Patient stress at the clinic during COVID-19
Implications to pets
The Coronavirus pandemic is having a fundamental impact on veterinary practice and the way we are able to manage patients and communicate with clients, whilst protecting staff and client safety, and maintaining social distance.
There have been some heart-breaking accounts of end-of-life situations, and the profession has come together beautifully to offer mutual support and advice from their own experiences, to help make this situation better for everyone.
There are also the implications to pets and stress at the clinic with all other appointments too, as we are sure you have all experienced over the past weeks. Sadly, this situation is not going to change soon, so it will really help us all if we consider what the main triggers for stress will be, and implement strategies to mitigate this.
Separating pets and owners
Whilst many may be appreciating the ‘kerbside’ approach to veterinary consulting, making it easier for staff to ‘get the job done’, there are of course drawbacks to this. Many pets see their owners as being their ‘safe place’ when they are at the clinic, and the presence of their owner will give them a high degree of stability and comfort. I know that this certainly applies to my own dog, and I’m sure many of you can relate to this too. Taking that animal away from the owner may create a degree of panic right from the outset, and especially if it is done in an abrupt way. Of course, we can’t make any dispensations to allow owners to be in the clinic, but there are things we can do to make this easier.
Treat trails and hidey blankets
We can slow down the process. For dogs, consider ‘treat trails’ from the owner to us, along with use of a long line, so that we are not physically taking the pet from the owner, but they are coming to us. We can even extend that treat trail for each patient into the clinic, so that their entry to the clinic is somewhat cushioned by the distraction of lots of tasty treats!
For cats, we can cover the baskets with a soft blanket, to reduce stimulation from the environment. Many of us do this already. Use fleece blankets so they can be washed and dried quickly and easily. Allow the cat to remain in the basket during the consultation if at all possible and is what the cat prefers.
We look and sound like aliens!
The presence of PPE can be very threatening to some animals. It is something they will likely be unfamiliar with, it reduces our communication with the animal, it makes funny rustling noises, and generally makes us look and sound like aliens! Something we can try is to go out to the car park minus PPE (as long as you are comfortable to do this), and whilst still maintaining distance from the animal and owner, put the mask on in front of the pet. If they already know you, they will recognise you, and seeing you actually put the PPE on may help.
For really anxious pets, it may be helpful if owners practise with a mask and other PPE at home. If pets have seen it in a familiar environment, and when getting given lots of treats for example, they are likely to be less fearful when they see the same getup in the clinic.
PPE is also a big obstacle to client communication, and it’s worth being mindful of this. Most of what we take from communication comes from non-verbal sources, and use of facial expressions is key to this. ‘Smile with your eyes’, use hand gestures and other body language to try and help with that non-verbal communication. The same techniques can help with animals too!
This is an exceedingly stressful time for practice staff, for so many reasons. Aside from that, many staff are tired, exhausted even, from long shifts and continual pressure. Pets will pick up on that, and it may affect how we cope with situations and manage them, and how pets react to us. There will be lots of pressure to ‘get it done’, as no-one wants a backup of clients queuing in the car park.
If it’s possible, try to book double appointments, especially for those cases where you think things may take a little longer. You can charge for that time – just explain to the owner the reasoning behind it. Make sure you take breaks wherever possible, and let someone know if you are struggling.
It can be really useful to speak to owners before their appointment, and I’m sure many if not all of you are doing this. Try and get as much detail as you can so that this doesn’t have to be done during the appointment, and you can pre-warn the owner if it is likely to be a serious situation, requiring admission for example. You can run through what you expect will happen to their pet during the appointment, remembering that they will not be able to see this. Prepared owners are less stressed, meaning their pets are less stressed too.
I heard an account from an owner last week of a puppy receiving its first vaccination. The puppy had never been to a clinic before, and his first experience was being passed through a window, being vaccinated and having his claws clipped (some were bleeding on return to the owner). This was his first experience, and may shape future responses to veterinary visits; and of course, with the current situation, there is no opportunity to offset that with any ‘happy’ vet visits either.
We all know that you always want to do your very best for your patients. Our health and safety has to be a priority of course, but seeing stressed pets and owners will add to our own stress, and make things more difficult in the long run. Our Patient-Friendly Practice course typically deals with everyday techniques for reducing patient stress, and whilst the above gives a simple overview of some of the challenges we face, this intake of the course will provide support and guidance for managing patients during this crisis, and help us to predict and prevent the problems caused by the extraordinary situation we face.
You can find out more about the course here.
Blog written by:
Jill Macdonald, with guidance and inspiration from Linda Ryan