Communication
Whenever you deliver bad news to a client, you should use clear and straightforward language. You might be tempted to use vague or clinical anguage, perhaps hoping to blunt the impact of the situation, but don’t. “Rusty’s condition appears to be terminal” might not be blunt, but it is also not as clear as “There is nothing more we can do to cure Rusty’s illness.” On the surface it may seem harsh, but the best way to deliver bad news is through direct communication, both verbally and non-verbally. This helps ensure the client understands the situation accurately. You want to avoid the client leaving the practice with any doubt about what’s going on with their pet.
Orientation
Clients may have unrealistic expectations about what can be done for their pet with a serious injury or disease. It is important that you help them to understand the realistic possibilities for treating a pet’s condition by communicating clearly. Balancing the difficult truths of their pet’s condition with supportive and hopeful statements can also be helpful. For example, “I am sorry but Alfie’s cancer cannot be cured” can be followed by “But rest assured, we are going to do everything we can to ensure that Alfie is comfortable and enjoys his time with you for as long as we can.” This allows the client to have realistic expectations and make the best treatment decisions for their pet without falling into despair.
Mindfulness
One of the principles of effective communication is “Attentive Listening.” When sharing bad news, attentiveness extremely important. Do everything you can to pay attention to the client’s cues, responding to their needs when sharing bad news. Avoid any distractions, maintain eye contact, and listen actively to everything the client says. Make the client and patient the center of your attention. It probably goes without saying, but this includes having the discussion in a quiet and secure place (some clinics set aside special rooms with calm surroundings for this purpose). Being mindful allows you to think before you speak and choose words that are both clear and empathetic.
Family
The presence and inclusion of family members, or a close and trusted friend of the client can provide helpful support. Acknowledge each person in the room, and build trust and understanding by actively involving them in conversations about the animal’s prognosis and care options. Practice in advance how you might conduct a conversation with multiple people present, though, so you’ll be able to make the most of the opportunity.
Ongoing
Make sure you are clear with your clients that even though the situation may be terminal or chronic, you will continue to provide support to the client, and excellent care to their pet. This helps prevent the clients from feeling a sense of hopelessness or abandonment. By continuing to communicate openly with the client, they will have greater clarity about what to expect as their pet progresses. Each visit, summarize where things stand, and what outlook the client can expect for the present and future, including options to consider. This can be done relatively briefly but it will help to ensure that the client knows every step of the way that your care and that attention is ongoing, which they will appreciate.
Reiterative
It is important to frame each new conversation in light of the previously delivered bad news in order to avoid any unrealistic expectations of a cure as time passes when no cure is possible. Use language that acknowledges that you are restating things you have previously discussed. For example, “Last appointment we discussed Rocky’s energy levels and how we might be able to improve them…” Then you have the opportunity to remind them of the situation as described previously as well as add to, or alter, the outlook based on more recent developments. Reiterative statements allow you to clarify questions, deliver additional information, and reinforce your desire to provide the best possible ongoing care for the pet and support for the client.
Team
Clients and patients interact with a broad veterinary team in your practice. Communicating as a team, including supporting one another as you support the client and patient is imperative. Communicating as a team helps prevent mistakes and misunderstandings and builds confidence among clients that their beloved pet is receiving the best possible care.
