October 11th, 2023
How to feel Compassion Satisfaction
By Celine Leheurteux, DVM
In 20 years of wearing my veterinary coat, I have seen the craziest situations. From a cat with an arrow through its epaxial muscles to a 200lb man crying more at the death of his dog than his mother. I have witnessed the evolution of the strength of the human-animal bond. I am no longer afraid to say that I feel compassion satisfaction in most of my euthanasia appointments. Euthanasia is recognized as a major contributor to compassion fatigue. But when we feel like we are making a difference, bringing all our knowledge and empathy to families and animals, satisfaction comes over us. These experiences that are so rich in humanity do not empty our empathy tank but rather fill it up. They garnish our collection of hand-signed cards and especially our chocolate consumption. Just as I am last reviewing this article, an email came in to thank me for helping in such difficult times. Who gets that on a weekly basis?
Learning from our mistakes
The road to get to this point has been fraught with pitfalls. Without academic training in sedation protocols, intravenous and intra-organ injection techniques, verbal and non-verbal language, client psychology, it has been challenging. I learned almost all my tricks by making big mistakes. Until my last breath, I will remember this exasperated client yelling at me “Just kill him, kill the damned dog!”, when I could not find a vein in her reactive though dehydrated dog in the back of her 1976 chevy on Saturday night. If I had known how to give him a decent sedation to get rid of his pain and anxiety and if I could have injected him intra-hepatically given the poor lighting and fragile veins, it would have changed the experience for all of us. The situation felt hopeless at the time: for the lady who wanted the best for her companion, for me who felt like an imposter (sound familiar?), for the empathetic technician, and for that poor anxious dog. After 20 years, I finally learned how to use the deep sedation techniques which prevent much of the unexpected. A growl, a shrill cry, a paw that withdraws. A source of stress diffused. What a relief not to worry about the unpredictable in such a tense moment.
On the other side of the mirror
I practiced for 15 years before I lost my first pet. I had no clue how it was to go through what some clients qualify as the hardest decision of their life. More than buying a house, getting a divorce, or changing jobs.
Conversations with a bereavement consultant took me through the looking glass, made me realize how our gestures, verbal, and non-verbal communication could be perceived by suffering clients whose perception is altered by stress and emotion. How to adapt our vocabulary to increase our chances of being understood.
· Physically separating the animal from its parents in the final moments, so dear to them before departure.
· Weighing the animal. They don’t understand why we weight animals; they associate it with health follow-up that contrasts with a euthanasia. They don’t live on mg/kg like we do!
By applying these simple precautions, I feel more in tune with the clients. I feel better. I feel emptied and filled at the same time. I feel alive.
Mapping the experience
We know the experience by heart, but let's remember what we didn't know when we didn't know. We need to describe in detail to the families what is coming. What they will see and feel, the physical and mental reactions to sedation, the time each step will take. Verbalize. A simple “it is not easy for you, but we are here for Billy and for you, we have already gone through this ordeal with our pet”, can change the dynamic for this family that is bathed in guilt and unite them in this intimate and privileged event.
Dr Dany McVety and Mary Gardner from Lap of love and Dr Kathy Cooney from CAETA (Companion animal Euthanasia Training academy) taught me positive comprehensive wording such as:
· Calming agent instead of a sedative
· A device in the vein instead of a catheter
· Too much anesthetic instead of euthanasia solution
· He will be comfortable rather than he will not suffer
· We are making the right decision instead of you making the right decision.
The devil is in the details, sometimes in just a couple of letters. What a difference in the perspective?! A minor adjustment which leads to major impacts.
Such a huge difference for the families who are looking for permission, a change in paradigm. My goal during this appointment is to turn the heavy feeling of guilt into a sense of mission accomplished. Together, we did the right thing for your friend. Cherishing this privileged moment with teary eyes and a smile looking at pictures or sharing memorable moments with this pet. Memories of his dog running at the 4-wheeler, her beautiful bird singing on her shoulder, the family dog always in the kid’s lap when they’re sad.
How is it possible to preserve the dignity of a beloved animal by putting it in a garbage bag? For so many years, I felt like in the mafia having to put beloved pets in plastic bags. It made me feel ashamed, like an imposter, and not worth the trust people were putting in me to be by their side in this intimate moment. I ended up designing the EUTHABAG body bag to be in line with my values. To honor the strength of the bond between my client and their little friend. To treat it as if it were my own until the very end. I can now show, without guilt, this part of the process, rather than trying to hide it at all costs. I freed myself at that moment from that feeling of not living up to the client’s expectations. Not to mention when the client changed his mind and wanted to take the body back and bury it the next day.
Visiting the crematorium
After 15 years, I finally decided to visit the place where I had sent thousands of patients when I had no idea what the place looked like. What does cremation look like? How do they handle the bodies? What does it smell like? Is it a presentable place? After my visit, I could finally say: don't worry, your pet will be in good hands, I have been there. I was able to see with my own eyes an individual versus a group cremation and understand that it's much more than being able to recover the ashes, it's a completely different treatment of the body.
Although the art of euthanasia and the science of death is not an integral part of the veterinary training program, it is made up of multiple aspects that are important to take care of in order to ensure our well-being, that of the family, and our team. A free 6.5H training including a webinar on alternatives to pentobarbital, recognized by RACE, is available online for your teams at veterinaryeuthanasiaeducation.com. Euthabag.com offers a plethora of free tools such as quality of life assessment sheets, pet burial sheets, and children and pet loss brochures. Even coloring pages and a list of books around pet loss for families. The AVMA's Companion Animal Aftercare Policy also emphasizes the importance of body care, choice of crematorium, and preplanning for body disposal.
Celine Leheurteux practices in Quebec, Canada. She created the EUTHABAG body bag to fulfill her need of a purpose-built body bag that she could not find on the market. She shares her best tips on Euthanasia in the Small animal Euthanasia Practical Classes, a free RACE approved training built to reduce stress and improve compassion satisfaction in veterinary teams available at euthabag.com.