Advanced Communication During Critical Moments

Veterinary nurses/technicians face communication challenges that most healthcare professionals never encounter. Managing conversations with panicked pet owners while coordinating with veterinarians during life-threatening emergencies creates communication scenarios that require specialized skills and mental agility.

Understanding Communication and Stress

Communication failures represent the most common cause of complaints in veterinary medicine, with these failures often leading to medical errors resulting in patient injury or death.¹

Unfortunately, the brain does not function normally during high-stress situations. Adrenaline surges cause cognitive processing to shift to survival mode. This reduces the ability to organize complex thoughts or process information effectively while also increasing emotional reactivity.

This physiologic response affects everyone participating in an emergency. Owners may struggle to understand medical explanations in critical moments. Team members may use shortened communication due to assumptions about shared knowledge, leading to medical errors. The veterinary nurse’s/technician’s role during this time becomes even more complex, as they are often required to facilitate information flow between veterinarians focused on medical interventions and clients seeking both information and emotional support. This dual role demands communication flexibility and emotional intelligence (EI).

Verbal Precision and Clarity Under Pressure

Effective emergency communication requires precise language that conveys urgency without creating panic. When communicating with owners, this requires technical accuracy with easily understood language that allows for understanding without eliciting a strong emotional response. When speaking with clients in these situations, consider the following:

• Lead with the most important information.
• Use specific, concrete terms.
• Avoid medical jargon unless immediately explained.
• Include time frames when available and relevant.
• Specify exactly what action is needed.

Instead of saying, “Your dog is having trouble breathing and we need to do something. Do we have your permission to help him?” consider this phrasing, “Your dog’s airway is partially blocked. We need to intubate him immediately. This involves placing a tube in his throat to help him breathe and will take about 5 minutes. Do we have your permission to do this?”

Nonverbal Communication

In highly emotional situations, body language carries more weight than spoken words. Because of this, veterinary nurses/technicians must maintain appropriate body language. This requires conscious control of facial expressions, movement patterns, and posture that either reinforces confidence or broadcasts anxiety. In these situations, it is important to consider the following:

• Keep facial expressions calm and focused.
• Use deliberate, controlled movements rather than frantic gestures.
• Position yourself at the client’s eye level whenever possible and maintain appropriate eye contact when speaking.

Utilize Emotional Intelligence

The ability to read and respond to emotions determines communication success during critical moments. This ability, known as EI, directly affects the quality of care provided and leads to better patient outcomes and lower instances of burnout and compassion fatigue.²

EI involves recognizing escalating emotions before they become disruptive and identifying when someone needs additional support. This requires adapting your communication style to match individual emotional needs while balancing empathy with professional boundaries. EI also requires self-regulation, particularly for those in leadership positions or general positions of authority during critical moments.

Emotional Regulation During Critical Moments

Self-regulation is critically important when your own stress response threatens communication effectiveness. The challenge lies in managing physiologic responses while maintaining professional communication standards. During high-stress moments, consider the following:

• Take 3 controlled breaths before speaking.
• Recognize stress signals (e.g., voice pitch changes, rapid speech, shoulder tension) and consciously adjust.
• Know when to step back and allow a colleague to take over if you sense your emotional state might compromise patient care.

Self-regulation also requires postincident processing. After critical situations, debrief with team members to identify what worked and what didn’t. This practice builds communication resilience while preventing burnout and compassion fatigue.

SBAR Communication Framework

Structured communication frameworks reduce medical errors in high-stress situations and prevent critical information from being lost during chaos. During emergencies, communication must be immediate, accurate, and actionable. The SBAR framework provides a structured method of communication during these moments. SBAR stands for situation, background, assessment, and recommendation (or request). See BOX 1 for a breakdown of the SBAR framework.

The SBAR communication framework is useful for framing any conversation, especially critical ones requiring immediate attention and action, such as when a patient is declining. The following example of the SBAR communication framework is being used to communicate with the veterinarian about a declining patient:

“Dr. Johnson, Rocky is showing signs of respiratory distress (Situation). He came in after being hit by a car 2 hours ago (Background). His respiratory rate has increased to 80 and his gums are becoming pale (Assessment). What would you like me to do next? (Request).”

Closed-Loop Communication Framework

The closed-loop communication technique ensures that critical information is received and readily understood. Using this technique, the speaker states information, the receiver repeats it back, and the speaker confirms accuracy. This process prevents dangerous assumptions in emergencies, especially when verbal orders are given.

Team Communication During Emergencies

Team communication during emergencies requires both structure and clarity. While the veterinarian and senior veterinary nurses/technicians are concentrating on medical interventions, others should coordinate information flow between the medical team and the client. This requires establishing clear protocols before emergencies occur. Consider the following:

• Designate who communicates with the client, who coordinates between team members, and who documents events.
• During active interventions, use concise, clinical language that conveys essential information quickly to avoid unnecessary descriptions that delay critical decision-making, such as: “Heart rate 180, respiratory rate 60, mucous membranes pale.”
• When communicating with owners during ongoing treatment, provide specific time frames, such as: “Dr. Watson is placing an IV catheter to give Buddy fluids. This will take approximately 5 minutes, and I’ll update you when it’s complete.”

Emergency Communication Checklists

Mental checklists offer another valuable communication tool.

When communicating with the team during an emergency:

1. Clearly identify who you are and who you are addressing.
2. State the urgency level.
3. Provide essential facts only.
4. Make a specific action request (exactly what you want done).
5. Confirm receipt and verify their understanding.

When communicating with owners:

1. Introduce yourself and state your role.
2. Assess their current understanding and
   emotional state.
3. Provide information in small, digestible bites.
4. Check for any questions and verify their understanding.
5. Explain the next steps clearly.

Building Communication Resilience

Effective communication in a crisis requires ongoing development. Continuously refine communication abilities through regular practice of structured communication techniques. Whenever possible, solicit feedback from colleagues and supervisors on communication strengths and opportunities for improvement.

Mastering communication during critical moments is not about perfection—it is about building resilience and adaptability in order to obtain the best outcomes for all parties. The goal is not to eliminate the emotional intensity of emergencies but to maintain effective communication despite that intensity. This requires ongoing skill development, regular practice, and commitment to professional growth.