Learning to Listen
One of my earliest memories of consulting in small animal practice occurs from clinical rounds whilst still in final year but it bears out the necessity of preparing graduates for the real world and of our ongoing responsibility to keep ourselves fit and well in our line of work.
Most veterinary schools conduct clinics for primary accession of public cases, supervised by registered veterinarians for the benefit of the student. Here is a recollection of the trials of such an experience and a reflection on their importance in our training.
Perhaps the most important and enduring lesson is to listen.
My case was an Old English Sheepdog and I can’t recall much else of the details at all because I have since learned that anxiety derails the learning process including being able to listen. I wonder whether if fewer than thirty years had elapsed between now and then I may recall some of the details but the overwhelming recollection is narrowly escaping having my face bitten off.
We weren’t told too much before being introduced to the clients and their animals but in hindsight I recall this owner saying that the dog did not like being looked at or words to that effect. Be careful of the face etc? I filed that away or perhaps only half heard it until it rebounded in my red faced ears moments later.
These days I have learned to read the animals much better and also give them time and space to acclimatise to me and their ‘scary’ surroundings but back then I was on a mission and had a job to do. Investigate. Coupled with the ridiculously small room we were crammed into (not unlike many consulting rooms I have since worked in), the combination of my intent, the dog’s anxiety, my lack of awareness and the absence of any adjustment/comfort time, led to a potentially dangerous situation. It is possible that the reason I still can’t tell you why the dog was presented nor anything else is because I was either, rapidly relieved from duty ( a commendable action of the supervisor) or I blindly and incoherently stumbled through with my mind solely focussed on my narrow and lucky escape, not hearing anything that followed.
The best thing to come out of it however was a sharp learning curve for life after graduation.
This short account bears out the necessity of being caring and attentive to the messages and directives being given by the animal and the owner. In the way I practice nowadays I am even more acutely aware of my own reactions and feelings during case taking and how these may also be reflected in the case at hand.
It is also worth noting that within the confines of a 15minute consultation these things get lost; especially if they run into back to back consultations over a number of hours. We need time to keep ourselves and our environment conducive to calm and effective practice. It is not always possible in busy practices to keep space between clients but if you have that luxury you can attest to the benefits. Keeping ourselves fit with exercise, good diets, optimal hydration and being happy will greatly enhance our skills as a practitioner and maintaining a quiet, clean welcoming consulting space does wonders to attract and retain clients as well as calm animals. Many people who leave a practice do so because their animal or they themselves, was stressed by it.
There are many little tricks and tips that we can offer each other from our own experiences as they unfold and I was heartened by the efforts of a colleague recently who conducted a webinar presentation on calming techniques for the consulting room. These included things such as being aware of smells, sounds and stimuli and providing treats or essences to reduce anxiety. Fortunately there are also members of our veterinary community these days who conduct seminars for personal development and enhancement of our veterinary services through self awareness.
Undoubtedly the most beneficial lesson I have learned in recent times has been the art of homeopathic case taking. This builds on my premise that the art of listening is far more important than the breadth of knowledge one may have. This technique is an immensely valuable tool that can be easily learned and applied to all situations whether or not you prescribe a homeopathic medicine. The actual case taking itself is a thorough, deeper more insightful look at the case in hand than any other consulting technique I have employed previously.
As a testament to the benefits of this technique comes many comments from my clients about how much they value being listened to and how they believe that the things otherwise considered unimportant by other veterinarians in regular consultations are often the owners main concerns.
It may be true that as regular veterinarians we may have no need or time for these pieces of information, eg; he likes ham but not fish, but it is important for the animal, the client and believe it or not, often for the success of the case.
Above all else, if you don’t listen you won’t hear even if you don’t always know what to do with the information.