Although I worked a 14-hour ER shift last night––definitely not my normal gig––I actually feel pretty great this morning. Energized, even. This fact, along with a few great comments filed under yesterday’s entry, inspired me to put together this post on how to know if your animal ER offers what you need when things go all wrong with your pets in the off-hours.

Though I’ve always loved ER work and have plenty of experience doing it (at least four years’ worth), it’s been years since I put in time on the overnight shift.

I tend to think of it as a young vet’s job, something you do when you have the energy and the high drive for hard-hitting work. But it’s also true that some people are just built for this job––the high stress, the long hours, the rush that comes with the kind of successes only life-and-death emergencies can provide.

Not that it’s all life and death, mind you. It’s also the midnight diarrheas, just-got-into-garbage cases, facial swellings from tooth root abscesses, can’t-sleep-because-she’s-scratching patients and sudden limpings that can easily wait a couple of days for cruciate ligament surgery.

Some of these were in evidence last night, but I also saw a hit-by-car in need of chest tubes, post-op orthopedic cases requiring careful pain management, and one heavy-duty, seriously critical seizure case.

Loved it. Too bad my lifestyle isn’t exactly conducive to this kind of career any longer.

In between emergencies, however, I did get to thinking about what makes a great animal ER run well...and what makes some falter. So I figured that even if I can’t work ER all the time, I CAN work to make my favorite ER even better by writing a letter detailing where they do things beautifully...and where they need improvement. Because even the best place can stand a little criticism, right?

To that end, here’s a ten-point checklist of what YOU, the pet owner needs from a great ER and, consequently, what a great ER needs to offer.

#1 Staff attitude and skills

A caring, knowledgeable staff (whose work ethic and positive interpersonal skills are tops) is THE MOST important element for a successful after-hours hospital. To achieve this you need a well-paid staff granted humane hours and cozy working conditions.

#2 Staff numbers

Frankly, any ER that doesn’t have a minimum of two technicians (preferably licensed or certified) and one doctor at all times (not on call, but actually there all night) isn’t always capable of doing your pet justice.

#3 Sleep policy

If the staff and doc are allowed to sleep...things will slip. I promise.

#4 Access to specialists

An ER run by a criticalist (veterinary critical care specialist) is the best, but a speciality hospital with internists and surgeons on call (or at least accessible by phone) is pretty fantastic, too. This way, pets that need them can be transferred to specialists first thing in the morning.

#5 Open 24 hours

ERs that are open only after hours are not set up for truly critical cases. I think of these more along the lines of “urgent care” facilities.

#6 Seamlessness of operations

ERs that rent space from specialty operations or general practices (a common setup) are somewhat hampered by their ability to offer comprehensive care seamlessly. Clients can be confused by the need for double paperwork and double billing and patient care can sometimes fall in between the cracks.

#7 Equipment

An animal emergency facility needs better equipment than what most hospitals have to offer. The critical nature of ER patients mean that digital X-rays, rapid, reliable blood testing equipment and a perfectly appointed OR (among other key tools) can make the difference between life and death.

This also includes backup generators and an evacuation safe location. Here in storm-prone Miami it makes a difference––a big difference. The last thing you want is a place that can’t handle a power outage or proves flood-prone just when you need its services most.

#8 Excellent record-keeping

Digitized records mean that everything is in one place for seamless transition to the next shift or to your regular veterinarian. ER hospitals that communicate well with general practitioners make for the best patient care possible in both short and long terms. In the best cases, overnight-working ER vets hang around until regular hospitals open to communicate personally by telephone with referring vets.

#9 Regular staff

Is your after-hours place staffed by ER professionals or by just any old vet in need of a few extra bucks on her off hours? You definitely want a place that prides itself on its staff’s consistency and specific expertise. And this is not just about the vets. The entire staff should be specifically ER-enabled and accustomed to working with the ER vets as a team.

#10 Reasonable prices and payment alternatives

You can’t work your veterinary magic unless people can afford to pay for your services. Working hard to pare down estimates, a willingness to provide step-wise care and offering options like the CareCredit payment alternative (essentially a veterinary credit card) definitely takes extra work...but means that more patients can access the care they need.


While my letter is bound to be much more detailed, these ten points are a great starting point. But I know you have more suggestions sourced from your own personal experiences. Help me out and offer them up below.