DrAndyRoark.com

Articles, Videos, & Training on Pets & Veterinary Medicine

Cherie Buisson, DVM, CHPV

What Was Good About Today?

by

There are days when my own goofiness is humbling. Today was one of them.  It’s been 15 years since I had a young dog. Now I have two. Although I am thrilled and grateful to have joy in the house after losing my beloved Muggle, I have to admit that they are a challenge. The youngest isn’t quite house trained. We’re working on it, but accidents happen. I stress over whether she’s going to leave another puddle on our white carpet. I’m a bit under the weather today, so my patience isn’t what it should be. I found myself grumbling during each walk where she’d rather snort and sniff in the grass than do her business. At one point, we were out there for 15 minutes, which doesn’t seem like a long time until you’re walking in circles in your own yard.

By 2 pm I was exhausted.

We went to the local pet store and bought some diapers, so that maybe I could get some things done and stop following her around the house. When we got home, she finally decided to pee, so we didn’t even need the diapers. At about 6pm it hit me; she didn’t have an accident ALL DAY. I spent the whole day stressed, and she was PERFECT. I spent so much time focused on the fact that she wouldn’t pee that I forgot SHE DIDN’T PEE IN THE HOUSE.

Finding the Positive

On my Facebook page at A Happy Vet, we have “What Was Good” Wednesday. This is one of my favorite techniques for reducing stress.  Negative things have a tendency to stand out. In the early part of my career, I’d come home and complain that I’d had a bad day. Typically, I had one or two things that went wrong and the rest of the day was fine. I chose to concentrate on the bad things and therefore condemned an overwhelmingly positive day because of one or two negative experiences.

I started driving to work each day telling myself it was going to be a great day. I’d list the things I was looking forward to. On the way home for lunch and home for the day, I’d list the good things, the good people, the positive outcomes. Lo and behold, I started having more good days! NOTHING about my days changed – except my attitude and focus.

Certainly, there were days that truly were bad. The days I lost a patient unexpectedly (a rarity, thank goodness), the days where nothing seemed to go right, the days where more clients were unpleasant than pleasant – but those were extremely uncommon. Even on those days, I listed my heartbeat, my ability to breathe and the health of my pets and family as the things that were good about today.

Write Down the Good, Not the Bad

Amazingly, so many things go right in veterinary medicine. Millions of vaccines are given that protect pets and don’t cause reactions, millions of surgeries are successful and complication-free, millions of clients are cooperative, grateful and truly love their pets. We don’t really think about those things much. Instead, the vaccine reactions, surgical complications and angry clients stand out……..unless you refuse to allow them to do so.

It’s amazing how many things go right in #veterinary medicine.

Try it. For one week, write down what was good about today. Don’t bother listing the negative things to see how they compare. Just look for positives. Every little thing you can think of: the clinic was not attacked by aliens with anal probes (okay, your patients probably thought so, but this isn’t their list, is it??), none of your patients were rabid (hopefully), your heartbeat, your lungs did their thing. Your team held you up, you went home to your family, your pets were happy to see you.

Take a deep breath and blow the clouds away so you can see the sunshine. Bask in the knowledge that you are a veterinary professional with a gift for healing animals. You are a rock star. You are a unicorn. Inhale gratitude – it’s a bright light. Exhale negativity, it’s a black cloud. By the time you get home, maybe instead of complaining to your loved ones about your bad day, you can smile, kiss them and know that there is so much good in every day – if you only take the time to look.

Try it. For one week, write down what was good about today.

The views and opinions expressed in this article are those of the author and do not necessarily reflect the position of the DrAndyRoark.com editorial team.

Let’s Be Alone Together: 7 Steps to Coping With Professional Isolation

by

Every single one of us has bad moments. We all have doubts. We all feel insecure today about something that didn’t bother us before. We all have fear lurking, waiting to pounce on us when we are weak. And somewhere, deep down, we all wonder, “am I the only one”?

I know someone with a button phobia. Even as an infant, she would scream and tear at her clothes if she could see buttons. Large buttons were worse than small ones. Four holes were worse than two. She has had to work around this problem her entire life.

I visited her one weekend, and we were talking about her phobia. I was fascinated (medical geek that I am) by her stories of how she copes. She told me she felt alone and weird, so I did an online search for “button phobia”.  Enter koumpounophobia. I showed her an article about button phobia, and her whole demeanor changed. There were enough people with this issue that someone had actually written about it!

There are so few of us who are alone in our troubles. Unfortunately, we often suffer alone. When I talk to my colleagues about an issue in veterinary medicine, I often hear “I thought it was just me”. When I’m part of a discussion where someone talks about overthinking a problem or working up scenarios in their mind, I’m always a little surprised that this isn’t a quirk that is solely mine.

[tweetthis]Somewhere, deep down, we all wonder, “am I the only one”?[/tweetthis]

Remember in college when they told us be sure to ask questions because there were likely several other people with the same question who were afraid to speak up? It’s like that.

Here are a few simple ways to feel less isolated as a veterinary professional:

  • Assume you are not alone: I’ll grant you that there are people out there who are the only ones suffering from a certain problem. The odds of that person being you are next to nothing. If you look hard enough, you’ll find that someone somewhere is right there with you. Most of the time, you don’t have to look hard at all.
  • Go out on a limb: If you feel you can, bring your issue up with colleagues you trust. Even if they’ve never experienced the same thing, they will likely show their support, and you will still not be alone. Beware of websites and forums that encourage you to wallow in your problem. Look for like-minded people searching for support and solutions.
  • Reach out: If you notice someone else struggling with a problem, offer to help or just to listen while they talk it out. Sometimes feeling useful can reduce feelings of inadequacy. Even if you think you aren’t capable of being strong for someone else, give it a try. There are days where having someone smile at me and say “good morning” makes a difference. Anyone can do that!
  • Help someone else with the same problem: One of my favorite things is teaching young veterinarians how to survive the first few years of practice. I was a miserable, anxious new vet. Helping others avoid that fate has given me confidence and satisfaction I never thought possible. Even if you are only able to empathize and offer your support, that could make a world of difference.

Red cat with computer keyboard lying on window board, close up

  • Write about it: Whenever you bring to light a problem in your profession, doors open to solving that problem. If no one will talk about it, no one can fix it. Submit an article or just write down your thoughts. Getting it out can be half the battle.
  • Embrace what you perceive as your weaknesses: We veterinary professionals hate showing weakness. Let’s stop thinking in terms of strength or weakness. Rather, let’s look at skills we’ve mastered and skills we have yet to master. There will always be items on both lists. Keep adding to each one and don’t get caught up in comparing the two. Pick one thing at a time you’d like to do better. Choose to do it better – even just a little bit.  Stop telling yourself “I hate surgery” or “I’m no good at bandaging”. Tell yourself that you are an excellent veterinarian who is always trying to do better.
  • Stop comparing yourself to others: In this world of constant connection, we see a “first date” version of everyone we know. Everyone has parts of their life that didn’t turn out as planned. Everyone has problems. I guarantee you that someone somewhere has looked at you and felt inadequate in comparison. Surround yourself with positive people who support and love you. Return that love and support.

We are part of a noble profession. There is always someone to give you a word of encouragement. If you can’t find anyone, let me know. I’ll be happy to lift you up; so many have done the same for me in my career. There are billions of human beings out there and hundreds of thousands of them are veterinary professionals! How could you possibly be alone?

There is always someone to give you a word of encouragement.

The views and opinions expressed in this article are those of the author and do not necessarily reflect the position of the DrAndyRoark.com editorial team.

10 Things Bicycling Taught Me About Veterinary Medicine

by

Here are four words I never thought I’d hear myself say: “I am a cyclist”. I’ve always detested exercise. If you ever saw me running, there was probably something chasing me.

When I started dating my husband, he introduced me to cycling. I bought an entry level bike, thinking it would have been much less work to just set the money on fire. I bought pants that made my butt look bigger on purpose. I bought pedals that fastened to my shoes. The first few times we did any climbing, I thought I would die before we finished the ride. Slowly, the climbing got easier, the pedals turned faster and my butt got smaller. I was in love – with the guy and the bike

Before long, I was screaming at Le Tour de France on TV, looking for bigger hills and longer rides and coveting a bike that cost more than my first car. When I don’t ride, my coworkers can tell. There’s something about the circular motion that clears my mind and makes me more positive. Over the last 8 years, I’ve learned a lot about cycling and myself. I’ve also learned how to better manage my veterinary career using lessons I learned while pushing pedals.

1 – When there is an obstacle in your path, look to the left or right of it. Where your eye goes, your bike will follow. Focus not on what’s in your way, but how to get beyond it.

2 – Balance is the key. If you want to move, you have to stay balanced. If you lean too hard in any one direction, there’s a good chance you’ll crash. Avoid leaning hard into work all the time instead of spending time with family or taking care of yourself.

Know that the ground is harder than your head.

3 – WEAR A HELMET. Know that the ground is harder than your head. Protect yourself all around – have insurance, protect your license, practice good medicine, listen to your gut, write it down.

4 – ALWAYS fill your tires. It’s much easier to get a flat when your tire is soft and susceptible to puncture. If you keep yourself filled with diet, exercise and positive thoughts, it will be harder for anyone or anything to deflate you.

Veterinarian doctor making a checkup of a cute beautiful cat5 – Have a great team. One unsafe, low-concentration, bad-attitude team member can make everyone kiss the pavement. If someone isn’t pulling their weight, put them on notice. If they can’t be a positive influence on the team, get rid of them.

6 – Everyone on the team needs to be healthy and well-rested. If you or your team are working hung over, sick or overtired, you endanger your patients and your license. Sometimes not being at your best is unavoidable, but if it’s becoming a frequent occurrence, address it.

7 – If you’re pedaling so hard that you lose your form, slow down. There is a point where you are seeing so many patients that you are practicing medicine beneath your skills. Figure out what that point is and avoid getting near it. Remember that if someone pushes you into practicing fast rather than good medicine, they will disappear the second it comes back to bite you.

8 – Respect the machine. The bike can’t ride without you and vice versa. Maintain your equipment, practice good self-care. Above all, listen to your body. Know when something just isn’t right and address it before things fall apart.

Here are four words I never thought I’d hear myself say: “I am a cyclist”.

9 – Clip in to your pedals. It’s scary being committed to anything. You don’t reach your full power until you tie your feet to the pedals. Not only do they push down, but they lift up, using the full potential of your legs. Commit yourself to being the best professional you can be. Utilize all your skills and learn new ones. Leave work at work and home at home as much as possible. Concentrate on the patient, family member or problem in front of you. Don’t forget to concentrate on the person in the mirror regularly.

10 – You can climb the mountain. It may be hard. It may hurt. It may make you cry – but getting to the top is like no other feeling in the world.

I’ve learned how to better manage my veterinary career using lessons I learned while pushing pedals.

The views and opinions expressed in this article are those of the author and do not necessarily reflect the position of the DrAndyRoark.com editorial team.

10 Ways To Stay Sane in Our Crazy Field

by

I just returned from a speaking engagement in Indiana where I educated young veterinarians about self-care. We talked about compassion fatigue, euthanasia, assertiveness and stress relief techniques. I flew home at night.  Because of weather delays, I didn’t see my bed until 1:30 am. This is past my bedtime.

I had the sense to take today “off” – meaning that I’m working from home, haven’t taken a shower and feel like I’m recovering from the flu. My body aches from dragging suitcases and falling asleep in an airplane seat. My entire digestive tract has declared mutiny and is demanding only healthy food for a little while. My phone keeps reminding me to “right self-care piece for Andy Roark”. I really hate that Siri can’t spell.

Considering what I’ve put my body through in the last 24 hours, I’m wondering if I should be writing or lecturing on self-care.  I know better than to do most of the things I’ve done in the last day. However, part of the self-care strategy is to avoid aiming for perfection. Mission accomplished.

Part of the self-care strategy is to avoid aiming for perfection. Mission accomplished.

I’ve written articles on self-care before. I’ve talked about saying “NO” and stress in the profession. I teach classes on setting boundaries. Before you can set boundaries, though, you have to figure out what they are! You have limits to what you can take without going all banshee on everyone. Like toxic doses of drugs, you should avoid stepping up TO that limit.  Give it a wide berth. Ask yourself the following questions.  I’m giving you some of my answers so you can see what I mean.

1 – What do I eat that makes me feel good?  For me, that’s protein, veggies, fruits, nuts and salad.

2 – What do I eat that makes me feel bad? The usual suspects: sugar, caffeine, greasy foods, spicy foods, red sauces, alcohol. Any combination of these is deadly. Did I eat pizza before my flight yesterday? You bet I did! It’s part of the reason my stomach felt uneasy on the plane. Is quatro formaggio pizza with bacon heavenly? Unfortunately, YES! This happened to be a bad decision, but I knew better than to drink alcohol or load up on sweets, so I was uncomfortable rather than miserable.

Young Cat With Open Mouth At Home3 – What are my stress triggers at home? Not enough sleep, the dog having accidents in the house, coming up with something not boring to cook, watching the news, politics, obnoxious loud music, negative discussions on social media.

4 – What are my stress triggers at work? Mean people, demanding people, overbooked appointments, emergencies that should have come in before today, feeling overwhelmed with too many tasks

5 – What relaxes me? Quilting, reading a good book, meditation, harp or other quiet music, yoga, a glass of wine (tricky because this is also a trigger), clean sheets on the bed, being cold and covered in blankets, playing online (with the exception of negative discussions on social media).

6 – What do I wish I did more of? Spending time with my family, spending non-vet time with my pets, canoeing, taking cycling trips, napping, quilting, working on my aquarium, writing, being outside doing nothing

7 – What do I wish I did less of? Checking email and social media, grocery shopping, laundry, cooking, worrying

8 – What people are the most positive influence in my life? Since the thought of trying to list
everyone without leaving someone out is giving me anxiety, I’ll just tell you this: These can be people you know or people you contact indirectly. Find ways to spend more time with these people. Whether it’s reading an author with a positive message or talking to a friend who is always there for you, make time to connect with those souls who are good for yours.

9 – What people are the most negative influence in my life? I’m pleading the fifth here as well.  Find ways to reduce your contact with these people. Sometimes just hiding a really negative person on social media makes your day better. Let them go to voicemail when they call. Be busy when they want to heap negativity on you.

Jack Russell Terriers Playing Fetch

10 – What do I want? Make a list of your dreams and goals. Pin it up somewhere and review it regularly to make sure everything you do is aiming you in their direction.  Don’t be afraid to change them as your life changes. Every time you move in the right direction, pat yourself on the back (you know, a treat for doing well, positive reinforcement?).

I know myself better than anyone. I’m the only person I’ve lived with for 40 years in a row. The more I know my reactions to my environment and other people, the more chance I have of directing my life positively. Seeing on paper what you love and hate and comparing that to what you are exposing yourself to in life is a revelation. Make room in your life for the things and people you enjoy. Hang a “no vacancy” sign for the rest. Know yourself well enough to know when you need to slow down, ask for help or unplug. Don’t wait for others to offer to give you a break – that so rarely happens in today’s self-centered world. Here in the U.S. we are guaranteed life, liberty and the pursuit of happiness.  Not happiness, the PURSUIT of happiness. Make sure your choices reflect that pursuit and you’ll be moving in the right direction.

The more I know my reactions to my environment the more chance I have of directing life positively.

The views and opinions expressed in this article are those of the author and do not necessarily reflect the position of the DrAndyRoark.com editorial team.

The Veterinarian’s Holiday Survival Checklist

by

Where did the year go? I need three more Augusts (minus the sweltering heat here in Florida) to catch up! The holidays are always stressful, even for those of us who love them. We have a tendency to do everything possible to make the holidays harder than they have to be. Here are a few tips to surviving all the cheer and chaos.

1 – Postpone – Leading up to the holiday, figure out what must be done and what may be put off until later.  Do the windows really need to be cleaned before everyone arrives for dinner? Will anyone care if the front yard isn’t perfect? Can you avoid making that new and complicated side dish this year? Deliberately choosing to relieve yourself of some of the holiday burden ahead of time can make the rest of your to-do list seem more manageable. Remember that clients are also struggling with the holidays – if there is pushback about workups and treatments, consider reassessing at a later date if that is appropriate. You may avoid a complete refusal of care by providing some breathing room.

2 – Cut back – If you are all stressed up with nowhere to go, the point of the holidays is defeated. If you need to spend a bit less on gifts, do it. The only people who will be angry probably don’t deserve a gift at all. How many food items do we need before family dinners become ridiculous? Pick a few favorites, and if anyone wants something else, ask them to bring it with them. If you are dreading holiday parties, decline invitations until you feel less burdened. If you aren’t going to have fun, don’t go. Multiple office holiday parties can get expensive. If the gift exchange game is voluntary, just sit it out this year.

If you are all stressed up with nowhere to go, the point of the holidays is defeated.

3 – Make it fair – If you cook, don’t clean. If you clean, don’t cook. If you are always the host, ask someone else to volunteer. If you are always asked to travel, offer to host and have everyone come to you. Don’t be the person who volunteers to work every holiday unless doing so makes your life better. If your work policy is to see everyone who calls the day after a holiday, encourage extra staffing to compensate. If not, send some cases to the emergency clinic if needed.

4 – Take a break – Go lie down and take a rest if you need to. Escape to a local park or to the movie theater. If work is slow, ask to go home early if you can afford to do so. Take lunch away from the office if possible. One year, my husband and I took a cruise for Thanksgiving. Although we missed spending time with our families, it made the rest of the holidays more enjoyable because we were well-rested.

Dog And Owner Walking5 – Keep it simple – Christmas lights always bring a smile to my face – until I have to put them up. Decorating and cleaning for the holidays can be exhausting. A few years ago, I was in a car accident. The thought of not decorating made me feel worse. Instead of going all out I got help with the outside lights and didn’t put a single ornament on my tree.  I wrapped it in poinsettia garland and white lights. I’ve gotten more compliments on that tree than any other. It’s been that way ever since.  It doesn’t take much to add a festive feeling to your home or office – only do what brings you joy.

6 – Sleep – Being overtired and dealing with guests or clients is a dangerous combination. If you’re not doing something vital to national security, GO TO BED EARLY. If everyone takes a tryptophan-induced nap after dinner, leave the dishes in the sink and go nap yourself. Trust me, they’ll be there when you wake up!

7 – Exercise – One of my favorite holiday traditions is the Ghost Town Bike Ride (this isn’t an actual thing, so don’t Google it). Every Thanksgiving and Christmas morning, my husband and I get up early and ride our bikes. There is NO ONE on the road. The quiet is almost eerie in our busy city. It’s as though the peace and physical exertion provide a Control + Alt + Delete for our stress levels (plus I eat with less guilt). We’ve also done an after-gorging walk in the park that helps our digestion and lets us breathe the fresh air. Even taking a minute to stretch at work or taking a walk around the building can clear your head and make you more efficient.

8 – Eat wisely – Oh, stop rolling your eyes! I know holiday meals are a time when most of us throw our diets to the wind and eat until we can’t breathe. I still eat everything I want, but instead of piling my plate, I take a small spoonful of everything the first time around. I can go back for seconds or thirds if I want, but challenging yourself to eat a giant plate the first round is just asking for trouble. Using a smaller plate can help you not feel deprived. My mom and I tend to split pieces of desserts so we can taste everything without making ourselves sick. I also try to make myself chew everything thoroughly instead of bolting it down. That gives my stomach time to fill up. Remember, you’ll get sick of leftovers before the week is out. Save something for tomorrow! The office break room is a dangerous place to be during the holidays. Put some of the holiday calories out for your clients to enjoy. Wrap a cheer plate for the postal workers, delivery people and reps as they come by.

Funny standing kitten and cat9 – Let it go – Refuse to take part in work or family arguments or acknowledge slights. It is supremely frustrating to try to fight with someone who won’t respond. If there’s a blowup at work, acknowledge that this is a very stressful time of year and work to defuse rather than discipline. If you are a holiday host, invite guests to step outside for the Airing of the Grievances. If you are a guest, busy yourself with dishes or take a walk if conversation becomes hostile. You are the only person you can control. Release yourself from the responsibility of making everyone happy or keeping the peace.

10 – Remember – Many of us have painful holiday memories. I lost both of my grandmothers within a week of Christmas, so there is always some sadness associated with that holiday. Every year, we toast those who are present and those who aren’t. We tell stories about our loved ones that make us laugh, even if we’ve all heard them a hundred times. If a recent loss is overshadowing the holidays, be kind to yourself and don’t take on so much. Consider honoring lost pets at your office and reaching out to clients you know are suffering. Kindness to others is a win-win.

May your turkey come out juicy and your cheesecake not so much.

I wish you all a peaceful holiday season. May you find more joy than stress. May your turkey come out juicy and your cheesecake not so much. May full mouths prevent ugly words. May the beauty all around you stand out. Above all, I hope you treat yourself with love, kindness and understanding in a world that often lacks all three.

The views and opinions expressed in this article are those of the author and do not necessarily reflect the position of the DrAndyRoark.com editorial team.

The 8 Hard Conversations You Need To Be Having Now

by

Today I spent the afternoon at a family dinner for my brother’s birthday. Gatherings with my family are always unique. My sister-in-law and I are both veterinarians, so if a meal doesn’t involve a conversation about poop or vomit, someone is off their game. This particular meal qualified in both categories.

On the dinner table was a pile of papers. My parents were redoing their health care surrogate paperwork. In our family, this isn’t the slightest bit weird to do at a birthday dinner (it’s one of the few times you can count on us all being in one room).  My mom told us the story about my grandfather instructing the family that upon his death, their second job was to cry and mourn him.  Their first job was to get to the bank and empty all his accounts before his death notice hit the newspapers. We’re a practical bunch.

I noticed that my mom’s chosen surrogates were my dad and me. My dad’s paperwork was blank. As he was filling it out, he hollered down the table at me, “Your mom picked you. Do you want me to pick your brother to make it fair?”

I answered through a mouthful of apple pie and ice cream, “I’m more likely to pull the plug on you. You decide.”

He picked me.

I make my living having uncomfortable conversations. This is ironic because I avoid conflict whenever possible. I hate arguments, debates and disagreements. When I first became a hospice veterinarian, I was extremely uncomfortable talking about euthanasia. Now, it’s the subject I’m most comfortable talking about. Why? PRACTICE.  Every veterinarian knows that the more you do something, the better your skills. Conversations about end-of-life care are the same way. Whether you’re discussing a DNR order for a sick pet or bringing up the subject of euthanasia, the more comfortable you are, the more comfort you can give the family.

This isn’t rocket science. You don’t need a book to tell you what to say. Talk to your team and ask them what comforts them most to hear at the end of their pet’s life. Ask yourself what words bring you peace during a difficult time. Say those words to your clients. Listen and look for your clients’ reactions. Adjust what you say based on that.

Remember that for the most part, the decisions they are making are being made out of love. Even if they can’t afford their pet, they likely still love them. I would rather see a client euthanize a treatable pet than shame them into going home pretending to follow my instructions and letting that pet suffer.

Here are a few of the difficult discussions that we need to get comfortable having:

1) Risks of anesthesia. Don’t let surgery become so routine that you forget to educate your client. There’s no need to scare the pants off them, but they need to be aware of the risks and sign that they understand them. Have you ever read the paperwork before you had surgery? It’s terrifying but necessary. Let’s lay out the reasonable risks and explain them to our clients. Don’t just hand them a piece of paper that they sign without reading.

Here are a few of the difficult discussions that we need to get comfortable having.

2) DNR . This is especially important for elderly and very sick pets who will be left with you. If you can’t get in touch with the owner, what should you do? Even boarding pets need to have a plan in case the worst happens.  I had a patient become agonal while the owner was away. The pet sitter called me for help. Because she had taken the time to talk with the owner and had written permission to do whatever was necessary, I was able to euthanize him and end his suffering without worrying what the owner would think when she found out.

3) Hospice care and euthanasia. Get comfortable explaining the different options of referral, aggressive treatment, conservative treatment, palliative and hospice care, and euthanasia. If the client gets upset, explain that you must offer all the options to make sure you’re doing right by the family. It is their choice to eliminate options, not yours.

4) Overweight pets. Your job is to educate the owner. If the client is overweight, that is none of your business.  You’re not fat shaming anyone by telling them their pet is overweight – you’re being a good doctor! Handle it sensitively, explain the risks and talk to them about diet and exercise for their pet.

You’re not fat shaming by saying a pet is overweight – you’re being a good doctor!

5) Dental disease. While some clients are going to let their pet’s teeth rot right out of their head no matter what you say, some will do so out of sheer ignorance if you don’t educate them. Some are terrified about anesthesia. If you say the pet needs dentistry and they make a face, ask them flat out: “What it is about dentistry that bothers you?” If the owner refuses dentistry, treat the pet medically for pain. Sometimes just realizing that you feel the pet’s pain warrants medication is enough to make them reconsider. A little gabapentin can go a long way towards providing quality of life to a painful patient.

6) Wishes for the pet if the owner is incapacitated. If the owner is physically or mentally ill and will eventually be unable to care for their pet, have them make a plan and put it in writing so their loved ones know what to do for Scruffy. So many pets are foisted on hospice workers, veterinary teams and unsuspecting relatives because there was no plan in place.

7) Owners who can’t medicate or handle their pets. This is especially problematic in feline medicine. If we can teach clients to give a pill early on, we’ll all be so much happier. Giving Pill Pocket samples to clients at their kitten visit is a good way to introduce easy ways to medicate. If a client can’t or won’t medicate a sick pet, we need to be up front that euthanasia will likely be necessary earlier because of it. I’ve met several clients who said they couldn’t medicate their cat. When I dug deeper, I discovered they’d never even tried!

8) Pain management isn’t negotiable. It is now beneath our standard of care to fail to provide pain control for our patients. Explain to clients that you and your team will not allow pets to suffer. If they don’t want pain medication for surgery, they’ll have to have surgery elsewhere. Make sure you spend some time in pain management seminars at conferences. Every time I go, they transform the way I practice.  We can extend both quantity and quality of life if we educate ourselves about pain.

Sit down with your staff and develop scripts for all of these scenarios. Role play. Change your intake forms to reflect the choices your clients have for care while their pet stays at the clinic. Create checklists for anesthesia discussions that both clients and clinic staff initial.

If a client declines a particular diagnostic test before surgery, type in and highlight on the intake form that they declined the test and understand that it may increase the risk of anesthetic complications.  Have them initial the highlighted area. Never be afraid to decline to do surgery or anything else that makes you uncomfortable.  It’s your license after all. Sometimes we have to take risks in order to provide for the comfort of the patient, but if your gut says “Don’t Do It” then don’t!

Clear, compassionate communication is by far the best way to protect your patients, your clients and your license.  I once thanked my Dad for his excellent handling of the “facts of life” discussions when I was a kid. He snorted and told me his heart was pounding and he had sweat rolling down his back the whole time. I never would have known. His outward calm made me less uncomfortable and made listening easier. Force yourself to practice talking about things that are awkward. Eventually, the awkwardness will go away. Until then, approach uncomfortable conversations with confidence and wear a lab coat – hopefully it will help hide the sweat!

Clear communication is the best way to protect your patients and your clients.

The views and opinions expressed in this article are those of the author and do not necessarily reflect the position of the DrAndyRoark.com editorial team.