Natalie Marks
DVM, CVJ
Fearless columnist Natalie L. Marks is an educator, consultant and practicing Chicago veterinarian. Dr. Marks is a leader within the Fear Free movement, was a member of the original Fear Free advisory board and is Fear Free Certified Elite. She passionately believes that all veterinarians should be committed to the physical and emotional health of their patients.
Read Articles Written by Natalie Marks
I have spent significant time over the past four years learning about and now teaching ways to recognize, treat and prevent anxious and fearful behavior in our patients. For many of us who started in veterinary medicine years ago, preserving a patient’s emotional health wasn’t taught in college. As a result, the learning curve has been tremendous, and the results are nothing short of game-changing. The truth is, the superstars in this part of my practice are the veterinary technicians.
Here is how these unsung heroes can lead the way to less patient stress and anxiety, elevated care and a healthy practice.
Improving Workflow
One could argue that the team members who know the most about the inner workings of the hospital are the veterinary technicians. They interact with almost every client, department and patient. They recall patients’ names, signalments and clinical issues upon request. Why does that matter? Because management should ensure that veterinary technicians are on any committee looking to improve efficiency, communication and medical care through the patient journey. Technicians often ask critical questions such as these:
- Why does a patient need to be in the lobby?
- How can we keep the patient in
- the exam room for diagnostics?
- How can we reduce stress when admitting a pre-procedure patient?
- How do we speed the checkout?
- How can we better communicate with a client about lab results?
- How can we teach clients to
- reduce their pets’ stress in the
- exam room?
- How do we create separate canine and feline treatment areas?
- How can all hospital team members act differently to lessen anxiety and stress in our patients and their owners?
Workflow efficiency improves patient care and spills over into other areas. Having a detailed understanding of patient needs can improve scheduling and reduce staff redundancy, which is a pain point for so many practices. Not every appointment takes 30 minutes; some require much more time. All this permits a more focused understanding of payroll — who is needed where, when and for how long? Efficient logistics means a more seamless journey for clients from start to finish, eliminating bottlenecks. What do jams lead to? The answer: client complaints.
Lowering Stress in the Exam Room
Veterinary technicians so often manage both the beginning and end of the exam room experience. They might be the first team member to ascertain the level of stress in the patient and owner. One of the keys to a relaxing veterinary experience is identifying stress triggers and providing solutions.
Assign a veterinary technician to formulate checklists for the stocking of exam rooms. The list should include everything needed to create a less stressful environment that takes into account a patient’s every sense. A relaxed patient is easier and more enjoyable to work with. Calm clients are hidden gems in the room because they listen, ask great questions and are more inclined to accept your recommendations.
Promoting Safety
One of my most difficult responsibilities as a practice owner was dealing with workers’ compensation claims. The hardest part was the emotional component because someone on my team was injured, and I took it personally. Fortunately, we usually dealt with minor, outpatient wounds, but that’s not always the case in veterinary hospitals. Handling animals carries a risk. According to the World Health Organization, some 400,000 emergency room visits occur annually because of animal bites. Veterinary technicians can be tremendous champions in helping practice managers and hospital owners identify ways to keep all team members safe and healthy.
Many workplace injuries begin with a patient’s fear-based aggression or reactivity and, some would argue, the veterinary team’s inability to interpret signs or interact with the patient. Many resources and training programs are available to help team members assess canine and feline body language. The knowledge isn’t a nice-to-have but rather a must-have. The sooner a technician determines a patient is showing anxiety, stress or rising fear, the sooner the interaction can be paused, redirected or postponed for the day, significantly decreasing or eliminating the chance of an injury.
Practicing Best Medicine
What’s commonly accepted in the veterinary industry is the negative effect of stress on the accuracy of bloodwork. Stress easily changes the appearance of complete blood counts, blood pressure readings and some chemistry values. It can impede wound healing and recovery from chronic diseases.
Technicians can intervene before the escalation of stress and fear by recommending that the veterinarian pause or postpone an exam or procedure, change its direction, or introduce sedation. Technicians can pick up early cues about how a patient responds to being weighed, moved or touched. They can suggest a different order to the exam or a different restraint position.
While many hospitals run appointments step by step (weighing, examining, doing lab work), a universal structure for every patient doesn’t address stress. Technicians often know an individual patient’s behaviors and preferences best, and the medical record should note those facts. The details not only prepare the team for the next visit — Macy loves peanut butter on a lick mat, prefers to be on the ground and enjoys being rubbed behind the ears — but also supports the consistency of care across the hospital.
Enhancing the Work Culture
Behind every successful veterinarian is a phenomenal and usually humble veterinary technician. While the doctors typically receive most of the glory, the technicians are at the heart of patient care, putting in long hours and working behind the scenes to better patients, clients and the hospital teams.
Clinics that choose to protect not just the physical but also the emotional health of patients encourage their veterinary technicians to be the strongest advocates for patients. Now is the time for practice leaders to embrace how we can empower our technicians to shine.
WHAT’S ON YOUR SHOPPING LIST?
These items should be stocked in every exam room to reduce patient stress and fear:
- Towels
- Pheromones
- High-impact treats
- Sound machine/calming music
- Litterbox
- Nonslip floor and table mats
- Toys
- Brushes