Advocating for Veterinary Patients

On the door of my classroom, I have sticker with several animals on it that states, “I speak for those who have no voice.” Veterinary nurses choose to enter the field with the goal of helping animals through supporting patient welfare and health care. We strive to educate clients and the community, collaborating with our team to ensure a well-rounded patient–client experience. We want to be that voice for our patients, but who is listening to us? How can we improve relationships with the veterinary team, clients, and the public to enhance patient advocacy?

The Veterinary Nurse’s Role in Patient Advocacy

As you know, veterinary nurses take on several tasks in practice, including (but not limited to) handling patients, performing laboratory tasks, supporting patients through a variety of procedures, and interacting with clients, all while keeping the patient at the forefront of care.¹ These interactions create opportunities that allow the veterinary nurse to use their vast skill set to ensure effective nursing through direct care, observation, and inquiry.²

To achieve an elevated level of care, veterinary nurses must remember they are an integral part of the veterinary team and advocate for the profession. Although veterinary nurses are not permitted to diagnose, prognose, prescribe, or perform surgery, their expertise in nursing, care, and clinical skills can improve patient outcomes. For example, care discussions throughout puppy or kitten visits set up the patient for future visits and inform the client about important vaccination protocols. Alerting the veterinarian to any new clinical signs discovered in the hospitalized patient can result in a change of protocols to help improve treatment. Encountering and communicating significant changes in patient vitals during surgery can help avoid tragedy, saving the patient’s life.

Conditions That Foster Patient Advocacy

The NAVTA Code of Ethics state that veterinary nurses must collaborate with the veterinary team to support patient care.³ A positive work environment, where everyone feels safe and welcome to speak, must exist to foster this collaboration with the overall goal of providing the highest level of patient care.⁴ What does it mean to have a positive environment? Veterinary nurses should feel valued, respected, and appreciated as important, vital, and educated veterinary health professionals, capable of using their expertise to the highest extent. Second, trust must be established so the veterinary nurse can be acknowledged when they have a suggestion, idea, or concern. Finally, the veterinary team can encourage communication through open dialogue, transparency, and accountability for learning and collaborative practices to occur daily. Rounds, huddles, and one-on-ones can be great additions to fostering partnerships and teamwork. In addition, setting goals, improving constructive feedback, and continuing education can improve communication.⁴

A foundation of collaboration and communication leading to a positive environment can extend to the clients. Veterinary nurses manage a variety of patient needs, with clients exhibiting an array of emotions. After the front desk staff, veterinary nurses are usually next to connect with the client. Knowing what to say to the client and how to say it helps improve patient care by providing rationale and education, assisting the client in decision-making. Appropriately relaying information can make the difference between the client being receptive or shutting down.⁵

How to Advocate for Patients

The veterinary nurse remains at the center of patient advocacy, asking for all interested parties to listen so the patient gets the best care possible. What are best practices to follow to build positive relationships with the team and client while cultivating patient care?

First, broaden collaboration. Veterinary nurses can maintain the veterinary-client-patient relationship while including their input and presence. Encourage a collaboration of care with all stakeholders. Include clients in the decision-making process with everyone present to keep communication open, authentic, and clear. For example, using a shared decision-making approach where the client offers their input and the team works to support and integrate the input can improve collaboration and communication and enhance patient care.⁶ Detailing choices, options, and decisions creates a constructive encounter where the veterinary nurse continues to educate and advocate for the patient.

Second, empower yourself. Educate and highlight your knowledge. When I was at my first practice, the doctor allotted time at our monthly meetings for staff to share a case, disease, or innovation in the field. Those 20 minutes helped us see each other as professionals and build confidence in our abilities. The topic of the month would be displayed in the lobby, encouraging clients to ask questions. Veterinary nurse/technician appointments are another way to share knowledge. These appointments are opportunities to continue preventive care and discover new conditions to share with the veterinarian and the client.

Finally, if you see something, then do something and say something! Fluid rate too high? Conflicting medications? Something abnormal during the physical exam? Veterinary nurses should not feel powerless; rather, they should feel confident in the ability to approach and inform the entire team of their findings. But what happens if you are nervous or had a negative experience in the past? When possible, be proactive rather than reactive. Start with smaller conversations regarding patient care, especially if there is down time and stress is low. For example, share something you may have read about an innovation, diet, or nursing care that would be beneficial to the patient. Make sure boundaries are set, and remember it is fine to question a treatment or order. Ask for more clarification before you proceed. Request to talk to the veterinarian in private if it is more comfortable for you. Remember to maintain balance in the conversation because the other party wants to be heard as well.

Other helpful tips include writing down what you want to say first, sharing with a trusted colleague for clarification, and taking time to prepare what you want to say.

As veterinary nurses, we can be the voice for our voiceless patients by promoting collaboration and communication, staying informed and empowering oneself, and speaking up and taking action for patients.

Perspectives on Veterinary Nurses Advocating for Patients

Sarah Herrera, BS, shift lead and veterinary technician student at Penn Foster

Clients sometimes assume that we are actively trying to find abnormalities in their pets because we want to take their money, which prevents them from approving the recommended care from the veterinarian. When it comes to decisions about patient health, veterinarians can recommend the best course of treatment, but the client is the ultimate decider. For that reason, we have to bridge that gap in the client–veterinarian relationship. As with any relationship, communication, trust, and respect are necessary. We have to be advocates for not only the veterinarian but for the client as well so we can continue to advocate for those who cannot speak for themselves.

Shannon Babyak, BA, CVT, VTS (ECC), professional development coordinator at Veterinary Urgent Care Center

If you break it down to its simplest form, our primary responsibility is to advocate for our patients’ welfare. Whether that’s through client education, medical treatment, or end-of-life care, our purpose does not change. At the end of the day, we spend a majority of our time with patients. We are the first to speak with clients when they come in for appointments and are usually the first to recognize changes in hospitalized pets. Having the confidence to speak up and advocate for the wellbeing of patients is a core responsibility of veterinary technicians.