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Life With Clients

It’s All Just Puppies and Kittens, Isn’t it?

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I have been in the field of veterinary medicine for 22+ years. It never fails that when I talk to someone about my job they make the statement “Oh, you get to play with puppies and kittens all day!” (Insert facepalm from me). I am a Veterinary Technician. It’s not all just puppies and kittens to me. It never has been, and at this point in my career it has never been farther from the truth.

My day starts at 5 a.m., if not earlier, with people calling in sick or running late for their shifts. I get myself ready. Get my husband up for work and my teenage son off to school. Feed the cats, let the dog out and feed her, throw a load of laundry into the washing machine and make the bed in an effort to put some type of appearance of order into my household, all while pulling my scrubs out of the dryer in an effort to make them wrinkle free. Iron? Who has time for that? Who even owns one of those?

The Starbucks barista knows me by name as I run in to grab my coffee, making general niceties, thinking of my day ahead. Arriving in a large nine doctor clinic to begin my day, I hit the ground running. Appointments start first thing in the morning, continuing all day long, every 30 minutes with four to five doctors in the mix. Don’t forget the scheduled surgeries – six, seven, eight of them on a given day. What about the non-scheduled work in surgeries? The dog fights, lacerations and don’t forget foreign bodies that always seem to round out an already busy day. Everyone wants their pets to go first. Asking at drop off when they will be ready for pick up.

I smile, greet, discuss and educate clients in my daily world with knowledge about veterinary medicine, their pets, and the addition of a few personal relationships thrown in. The receptionists call out “EMERGENCY” and we run, jumping in to help. The hit by car dog that is already struggling, stops breathing. He has no heartbeat. We intubate and start CPR, all while placing an IV catheter on a pet with no blood pressure, wounds too numerous to count and a hysterical owner standing in the door way, sobbing in the arms of her spouse watching as you help attempt to resuscitate their beloved family member.

Due to our exhaustive efforts, we are able to get our patient stabilized, he is still critical but now breathing on his own, his owner thankful and sitting by his side as he is in the ICU. Those scheduled surgeries are still waiting to be done, lets the ball rolling on those. Oh, don’t forget that meeting you had scheduled a few weeks ago for today… how do we fit that in? Deftly dodge the sales rep in your lobby as you slip through the reception area in an effort to take a bathroom break. Remember your bladder, your body will thank you later. Lunch? Who has time for that? Thank goodness you keep a few frozen meals in the breakroom just for days like this.

As the afternoon continues on, it’s much of the same as the morning, with the addition of a cat that is acutely neurologic and a ferret with low blood sugar. What else can this day bring? Surgeries are finishing up, owners picking up as planned, pleased for the most part with your teams efforts to make their pick-up time work. Appointments are still in progress, those seem to never end some days, do they?

The clinic closes at 7 p.m. You walk out the door at 9 p.m. after staying late to help your co-workers finish up and finalize your charts. Tired, but feeling satisfied for all you helped to accomplish today. As you get in your car to go home you think to yourself… “Yep, I just play with puppies and kittens all day. I sure do,” – said no Veterinary Technician ever.

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.

Jamie RauscherABOUT THE AUTHOR

Jamie Rauscher is a Registered Veterinary Technician and Medical Manager of a nine doctor practice north of Atlanta. She is President of Georgia’s Veterinary Technician and Assistant Association and serves on several NAVTA committees. Her interests include pain management, sick pet care, and anesthesia as technician empowerment. She is currently pursuing her VTS in ECC.

Your Attitude Shapes Their Experience

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I’m a Floridian living in Canada. When I went home to visit family last year, my wife and I took a trip to Key West at Thanksgiving. Key West is a magical place, a whole different world in Miami’s backyard. You’ll meet all kinds of people there and probably a few characters, much like in our vet clinics. They are part of the experience, the atmosphere, the ambiance.

Aside from the various personalities on the street, there are the ones who cater to tourists. At one restaurant, our waiter was personable, interactive, and sociable. When we asked questions about events in town or where to go first that day, he was more than excited to share his knowledge of the community. He sat down and spent a few minutes sharing his experiences and based on our questions, made some solid recommendations for us to enjoy our day.

At a different restaurant that night, we asked for suggestions of wine pairing with dinner as well as evening activities. It was obvious from his expressions and tone of voice that the waiter wasn’t interested in customer service. He failed to mention that for my dinner, they had run out of the side dish ingredients and didn’t offer up a substitute. It was a leisurely walk back to our inn in a light rain and a stop for a gigantic Key West cookie (seriously, the size of a dinner plate) instead.

I realized that this is the exact same situation our veterinary clients and patients experience when they come to the clinic. Everyone working in the clinic is responsible for the environment we create. Friendly, helpful faces greeting a client and their pet will help set up a good tone for the rest of the visit. If your front desk staff is stressed, fighting, or grumpy about being at work, your clients will pick up on it and may not feel as though their pet will get the best care they expect.

For technicians and doctors, this is critical as they will be spending the most time with pet owners and the patients. Sometimes these visits will be happy, while others may involve difficult discussions. The approach we take can greatly alter what happens – similar to a choose your own adventure book.

Using our own experience and judgment, we need to find that balance to clearly explain what is happening to the pet and what options there are for treatment. Don’t rush and don’t turn it into a lecture as you’re more likely to lose the client’s focus. Have a seat and have an honest conversation. Trust me, your clients and patients will feel more valued for their visit and a genuine sense of satisfaction. Rushing through the appointment and seeming disinterested in their pet will just likely lead to them looking for a new vet.

Even in difficult or emotional situations that can happen in veterinary medicine, we must find that proper level of compassion to be able to treat everyone as the most important person in that moment. Remember, like any other business, a positive experience will often lead to return visits and longer lasting relationships. It all starts with putting your best foot forward and keeping a positive attitude.

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.

Why My Recheck Exams Are Absolutely Free (And It’s Not Why You Think!)

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Okay, okay… I know. We are supposed to charge for our time. I am a huge advocate for charging appropriately for all our hard work. I am a dentist/oral surgeon, after all. As a group, we all need to recognize extraction of a canine tooth is worth more than 25 bucks.

But, I will admit, I make a hypocrite of myself when it comes to my own recheck exams. Whenever I perform any dental care or surgery that involves an incision, extraction, or -ectomy, I ask the family to please come back and see me two weeks later for a free recheck exam. And nope, I do not secretly wrap the cost into the surgical price somehow, it is genuinely free. No dinero necessary.

From a strictly marketing standpoint, you could argue this is a value-added service. An opportunity to show the client we genuinely care about their pet’s wellbeing and ensure their beloved four-legged friend is doing well. From a patient care standpoint, certainly we want to be sure the mouth has healed, and our little furry beasts are eating, playing, and being exactly the mischief maker they are destined to be (with a comfy, healthy mouth to boot). You could argue this is my opportunity to reinforce the concepts of oral health, provide resources regarding home dental care, or reinforce the importance of an annual cleaning. And I suppose, all of these benefits are true. But, if I am honest, that is not my real motivation.

Here is the kicker. I could bet that 99 out of 100 post-operative patients I see are going to be beautifully healed at the time of their recheck exam and Rover likely did not miss a beat. If we are playing a statistics game, I am definitively wasting a clients’ time to herd their pet into a carrier, drive through morning traffic, and people watch in our lobby waiting for me to come and take a peek. Let’s face the tooth (get it? that’s a stupid dentist joke), their little shih tzu’s mouth is going to look great.

The truth is, my recheck exam is for ME. It is my opportunity to simply sit back and listen to the warm fuzzies. In those moments when I trap a family into an exam room two weeks following my care, I relish the story about how Maverick the weiner dog found his old rope toy even though he is toothless. I soak up the tale of how Snowbank stopped hiding in the leftover Amazon box that had become his home these last few years. I savor the adventures of cutie patootey Lucy who can finally ride between Grandma and Grandpa in the front of the RV again because that trench mouth stink is gone.

My heart fills when Tank’s wiggly butt tries so hard to sit on my lap.

Goosebumps swell as I literally stand in the doorway watching Drake pull his family’s arm off while heading out the front door.

Tears well when a family stops to hug me and say thank you.

How many of the good cases do we all remember? Few. But I bet you can name the last patient that passed away in your care. We need to fill our buckets with the love that is easily shared with us if we just take the time to listen. We need to hear the beauty of what we do and let it seep down into our soul… go ahead… trap your families in an exam room… pause and listen.

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.

 

Donnell Hansen, DVM DAVDCABOUT THE AUTHOR

Dr. Donnell Hansen is a board certified veterinary dentist and oral surgeon from the Minnesota BluePearl Hospitals.

A Minnesota native, Donnell went to school at Luther College, graduated veterinary college at the U of MN, and spent a year in Stillwater, Oklahoma for her internship before returning home for a residency at the University of Minnesota. In 2009, Dr. Hansen joined forces with friends to form Moxie Center, which is now known as BluePearl Veterinary Partners.

While managing a busy clinical caseload, Dr. Hansen also speaks nationally about the value (both from a patient care standpoint and practice health perspective) of veterinary dentistry and oral surgery. Dr. Hansen has a special interest in maxillofacial surgery but honestly, loves the whole gig.

To provide a little balance to life, Donnell enjoys time with her family, including her husband (a fellow veterinarian) and two children, out on Minnesota’s 10,000 lakes or working a jigsaw puzzle during the long Minnesota winters. Like any veterinary family, there are an amalgamation of pets at home but the beloved include her pocket pittie, names Crickett and a beast of a labrador named Goose (or depending on the day, Goosifer).  There may or may not be a bunch of bull head eggs hatching in her daughter’s aquarium.

The Top 5 Emergencies Vets See on the Fourth of July

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Backyard barbecues, pool parties, picnics and fireworks shows might be fun for us humans on the Fourth of July holiday, but, we know they are not necessarily a good time for our pets. There are so many hazards related to the holiday that we decided to ask the veterinary professionals in the Uncharted Veterinary Conference Community to tell help us narrow down the list to the issues they see the most in practice. We also asked them to tell us the number one thing they wished pet owners knew about pets and the holiday. Here’s what they told us:

5. Your dog does not want to go see the fireworks.

Even the calmest dog isn’t going to enjoy hearing loud explosions in an unfamiliar environment. “I had to tell my mom that her dog did not, in fact, want to watch the fireworks! That made me realize how many things that seem obvious to me, do not seem that way to the general public.” – Anonymous

4. You’re asking for a dog fight.

Perhaps your dog is well-socialized and the life of the party, but that doesn’t mean other dogs at the picnic will be on their best behavior. Emergency veterinarian, Emily M. Tincher, says her clinic sees a lot of problems from dog fights from family and friends bringing dogs over. It’s best for everyone (and every pet) involved if you leave Fido home.

3. Watch what your pets eat.

Director of operations, Lee Allen, says they see a lot of dietary indiscretion problems on the Fourth. It’s no surprise with all of the ribs, chicken and other potentially harmful food served on the holiday. Tincher says they see “a lot of corn cob foreign bodies” in their emergency room, too.

2. Lost pets with no identification.

Many of the vets we polled said lost pets with no collars, tags or microchips is a huge problem for them on the holiday. Often when they do have microchips they aren’t registered. There are many reason dogs and cats get scared on the fourth and might try to escape. Be sure you have their collars and tags on, and offer them a safe place.

1. Last minute calls for medication to help noise phobia.

The number one piece of advice the majority of vet want owners to know is that they can help your pet deal with their fear of noises from fireworks, but it requires a prescription. Don’t wait until the last minute to call your vet. Plan ahead and let your vet help your pet have a more relaxed and comfortable holiday.

Uncharted member and veterinary practice manager Carol Hurst offers some great advice for pet owners,” They should put some sort of plan in place for their pet. Whether that means a cozy place to sleep, toys or treats to take their mind off of things, a nice long walk/jog or playtime during the day so they are nice and tired,” says Hurst.

The Fourth of July doesn’t have to be torture for anxious pets. Get help early and get a plan in place to keep them safe and happy.

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.

There, I Said it: I’m Sorry I Judged You

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A client came into the clinic with her ancient dog for an appointment. Fluffy really needed to cross the Rainbow Bridge… like, two months before. This dog was receiving subcutaneous fluids for renal failure, and the owner insisted that the poor creature was still running and frolicking at home. We all found this hard to believe, since we had to administer the treatment while Fluffy was in lateral recumbency. She had to be on her side; she could barely lift her head.

The judgment in the treatment room was strong. Murmurs grew against the client: how cruel it was that she insisted on treating Fluffy when she was clearly suffering, how we wished we could put the dog out of her misery. A couple of vets already gave her the “Come to Jesus” talk, but the client wouldn’t budge.

I felt so awful for your beloved dog, but not for the reasons you may think. I have the same disease as Fluffy.

Yes, the technician that gave Fluffy her SQs is in renal failure.

I’m on the kidney transplant list and doing my best to keep my head above water at work. Every time I have a patient with CKD, it haunts me a little. I scan their blood work and compare their numbers to mine. I take a history and note that my patient is vomiting a few times a week. I did the same thing when my numbers looked like hers, and I know what’s coming for her. Anemia is not kind. The insomnia, the nausea, and the confusion are crippling. The treatment options are just that, treatments. There is no cure. And the treatments are only temporary bandaids.

One shift we had three patients in a row that were newly diagnosed with CKD, first thing in the morning. I wanted to cry, seeing room after room of clients, their faces contorting at the news. I imagine mine did the same thing in front of my doctor when I found out I have CKD.

I also know how much it sucks to have a beloved pet with renal failure. The whole thing hit home for me when my old kitty went in for blood work a couple of months ago. Besides his other numerous issues (I’m a technician, and it’s nearly required by law that I have a pet with issues), his renal values are creeping up. The clumps in the litterbox grow larger, and the water bowl empties faster. I know it’s just a matter of time before I’m bringing him in for a date with the pink juice.

Last weekend was a bad one for my kitty: lots of vomit, lots of confused yowling. I thought we’d be lucky if we made it to Monday, and I checked to see who the weekend on call DVM was, just in case. While discussing euthanasia with my spouse, the cat jumped on my lap and head-butted me while purring. The little !@#!. I started to cry.

I couldn’t do it. He’s still around, and I’ve blown through a bottle of Nature’s Miracle.

Dear client, I’m sorry I judged you. I’m sorry for contributing to the negative clinic chatter about how selfish you are, and how the huge needle is just torture for Fluffy three times a week. I’m sorry you’re watching her go downhill, and there’s not much you can do at this late stage.

And I’m sorry for the technicians that have to watch the horror show every treatment. I wonder how my spouse will handle my treatment, when dialysis comes. I wonder if transplant will happen for me, and if I will ever work full time as an on the floor technician again, or if my days “teching” are gone forever. I wonder what I will feel like, when my BUN and creatinine rival your pet’s values. Will I be able to lift my head, or will I rest in lateral?

I’m sorry for us all. It’s a horrible disease.

I don’t know your personal reasons for keeping Fluffy alive, but I’m sure they are important to you. I’d love to hear the story of how Fluffy came into your life, and what she means to you. And yes, when you realize it’s time to free Fluffy from her suffering, I’ll be relieved for her, but I’ll also cry with you for your loss.

My illness has led me to be a more compassionate technician, and I’ve gotten quite comfortable discussing treatments and medications and diets with clients. I just need to remember what it looks like from the other side of the table, the client’s side.

Sincerely,

A Very Exhausted RVT

There I Said It

 

The views and opinions featured on There, I Said It are those of the authors and do not necessarily reflect the position of the DrAndyRoark.com editorial team.

What Appliqué Taught Me About Teaching Students

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Every year at my week-long quilt retreat, I meet up with friends and indulge in my favorite pastime. Even though I am a doctor, and you’d think nothing about quilting could be scary, there are things I’m reluctant to try. Appliqué (APP-lik-ay) was one of those things. I had made a star quilt for a friend’s baby, and because of a mistake in the instructions, it couldn’t be sewn together with squares at the corners to make a quilt top. I asked one of our more experienced quilters for help.

Martha is a retired teacher, and she is brilliant at explaining things in a non-intimidating way. She suggested I appliqué the piece onto a large square of fabric, thereby removing the problem of the not-quite-90-degree angles. I hemmed and hawed. I wasn’t really looking to try something new.

“Come here, Darlin’,” she said in her no-nonsense tone. “Let’s get this done.”

She walked me through the process. She was always there to answer questions when I was stuck. She never made me feel stupid or like I was bothering her.

That’s the kind of teacher I try to be.

I don’t know what makes people think that the best way to teach someone is to humiliate and insult them. I can’t fathom why we want students to absorb something and determine that the most prudent course of action is to make sure they are sleep deprived before imparting information. The most common “reason” I hear is “that’s how I had to learn it.” If only I could cough and say the word bullshit at the same time in writing.

I talked to a vet student from Iowa State this week, and we found we had the same passion – wellness for students. Obviously, it would be easier if we could start wellness as children, but if we can’t, then starting with future vets and techs is the next best thing. I know that school is hard (I’ve been there), but there are things we can do to make learning better and help us turn out resilient, healthy students. If we are turning out brand new veterinary professionals that are already riddled with burnout and compassion fatigue, why are we congratulating ourselves?

I’m not suggesting trophies for everyone or not using red pen so as to preserve everyone’s feelings. I’m saying that we need to provide support while having the goal to turn out self-sufficient, confident veterinarians and technicians who either know the answers or know how to find them.

The professors, staff, and students in school who bully and torment others are not a secret. EVERYONE knows. When I was in school, there was a professor who picked a favorite and least favorite student and proceeded to lift them up and stomp on them, respectively. And we were warned ahead of time that this would absolutely happen. That kind of crap needs to stop freakin’ yesterday.

Are we professionals, or are we a fraternity running a hazing? You know how everyone freaks out and destroys campus groups when they do something stupid that results in a death? Maybe we need to look at school the same way. Veterinary professionals are contemplating and dying by suicide at an alarming rate. We need to make sure that as teachers, we aren’t contributing to the problem.

It is said that we learn the most from failure. This is true. How we learn and recover from failure is directly related to how we and those around us react. If shame comes from within (as it always does) AND without, then we don’t have a hope of recovering in a positive way. For instance, I once attempted to spay a male cat. When I discovered the mistake, I went to my boss in tears. He chuckled and said, “If you haven’t tried to spay a male cat, then you’re either new to this or lying.” Then he sat down with me and we created a protocol to ensure this never happened again.

He emphasized that while it was also my job to check, the staff had missed this, as well. He also walked me through what to say to the owner and was nearby while I called and spoke to him. Had he yelled at me or written me up, I probably would have been too afraid to attempt surgery again for a long time.

Some lessons have to be harsh so they are taken seriously. But vet medicine has a natural harshness built in: if we screw up, our patients may die. That should be the hardest lesson we have to learn – and every single one of us will learn it the hard way.

Congratulations to the schools making wellness a priority. Thank you for putting your students first. Thank you for remembering these students are, in fact, your customers. They are paying you large amounts of money (in some cases hundreds of thousands of dollars) and treating them like dirt shouldn’t be an option. In fact, I’m guessing if they aren’t left with scars from your school, you might actually get a donation from them when you come asking.

I’m challenging everyone who teaches to decide what kind of teacher they want to be. Will you leave impressions or scars? Will you build up or tear down? Will you be remembered with gratitude or as a traumatic experience? The choice is yours, and I hope you make the right one.

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.