Behavior wellness programs can create safe, compasionate environment

Compassionate care in the veterinary hospital setting would seem to be a given fact of everyday operations.

Nonetheless, a few recent high-profile media exposès seem to portray the opposite.

For example, some of these stories disclose the potential rough handling some difficult to handle animals might receive, whether real or perceived. These news stories probably do not consider all of the facts and circumstances. But, anyone who has been an employee in a veterinary practice setting knows the potential. Outsiders don't necessarily understand the stresses and challenges any veterinary staff can face from time to time.

Contributing factors

What contributes to staff anger and short-tempered responses during patient interaction? Time constraints for multiple case management and the pressure of handling many tasks at once are contributing factors.

Pressures come from other sources: the need to complete work and also have a presence with your family; the requirements to meet a never-ending assortment of rules and regulations guiding business operations; the demands of coworkers and employees.

Workspaces that are too small or not well designed, resulting in insufficient personal space for both staff and patients are another source of stress.

Keep it personal

Perhaps the patient becomes an outlet for anger building up about other aspects of personal and practice activities. Veterinarians and other staff members experiencing burnout are at risk for de-personalizing their patients, potentially leading to bad situations. One warning sign may be when patient restraint techniques veer more to strong-arm control tactics compared to what should be a cooperative approach with the patient.

Not only do such staff attitudes and potential misbehaviors present a significant risk to the patient, but danger also exists for the community reputation of the hospital, and the overall workplace safety of employees. When short tempers fray, the probability of mistakes for human as well as animal injury are greatly increased.

Credibility at risk

Veterinary staff that has not learned compassionate behavior-based handling techniques may put their own credibility at risk. For example, when a dog is manhandled in order to vaccinate it or complete a phlebotomy, the client may perceive that veterinary hospital employers are at best inept. When patient interaction is poorly conducted, clients may perceive staff as uncaring, and will discount an employee's ability to discuss any aspect of animal care and welfare.

Behavior-based handling

A solution to combat the potentially devastating results of anger and overzealous patient restraint in the veterinary hospital as well as to increase employee and patient safety is behavior-based handling. What does this mean? Behavior-based handling refers to a compassionate approach to patient care that incorporates knowledge of normal, species-typical animal behavior into every patient interaction; so that restraint and management techniques are chosen to decrease patient stress and arousal, and thus the likelihood of injury. This results in more efficient completion of tasks, lowered stress for staff and more enjoyable interactions with patients and clients.

Behavior-based handling is a foundation stone of incorporating behavior wellness into veterinary practice. Behavior wellness is an actively sought goal of acceptable pet conduct that enhances the human/animal bond. Hospitals embracing behavior wellness concepts give planned attention to pet conduct, and actively integrate concern for and knowledge of behavior into the delivery of pet-related services, including routine veterinary medical supervision.

Behavior services

Veterinarians tend to be skeptical of introducing behavior services into general practice. Some mistakenly believe that behavior services are solely based in problem resolution.

In fact, with behavior wellness, the opposite is true. Formalizing staff and client training about animal behavior results in a practice structure that supports communication and enhancement of appropriate animal behavior with every medical appointment, beginning early in the pet's life. The goal is to thwart the probability of difficult behaviors from developing that must be corrected at a later date.

Behavior wellness cornerstone

Before effective behavior wellness counseling can begin, the entire practice hierarchy must embrace a mission of compassionate care supported by behavior-based handling techniques.

The benefits of such an approach are immense. When all employees are well-trained to use their behavior knowledge to minimize confrontational, stress-inducing interactions, and instead promote calm cooperation from the patient, worker safety increases substantially.

Incidents of bite wounds, back injuries and other psychologically and physically debilitating accidents can be reduced. Workers, who use behavior-based handling techniques, are non-verbally communicating to clients their understanding of behavior and 'positive' training techniques.

The actual body language used by trained staff results in client perception of a more gracious and kind handling of the pet. Competent performance improves client perceptions of worker sensitivity toward their beloved pets.

Client, staff turnover

In many practices, animal restraint and handling techniques may be appropriate, but the client may perceive them differently. When staff has apathy about client observations and concerns, increased likelihood for the client's silent withdrawal from the practice in search of an alternative provider increases.

Increased staff turnover may also result from what is perceived as inappropriate handling techniques. Technicians and veterinarians may not have the desire to stay in a practice that does not formally support tenets of anger management and proper animal control techniques through formal training.

As for clients or any inexperienced observer of practice activity, perception is everything.

Stepping stone to behavior care

Behavior-based handling techniques become the training and foundation for a variety of positive practice outcomes. The first of these is improved employee communications with clients. When clients can directly see what a difference this approach can make in their pet's behavior in the practice setting, this serves as an opening for staff to discuss other behavioral topics.

Information about normal social behavior, animal communication signals and body language, what constitutes threatening or non-threatening human body postures, what motivates various behaviors, warning signs of behavior problems and other aspects of providing behavior care can be relayed effectively to clients. Through formal training, practice administration has reduced the probability of incorrect information transfer.

Much of what staff learn through formal training to be able to implement behavior-based handling, can be applied to other aspects of behavior care, including promoting behavioral health and preventing problem behaviors. Veterinarians and technicians become more comfortable conducting behavior-related discussions with clients.

Warning signs

The following examples illustrate the probability that behavior-based handling technique training may be helpful in your veterinary practice:

  • · Do you dread the arrival of certain patients recorded in the appointment book?
  • · Do you sense a trend of increasing numbers of patients that are difficult to handle?
  • · Does your staff tend to dispense medications over the phone, rather than establish an appointment when a client reports a problem?
  • · Are some standard patient treatments deferred for a lesser treatment protocol, related to the difficulty in patient handling?
  • · Does your staff have the attitude that wrestling with a nail trim procedure must be par for the course?
  • · Does the hospital's treatment atmosphere change from hour- to-hour or day-to-day, in that sometimes a tough approach to animal restraint is taken and at other times, a slow and easy attitude occurs?
  • · Does your staff feel conflicted about which approach to take with any particular patient at any particular time?

Where to begin

A first logical step is for veterinary hospitals to develop formal ethics and procedures for the handling and restraint of patients. In JAVMA (Vol. 218, No. 4, February 14, 2001), Drs. Gary Patronek and Charlotte Lacroix recite ideas for veterinary standards. Incorporation of such standards within hospital policy and procedure manuals would be a logical first step. The Delta Society's "Professional Standards for Dog Trainers: Effective Humane Principles," while focused more on dog training, also has standards applicable to handling and restraint.

Secondly, communication of such standards must occur. Employee training can be furthered through other resources such as ACT video education programs for teaching staff to accurately observe and interpret animal body postures and introducing them to behavior wellness concepts.

Back to the basics

Many times, those who are experienced in providing veterinary care forget that new employees may not have a common knowledge base of normal animal behavior. Without this basic information, employees are at risk for causing injury to themselves or to the animal.

Employees need to know the correct responses to client questions about animal behavior, and also to set their own expectations of normal. Various books and literature are available but a ready access can be found through Internet access via VetSuite (www.vetsuite.com). This new resource for veterinary hospitals allows employee access to peer reviewed articles regarding behavior issues.

Consider staff membership in the Society of Veterinary Behavior Technicians whose mission is based in the enrichment of human/animal interactions by promoting scientifically based techniques of training, management and behavior modification.

resources

  • Animal Behavior Associates, Inc., 4994 South Independence Way, Littleton, CO 80123; (303) 932-9095, www.animalbehaviorassociates.com
  • Animal Care Training, Inc., 918 N. Elm, Denton, TX 1-800-357-3182
  • Delta Society, 289 Perimeter Road East, Renton, WA 98055-1329; 425-226-7357, www.deltasociety.org; info@deltasociety.org
  • Society of Veterinary Behavior Technicians, 406 Branchway Road, Richmond, VA 23236; (804) 379-4702, www.svbt.orgHospitals that embrace the concept of more compassionate behavior-based handling will win advantage in multiple areas of operations.

Clients will perceive a gentler handling of patients. Staff will experience less anger and distress. Burnout may be reduced and professional fulfillment increased with reduced staff stress. Client referral of new clients is enhanced.

Improved workplace safety leads to decreased absenteeism due to injury, and reduced premium cost for Workers' Compensation insurance.

Practice value is protected through decreased likelihood of situations leading to potential permanent damage of the practice's reputation.

A proactive approach to workplace safety through behavior-based compassionate handling presents huge opportunities for improved operations and patient care.