Wednesday, February 15, 2017

Client Education

Client education is one of the most important parts of an RVTs job and yet many of us don't spend the time to do it well.  We want to work with the animals, not the people!  But always remember that any pet that you are working with has a human attached.  We do a great job taking care of the pet while they are in hospital, but we also have a responsibility to ensure that we educate the associated family members on how to continue that care at home.

Dog in hospital
After any surgery or hospital stay, there will be aftercare involved.  Whether there is a wound to care for, medications to give, or exercise restrictions, it is essential that the client be taught how to properly perform these tasks.  Book an RVT appointment to ensure that you have time to go over everything without rushing.  This can be done at the time of morning drop off, or when you call to give an update.  Take the client into an exam room, without the pet present, so that there are no distractions.  Do not try to give homecare instructions in the reception area!

Where possible the RVT who worked with the patient should be the one to go over homecare.  Introduce yourself by name, as the RVT who took care of Fluffy.  I always try to make a personal comment about the pet such as "she has been a very good patient" or "I love the little spots on her nose".  This can help establish a connection with the client and builds trust: Fluffy is not just another dog to you.

Be sure to go over every aspect of the patient's care with the client and have written instructions that they can take home.  Use plain English: just because you understand medical terminology, doesn't mean that the client does.  Speak slowly and clearly and be aware if there are any communication barriers.  For instance, is English a second language?  Does the client have hearing challenges?  Knowing of these in advance will allow you to take steps to ensure that the communication is received.

Go over each of the medications that you are sending home.  What is the reason for each one?  Do they need to finish all the medication or do they give only if needed?  Describe any side effects that they may see with each medication.  Under what circumstances should they discontinue use and call the office?  How many tablets should be given each dose and how often should they be given?  Be specific with instructions: remember that clients do not know what BID means and some may not understand that "twice a day" means every 12 hours.
Going over medication

If the pet has an incision or wound, describe how the client should care for it.  Does it need to be cleaned daily?  If an Elizabethan collar is to be worn, explain why it is important, as well as if it can be removed at any time.  Offer alternatives to the collar if possible as some pets won't tolerate them.  Describe signs of infection: "you may notice some swelling and minor discharge initially, but if it increases, is accompanied by heat, or it concerns you in any way, call our office".  When should the pet be rechecked?  When are the sutures to be removed?  Are there exercise restrictions?  "No running or jumping until the sutures are removed.  Five minute, leashed walks only for the first 3 days.  Increase to 10 minute walks on day 4 and 5; 20 minutes thereafter until the sutures are removed."

Dietary needs should be outlined for the client.  Explain that the pet may not want to eat right away after an anesthetic.  If they are fed, they should be given only one-half of a normal meal to reduce the chance of vomiting.  Is there a specific food that should be fed after the pet's hospitalization?  How much and how often should they be fed?  When should the client start re-introducing the pet's regular food and how gradually should they do so?  Again, be very specific with instructions: feed every 8 hours for the first two days and give 1/4 of the regular food with 3/4 of the prescription food.  On days 3 and 4 feed every 12 hours and give 1/2 of regular with 1/2 of prescription, etc.

Keep in mind that having a pet hospitalized is a stressful time for clients; they may be feeling overwhelmed and not able to take in everything that you are saying.  Having written instructions, as mentioned, is essential.  Be sure to ask if they have any questions, but recognize that they may not think of them until they get home.  Let them know the office hours and tell them to call if they have any concerns.  Tell them they can ask for you directly.

Providing clear homecare instructions gives your patients the best chance at a full and quick recovery.  It also ensures that your client knows that you care about their pet, almost as much as they do.  There is no greater feeling than having a patient come back in for a recheck after a hospital stay with a happy wag or a purr, knowing that you helped make that happen!

This is a great article on post-op care.
This article offers practical tips for communication and client education.
This AVMA webpage is a great source of client education articles and has many client handouts and patient care form resources.
Also from, the top 10 favorite veterinary handouts of 2016. (Not specifically homecare instructions)

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