Most veterinary professionals love conversations with owners of healthy puppies and kittens that are in for their first wellness visit. There’s usually very little chance that there will be anything stressful or difficult to talk about. Unfortunately, other types of consultations can be more challenging, with conversations that are much more difficult to have; Conversations involving sharing bad news, about a pet’s serious chronic or terminal illness, an injury for which little can be done, an unexpected loss of a pet during surgery, or end of life discussions.
Nothing can make these types of conversations easy, but there are communication techniques which can make them a little more manageable and less stressful for both you and your clients.
One unique thing about these conversations, is the kinds and power of emotions you and the client may feed. From fear, uncertainty, grief, shock, despair and even anger, you are likely to have to manage a range and intensity of emotions you wouldn’t encounter in any other type of dialogue with a client. These conversations can be very difficult, personally and you may experience unexpected emotions[1]. Getting yourself prepared mentally is very important before you begin a difficult conversation.
How you deliver news can greatly influence the relationship you have with your client. You should aim to communicate bad news in a straightforward, non-judgmental, and empathetic way[2]. Communicating well can help clients to process the information, increase the trust they have in your guidance[3], and even affect the decisions they make about care measures to take.[4] All this can greatly impact the quality of life of their pet at a very difficult time in both of their lives. On the other hand, poor communication can lead to clients being dissatisfied with their pet’s care[5] and it can increase the likelihood of a malpractice complaint[6].
In order to break bad news, using a technique called a “Warning shot” is advised. A warning shot is an opening phrase that warns the client that they are about to receive bad news. Examples of a warning shot include: “I’m sorry but I am afraid it is not good news” or “You may want to sit down”. Following this, there should be a short pause before delivering the difficult news.
Then comes the next challenge; Expressing empathy and acknowledging the owner’s feelings while clearly communicating the facts, and making sure that clients understand what you intend to convey. This is key to your client being able to make the best decision for their pet.[7] It can be helpful to break up your explanation into smaller chunks, checking in with your client and making sure that they understand before delivering the next bit of information[8]. This is called “Chunk and check”.
[1] Alexander, D.A. and Klein, S., 2000. Bad news is bad news: let’s not make it worse. Trauma, 2(1), pp.11-18.
[2] Stoewen, D.L., Coe, J.B., MacMartin, C., Stone, E.A. and Dewey, C.E., 2014. Qualitative study of the communication expectations of clients accessing oncology care at a tertiary referral center for dogs with life-limiting cancer. Journal of the American Veterinary Medical Association, 245(7), pp.785-795
[3] Spigelman, R., 2015. Veterinarian communication and its impact on dog and cat owners’ satisfaction with care, trust, compliance and the veterinary care a pet receives (Doctoral dissertation).
[4] Hersch, J.K., Nickel, B.L., Ghanouni, A., Jansen, J. and McCaffery, K.J., 2017. Improving communication about cancer screening: moving towards informed decision making. Public Health Research & Practice, 27(3).
[5] Coe, J.B., Adams, C.L. and Bonnett, B.N., 2008. A focus group study of veterinarians’ and pet owners’ perceptions of veterinarian-client communication in companion animal practice. Journal of the American Veterinary Medical Association, 233(7), pp.1072-1080.
[6] Levinson, W., Roter, D.L., Mullooly, J.P., Dull, V.T., Frankel, R.M., 1997. Physician-patient communication: The relationship with malpractice claims among primary care physicians and surgeons. JAMA 277, 553– 559.
[7] Nickels, B.M. and Feeley, T.H., 2018. Breaking bad news in veterinary medicine. Health Communication, 33(9), pp.1105-1113.
[8] Abood, S.K., 2007. Increasing adherence in practice: making your clients partners in care. Veterinary Clinics: Small Animal Practice, 37(1), pp.151-164.
