Life With Clients

Dear Emergency Room Pet Owner,

Your pet is sick or hurt and you’ve just been told that you are going to have to leave him in the hospital overnight. You’re scared, you’re worried, you’re angry, you’re tired. You just want him to be ok. You just want to take him home.

Instead, you’re led to to the central treatment area. There are people dressed in scrubs speaking in what sounds like a foreign language and they say things “pericardial effusion,” “increased lactate,” “PT PTT,” and “obtunded”. There are machines making high pitched beeping noises. There are other pets being treated for various problems. There are familiar smells of alcohol and antiseptic like you would find at any other hospital you’ve ever been in, but there’s an added aroma of animal.

You’re shown to a room just off from the central treatment area. There are kennels in this room and there are more of those beeping machines. This is where you find your pet. He is in one of the kennels. His name is on a card clipped to the kennel door and there’s a clipboard hanging next to it that says why you brought him in.

This is the moment that you meet me, his technician, the person responsible for his care while he is in the hospital. You don’t know me, and I am sorry that we have to meet under these circumstances. I wish I could tell you some things about myself in the few minutes that we have to talk.

If I could, I would tell you that I knew I wanted to work with animals since I was four years old. I would tell you that I started working in the veterinary field as a veterinary assistant when I was 16 years old. That I spent the next ten years learning everything I could about recognizing disease, taking patient history, monitoring anesthesia, giving medications, pulling blood, running lab tests, placing IV catheters, taking radiographs, performing dental cleanings, and anything else a good veterinary technician is supposed to know.

I would tell you that once I learned everything I could while on the job, I moved 1,200 miles away from my family and friends so I could go to school and learn more. That I earned a degree in applied sciences. That I took a four hour exam and officially became a certified veterinary technician. That every year I spend hours in continuing education classes to maintain that certification. I would tell you that I have spent the past year focusing on emergency/critical care and trauma.

But I can’t. Your pet is waiting. And he’s more important right now. What I can tell you is this: I work in a position called “patient care.” Not only is it my job, it is my privilege to take care of your pet. He is my patient and my responsibility. And I feel, in some small way, that this makes him a little bit my pet too.

So I will do whatever I can to help him. I will talk you about what will happen to him while he is with me overnight and what to expect tomorrow morning. I will let you visit with your pet and I will answer your questions so you will feel better about having to leave him there. I will walk you up to the lobby and tell you to call any time to check in (and I will mean it). Then I will go back and introduce myself to your pet. Like you, he is also scared and he doesn’t feel good. He won’t have you there to tell him he’s a good boy so I will do my best to reassure him. I want him to feel safe so he can rest and hopefully get better.

While you are at home sleeping, I will be keeping an eye on his vital signs. I will take him outside to go to the bathroom and I will clean him up when he doesn’t quite make it there. I will give him medications and keep close tabs on his IV fluids. I will offer him food and water if I’m able. I will take radiographs (x-rays) and run lab tests. I will talk to the doctor about how he is doing and if I am worried about anything. I will tell her if I think he is in pain or if he is breathing harder or if his behavior suddenly changed.

I will wrap him in warmed blankets if his temperature starts getting too low. I will dim the lights in the room so he can sleep.  I will call him a naughty boy when he tries to chew out his catheter and then I will rub his head so he knows that I don’t really mean it. I will apologize to him when I have to do something he doesn’t like (like take his temperature) and I will talk to him so he knows that he hasn’t been abandoned.

I will sit in the kennel with him because he wants someone to be with him in this scary place with the strange sounds and smells. I will tell him that you love him very much and you will come back to see him. I will tell him that I hope he gets to go home soon because no one likes being in the hospital.Tomorrow I will let you know how he did. I will tell you what’s going to happen next and that the veterinarian will discuss his treatment options so you know what to expect.

When it’s time to go home, I will go over his discharge instructions and his medications with you. Then I will go and bring him back to you. I will tell you to call with any questions or concerns. I will tell him he is a good boy and that I hope I never have to see him again because that would mean he is sick again.

Or I will be there when the veterinarian has to tell you that we’ve done everything we can, but we can’t make him better. That it’s time to say goodbye. I will explain everything that will happen. I will tell you that the injection will be given in the catheter that he already has and that he won’t feel anything. That he will just go to sleep and then he will wake up at the Rainbow Bridge. He will wait for you there and he will be happy and healthy and whole. I will be there while you say goodbye and my heart will break a little like it has for every pet I’ve cared for that didn’t get to go home. And I will cry.  Mostly I will cry for you. Because you loved him and you had to say goodbye when you didn’t want to.

Then I will take care of him one final time. I will make sure your wishes for him are fulfilled. I will pet him and tell him that I am sorry that we couldn’t fix him, that we couldn’t make him better. I will say goodbye. Then I will make myself wipe the tears from my face, close my eyes, and take a few deep breaths. Because another pet is waiting for me and I need to take care of her too.

I will still think about your pet, sometimes even years later, and I will miss him. While he was in the hospital, he was mine too. That is who I am. That is who we are.We love what we do and can’t imagine doing anything else. Thank you for letting us take care of your pet.

Sincerely,
An emergency room veterinary technician

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.

About The Author

Mistie Pruitt CVT has been working in the veterinary field for over 17 years, and is currently employed at a specialty hospital (internal medicine, oncology, neurology, surgery, ophthalmology, cardiology, dermatology, and emergency) in Denver, Colorado.

Recently, I saw a dog for a sarcoma. The consultation was arranged after the owner was yelling at our staff in the waiting area that he needed be seen immediately for the tumour that had been growing on his dog’s leg for the past year and was not bothering the dog. However, he had spent thousands at our hospital and demanded to be seen at once. He was told that we did not have a surgical oncology appointment available, but that he could be seen by one of the emergency doctors if he needed immediate assistance. He refused, he only wanted to see a surgical oncologist, nothing else would do and he was belligerent with everyone trying to help him.

He saw me about a week later, during a scheduled appointment. We discussed recommendations, and he argued with me about each one, telling me that he didn’t think that the workup that I recommended was necessary. In the end, he decided not to treat. As our consultation was drawing to a close, the owner nodded my way and said, “Oh, and I need some more Heartguard”. I asked him who his family veterinarian was and he said that he didn’t have one. I told him that I did not manage heartworm prevention because I am a surgical oncologist, not a general practitioner. He was not amused.

When I left the room, he asked the student to get him some heartworm medication (which she cannot do because she is not a veterinarian). Quick tangent: When my own dog developed his Florida-Allergy Dermatitis, I took him to a veterinary dermatologist (because I don’t know anything about managing itchy dogs anymore either.) The dermatology technician asked me what he was on for heartworm prevention and I said, “Advantix”. She told me it doesn’t get heartworm. I said, “It doesn’t?” then burst into tears. (Note: Rumble was negative for heartworm on two consecutive tests and is on appropriate prevention now.) My point is that I don’t even script heartworm prevention for my own pets anymore and I don’t prescribe it to my surgical oncology patients either. My other point is that I do not love being treated like someone’s Heartguard bitch. No one does.

My colleague recently told me about a stray dog that was found and brought in to the emergency hospital where he worked. The emergency doctors and technicians located and contacted the owner, who could not come and pick up her dog until the end of the day. The dog was fed, watered, walked and kept safe until his owner could collect him. When the owner (finally) came to get her dog, she was not charged anything for this good Samaritan service, but still, she complained that her dog’s nails had not been trimmed during his big day at the vet, because “That’s what vets are supposed to do.” That really happened. Who are these people?

I also recently saw a 62kg Labrador Retriever with a pathological fracture due to osteosarcoma- that is, a broken leg due to bone cancer. It’s hard to describe how obese a 62kg lab is (ed note: 136 pounds), but we had a long discussion with the owner about how I was not sure how the dog was going to do after limb amputation, but that this was the only treatment option. We also could not do a test called a bone scan to look for spread of the cancer to other bones (which I always recommend) because he was so painful and his leg was broken, we needed to address this right away and then consider a bone scan later. I also told him that I didn’t think the dog would walk for at least a month. I gave a guarded prognosis and we also talked about euthanasia, but he wanted to try.

We did an amputation. The dog proved me wrong and after some serious heavy lifting by myself and the other clinicians and staff, we had him walking with sling support within a few days and he went home. We were so happy! Then, a couple of months later, I received a personal letter at work. Usually personal letters at work are nice thank you notes from grateful clients. The letter was from this owner, he detailed that his dog had died, likely due to spread of the cancer to the spine. He closed the letter, “I hope that everyone involved received their commission. Just another business transaction.” He signed it from his dog and enclosed a picture. He also enclosed one of the super cute bandanas that I give to all of my cancer patients that say “Cancer Survivor”, only he had cut out the word “Survivor” so it just said, “Cancer”. The whole thing had a creepy serial killer vibe and was intended to make me feel awful. It did. Interestingly, academic surgeons do not make a commission and there is zero financial motivation in our casework. It is one of my favourite things about being an academic clinician.

We recently had another client whose dog had had a lung lobectomy for lung cancer and an adrenalectomy for an adrenal tumour. Everything went great and she was very grateful. When we sent the dog home on a Friday, he was discharged with all of the required medications. She then called on Saturday and said that we forgot to give her one of the medications. My intern was positive that she had it and went to great lengths to talk to her multiple times to spell out the medications on the phone and to give her instructions. He was patient and kind.

She called back again and talked to an emergency doctor, insisting that we had not sent her home with all of the medications that she needed for her dog. The doctor apologized, went over the file and called in the prescription to a pharmacy. She then called again on Monday and went over things again, realizing that she did have the medication in question all along. She then filed a complaint through our online system that we should have never called in a prescription for a medication that she already had, insisting on being reimbursed for the second prescription that she did not need.

I called her to discuss. When she realized that the lady on the phone was the same person as the surgeon who had “saved her dog’s life” she became hysterical. She said that she didn’t want me to get into trouble and didn’t want a complaint against me because she was really happy with everything that I did for her dog. I told her that we are all the same people and I just wanted to resolve things. She was clearly mortified that this seemingly anonymous complaint method had found its way back to me and was going to get me in some sort of trouble. She started crying and asked if we could just “drop it”. I told her that would be fine.

You are probably thinking, wow, that is some crazy stuff, you must have saved these stories up for years! But no, these are just a few things that happened recently that I can think of off the top of my head. Clients who lie, yell and push to get what they want is becoming so common that I could literally write a blog called “Clients Behaving Badly” about it every week.

It’s frustrating because being a veterinarian is hard enough. Being a good clinician and trying to help our patients to be as healthy as they can be, watching animals suffer at times, and letting them go when we can no longer help them is all pretty challenging. In short, being a veterinarian is hard. When clients behave badly, it makes our first task, caring for the patient, much more difficult.

So, to all of you naughty clients out there: We know you are stressed, we know this is your fur baby. We are here to help you. Mistreating your veterinarian will not make the care better. It might make it worse. If you really feel like your veterinarian is not on the up and up, you should not entrust them with your pet’s care. Trust is the foundation of our veterinarian-client-patient relationship. I honestly do not want to do surgery on a dog or cat with an owner who does not inherently feel that they trust me and that my sole motivation is to work in their pet’s best interest. I know it is hard to be good, but please don’t make a stressful day for you even more stressful by bringing your bad behaviour.

Be good. Sit, stay.

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.