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changing practice culture to less stressful

American Veterinary Society of Animal Behavior Forums Members Members General Discussion changing practice culture to less stressful

This topic contains 4 replies, has 3 voices, and was last updated by  Sally Foote 2 weeks, 5 days ago.

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  • #13136

    Sally Foote
    Keymaster

    I would like to hear from other practitioners about how they got their staff on board to use less stressful care practices in their practice.  For those who have or were frustrated in resistance to change, I especially would like to get a discussion going about how you were able to create change, if you were.  And if you were not, what was the point of resistance?

    On many of the various facebook groups I am reading frustrations about internal practice resistance and I hope we can gather some of the ways that helped to make change so we can share this with others.

    Please post away!

    Sally J Foote DVM

  • #13137
    Terri Derr
    Terri Derr
    Keymaster

    My primary practice is my behavioral one, but I work several mornings a week relief at a local small animal practice. When I asked to present a short informational talk about decreasing stress and fear during one of the staff meetings, I was given ten minutes to do so. Two techs listened. Every one else, including the doctors, checked their phones.

    So instead, I practice what I preach, and little by excruciatingly little, I’m making headway. The techs who on a gut level agree with making a visit to the vet more pleasant work with me and learn my handling techniques.

    My preference for injectable sedation for orthopedic radiographs has won the quickest acceptance. My insistence that puppies under nine months of age be handled with treats and enthusiasm is also making headway.

    Because I’m not on staff I have no authority to insist on anything, but I have twice physically removed an animal from an abusive tech, calmed it, and then finished what needed to be done using proper humane handling. Those around us see that what she did made it worse, and what I did made it better. Now, some of the techs actually apologize to me when I walk through the treatment room and see four of them piled on a screaming dog getting its nails trimmed.

    Progress? Hardly. But I do what I can do. (Reporting the abusive tech to the boss was useless, but I did it anyway.)

    Not sure if this is helpful to anyone else, but I do feel the pain of being an agent of change.

     

    Terri

    Terri A. Derr, DVM
    Veterinary Behavior Options
    Golden Valley, MN 55422

  • #13138

    Sally Foote
    Keymaster

    Thank you Terri.  You are making change – the techs are apologizing for 4 ganged up on a nail trim – you have increased awareness and that is the first point of change.

    The injectable for x rays is an excellent point.  If there are no handling skills for less struggle then injectable sedation and especially pain relief prior to x ray to reduce struggle is essential IMO.  Also you grabbed the teachable moment by removing the animal harshly handled and showed how to make it less upsetting and get the job done.   That action alone showed the staff this is important not only to you but also to that animal’s welfare.

    So, act in the moment – lead by example and use your DVM authority as much as you can.

    While the owner DVM did not seem to care about the report, you have made it so it is count 1 on demanding change.

    Would you consider keeping track of easier exams, improved client compliance or reduced staff injury in your positive vet care exams?  That would be data to report to the boss as well.  even if it was just a simple comparison of 8 exams with you with little patient struggle/ bite risk as compared to 8 exams with other staff using extra help/ more struggle and bite risk.

    From my bite/near bite job stress survey DVM support for sedation meds was one of the leading staff stress reducing items needed.

    Thanks  I look forward to more commenting.

    Sally

  • #13142
    avsabe@gmail.com
    avsabe@gmail.com
    Keymaster

    I love this topic! I am no longer in a practice as I do in-home visits but I was there for 23 years. I too, found that resistance, especially with cats – even before it was a “movement” to have a fear-free practice – another thing I love!

    I tried to lead by example too, again, especially with cats. I also often used Adaptil, Feliway, Thundershirts and treats in the office. It didn’t really generalize, unfortunately. The profession has a culture, IMO, that is resistant to any change so it’s hard. Plus, when they did see me working with difficult animals successfully, they didn’t see how it could transfer to them. They just attributed it to my skill with behavior. So convincing the staff that they can do it too can be a challenge to overcome. But I agree, Teri, that you made a difference!

    I think posters with a simple list of what can make a vet visit easier could make a difference, if veterinarians would hang them, and also educating the public, as you are doing, Sally. When I asked my Dad, who is also creating a major shift in an area of medicine, why the change was taking so long, replied that historically, it usually takes 25 years or 2 generations to change the belief in a culture. Interesting to think about.

    Sally, if you have tweets or facebook posts that I can share, I’ll be happy to do so. 🙂

     


    Carolyn Lincoln, DVM
    AVSAB Corresponding Secretary

    Carolyn Lincoln, DVM
    AVSAB Corresponding Secretary

  • #13158

    Sally Foote
    Keymaster

    Thanks Carolyn.

    How depressing that in medicine it can take 2 generations of doctors to change culture!  Karen Gavzer a business practice management speaker said 2-3 years in an individual work place – I guess if you figure a one by one practice that would be 2 generations.

    There is a poster  that shows how to easily make vet visits easier – showing a doctor rushing in, then one walking calmly greeting from the side – the techs dumping a cat then the techs taking the carrier apart. from CDP.   It is not on the website so   I will attach it.   we also have the low stress handling facebook page which is an open group. we are forming a closed group for the certified handlers but we have had a lot more sharing and posting on the open group.  IT would be good to have more veterinarians knowledgeable about behavior on that page so please join us!

    I agree – we are all an independent bunch who looks for the one plan applicable to all for handling even with fear free.  That movement is making a big change for the better which is great, but those practices are feeling the pain of change.

    thanks and let’s keep the conversation going !

    Sally

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