Volunteer Training Guidelines

Overview

Training a new volunteer requires you to be an expert in almost all aspects of the running of the Parvo ICU. You should be familiar with the bulk of this wiki and be capable of answering questions and instructing on the execution of procedures. Not everyone feels comfortable in the role of teacher, but with practice, humility, and patience, anyone can be taught to instruct.

The most important rule in teaching is the same as in medicine: do no harm. In teaching, this takes on a different tone as the harm would be causing the mistrust of sources, information, or self you could instill in your student. This especially means only telling information you know is true and being honest if you think something may be true but aren't sure. Your goal is to make the student independent and, in the best case, replace you. This page will help you with some tips on how best to train new volunteers with these goals in mind.

First Day

On your first day, remember that many volunteers may not have even held a syringe before. They'll likely be animal lovers, but this may never have extended past playing with puppies and picking up their poop. It is advised that the team manager perform the first day of training in order to establish a relationship with each volunteer. The first day has the most content of any day and can be overwhelming, so it's important to follow the curriculum as closely as possible. It has been carefully designed to avoid missing important information.

Red Flags

Keep an eye out for red flags. Some people are not cut out for medical volunteering. These could include:

• Irritability

• Inability to perform tasks with more than one step

• Inability to perform basic arithmetic (as is needed with pump unit conversions and dilutions)

• Fear of dogs or lack of understanding signs of aggression in dogs

Don't be afraid to let someone know that this may not be for them. Offer the option to perform non-medical duties if the person seems receptive.

Obstacles

There won't always be the ideal configuration of patients to teach each topic. In particular, if there is only one IV patient, the first day can be challenging. Don't be afraid to change the order of the curriculum if there is no other option. It is, however, extremely important that new volunteers get trained on all information. It is, therefore, ideal to begin training in when there is an average number of dogs in the ICU.

Efficiency

Focus on efficiency early. Make sure to always teach what is correct, while following up with what can be done when time is limited. This may also involve providing extra practice for some of the more challenging procedures such as administering SQ medications to small, energetic puppies.

An important step in efficiency training is identifying which animals should be treated in what order. This involves identifying dogs which are isolated (and therefore must be treated last), dogs that are critical (and could use treatment first), and dogs with special needs which can be done in parallel with other treatments (hetastarch, CRIs, nebulizing, etc.). Also note if any particular dogs will take a long time and ask other available volunteers to treat.

Patience

The first day can be overwhelming. Some tasks, such as drawing up medications, require lots of practice. Encourage your student and provide personal feedback about tasks you struggled with when learning. Use each struggle as a "learning moment" in which you can explain why things are done the way they are, how we've made them better than before, and what we might do to make them better later. Under no circumstances should you make your student feel bad for not knowing or remembering something, even if it's something you just told them. It's vital that volunteers feel comfortable admitting when they don't know something or made a mistake as it will prevent mistreatment of animals.

Show Then Tell

It's tempting when teaching to spend a lot of time showing the student how something should be done, but they need to learn it more than you need to practice it. Although you should perform each procedure once for them, nothing we teach is so complicated they can't try it the second time. Have them do nearly all the work. This may involve a lot of standing around, feeling like you're doing nothing, but if you get that feeling you may not be paying close enough attention to your student.

In the cases of things like drug dosing, make sure to check all of the medications the trainee draws up before they administer any. It is a very common error to have the drug dose off by an order of magnitude (1cc instead of 0.1cc). Be very cautious of this type of error.

Middle Days

The middle days are a time to practice previously learned procedures, quiz on drug information, and learn new protocols and procedures not covered on earlier days.

It's very important to always ask your student what they know before making any assumptions. Don't assume the first day was covered properly. Don't assume they know anything until they've shown you they do. Asking questions (the Socratic method of teaching) is a wonderful way to teach. Example questions include:

• Q: How do we always give baytril SQ? Why?

  • A: We always dilute Baytril at least 20:1 in fluids to prevent abscesses

• Q: How do you give polyflex? What happens if you give Polyflex IV?

  • A: SQ only, giving Polyflex IV is fatal.

• Q: What happens if you give IV baytril too fast or undiluted? 

  • A: Giving IV baytril too fast or undiluted can cause seizures or be fatal

• Q: How do we give ampicillin? Why? 

  • A: Ampicillin is an IV drug that must be given over 5 minutes or it will make the dog nauseated.

• Q: List the different antibiotics we use and why/when we use each one.

  • A:  Polyflex (SQ only), Baytril (SQ usually, always diluted 1:20 in fluids, only used IV on the instruction of a doctor, if given IV must be diluted 1:10 in the syringe and given over 30 minutes), broad-spectrum antibiotic, Ampicillin/cefazolin- IV only, given over 5 minutes.

• Q: List the different antiemetics and their strengths,

  • A: In order from weakest to strongest: Reglan, Ondansetron, Anzemet, Cerenia

• Q: What is the standard SQ treatment?

  • A: Baytril, Polyflex, Reglan, LRS

• Q: What makes <drug name> dangerous under what circumstances?

There are also questions on the training curriculum which you can ask.

Review all the curriculum and skills every day. If they're ahead, spend some time on soft skills like laundry, end of shift reports, and inventory. Although these topics need to be hit regardless, they're lower priority than proper medical care.

Introduce volunteers to each other. If you don't know the volunteer, introduce yourself. It's important new volunteers feel like they're part of a group.

Last Day

On a student's last day, they may not feel 100% confident they know everything they need to. This is likely just a confidence issue, but it's important to assess the student's knowledge to determine if they are missing pieces of information. It's ok to not know certain things (like details about drugs), but a student should always be aware of what they do and don't know and where to find the information they're missing. It's vital that you ensure a student is not guessing when they don't know. This can lead to dogs being injured or killed.

On their last day, a student should need little to no help from you other than casual reminders to save time. Encourage them to look up information in the wiki when they don't know rather than ask you. Roleplay that they're the only one there and have to handle it on their own. Review the curriculum as needed and ensure they know how to find it if they need it.

When the shift is over, have them be the last one out. Congratulate them on completing the training, and offer them kind words or encouragement. Working in a Parvo ICU can be very emotionally stressful. Now is a good time to remind them that they have friends in the ICU to lean on for support.

Tips

• Teach the names and terminology of things (fluid line vs. extension set vs. port, bolus vs. CRI)

• Clarify the meaning of phrases like  “dilute in the syringe” (like we do with IV baytril, oxytetracycline, and IV dextrose) vs. “dilute in the line” or “dilute in fluids” (which is what we do with SQ baytril and IV ampicillin)

• Clarify brand names (Reglan, Prilosec) vs. drug names (metoclopramide, famotidine), if they’re not sure both brand names and drug names are on the drug chart

• Clarify drug classifications and interchangeable medications (i.e. Ampicillin and Cefazolin can be used interchangeably)

• Point out that some drugs have (sort-of) similar names and make sure they don’t get them confused (metro vs. meto)