This is Part 1 of our Support Protocols for 14 Common Situations series. The cases described in this series are drawn from everyday scenarios found in general veterinary practice or emergency and specialty practices. Below you’ll find an example of a type of case you’re likely to encounter in practice. This blog’s subject is a case involving a crisis or emergency.
Situation: Crisis and Emergency
Rhonda rushes her dog Romeo to your veterinary clinic on a Friday afternoon at 4:45 p.m. Romeo has just been attacked by another dog, his injuries are severe, and his life is in danger. Romeo needs immediate treatment, but Rhonda is clutching him to her chest and won’t let you examine him.
“My husband and son will be furious if they find out I left the door open,” she says. “I was bringing groceries in and I just wasn’t paying attention! You have to fix Romeo! If he dies, they’ll be devastated! This is all my fault. They’ll both hate me forever!”
By this time Rhonda is crying and, still cradling Romeo, she walks to the far side of the waiting room. But in a sudden burst of anger, she quickly returns to you. She shoves Romeo into your arms, screaming, “Go fix him! Don’t just stand there! Go fix him!” Then she collapse into a chair and sobs.
Assessment: What’s Going On Here?
Rhonda is in crisis. Crises cause people to act in ways that are not normal for them. When people are in crisis, they may feel out of control, panicked, angry, and confused. They experience time as moving either very quickly or very slowly. Crisis makes it hard for people to listen and to later recall information.
People in crisis often display symptoms of shock and anxiety. Many are unable to think clearly or to follow directions. In the acute stage of crisis, some people behave in erratic or irrational ways. The skills and knowledge they normally use to cope with life are either forgotten or no longer work. Crises escalate when people feel helpless and cannot find effective ways to respond to events that are unfolding.
The purpose of providing client support during crisis is to direct people toward an acceptable resolution to their problem. Generally, the main goals in a crisis are to stabilize the situation and to stabilize your client.
Plan: Support Protocol for What to Say and Do
Lay the Foundation (Step 1)
- Designate one staff person (who is not involved in providing direct treatment to the animal) to facilitate your client’s emotional support. This person should notify other clients about the emergency and reschedule their appointments, if necessary; wait with the client while the pet’s medical condition is being evaluated, if possible; keep the client well informed about the pet’s medical status while treatment is taking place; and offer the client tissues, a glass of water, and assistance in notifying other family members regarding the emergency.
- Structure the environment by gently, yet firmly, guiding the client to an office, an examination room, or even a treatment room, depending on the medical status of the animal. If the client insists on carrying the pet, allow this, place a firm arm around his or her shoulders, and quickly walk with the client and pet to wherever they need to go.
- Use touch and a soothing voice to calm the client.
Implement Support Techniques (Step 2)
- During a crisis, it is important to respond as quickly as possibly and pay attention to what clients say they want and need, in addition to what you think they want and need. When clients feel that their needs are validated, they begin to relax and develop trust in you and are better able to listen to you and make decisions about the medical options you offer them.
- Acknowledge the client’s emotions. Give permission to express them by saying, for example, “I see how much you love Romeo. I would expect you to cry in this situation.”
- Clinical experience shows that clients who are deprived of contact with their ill or injured companion animal usually become more anxious and demanding. Everyone’s needs are better served when clients are invited and even encouraged to visit their pets while they are hospitalized. This is especially important if the prognosis is poor and the patient is not expected to live.
- If you are concerned about how clients may respond to seeing their pet hooked up to emergency equipment and monitors, take time to prepare them for what they will see. For most pet owners, the benefits of visiting a pet in critical condition or having the chance to say goodbye one last time far outweigh any anxiety about medical procedures or equipment.
- Occasionally, someone other than the owner will bring the injured animal to your clinic. These animals usually have been injured without their owner’s knowledge. If these “John Doe” animals have no identifying information, consider photographing them so that, if they die, they might later be identified.
Stay Connected through Follow-up Care (Step 3)
- When a crisis reaches a conclusion, make sure your client is calm and stable enough to drive home. It’s difficult to function during a crisis, and even second-nature activities like driving can feel overwhelming for people. Sometimes it’s best to encourage your client to call a friend or family member for a ride home.
- If you are sending the patient home with the client, provide written instructions about the pet’s care and demonstrate any procedures the client might need to perform.
- When providing support during a crisis, it is important to assist your client with the situation at hand while at the same time assessing what his or her needs might be at a later time. For example, you may want to refer the client to community resources such as veterinary medical specialists or pet-loss support groups that can continue to provide assistance in the days and weeks ahead.
- As a veterinary professional, you will feel most successful when you are able to save the life of the animal brought to you during a medical emergency. Yet this is not always possible. Even if your patient dies, however, you can provide top-notch care for the client. When your client thanks you for waiting with him or her, tells you that your frequent medical updates are appreciated, or simply lets you know that he or she truly felt that you cared, you will know that your helping efforts made a difference in the client’s emotional life. And the odds are in your favor that the client will return to your practice in the future.
Crisis and Emergency Role-Play Ideas
- For hospital managers and client care specialists: Use the above situation to practice calming down a client in crisis. Pay attention to your voice, mannerisms, and nonverbal communication.
- For veterinary technicians: Using the above situation, practice how you might provide periodic updates to the client. Practice your support techniques in trying to calm the client down.
- For veterinarians: Practice working with a client using the above scenario. Pay attention to your voice tone, nonverbal communication, and responses to his or her anger, sadness, and shock. Practice providing periodic updates as to how the pet is doing, and practice making a referral for additional support.
Keep up the good work,
World by the Tail, Inc.