{"id":20194,"date":"2020-02-19T21:10:13","date_gmt":"2020-02-19T21:10:13","guid":{"rendered":"https:\/\/todaysveterinarypractice.com\/?p=20194"},"modified":"2022-03-25T20:33:59","modified_gmt":"2022-03-25T20:33:59","slug":"mixed-emotions","status":"publish","type":"post","link":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/personal-professional-development\/mixed-emotions\/","title":{"rendered":"Mixed Emotions"},"content":{"rendered":"

Given that most people consider their pets to be part of the family, it is not surprising that strong emotions are often encountered in the veterinary clinic. In one exam room, a happy family shows off their new kitten. In the next, a 20-year-old man and his family cry as they say goodbye to his childhood dog. While one member of the vet team is thanked by a client for the post-op care they provided to a patient, another team member is accused of being \u201cheartless\u201d after presenting an estimate to treat a sick pet. These intense emotions can affect the client\u2019s decision-making and require careful handling by the veterinary team.<\/span><\/p>\n

Discussing Quality of Life and Euthanasia<\/h2>\n

Euthanasia is thought to be the hardest part of the job by many outside of the profession. In reality, it is the conversation leading up to a euthanasia that is <\/span>considered the most difficult part of the process by many veterinarians.1<\/sup> These conversations are often emotionally charged, though the emotions surrounding the decision to euthanize may vary in different situations. <\/span><\/p>\n

In some cases, the client may present their pet for a quality-of-life evaluation. Some clients are open about this, while others may feel too nervous or guilty to begin the conversation. When the veterinarian or their staff senses this, using a question such as, \u201cWhat is your goal for today\u2019s appointment?\u201d can give clients the opportunity to share their thoughts. While conversations surrounding quality of life can be emotional for both the veterinarian and client, when all involved agree that euthanasia is the best option the process is easier.<\/span><\/p>\n

Unfortunately, not all end-of-life discussions are as easy. Finances often play a role in decisions surrounding treatment and euthanasia. For a client with limited finances and a pet that requires a life-saving surgery costing hundreds or thousands of dollars, euthanasia may be in the patient\u2019s best interest. In situations of economic euthanasia, clients are more likely to express anger at the clinic\u2019s payment policies or guilt surrounding their limited finances. The veterinary team can help guide clients in their decision and offer support if the client makes the difficult decision to euthanize. Providing reassurance to the client that they are acting in their pet\u2019s best interest and withholding judgment on their financial situation are crucial to successfully managing these situations.<\/span><\/p>\n

In other cases, a pet owner may be unwilling to euthanize despite the pet\u2019s poor quality of life. As veterinary medicine becomes more advanced, there are often many things we can <\/i>do for a pet. But should we? Most veterinarians have experienced situations where clients request treatment that the vet feels is futile.2<\/sup> These situations are especially difficult for all members of the veterinary team who can see the pet\u2019s suffering and feel unable to do the \u201cright thing.\u201d2<\/sup> Utilizing existing quality-of-life evaluation scales, having multiple conversations, and offering to refer a patient to a hospice veterinarian are all strategies that can be used to help move a client toward the decision to euthanize. The longer these conversations take, the more distressing they can be to the veterinarian.1<\/sup> It is important for veterinarians to stay aware of their own emotions during these conversations and avoid expressing frustration to the client.<\/span><\/p>\n

In all euthanasia situations, veterinary teams can help the client through the process by clearly explaining the procedure and preparing clients for any potential adverse events. For clients who express high levels of grief, offering the services of a trained social worker or grief counselor may be helpful. Some grief counselors <\/span>may be open to working with a client prior to euthanasia to help them make the decision to euthanize.<\/p>\n

Emergency Situations<\/h2>\n

Emotions are often magnified in emergency situations when decisions must be made quickly, money is more likely to be a factor, and the situation is unexpected. Because of this, emergency hospital staff often take the brunt of an upset client\u2019s negative emotions. <\/i><\/span><\/p>\n

It is important to remember that emotions do not occur in a vacuum. Take, for example, the client who has just brought the family\u2019s 2-year-old chihuahua to your clinic after he was attacked by a large dog on their evening walk. The patient is in shock, has numerous puncture wounds and a large abdominal hernia, and is in respiratory distress. You discuss diagnostic and treatment options and give the client a guarded prognosis. The client begins to yell at you and your veterinary nurse. While this client\u2019s reaction may be inappropriate, it is likely driven by a number of emotions\u2014guilt that he or she couldn\u2019t protect the dog, shock at the situation, fear of losing the dog, anger at the other dog\u2019s owner, or worry over the cost of veterinary care. By acknowledging these emotions, the veterinarian can begin to work with the client to make the best decisions for the pet. Expressing empathy is one of the most important things a veterinarian can do during these cases.<\/span><\/p>\n

Managing Emotionally Charged Situations<\/h2>\n

Much of successful management of client emotions comes down to communication. Veterinarians with excellent bedside manner and communication skills are more likely to have a satisfied client and less likely to receive board complaints or malpractice claims.3<\/sup> Communication is now considered a core clinical competency for veterinary students.3<\/sup> <\/span><\/p>\n

Communication training can be provided for the entire veterinary team through mock situations or reviews of recorded client interactions. Key communication strategies that can be used in emotional situations include expressing empathy, providing information in small chunks, and reflective listening. <\/span><\/p>\n

As discussed in my previous column in the January\/February issue (<\/span>todaysveterinarypractice.com\/the-cost-of-caring-too-much<\/span><\/a>), financial concerns are often a contributing factor to emotional situations. Discussing finances with clients is the third most common stressor for practicing veterinarians.4<\/sup> There are resources and continuing education opportunities for veterinarians to learn how to best discuss finances with their clients, but here are a few tips to lessen the stress:<\/span><\/p>\n