, do you have a minute later today?
And I was like, oh god, oh god, this is it. Like, either I got the job or I didn't. And I didn't know what I was going to do if I didn't. Because like, once you see that there's like this other different thing, you're like, ugh. And so, yeah, I can remember like slipping away and it was so stupid. Like, I was in the middle of drawing blood cultures on this patient.
I texted him back and I was like, I have 30 minutes between 11 and [00:25:00] 11 30 because I have to draw this blood culture at 11 30, right? Sterile lead and whatever. And so, yeah, I can remember I was sitting, I found an exam room to hide in and he immediately started in with like, as you know, we had seven candidates and everybody interviewed really well.
And I was like, I'm not going to get this job. Like, I just felt like I was going to throw up. And he like worked his way around and now it's Yeah. A verbose and delightful man, but he rolled up at the end of it and he was like, so what I'd like to, I'd like to ask you to be our regional nursing partner.
And it was, it was like a proposal. And it was like, yes, I will like, so it was, it was kind of a gradual acceptance of the idea of leaving the clinic. And then in practice, it got. I mean, there were some stressful moments because, right, you, your clinical life ends, right? You work out a notice and you walk out of the hospital and then you start working remotely as a leader.
And [00:26:00] I definitely went through a crisis of what's my identity. Can I still call myself a technician, like wholeheartedly? Having had patient care and patient advocacy be such a part of my professional and personal identity for a really long time, I definitely had this kind of wobble where I was like, well.
Who is Kelly now, and I am very lucky that my leadership team with Blue Pearl and the other RNPs are wonderful and people just helping me through it. Like they understand that transition because they've all made it, you know, and I always jokingly say that between my boss and I, like, we're basically like kind of the island of the misfit toys, right?
Like we are leaders. But we really want to be in a clinic somewhere. And so, like, when we go on hospital visits, I, I think everyone in our region just knows that we're going to be obnoxious and be like, what's going on with this one? What's going on with that one? Oh, you need help with that? Like, you know, can I draw some blood?
So [00:27:00] it was challenging, but probably the take home message is that I think that transition was anticipated for me and observed. And so I had help through it. It could have been very different. It could have been very I think if it had been very different, I, I probably still wouldn't have the job today, right?
Because I, I would have been like, no one's looking out for me. I don't know what I'm supposed to be doing right now. What's the point of me? And I would have rushed back to a clinical setting because it's very easy, right? You're like, okay, here are my treatments. And I finished the treatments. I see the animal respond to therapy.
And I know what I accomplished today. And leadership is much more nebulous. It is much more nebulous. Sometimes you do not know what you accomplished today.
Megan Sprinkle: Those are really good callouts, and just to back up a little bit, because I think this is important to note, I've had several guests mention it. It's that you don't have to [00:28:00] have a career change because something is wrong.
Kelly Foltz: Correct.
Megan Sprinkle: It could be that you are ready for something different.
Kelly Foltz: I wanted different challenges and when the job description came to me. And, you know, started, started interviewing and people kind of explaining the role to me. Cause it is kind of a weird role. Like, I'm not going to lie when I meet people and I tell them what I do, they're like, but what do you, what do you do?
Yep. I'm sure you get that too, right? Like, what do you, what do you do? Like what's a day in the life? Cause you can say all this stuff, right? You'd be like, Oh, I, I lead, I influence, I advocate. But then at the end of the day, what you really do is you have a lot of virtual meetings, right? You have a lot of conversations.
You. are reading a lot of body language. You are learning a lot of personalities and looking ahead. And so I really wanted those different challenges and the scope of it is remarkable. It's wild to me that I went from, you know, a department [00:29:00] in a hospital and now it's 20 hospitals. In six or seven states, right?
And each is unique. Each has its own strengths and weaknesses and dreams and goals. And so these are exactly the kind of challenges that I wanted. And so it's very, very apt of you to say, like, yeah, you don't have to make a change because something is wrong.
Megan Sprinkle: Yeah, and I just want people to know that too.
So also if someone. Says, Hey, if you've ever thought about this, it's okay, you're not going to get in trouble if you mull it over for a little while and maybe let me think about that. So I think those are really exciting opportunities and not only are you mastering people skills and advocating and.
Going and speaking at conferences and different things. You also, it sounds like, are getting to participate in some research as well. You had said [00:30:00] one of the things you're really excited to work on right now is looking at the impact on participants on medical futility. And I am very open when I don't recognize something because I'm not afraid to look stupid.
And I was like, I've never heard that term, so do you mind sharing a little bit about this project that you're really interested in? Because again, I hadn't heard of it, but once you kind of explained it, I was like, oh yeah, that is really interesting and important, so can you elaborate?
Kelly Foltz: Yeah. Yeah. So. I read a JAVMA article in 2022 by Nathan Peterson, who is at Cornell, he has a couple of research partners, and it was about medical futility in small animal clinical practice.
And I, like you, had never heard of medical futility described in those terms, but like you, when I started to read [00:31:00] this, I was like, Oh my God, this happens every day. And in tertiary referral in specialty medicine, it happens a lot. And so we can think of medical futility. It may be easier to think of it as nonbeneficial care, right?
So, care that is not going to render a cure. Care that is not necessarily going to change the outcome, right? So, the example I use in human med is like someone's grandfather. He's 96 years old. He has lung cancer. Maybe he He codes, we resuscitate him, in the course of that, we create pulmonary contusions and potentially some rib fractures, you know, now potentially he's ventilated and it's not going to cure his cancer.
It's not going to improve his quality of life. That's kind of the definition of medically futile care that was offered in the paper. And [00:32:00] the paper was about veterinarian perception and understanding of medical futility. And they were trying to determine in the paper the frequency with which it occurs.
in small animal practice. And so it was a survey of about 477 veterinarians. It was a web based survey. And 99 percent of respondents were like, yeah, this absolutely happens in vet med. About 42 percent were like, yeah, it happens more than six times a year. And so I, I read this paper and it just blew the top of my head off.
I was like, this happens all the time in specialty medicine. It is corrosive for veterinary technicians because As hard as it is on the veterinarian, and I mean no offense, y'all get to write orders and conceivably walk away. And you have to have all those conversations with the client, but when it comes to executing a treatment order that's potentially invasive or that's going to cause discomfort to the animal [00:33:00] without curing what's wrong with them, we have to do that.
Right. We have to place the catheters. We have to place the feeding tubes and we are not always privy to the conversations that you have with the client and we don't always know what you've told them and what their worldview is. And so I, I did a thing that was bold and could have not gone very well for me.
I. I found Dr. Peterson's email address and I emailed him. I've never met him before in my life. And I said, Hey, I just read your paper. It blew the top of my head off. Have you ever thought about doing a similar project with technicians? Are you looking for a research partner? And he actually emailed me back the same day.
And said, I actually wanted to do the first paper on technicians, but I couldn't figure out a way to distribute the instrument. And I was like, Oh, we, we've got you covered there. And I rattled off six or seven or eight tech [00:34:00] organizations, right. That we could probably try to partner with. And so that's how the whole thing began.
We have presented our abstract at the emergency critical care conference. We are in the process of drafting the paper. It's pretty remarkable. You know, the. The DVM study was slightly different in that they were just trying to figure out, does it occur at all? And if so, how often? We very much focused on moral distress in the technician paper.
And so what we had, I think over 1900 respondents. Clearly people feel like they have something to say about this and their experiences that they want to share. The numbers are very similar. I think over 98 percent of the technicians responding said, yeah, this absolutely happens, it happens all the time.
We definitely. In looking at the moral distress and like potential for attrition, our data indicates that it might potentially drive attrition. We did ask, you know, have you thought [00:35:00] about leaving your job due to moral distress from proximity to or participation in medically futile care? Folks were like, yeah, absolutely.
We asked them if they know someone that has left the profession. Or a job due to moral distress from participation or proximity to medically futile care. People were like, yeah, absolutely. What really kind of broke me was we gave folks the opportunity to long answer, what's your personal definition of medical futility?
And then we also gave them the opportunity to tell us about an experience that they've had with medical futility and like reading that like hundreds of responses. It just, it broke me a little bit. We found that folks are self medicating with drugs and alcohol and food. We found that folks have thought about self harm.
The predominating emotions seem to be anger, [00:36:00] frustration, guilt. So I'm really excited about it. I I'm very grateful to Dr Peterson and his colleagues for just taking this cold call from this rando in Alabama and bringing me on to the research team. I, I hope that it will have value. And really, I think.
What matters the most to me about medical futility is we just need, as you and I started, we'll bring it all full circle, right? We talked about bringing everybody together, and in the context of medical futility, like, we just need to bring people together, like, have that huddle, right? And say, hey, I just got off the phone with Mr.
Smith. They philosophically and religiously object to euthanasia. He is a human health care provider. His beliefs are informed by his experience and his training. You know, I feel like I've done the best I can to explain that Robbie is not comfortable right now and he's not going to recover. Mr. Smith and his family want us [00:37:00] to continue until Robbie experiences a natural death.
Would anyone be more comfortable tapping out of Robbie's case? If caring for Robbie is going to cause you distress, we're not going to judge you. If you want to step away, if you are continuing to participate in Robbie's care, if you need to step away, if you need to talk to the social worker, you have that option too.
I just want to reiterate my commitment to all of you that we're going to make sure that he has pain management. All those things, like, even something just like a huddle of that nature, instead of retreating to, like, I'm the doctor, I talk to the client, here's what we're going to do, I don't want to hear any grumbling, like, and I'm not saying that's what happens in practice now, but I think when we feel stressed and shamed, sometimes we retreat to hierarchy.
Megan Sprinkle: Or Just not addressing it at all. It's what my mind went to.
Kelly Foltz: It's like, well, this is what the [00:38:00] owners wanted. And that's what we do. We do what owners want. But we can't do anything against their request. So, here's the plan.
Megan Sprinkle: And I think just acknowledging that this is a really tough situation. And I know you guys really care about this patient, and that's why we're here.
And, like you said, calling it out, saying, you may have really strong emotions about this, and that's okay, we respect it. And we're here to support you. So, Again, just acknowledging that the feelings are there because I think there was a paper that came out, someone posted on LinkedIn not long ago, and some of the top things that they found, and this may have been veterinary, no, it was the whole staff, on if they, how committed they were to our clinic, so how likely were they going to leave, basically.
And the lack of control or feeling like you have input. the lack of meaning in your, in your job, like, those were two of the top three. And [00:39:00] so I think just having that conversation, acknowledging that I see you, I see that this is hard. What can we do to support you in this?
Kelly Foltz: It would be game changing. And also to empower people through, I can think about incidences in my own career, right?
Where I am caring for an animal and it's becoming a bit of a death march. The clients don't want to stop. Everyone knows how the story is going to end. It's just a question of when and you feel powerless. And you feel compromised, you know, and maybe you go to the clinician and say, I think he's uncomfortable, you know, and sometimes it just really stinks.
And they're like, Oh, we don't have the budget for that. I think just Even beginning with carving out an acknowledgement of I understand everyone's going to have a lot of feelings and I want you to feel free to articulate and label them and Creating this space to step away. [00:40:00] You mentioned the LinkedIn article.
We are all here for meaning I think in vet med, you know, we're all here for impact and so Again, going back to that question of identity that I mentioned, talking about career changes, if my identity is as a caregiver, an alleviator of pain and discomfort, and then I'm placed in a situation where I low key don't feel like I can do that, it's a profoundly uncomfortable place to be, and in some ways like a dangerous place to be.
So I think. Yeah, it, it's going to be really exciting. I don't think anyone's ever asked these questions. It's not perfect, right? It's survey data, so it's self reported, but it's going to be information that we didn't have before, you know, 2 years ago or whatever. And so that's. That's got to count for something, I think.
Megan Sprinkle: Well, and funny enough, the third of the top three of why people are [00:41:00] considering leaving is around the leadership. And so, I believe this type of information and awareness allows us opportunity to know how to be better leaders within. But whatever setting we're in, and I think in some form or fashion, we're all leaders.
It may look a little bit different, but I think we all are leaders. And so if we can bring up this awareness and then partner it with, and this is what we think we can do to help the awareness. That's why I don't want to leave people with, well, that's a bummer. This is what we're learning that can help with that.
Um, because I don't think we're going to. Ever fully get rid of those types of situations? No. So what we need to do is how do we better handle it as a team? Do we talk about it? How can we support individuals to make sure that we are addressing it?
Kelly Foltz: So yeah, there's something to do. , and the answer isn't [00:42:00] like to refuse to participate, right?
The answer isn't to tell a client that they're cruel and they're misguided and we are not gonna be part of this. The answer is I think, to embrace. Imperfection and candor and vulnerability, and I think sometimes clinicians are maybe uncomfortable thinking of themselves as leaders, right? They're like, I'm here to practice some medicine and I didn't sign up to lead a team, you know, or all that, like, jargony kind of businessy stuff.
But you're right. We are all leading every day, every minute with the choices that we make. And I think what I would say is that, you know, think of how far we've come, right? I love that we can do a project like this. Thanks. understanding that we're all professionals and we all have value on the team. And it's important to not just look at like the clinician’s experience of this.
That to me is the great take home, that idea of collaboration and bringing everybody to the table.
Megan Sprinkle: I like to end with the [00:43:00] final question is what is something you are most grateful for?
Kelly Foltz: I am so grateful for this career. You hear that technicians, the average professional life is like five years or seven years or three years.
I I'm so grateful for this remarkable industry and this incredible career that I have, that has enabled me to pivot and explore and do good and find meaning. I, I have never considered leaving the profession since I set my feet on the path. And so I, every day I'm insanely grateful for veterinary medicine and all of that, all that that entails, right?
My colleagues, the patients. Um, the medicine, just all of it. It's remarkable. It's engaging. I never bored with it. I hope you were as inspired with Kelly as I was. The Javelin paper that we [00:44:00] discussed and other resources will be in the description. If you liked this episode and haven't listened to Nicole Dickerson's episode, it is a must listen and see, so check out the YouTube channel for great content.
B roll visuals on that one. And please make sure you hit the follow for this podcast. I made so many great connections at VMX, so I have a hot lineup of stories and visions of a beautiful veterinary tomorrow. We are approaching our second anniversary at VetLife Reimagined, and we will have some new and exciting things coming, hint, hint, until next time.
