Thank you very much, Sylvia. So, as Sylvia, it's been so lovely to introduce me to you all. I hope you've been enjoying your morning so far, and I thought Lucy's talk was absolutely brilliant and covered a lot of the stuff that, yeah, like me and Sylvia found in our first year, doing our internship.
So, Sylvia approached me a couple of months ago and asked me if I could do a talk on communication. So, I sort of thought it tends to be a bit of a, a dry lecture at uni. So I thought, how could I make this a bit more interesting, hence the name, how to approach the crazy cat lady.
Just to try and lighten things up a little bit because we've all met these people and all, struggle maybe a little bit to understand them. And work out how it's best to, to communicate with them, because at the end of the day, our main priority, with our work is, is to, you know, communicate well with owners so that we can fix animals at the end of the day. We can't do all the cool stuff like GDB surgery, blood transfusions, orthopaedics, all the stuff that we find really fun, unless we can get the owners on board with the plan that we want to, want to do.
It can be the hardest part of being a vet, and I hope that at least something that I say over the next sort of half an hour will help to make this a little bit easier for you. Being able to communicate well will help with your job satisfaction, because you're gonna be able to be less stressed at work and feel like you can do a better job. So this doesn't.
Exclusively applied to Crazy cat ladies, but also Crazy Horse ladies. I'm sure Andy can fill you in on some of those that he's probably had to deal with. but it's also really important for how you work as a team, and that in itself is really important with how happy you feel at work.
They, your team and the people that will have your back when, Everything's getting on top of you. It's busy, it's a bit mental. And especially over the last year where we've all have been having to deal with learning how to change our practise in terms of dealing with the COVID pandemic.
So it is really, really, really crucial. OK. So.
Ah, this is me back in my carefree days at the RBC. So, but, but how did I start all of this? So, I guess when I was younger, I worked at a pub and a riding stables in between, school, I guess.
And that in itself, for me, I feel was my starting point for learning how to talk to different people. And learning from people's body language, especially when you're teaching them to horse ride, is really important. So actually, before I did my degree in, the RVC, I did a degree in equine science.
And I, in between my 2nd and my 3rd year, I worked as a feed advisor for Denjy Horse Feeds. So a lot of that was emailing people, speaking to people on the phone, talking to them about their horses, about what they wanted to. Achieve about whether they had any health issues, and we needed to consider that in terms of what we were feeding their horses.
And just generally building up a rapport with people and promoting the company and promoting a more natural way of feeding as well. So that was, that was brilliant experience. So, as Sylvia said, graduated from the Royal Vet College in 2015.
I can't believe that's nearly 6 years ago. That's gone very, very quickly. But I feel like, again, a very important thing for me in terms of being able to talk to owners was the fact that I worked in hospitality through vet school.
So I worked for pubs. I worked for, a team where we would work at Twickenham and Wembley, with people. And again, that really, Really made the then transitioning into practise and that first, you know, week or so in practise where you'd have to speak to owners.
It took that, it took that stress away. So if there's anything that I can encourage you to do, obviously, it's not really, easy to do face to face at the moment in terms of getting a part-time job in hospitality. But if you can, I, which would involve speaking to people on the phone or emailing people, and that in itself can be really, really helpful.
OK. So what's the next one? So, yeah, so, as Sylvia said, we did our internship at the Epine Hospital.
During an internship, I guess your interaction with owners isn't as great as it is when you're in, in terms of quantity, as, as in sort of practise. Normally, you're just updating owners rather than taking, so much of the history or deciding on a treatment plan. So after I did, my internship, I kind of felt like I wanted to do a bit more surgery and have a bit of a better work-life balance, hence I moved doing small animals.
And the first practise that I was at. Was incredibly supportive, and had some brilliant vets in terms of their ability to communicate with owners. Very patient, very thorough, and brilliant people to learn from.
So, during my time there, I started doing the locum shifts for Vets Now and really enjoyed the emergency side of things. But again, that's a whole completely different ballpark in terms of how you're communicating with owners because in some of those cases, you do not have time. To go through the whole history.
So ask saying to the owners, I'm sorry, we're not gonna have time to go through the whole history. I need to know X, Y, and Z, so that I can stabilise your animal if you give me consent to, and then we can start from the beginning. And, and you can feel me on and everything.
And as long as you use that sort of sign point to them, that, that you are going to talk about everything, but don't have time to do that now, then 99% of people are more than happy with that, and they just want you to get their animal fixed. So, yeah, I got, I got the bug for doing out of hours, and I've been, full time at Winchester for, it'll be 2 years in March, which is quite scary. And during that time, as I said before, we've had to completely change how we communicate with owners because we're having to minimise face to face contact with them, hopefully, as we progress through this year.
more of the population get vaccinated and we can start to get back to normal, because for me, I know I found it quite difficult in the first place. I like chatting to people face to face. So then only chatting over the phone or, through other colleagues made everything a lot more difficult.
So, but you've got to learn, overcome, and adapt to, to practise. Oh, that was what I was gonna say. My random picture here is one of my, my favourite things that I find on ultrasound scans.
I just thought it was a bit more interesting than a com, communication picture. If you can see, this is a, liver in a dog. And the, hypoechoic area that you can see is the gallbladder.
I hope you can appreciate there's sort of a line around the edge of the gallbladder, which is a sign of, gallbladder wall edoema. The main two things you find that in is anaphylactic shock or right-sided heart failure. So, it's a pretty, pretty cool thing to find.
OK. So these are our learning objectives. We, I hopefully we'll cover through, most of these.
But if, if, if I don't, then, you know, it's, there are things, things to work towards, I guess, in terms of where we want to sort of aim to be good at what we do. But I think the most important thing with this is it's a constant learning process, and nobody's ever perfect with communication. We all have, good days and bad days, and that's fine as long as you can reflect on the bad days and sit down with someone maybe and go, This is how the conversation went.
Where did I potentially go wrong? How can I improve on this? Then that's, you know, that's a brilliant thing to be able to do.
So, in terms of forms of communication, everything has very much changed, as I said, due to the pandemic. So we're not getting as much of a face to face contact with people. So we lose that ability to read people's body language, work out whether we're talking too fast for them, because I think I think that can be a massive issue, for some owners, especially if they're hard of hearing, or if you've got an accent.
I know, my head fat. Jack is a brilliant vet, but he's Polish and he can talk extremely fast, and has quite a strong accent. So, some sometimes I think we have to sort of remind him to, to slow down.
And your tone of voice are really, really important. It's not all about what you say. People, in general, sort of decide whether they like you or not, apparently within 7 seconds of meeting you.
So I guess the best thing that you can do is be, be friendly, have a happy tone of voice, make them feel like you're paying attention to them. There's nothing worse than for a client than And walking into the consult room door and you've immediately turned your back to them and you're staring at the computer, they want to engage with you. And one of the best things you can do is engage with their animal, because that's why they've come to see you, because they're concerned about their animal.
If they've got, you know, a dog with them or a cat with them, I always greet them as well, because that's, that's why they're here to see you. And that really gets people on board with, with liking you. I guess one of the most difficult things as a new grad as well, I found when I went into practise is that a lot of clients, at the practise I was that had been there for years and they've been used to seeing the main two partners of the practise.
So me coming along as a new fresh face that they didn't know. We're like, Oh, well, I wanted to see such and such. So you've got, you've gotta work hard to win them over.
But when you do, it's, it gives you a real sat, you know, feeling of satisfaction. And, yeah, and it, it, that's really, really lovely. .
So in terms of emails and messages on the internet, I think you've got to be really careful. We see the internet and promoting our practises on the internet means that we can reach a much wider audience. But then also, we've got to be careful because some of our clients.
So, you know, in their 80s or 90s, and they don't really use smartphones or the internet. So we've got to be careful not to, miss those people out and make sure that they're, you know, they're not missed out in terms of, in terms of talking to them. So as yeah, as I'm sure you've probably heard people say before, we all love animals and that's one of the reasons why we love doing this job, but we also need to learn to love people as well, or at least learn to communicate with them.
The most important thing that you can possibly do when you're going into each console is to have a plan. So, a lot of the time, we'll have some idea of why the animal's coming in to see us. There might be a little bit of a history from the receptionist or whoever's booked in the appointments.
So you want to have in the back of your head a bit of a, a structure to sort of break down and follow, because that means you're less likely to miss something. So, in terms of learning communication skills, I've covered all of, I think I've covered a few of these before already. So, the best thing that you can do is practise, practise talking to people, practise talking to.
Owners, and you're only gonna get better from, from that. You hopefully you shouldn't get worse. So, and I guess one thing for me, as I said, is watch other vets at work.
It's so important. You pick up on, you pick up on things that they do well and things that they might not do quite so well. And then you sort of develop your own style from, from that.
The other thing is, yeah, it's obviously communicating with your patients. This is my boy, Thunder is a rescue husky. He's, he's quite easy for me to deal with now, but initially, he was not overly easy at being handled.
And I think a part of that with communicating with clients and having a good consult is if you can be calm and confident with handling their animals, and that in itself. That communicates to them that you're happy with what you're doing. And again, that all comes down to practise.
I remember when I started in the small animal work, and I'm quite happy and confident with handling dogs, but with cats, I just found them to be spiky ninjas. So, You know, learn from, learn from other people in the clinic. So, other nurses and other vets taught me their sort of tips and tricks for, for cat handling.
And, you know, for a crazy cat lady, if you can handle the slightly crazy cat, then they will love you forever. . So, this is my general structure that I try and stick to, when I'm having a, holding a consult.
So as I said, welcome the client and patient, acknowledge that they're there. Don't just stand and stare at your computer. Ask start them off with asking the most open question you possibly can.
So, say, what's been going on with Molly? And then listen. I know that.
I find it difficult to not interrupt people because my brain starts going and I'm starting to think, oh, OK, what's going on with this? It could be this, this, that, working, starting to work through, like, my differential diagnosis list list. But then you might end up missing something if you're interrupting them.
So the way that I help with that is I write what they're telling me down, because then I feel like I've got that right in front of me. It's not gonna go in one ear and out the other. And, I, I, they, it makes me look to them like I'm listening to what they're doing and taking note of, of everything that they're saying.
. The other main thing with this as well is you'll find that people will tell, or clients will tell receptionists and nurses and your other support staff, different little bits of history that they might not necessarily remember to tell you. So, again, that's a really important point, is to communicate with your team. Has Mrs.
Such and such, like, said anything to you that I should know of? And And if you're, you know, if you, you work well as a team, you know, get them to take note of what they've said and then feed back to you as soon as they think, oh, that could be important to this case. It's so, so useful.
You know, for dogs that have come in for vomiting, and they might not tell you that they think it could have eaten a sock, but they'll tell the nurse. So go back through what they've told you, to make sure that you're not missing anything. And it shows them to So shows them that you're trying to understand what's happened, then perform your examination, and get a plan together, .
Ask the owner if they, you know, feel like, you know, there's anything going on themselves. A lot, you know, most of, most owners want to be involved in the decision making with their animals. So you need to, yeah, get them involved and get them on board.
But at the same time, you're there to, to be an advocate for the patient. OK. So, most common consult that you're gonna come across in general practise is your annual health check and booster.
And I feel like a lot of the time they get sort of dismissed as a boring appointment and you try and race through them to get to the interesting stuff. But building a rapport and building a relationship with people then is, is so crucial because if that animal then does consequently, Become ill, then if they trust you and, you know, trust your advice, then those clients are gonna come to you at the start of a disease process, when hopefully you can get to the bottom of it and fix it rather than leaving it too late. And I found one of the most important, the two most important things that I found in practise in terms of what you can do in these consults for improving patient welfare is to make sure that, it's to talk about things like diet, because we know that more and more of our patients, are, are becoming overweight.
And also, and one big thing for me was arthritis as well, especially in cats, like something, I think it's something crazy, like 80% of cats by the time they're 11 have some degree of osteoarthritis, but. People aren't great at picking up on the signs of pain, so you have to. You know, communicate with them well so that they know what to look out for.
And people learn in different ways. Just standing there and talking at clients doesn't necessarily get across to them, what, You know, You need to really need them to take home and remember from that consult. So sometimes showing them a thing.
So if they've got, an overweight dog like this guy was in the top picture, you know, get them to feel their dog and say, you should be able to feel their rips. You should be able to feel their spine. They should have a, a, a tuck up in their waist from the side and above.
And once they can see that, then you can start to work to get these people on board. And then 3 months later, this guy, was looking a lot from her. He had had a bit of a haircut as well, but I can tell you, he was, he was a good 3 kg lighter as well, which was brilliant.
And it was lovely because the owner was like, Oh, he's got so much more energy, and, and so much happier, which is fantastic. Again, if you've got an arthritic patient and you can feel the crappiti in their joints, get the owners to put their hands on that joint and have a feel themselves. And that in itself can make them go, Oh, God, joints, joints shouldn't feel like that.
Give them reading material to go away with. So the international cat care website is brilliant for things like, idiopathic, fe unknown and low urinary tract disease, managing patients with kidney disease, . If people want to look things up on the internet, then it's part of our job to send them in the right direction and give them the right information.
A, so they don't end up doing the wrong thing for their animal, and B, again, so they feel like they're on board with their animal's treatment. Obviously, in day practise and in out of hours work, you've got to manage your time. In day practise, it depends where you're at in terms of, consult slots, but try and, either work with your receptionist, book it, book appointments in for yourself.
If you know that someone's gonna be talking for ages, book yourself a half an hour appointment if you can. And then it feels like they've, they feel like they've got value for, time for their money. So, one of the, one of the million dollar questions that I love.
If it was your dog, what would you do? Be honest with people, because they will appreciate your honesty. Try and give people a bit of an idea as to what way you would go if it was your dog.
You know, that tends to be something that people ask at at euthanasia appointments. If it was your dog, what would you do? And, you don't have to necessarily answer this question directly.
I tend to try and go around it by, sort of saying, Well, if they're having more bad days than good days, and they can't go out to the toilet for to themselves, and they're going off their food, and those things then start to sort of tick certain boxes in their head, and they start to answer that question themselves. So, I guess the other main thing is, well, be confident in yourself. If you're not confident in yourself, these owners will pick up on it straight away, and go, well, if the debt, the vet's not confident, then how can I be in themselves and how can I be confident in them.
So. It's, it's not a static thing. We will have good days and we will have bad days.
But you've gotta have some belief in yourself. You got through vet school, you know what you're doing. You've just got to try and put that into practise.
So just be prepared for criticism now and again. Take that on and feed it back into yourself and, and just move forward with it. And decision fatigue is, is a massive thing that we need to.
Be aware of it affects us and it affects our clients as well, so sometimes, If it comes to sort of making tough decisions, there's no, there's never a, it's never a bad thing to give yourself more time for either the owners to mu things over, or for you to think about, you know, different options for your patient. So, when you're making recommendations, . The four main things, I guess, is you need to be clear.
Write things down for them. If you don't, if, you know, and ask them, Do you want me to write it down for you? And sometimes they'll go, Oh, no, no, no.
I'm fine. I've taken that all in. And sometimes they're like, Oh, that's brilliant.
Yes, please. Especially when it comes to things like that you're starting an animal on multiple drugs, like, have a little sort of timetable that you can just click print off and fill in for them. That they love that.
That's absolutely brilliant. It's really easy to do. Mayo is aware that goalposts can change.
If you're saying to people, we might make a different decision about this next time. I just did a really good course on, extreme wounds by the BSAVA with, John Hall. And he said that, you know, every time he's doing a dressing change, he's saying to the, he's like, We might do this next time.
We might do that. We might have to do a repeat surgery. We might have to take this thing a couple of steps back.
And as long as you let people know, then they're prepared. For it if they think that it's all gonna get better in this time frame and then you change that, then that really upsets people. And especially at a time like this where we've had so much uncertainty, I'm definitely finding that people are wanting answers to things straight away.
And you have to let them know we can't know what's going to go on at this stage. And I can't predict what's gonna happen in the future. Tends to be quite a good line.
They suddenly go, Oh, actually, I'm asking. The vet to, to have a crystal ball, so it's, it's not always feasible. So, in terms of discussing costs, people want to know what they're paying for.
If you can show them an itemised invoice and talk them through the breakdown of the costs of things, then they tend to take that on board a lot better. We need to remember that as a country, we're not used to paying for healthcare. So, for our owners to then come and pay X amount of money for their animals, it always seems like a lot.
But if you can break down, well, this is how much this costs for the consult, for the medication, for the blood tests that we've done. I always find it's better to overestimate than underestimate. If you, if I say a patient's gonna be in for 36 hours with this over the weekend, and it's gonna be 1500 pounds, and I end up, and it ends up being 1000 pounds, well then people think, Oh, that wasn't as much as I thought it was gonna be.
It's always better to overestimate than underestimate and keep people posted on. Where you're at in terms of, in terms of costs as you're going through the weekend, so they've got that in the back of their head, so you don't suddenly go, oh, we've gone from 200 pounds to 1800 pounds cos that's a bit of a scary jump for people. And we're all gonna have difficult clients.
You know, it's, it's part and parcel of our job. I know that in the last couple of weeks, I've had two of the most difficult clients that I've had in my whole career, and it really kinda hit me sideways, especially doing this talk today. But you have to just take on board that you are gonna come across these people, and that's fine.
Best thing you can do with them is be patient and listen, to what their problems are. And, and, you know, accept that it is difficult to deal with, and you need to talk to people about that. You know, talk to your team, talk to your friends, talk through it.
And that really, really helps. I love the fact that, that's now we've got recorded phone lines. So if we have any difficult phone calls and someone else can listen back to that conversation, and then say, Oh, yes, you did really well in handling that, or, OK, maybe next time you can talk about this with them, and that'll help you deal with the whole situation a bit better.
When we were able to have people in the clinic, I, if I was gonna have a difficult conversation, or I thought, oh, maybe this owner would quite like an opinion from another fair, then I'd have someone else come in for that difficult conversation. A, it's great to have someone there as sort of back up for what you're saying. And, and, yeah, B, it's a bit of support as well.
At, on the same note, really don't tolerate people being rude to you. Swearing and, yeah, putting, putting down what we do is just not, you know, we don't have to tolerate that. And if you need to say to people, I can't tolerate that, you know, that language, at the moment, and I need, you know, if they carry on and they don't listen to you, say, OK, we're gonna end this phone call now.
If you can call me back when you've calmed down and we can have a more rational conversation. You're well within your rights to do that. You don't have to have to put up with that.
And yeah, never be afraid to ask for help. So, this lovely little girl was, brought into me last year. She had completely collapsed after, she'd been spayed, was white as a sheet.
So we sort of resuscitated her and got her back on her feet a little bit, and turns out she had a, Bartonella infection before she even went for her spa, so. But I feel like this is the, this is the goal of, of, you know, of having good communication with your clients, is you get to see your patients doing well after, after you fix them, and you get these lovely thank you cards. I know I keep all my thank you cards, in a little folder upstairs.
And when you feel like you've had a really tough day and been struggling to communicate with people, look through those cards and remind yourself that you are really good at your job. And You know, you've obviously, you know, made people happy because they've taken the time to, to send you cards. And I guess remember with, with people, it's, it's always a marathon, not a, not a sprint, in terms of, in terms of where we want to get to with improving our communication skills.
So, don't put too much pressure on yourself. Ask for help and, you know, be patient with people and be patient with yourself, I guess.