Overview
Join Sophie White BVetMed MSc MRCVS as she talks through how to approach the 'scared of fireworks' consult.
This one off course will help you feel more confident when advising clients on how to help their pets cope with fireworks. There is information on the underlying emotions and possible health problems that are often associated with these fears, as well as advice on how to select appropriate medication.
Target Audience
Tailored for veterinary surgeons in first opinion practice, but nurses are more than welcome too!
This course aims to open your eyes to the possible links between behavioural issues and health. No prior behaviour or training knowledge needed.
If you feel unequipped to deal with those 'scared of fireworks' consults, or maybe you just want to understand a little more about companion animal behaviour then this course is for you.
What You Will Learn
CPD/CE Hours
This course is worth 1 hour of CPD/CE.
About The Provider
Sophie White BVetMed MSc MRCVS graduated from the Royal Veterinary College in 2011. She spent the 8 years in small animal practice before completing a Masters degree in Clinical Animal Behaviour at the University of Lincoln. She has spent the last year gaining hands on behaviour and training experience working for Dogs Trust. She runs Veterinary Behaviour Support with the hope of raising the profile of behavioural medicine within the veterinary profession, whilst helping owners and their pets. Her particular areas of interest are human directed aggression and the provision of medical care to 'difficult to manage' patients.
To give us more insight in to her work Sophie took part in a quick fire Q&A with the Vet Academy team:
]]>Did you know?
Euthanasia is one of the most common source of complaints that
veterinary colleges receive. The use of plastic bags for disposal of deceased pets is one of the issues raised surrounding euthanasia.
Before Euthabag, there were no functional alternatives to plastic bags.
Veterinarians now have a professional and practical solution for the transportation, cremation and burial of deceased pets that is, most importantly, respectful for the animal and their caregiver.
Practical Classes in Small Animal Euthanasia, by the creator of EUTHABAG, Dr. Celine Leheurteux, DVM
Course includes 6.5 hours of RACE approved CE consisting of to-the-point presentations that share contemporary advice for your practice.
Modules included:
1. Enhancing the Euthanasia Experience: Tips to Make it Easier for All
2. Euthanasia in Times of Crisis
3. Facing Compassion Fatigue Head On
4. Handling Euthanasia as a New Grad
5. Pre-Euthanasia Sedation Winning Protocols
6. Simple Oral and Injectable Pre-Euthanasia Sedation Protocols for Calm and Reactive Animals
7. Tips: 10 Dos and Don'ts of Euthanasia
Weather-Smart Worm Control - Wednesday 8th September 7pm BST
This webinar will discuss how climate and weather affect parasite transmission and generate the typical infection patterns observed on farms in Europe. Further, how climate change and increasing variation in weather patterns lead to challenges for parasite control on farms. Finally, how advisors can help farmers to navigate this changing situation, especially as the effectiveness of synthetic anthelmintics diminishes and new but complex options for parasite control emerge.
About the speaker:
Eric Morgan is Professor in Veterinary Parasitology at Queen’s University Belfast, and Diplomate of the European Veterinary Parasitology College (DipEVPC). His research interests centre on the epidemiology of animal diseases under climate change, especially helminths in grazing ruminants, and consequences for their management. This includes the use of experiments, computer models and field trials to develop efficient and sustainable approaches to control under increasing anthelmintic resistance. He supports the development and dissemination of best practice in parasite control through industry and government bodies, including COWS and SCOPS in the UK, EU COST Action COMBAR, and the Star-IDAZ international research consortium on animal health.
If you can't make the live event please register above and you will receive a link to access the recording.
The first two webinars in this series can be accessed free of charge here on Vetacademy.
]]>Practical tools to monitor anthelmintic efficacy and detect anthelmintic resistance, Weds 28th July 15:00 BST
There is a great need to establish field-applicable and improved tools for monitoring anthelmintic efficacy and detecting AR in livestock. This presentation will update the different approaches used for the assessment of anthelmintic efficacy and hence for the diagnosis of AR in ruminants, including in vivo (faecal egg count reduction test), in vitro and DNA-based molecular methods. It will cover the activities of the Working Group 1 of the COST Action COMBAR and provide room to discuss with participants the harmonisation of standardized protocols with the aim to provide up-to-date and reliable information on the occurrence of AR in ruminants in Europe.
If you can't make the live event please register above and a recording of the event will be emailed to you shortly after the webinar.
The webinar recording will also be available free of charge on Vetacademy
]]>Charlotte qualified as a veterinary nurse in 2003, whilst working in practice in London. In the same year she moved to the Royal Veterinary College to work as a medicine nurse. In 2006 she became the dedicated cardiology nurse for the Queen Mother Hospital for Animals. In 2010 she passed American veterinary technician exams and became the first nurse to hold the Cardiology qualification outside the US. From 2012, Charlotte has taught veterinary nurses on both degree and diploma programmes. In 2015 she returned to veterinary practice and continues to write and lecture on veterinary cardiology.
This session is relevant to all veterinary nurses who take electrocardiograms (ECGs), and would like to understand the trace it gives, and relate that to the nursing care required.
It will start with a comprehensive examination of what a ‘normal’ ECG should look like, breaking down each stage of the conduction cycle. The session will then look at how to interpret ECG traces and identify common arrhythmias seen in practice, such as atrial fibrillation, ventricular tachycardia and atrioventricular block.
This webinar also includes a short quiz, upon completion you will receive a personalised certificate.
We had the opportunity to host a Q&A with Charlotte where she answers
some quick fire questions about herself and the courses.
Together we shall be bringing you a series of FREE webinars focusing on 'anthelmintic resistance.'
Anthelmintic resistance is a growing concern in the control of helminth infections in ruminant livestock worldwide.
This presentation will update on the current situation of AR in sheep, cattle and goats in Europe, its driving factors and economic impact. It will cover the activities of the COST Action COMBAR and provide room to discuss with participants solution routes towards sustainable control approaches that preserve the efficacy of anthelmintic drugs. Through joint collaboration COMBAR aims to pave the way towards a transnational, multi-actor initiative to achieve sustainable helminth control approaches and develop new solutions.
The first webinar takes place on Wednesday 30th June at 13:00 GMT.
If you can't make the live event please register above and a recording of the event will be emailed to you shortly after the webinar.
The webinar recording will also be available free of charge on Vetacademy
]]>
The theme for this year is 'Nature' as picked by the Mental Health Foundation. After the year we have had, a lot of us have returned to nature to find some calm and a healthier mindset.
As our mental health can affect our working lives, it important to recognise the signs in yourself and others.
Microlearn have a useful library of CPD/CE focused on this topic which is available on Vetacademy.
]]>Liz Watkins, an experienced veterinary surgeon who manages three practices originally came up with the concept of Chunk Training from the needs of her own practices and ensures that the content is very relevant and valuable for the real world!
The courses available on Vetacademy are ideal for all practice staff inlcuding non-clinical team members!
We recently had the opportunity to host a Q&A with Catherine Watkins from Chunk Training, where she answers some quick fire questions about herself and the courses:
]]>During his time at Tufts University’s Cummings School of Veterinary Medicine, since 1987, he has twice received the Pfizer Distinguished Teaching Award, as well as several other teaching awards.
John has created a number of Canine and Feline online CPD/CE courses specifically for our learning platform.
Check out some of his best-selling courses available on Vetacademy.
We recently had the opportunity to host a Q&A with John, where he answers some quick fire questions about himself and his courses:
]]>
Alex Taylor currently works as a locum RVN and runs her own company ‘The Cat Nurse’ where she offers CPD about feline nursing and behaviour.
She has partnered with Vetacademy and joined our team of providers. Her first collection of CPD modules are now live and cover the topics 'Feline Idiopathic Cystitis' and 'Creating a Feline Friendly Practice'. Although the courses are tailored for veterinary nurses, they are also suitable for all other veterinary professionals in small animal practice.
To give us more insight in to her work Alex took part in a quick fire Q&A with the Vet Academy team:
]]>
Overview
Join Sophie White BVetMed MSc MRCVS as she talks through how to approach the 'scared of fireworks' consult.
This one off course will help you feel more confident when advising clients on how to help their pets cope with fireworks. There is information on the underlying emotions and possible health problems that are often associated with these fears, as well as advice on how to select appropriate medication.
Target Audience
Tailored for veterinary surgeons in first opinion practice, but nurses are more than welcome too!
This course aims to open your eyes to the possible links between behavioural issues and health. No prior behaviour or training knowledge needed.
If you feel unequipped to deal with those 'scared of fireworks' consults, or maybe you just want to understand a little more about companion animal behaviour then this course is for you.
What You Will Learn
CPD/CE Hours
This course is worth 1 hour of CPD/CE.
About The Provider
Sophie White BVetMed MSc MRCVS graduated from the Royal Veterinary College in 2011. She spent the 8 years in small animal practice before completing a Masters degree in Clinical Animal Behaviour at the University of Lincoln. She has spent the last year gaining hands on behaviour and training experience working for Dogs Trust. She runs Veterinary Behaviour Support with the hope of raising the profile of behavioural medicine within the veterinary profession, whilst helping owners and their pets. Her particular areas of interest are human directed aggression and the provision of medical care to 'difficult to manage' patients.
To give us more insight in to her work Sophie took part in a quick fire Q&A with the Vet Academy team:
]]>A full cycle of Basic Life Support is 2 minutes long and focuses on ABC: Airway, breathing and circulation.
Airway: visualize airway and place endotracheal tube.
Breathing: ventilate with oxygen at 10 breaths per minute. Ventilation can be achieved with an anaesthetic circuit although an ambu bag is preferred.
Circulation: with patient in lateral recumbency, begin cardiac compressions at 100-120 compressions per minute. There are two techniques for chest compressions, usually depending on the size of the patient:
There are certain indications where it might be more appropriate or beneficial to enter the thoracic cavity to directly compress the heart (internal chest compressions).
Charts for emergency drugs and dosages should be accessible with the emergency drugs and emergency trolley if available. It is preferable to gain intravenous access, if this cannot be achieved then drugs can be administered via a (dog urinary) catheter which is longer than the endotracheal tube. The drugs should be diluted in saline and given at a higher dose x2. Epinephrine /adrenaline, atropine, vasopression, naloxone, and lidocaine can be given via this route.
Defibrillate as soon as possible - precordial thump could be considered if defibrillation not available.
Check blood glucose and electrolytes if possible and correct where necessary (DEFG - Don’t Ever Forget Glucose).
No clear guidelines exist as to when to stop basic life support (BLS). However, with prolonged resuscitation the chance of a successful neurological outcome is poor. 20-40 minutes can be considered depending on the patient and the suspected cause of the arrest, eg longer for a patient that has had an overdose or waiting for drugs to be reversed.
It is essential that BLS should be practiced and rehearsed to improve changes of return to spontaneous circulation (ROSC). Algorithms and drug charts can be downloaded from: http://www.acvecc-recover.org/
For further information on EGUS check out this related content available on Vetlexicon Equis:
Click here to view all equine online CPD courses available with Vetacademy
]]>▶ Update your knowledge of the clinical signs and treatment objectives of Ethylene Glycol Poisoning in Cats
▶ View all poisons CPD on Vetacademy]]>■ Pathogenesis
■ Diagnosis
■ Treatment
■ Prevention
How To Access Free CPD
Simply add Theobromine/chocolate poisoning to your shopping cart and follow the steps to register and checkout (no payment required!)
You will receive a confirmation email with details on how to access your personal learning account and free CPD.
This module will be free until 31st December 2019.
]]>
Strangles is caused by Streptococcus equi subsp equi and is a highly contagious upper respiratory tract disease transmitted by inhalation or direction contact. In the pharynx, toxins and enzymes lead to sever tissue damage causing lympadenitis and abscessation. Mortality is rare but can be up to 8-10% in individual outbreaks.
Equine influenza in an epizootic disease of the upper and lower respiratory tract. Caused by the equine influenza A virus (two main strains are H7N7 and H3N8) the disease is generally spread via contact with infected equids, but can also be brought on by stress, eg transportation, or by a compromised local immunity, eg young foals. Control via vaccination is essential and required for competition. Prognosis is good with uncomplicated cases.
RAO is a common, chronic, progressive lower respiratory disease syndrome. The term RAO is often applied to both young and older horses with lower airway disease characterized by inflammation and accumulation of mucus, however, in younger horses there is no measurable evidence of airway obstruction. Causes include chronic exposure to inhaled dust particles containing allergens, eg moldy hay, and thermo-actinomycetes. Treatment is palliative only, including a change of environment, removing allergens and improving management. Inflammation can be controlled with corticosteroids and airway diameter can be increased using bronchodilators. SPARAO clinical syndrome is almost identical to RAO but affects pastured horses with no access to hay and straw.
IAD is a common disorder of young performance horses, but also occurs in older performance horses, and is a less severe form of airway inflammation than RAO. Horses with IAD do not have obvious respiratory distress, and usually have no systemic signs of illness, but show varying evidence of airway inflammation. The aetiology, pathophysiology and diagnosis of this disorder are currently controversial, and the term probably encompasses a number of different diseases that are associated with lower airway inflammation in young and older performance horses.
For further information on equine respiratory diseases check out this related content available on Vetlexicon Equis:
]]>It is important to remember that wound healing does not always occur in a linear fashion and so there can be overlap between the different phases of wound healing in any given wound.
The inflammatory phase starts at the point of injury and in experimental wounds the inflammatory phase is complete in approximately 5 days. The inflammatory phase is characterized by both vascular and cellular responses.
In uncomplicated wounds the proliferative phase may start as early as 3-5 days following injury. During this phase of wound healing granulation tissue will form in the wound bed, epithelialization will begin, and contraction of the wound bed will occur.
The maturation phase is also known as the remodeling phase and occurs up to 1 year after injury. The scar formed following injury will be 15-20% weaker than surrounding tissue. Scarred skin will also be alopecic, and if non-pigmented will be prone to damage by sunlight.
To find out more on this topic, take a look at the online CPD module Wound Healing Evolved - Modern Techniques for Successful Outcomes availble on Vetacademy.
For further information on wounds check out this related content available on Vetlexicon Canis:
So, I find myself sat here after listening to a piece on LBC recently as I am now ‘of age’. The article was explaining why there has been a surge in measles in the USA (300 cases in January 2019 alone) and why it is of such a concern.
Partly to blame is social media allowing a lay person to convince other lay people not to vaccinate their children with MMR due to the link with autism (cheers Dr Mr Wakefield). Unfortunately there is an international cohort who believe that vaccines are more dangerous than contracting the diseases they are designed to prevent. This has now spread across to the veterinary world where animals are unvaccinated due to reports of subsequent diseases/illnesses caused by the vaccine, and there are also clients not giving appropriate flea/worm treatment for similar reasons.
The layman posts range from the benign ‘I only treat for fleas when I see one’ a comment frequently also made by vets and vet nurses(!) through to puppies not having any vaccinations – including parvo, catching the virus and then…I think we all know what the likely outcome is.
So how do we deal with these clients? The ones leaving their pets vulnerable to a whole array of diseases?
We need to think about human nature and the different ways in which we learn. One way we learn is cause and effect, trying to make links between inputs and outcomes. If you took your car to a garage for an MOT and within 3 days something went wrong with the car, would you think ‘ho hum, it happens, it’s just a coincidence that it happened days after the car was in the garages care’ or would you try and blame the garage and make a link, perhaps they loosened a screw without realising? Perhaps they even did it on purpose to get me to go back and spend more money? It must have been the garage as if there was an issue, the garage would have picked up on it three days ago and done something about it – can you see when I’m going with this?
Firstly, it is important not to lecture or reprimand the client for their beliefs, putting yourself in the situation above, how would you feel being lectured by a mechanic telling you that you are wrong and making you stupid. These clients have a fear and as irrational you may this it is – it is a fear. We all have these fears and a telling off or a ‘it’s fine’ does not change our mind.
Think of an irrational fear you have, if you don’t think you have one you can borrow mine. I have an irrational fear of water – there could be sharks in there ready to bit/eat me! This is a fear to the point that I will go ankle deep into open water and no further. My friends think it is hilarious as they swim out to sea and I sit biting my nails until they come back to shore, I don’t want them to be bitten by a shark either. They’ve said to me that I am silly, we live in the UK, I am not going to get bitten by a shark. It’s is the same with your clients. Being told your beliefs are wrong is not a way to overcome the fear! The thousands of animals you have vaccinated without an issue is of no currency to them as they have seen thousands of animals on social media become unwell – although in 99% of cases it is not related to the vaccine, they have been told it is related.
Try asking them (tactfully) why they feel that way, listen to their concerns and fears and put yourself in their shoes. It’s likely that their argument is invalid and based on information found on Google, social media or from their breeders but that is how they feel and what they believe, a telling off will only make their beliefs stronger as you will be seen trying to push your opinions onto them.
Ask yourself ‘Are you all prepared?’ from your day one receptionist to your senior clinician you should all be able to listen to clients and give appropriate advice. Whilst I appreciate your ‘day one’ receptionist cannot give any clinical information, they should be able and prepared to see the warning signs, listen and refer, know what to say and more importantly – know what not to say.
Are your flea and worm protocols streamlined and does everyone in the practice know the protocol and options? The recent refashioning of flea tablets has bought with it many ‘INSERT FLEA TABLET killed my dog’ stories on social media. If your main protocol is ‘INSERT FLEA TABLET’ and a scared client calls, do you/your staff know what warning signs to look for and what other products are available to suit, if not you may have just lost yourself a client. If this client was simply looking for a spot on and was not offered it, where is this client going to go next? The local pet shop? eBay? To the breeder? This could be worse than using no flea/worm treatment at all as there is a lot of incorrect and potentially harmful advice out there.
Sincerity is also a key player in this conversation, a phrase I like to remember is that ‘people don’t care how much you know until they know how much you care’. Their objections are genuine so your response and actions should be too. Lecturing them on the implications of not using certain treatments will fall on deaf ears, you really need to find out the root of the objections and professionally try and overcome them.
Correct online literature can be an aid too, if they client is going to use the internet try to sway them towards your own website if you have a section on there of the importance of preventative treatment.
One final conversation to have with the is the potential of humans being at risk from living with untreated animals, especially if there are children in the household. This can really get the owners attention and encourage them to rethink their position on not using preventative treatments.
How can Chunk help you to help your clients – we have specific courses on Winning the Client, The Art of Persuasion, and customised courses to ensure your staff are up to date on your flea and worm protocol. As an industry we can all work together to help the client, why not give us a go?
Click to view all management and reception CPD by Chunk Training
]]>Friends always say to me that they want a puppy/kitten but also want to adopt. So after my 20 minute generic talk on the level of emotional, physical and financial commitment needed, I tell them to head to their local rescue around February/March time. This gives the unwanted Christmas puppy time to disappoint his new owners as he was not born toilet trained, is now teething and their youngest child appears to be allergic so he is given to a rescue centre.
Lucy’s law has now effectively made it illegal to run puppy/kitten farms, which it kind of was already as 0/5 of the Five Freedoms (at least that’s what they were called when I was at college, it may have changed now) had been met. My concern is that the more something is banned, the more it goes down the back allies of society. If this is to happen with puppy farms, the worse the conditions will get. Puppy farmers are already excellent deceivers and are well versed in hiding their tracks so they will find a way to continue.
But what about the buyer of the puppy? Should they not be held responsible too? After all there are other laws we have which make it the buyers responsibility to ensure their goods are ethically sourced. If you unknowingly bought a stolen car, in the eyes of the law you are potentially a criminal as it would be your responsibility to make sure the sale was above the law.
A friend of mine bought a puppy, this puppy is now nearly a year old and has not once had a firm stool and consistently has an upset tummy. It transpired that they got it from a puppy farm (despite my 20 minute generic talk). After admitting the dog was probably from a puppy farm I crossed my arms and pursed my lips in anger at him. His response was ‘But the way I see it, we saved the dog’ and then on came my 30 minute talk about how for every one puppy bought, five more are bred – that’s how businesses work, they sell a product, make money, expand and repeat. The issue here is that lay person does not actively want to buy from a puppy farm but when they find out they have, they think they have done a good deed by ‘saving’ that pup.
Now, had my friend have been threatened with a say £200 fine, I don’t think he would have been quite so happy about the situation and would have maybe done a bit more research into where his puppy came from.
The issue we have here in relation to puppy farms is that the lay owner who is simply buying a pet has no idea what signs to look for and the puppy farmers will have all bases covered. Puppy farmers will have a ‘show mother’ who is a dog of the same breed as the pups, in incredibly good health and kept in the family home, the pups are then delivered to the ‘show mum’ when potential buyers come to view, so they have ‘seen the mother’, at least they think they have and buy a pup without realising what’s going on behind the scenes. This is the part which needs to be tackled. Fining the buyers may seem unfair but it may also encourage them to do more research into the breeder or even push them to adopt from a rehoming shelter. It may encourage them to ask questions, reputable breeders will not be insulted to be questioned further, they would welcome it as it would show that the buyer really does care. Charities should be registered so can be authenticated and again, would have no problems with buyer asking lots of questions about the business.
Education is also key and the public do need to be educated – where may they go for that? Hopefully straight to the vets where staff can give honest, unbiased advice. As an industry vets, nurses and receptionists need to be well armed in this department.
Staff training in this area is key as they need to be tactful but firm without being too gruesome about the reality of puppy farming. Vets should be more proactive when they suspect a puppy from a farm and front of house should have a good knowledge of signs which the owner should look out for when buying a puppy.
One day, people will realise the damage they are doing to these poor puppies/kittens in order to make a quick buck, but until then, as an industry we all need to work together to help Lucy’s law be as effective as possible.
]]>Coming into December and moving through to January, people slow down from work and have time to spend reminiscing on the past 12 months and make plans for the next 12 months to spend with time with their loved ones, perhaps this includes their pets? Perhaps their pets were with them at the beginning of the year but have now crossed the rainbow bridge. Perhaps they haven’t yet realised it, but they may be about to participate in ‘The Christmas Cull’.
Anyone new to practice may not have heard of this yet and those of us who have experienced a few festive seasons in practice will understand exactly what this is and get confused when our non-vetty friends think we’re are making it up.
If you are new to practice, here is a rundown of what the Christmas Cull is;
It is where you will find an increased number of people coming in for a put to sleep in the few weeks prior to Christmas and there are a few theories as to what is going on, I would say that they are all correct.
Theory 1 – The Johnsons with 18 year old Muffy.
Muffy, the terrier, was bought as a pup 18 years ago, since then the Johnsons have had 3 children, 4 cats, 2 house moves and very few visits to the vets, but Muffy is now starting to show her age, the Johnsons are quite cost aware and it’s the last time their family will be together for Christmas as he eldest child plans to move to Australia. They look to Muffy who now is slow, has to be lifted out of the house to the garden and is as blind as a bat. Mr and Mrs Johnson decide that they may as well get Muffy put to sleep now, just in case she needs out of hours care and/or disrupts Christmas day. After all, it’s likely that Muffy will be put to sleep in the next few months anyway and the vet is aware of her issues, however Mrs and Mrs Johnson would never reveal their true motives.
Theory 2 – The Smiths with 5 year old Bailey
Bailey is a loving moggy, nothing special to look at but a pleasure to be around, and recently he was diagnosed with kidney failure. Generally speaking, Bailey is of no bother to the Smiths and he does quite admire their recent addition to the family. The new addition wasn’t a conventional looking cat, it cried a lot, didn’t have any hair or whiskers. It also seemed quite dependent. But it got its own super fancy box to sleep in next to Mrs and Mr Smith’s bed so Bailey thought it must be special. Bailey didn’t notice his kidney failure, he’s a cat – he doesn’t know what kidney failure is but The Smiths had recently noticed small puddles of urine around the house which smelled quite strongly. The Smiths didn’t mind, but Auntie Mable did and she was coming to visit this Christmas for the first time since the new arrival and everything had to be perfect for her, it always did. Auntie Mable was allergic to cats and would not appreciate a cat in the house, let alone an incontinent one. The Smiths made their decision as they had been told by many of their friends that when an animal ‘toilets’ in the house, it’s the beginning of the end.
Theory 3 – The Blacks with 9 year old Ben
Ben is a black Labrador who has been at his master’s side through thick and thin for as long as he can remember. He was a loyal servant and adored Mr Black, they went out every Saturday in the colder months and Ben would wait patiently by Mr Blacks side whilst he shot, Ben was always so thrilled to get the command to pick up and come running back to his post with his retrieve. Life was good for everyone until Mrs Black took a turn for the worse and passed away earlier this year. Mrs Black left behind her beloved husband who struggled over the next few weeks, there was only one reason that Mr Black kept going – it was for Ben. Ben made sure that Mr Black had a reason to get up in the morning and leave the house and that the house was never quiet or lonely. Over the summer, Ben started to look a little old, walking long distances was a problem and running became a distant memory so Mr Black took Ben to the vets where he received the best supportive care to help relieve the pain but Mr Black made the difficult decision not to shoot this season. Instead they would spend their Saturday mornings at the local shops, talking to the passers-by. One November morning someone asked Mr Black ‘So, what are you doing for Christmas?’ Mr Black hadn’t thought about this, he has no children and very few friends, it had always been Mr and Mrs Black together at Christmas. It’s ok, he had Ben, he and Ben would wake up, exchange gifts, eat food and fall asleep in front of the TV. As long as he had Ben by his side, Mr Black would be ok. Ben had been seeing a vet every two weeks (he was insured) so the vet understood the situation but also had to think about what is best for Ben as he quickly deteriorated and did speak to Mr Black about time-lines. The vets prayed that Ben would be comfortable enough just until January but it was not to be, the phone call came in (as it always does) on a Friday afternoon at 5.30, 5 days before Christmas, it was Mr Black. Ben could not get up, his eyes were vacant and he looked like he’d already given up. The vet got straight in the car to pay one final home visit to Ben.
As a member of staff in practice these situations can be difficult to deal with and in my experience it is generally frowned upon for members of staff to admit they are upset and even less frequently heard of that staff talk about their feelings post put to sleep.
With mental health being more present and accepted that ever it is this time of year that it is most important to be sure not to keep things bottled, don't let them itch away at you. Talk to people. There is a well-known Facebook group full of lovely vet nurses who have been there, done that and got poo on their t-shirts. Ask them for help if you feel you have no one else, you’ll feel better after letting it out – I promise.
Merry Christmas all.
Lots of Love
]]>As a practice manager/partner/owner a lot of your time is taken up in the office, consult room, theatre etc., do you know what type of care the client is receiving when in the waiting room?
I have self-labelled myself as a professional client, I have 12 years’ experience in veterinary customer care and my current ‘9-5’ is as a veterinary pharmaceutical sales rep and I run Chunk Training alongside this.
You’ll notice my working hours are in inverted commas, as I am sure you are aware, if you work in the industry, there is no such things as a 9-5, even for us reps, honest!
Being a rep I spend a good deal of my time in the waiting room and on the phone to veterinary practices. Some of the front of house care I have seen/heard/experienced is verging on the side of shocking.
‘If you just fill this form in, the insurance company will pay out and I can see that your pet had diarrhoea three months ago so you may as well try and claim for that too’.
These are just a few examples of things I have heard/seen in practice. As a professional client and millennial I found it very hard not to speak out and explain the mistakes that had been made.
I know some see us reps as a pest but I commonly call a practice and simply say ‘Hi, please could I speak to Mr Smith’ (by this point the receptionist has no idea I am a rep and for all they know, I am a valued client) the reply from the receptionist does then vary but a common variation is ‘hang on!’ and the phone goes silent. Somewhere between a few moments and minutes later the receptionist picks up my call and I get told ‘he’s busy’. No apology, no willingness to help and no way forward for a potential client.
Now, if I was a client in the above situation I would be very unimpressed and would probably seek out a new practice, just over a few words exchanged between myself and the receptionist. I’d like to take this opportunity to confirm that a good majority of the front of house staff I communicate with are lovely and helpful towards myself and clients but it begs the question ‘have I lost any loyal clients/potential clients due to poor customer care?’
The point I think I am trying to make is that many practice staff out there do need training, some more than others and it may be that the owner of the practice is completely unaware as they have bigger fish to fry (or dogs to ex lap, cats to express or cows to TB test).
With associations such as BVRA (British Veterinary Receptionist Association) now aiding the industry, it is being more and more recognised that front of house staff are critical to a practice’s health.
Always remember you are a private business with competition all around, sometimes this competition can be within yards of your front door. I live in a small city and have 4 practices along the same road with 1.6 miles between the first and last.
Ask yourself what sets you above your competitors? It could well be the first impression the client gets. If the first impression is poor, they will not progress to a loyal client.
Chunk Training provides front of house staff training including personalised clinical modules (flea, neutering and vaccines protocols) and we also offer training to vets that the vet schools seem to forget about such as bereavement and compliance training. All of the training is online and can be stopped/started at will, so that the learner can progress at their own pace. We also offer free trials to give you a feel for what we do. Check us out at http://www.chunktraining.co.uk/
Click here to view all online CPD with Chunk Training available on Vetacademy
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If your compassion does not include yourself then it is incomplete
Jack Kornfield
This is one of those phrases that is easy to say but very difficult to do. In my face to face compassion fatigue training I ask those attending to take a selfie over lunch and then in the afternoon we use it for a self-compassion exercise. It’s very simple, I ask them to take out the picture, look at it and then say something, nice, kind and encouraging to themselves. Easy? Well apparently not! People genuinely cannot think of anything to say, won’t speak or sometimes get very emotional and even cry! What is this about? Why can’t we be nice to ourselves? I remind them that if I had asked them to look at a picture of the person next to them they would have immediately thought of something nice to say so why can’t we do it for ourselves.
It’s partly a cultural thing; the British are not very good at ‘blowing our own trumpets’. You only have to watch someone squirm when they are given a pubic compliment to understand that. But it is also partly biological; if I asked people to name some of their faults or mistakes they would find this much easier as we are genetically programmed to look for mistakes. We dwell on them, for example after an appraisal we drive home thinking of the one thing our boss said that we did wrong rather than the ten we did right. As humans we are supposed to think about errors otherwise next time it could be more serious (oh, I thought it was a snake/tiger!) and it seems this trait is very hard to shake.
In the book, The Happiness Trap author Russ Harris says 80% of everyone's thoughts contain some sort of negative content. So it is normal to have negative thoughts. It's part of our evolutionary heritage. We’re constantly scanning our environment (generating negative thoughts all the while) looking for problems to fix.
In the Pixar movie Inside Out we meet the ‘emotions’ in the little girls head and see how they control her and how things go wrong when one goes ‘missing’. But did you know that you don’t have to listen to the voices in your head? The negative ones are so very loud sometimes, so loud in fact that they can drown out all the others if we let them. A psychologist I did some training with said something that has stayed with me, he said “all events are neutral, they don’t mean anything until you put your own thoughts to them”! The example he gave was this:
‘You are driving to work when suddenly out of a side road a car pulls out straight in front of you causing you to have to brake hard’ Now, depending on who you are, your past experiences and what kind of morning you’re having these are some of the things that might go through your mind:
“Wow that was close, thank goodness we are both ok”
“Oh no, oh no, not again”
“I wonder why he’s in such a hurry”
“Right I’m having you my friend”
“I’m taking his number and calling the police”
“It’s my lucky day”
“Why do they always pull out in front of me?”
That’s just a few. There are literally hundreds of possible thoughts you can have as a result of just one action from someone else. The point of the story was that we can only control our reactions, the ‘Locus of Control’, we can’t control other people. But we do try and it generally makes us very unhappy and frustrated when we do.
But the problem is we do listen to those voices in our heads especially when we have made a mistake and one thing can lead to another until we are seriously beating ourselves up for actually just being human. This can lead to a downward spiral where one mistake or misunderstanding leads to another, eventually turning into a major trauma and we conclude that we must be a terrible person. Some people are much more inclined to do this than others.
So, what can we do? Basically, it’s about being as nice and kind and compassionate to yourself as you are to the people or animals that you care for. It’s about giving yourself a break, you are only human and you’re not completely ready for everything that life can throw at you. It may be the way you were brought up, that you have very high or unrealistic expectations of yourself or simply that you had an off day.
Next time this starts to happen to you I want you to try one of these things.
Catch yourself starting to say the negative things and quickly say STOP. You can say it out loud if it helps (unless you are in a public place or at work!)
Write down the thoughts, screw it up and throw it away, or burnt it!
Thank your mind for having the anxious thought as it’s trying to keep you safe, then add in a little dose of reason e.g. “thank you mind for worrying about the pilot of this plane but I’m sure they’re very qualified to do their job”!
There are lots of others you can try of course and some really good advice on psychology websites and in self help books. You need to find what works for you and keep practicing – challenging your unconscious thoughts requires conscious action. If though you do find you cannot change the way you feel and are constantly very negative and lacking in self-compassion please go and see your GP or look for a suitably qualified counsellor.
When you are doing a very emotionally demanding job, juggling many different roles or caring for humans or animals, self-care and self-compassion are not an option; they are a necessity so start practicing.
“be careful how you talk to yourself because you are listening”
Lisa M Hayes
View all the range of Compassion Fatigue Awareness online CPD modules by Jayne EF Training
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An old man was walking along a beach when he noticed a young woman off in the distance. As he got closer, he noticed that the woman was collecting starfish that had washed up on the beach and tossing them, one by one, back into the ocean. “Excuse me, young lady, but what are you doing?” the old man asked.
“All these starfish have been washed up by the tide. If I don’t throw them back they will die”, she replied.
“But there are hundreds and hundreds of starfish on the beach,” the old man said. “You can’t possibly make a difference.”
The young woman listened politely, bent down, picked up another starfish and tossed it into the ocean. She looked at the old man and replied, “It made a difference for that one”.
Adapted from “The Star Thrower,” by Loren Eisely
Compassion Fatigue
I love the starfish story; it doesn’t matter who I read that to, whether it’s to animal or human care staff, they all ‘get it’. Sometimes it makes people very emotional as they realise what I am going to say next. I always start my face to face compassion fatigue training with it as it makes people sit up and wonder what I’m doing!
In fact, this story is a very visual image of what compassion fatigue feels like, it’s that feeling of being totally overwhelmed by the ‘rescuing’ you are trying to do and the emotional toll this is taking on you.
When I finish reading the story I point out to the learners that this young woman is in is very real danger. If she continues to walk along the beach trying to save every starfish she will become overwhelmed by the task but equally she also runs the risk of not noticing that the tide is coming in. The danger we all face when we work in any helping profession is that we get so absorbed by our ‘mission’ that we fail to notice the effect it is having on us and end up neck deep when the tide comes in. Now if we are lucky, someone might turn up to save us before we drown (think orange boat!) but for many of us this doesn’t happen so we end up in a very dire situation with only ourselves to rely on and sadly most of us are very ill equipped to do this.
I am vs I work as
The professions (with a big P) usually introduce and describe themselves as their job, “hello I’m a … Vet/Dr/Nurse/Lawyer etc. whilst people which other types of jobs will say “Hi I’m Bob and I work … in finance/in a restaurant/for Marks and Spencer’s etc. I’m just as guilty as everyone else; I spent years telling people that I ‘was a nurse’ but this is dangerous language and I no longer do it. Now I tell people that I work as a nurse. It’s a very subtle change but it can make a very big difference. You see most of us who work in the helping professions do so because we have a very strong drive to want to help. This drive can come from many different sources, some people come from families where service to others is seen as very important and a fundamental family value so children will be encouraged to join the helping professions. I often find that when we go around the room in the training and ask people to share why they work as a … they will begin by telling me that a parent/grandparent/uncle/aunt also does or did the same job! But equally through personal trauma some people are drawn into the helping professions, I’m sure that my father being ill and in hospital a lot gave me the drive to want to be a nurse and I thought they looked like they were having fun (not always the case I was to discover!)
So, in order to start to help people to become aware that they need to be more than their job to be able to survive it I will encourage them to tell me their name first, then that they are a parent/sibling etc. and then what they work as. This is important as through changing this one little thing we can help them become aware of the fact that if they identify too closely with their job and make it their life mission and then their job becomes stressful or begins to overwhelm them at times (which, by the way, is totally normal) they may feel they have failed as a person not just in their job. Feeling you have failed as a person in your personal mission in life will have a very serious and profound effect on you.
Learning to surf
If you have chosen to do a job where to do it well you need to give of yourself emotionally you also need to take responsibility for taking really good care of yourself!
No one forced you to do this job but you may have found it much harder than you could ever have imagined and sadly many employers provide staff with lots of training in how to wash their hands and bend over correctly (!) but not how to care for themselves emotionally. I’m hoping this is changing but in the meantime it’s up to us to be aware of how our job can affect us and make sure that we have lots of other things in our lives that give us joy as well as our jobs which we of course get immense satisfaction from otherwise we wouldn’t do it.
Dr Amy Cunningham an American psychologist has a really great TED talk online about compassion fatigue and she ends it with asking everyone watching to promise for the rest of their lives to take 10 minutes every day to do something just for themselves, to read or talk or walk, to meditate or just take a long bath and I think that this is very sound advice. Awareness of the issue is the first step and the next one is to act to prevent being left with your back to the cliff and the tide coming in. You saved the starfish but what about you?
View all the range of Compassion Fatigue Awareness online CPD modules by Jayne EF Training
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This is the ‘elephant in the room’ and it’s time to acknowledge its presence, examine and treat it.
What is it about the veterinary profession that makes this the case? Vets do report high levels of stress and there are many theories about the causes which include, poor workplace relationships, career concerns, issues with clients and unrealistic expectations. Rosie Allister, chair of Vet Helpline, points out that ‘the veterinary profession has an occupational culture of perfection and self-sacrifice, independence and omni-competence which is totally unachievable.’
Could it also be that it is the type of person attracted to the profession that makes them more likely to suffer from stress and compassion fatigue? Former West Australian Turf Club veterinarian Peter Symons, who has himself suffered from stress and related medical issues, explains that “vets are often do-ers (working to get through many jobs in a busy day), perfectionists (a trait required to get good marks to enter the course, and to survive the intensive tuition) and carers (the reason why they were drawn to the profession in the first place).”
When you examine the evidence, you see that the profession attracts high achieving young people who are unused to failure, have a very strong compassionate drive, are highly motivated and are perfectionists. They are joining a profession that is very hard on itself with very unique stressors and this combination can for many people be a recipe for disaster.
There is no ‘one size fits all’ answer to this problem and to suggest that there might be is totally unrealistic and simplistic. It is absolutely clear to me that the ‘elephant in the room’ can no longer be ignored – it’s presence must be acknowledged and the profession must go further and embrace it as part of the solution.
In the late 1990’s American Traumatologist Charles Figley realised through his work supporting staff who cared for traumatised people and animals that, as a result of vicarious trauma (our inability to effectively differentiate between trauma that has happened to us and that which we witness), these staff were showing the same symptoms as those they cared for. He called this this compassion fatigue.
Awareness
Awareness is the key first step. Organisations and individuals who to turn and face the issue can begin to look for effective solutions.
To raise awareness, we have to get people talking about it. Mental illness is a real thing but all too often the fear and stigma surrounding it means that it is only talked about in hushed tones and away from other people or not at all. The other issue is that if people do admit to it they feel guilty, how can you admit even to yourself that you are ‘running low on compassion’ when this is the very emotion you need to do your job and support the animals and people you are there to help. Furthermore, in many professions admitting to anyone that you are feeling this way can be viewed as weakness and that you are unable to cope with the demands of your job. In the worst case you may even be told to ‘man up’ or reminded that ‘you knew what the job was when you trained for it’. For what should be very obvious reasons neither approach will work in the long term and can in fact lead to very real harm as when people feel that they are not able to share how they are feeling they will pretend they are ok with sometimes tragic consequences. Many animal health care professionals know of colleagues who have taken their own lives.
Prevention
It is rarely sufficient for people working in a caring role to be able to cope with the emotional demands of their job simply through awareness of the potential dangers of the role and subsequently taking responsibility for caring for themselves. Those who train, manage and support these staff have an equal responsibility to put measures in place inside the workplace to adequately support them.
It is simply not enough to just give ‘lip service’ to the issue and write about it in journals. There needs to be a mandatory requirement to provide emotional health and safety training for staff in the same way that we provide physical health and safety.
The emphasis MUST be on prevention as well as cure. It must include pre-event intervention not just deliver post-event diagnosis.
What are the chances that the contents of the first aid box in a corner will prove adequate if you didn’t know that the animal you are about treat might be dangerous, and therefore have taken no precautions?
Emotional Health and Safety
What is needed is a change in legislation to force employers to take the same care of their employee’s emotional health as they do their physical help and alongside this training. But not just any training in stress management, it must be training that is designed to acknowledge compassion fatigue, secondary or vicarious trauma so that those attending understand the physical and psychological reasons why they feel as they do. It is not enough to just give staff advice on self-care, they need to understand why this is so vital and what the early signs and symptoms are that they are beginning to suffer so they can put measures in place to increase their resilience. Resilience is a muscle and it can be strengthened but only when you know when and how.
The old saying is ‘you can’t eat the whole elephant’ and this rings true for the metaphorical elephant as well, change will not happen overnight but it is coming and it needs to be embraced; a mentally and emotionally fit and resilient workforce is good for everyone, human and animal alike.
View all the range of Compassion Fatigue Awareness online CPD modules by Jayne EF Training
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