How to behave during euthanasias

RE: How to behave during euthanasias

Selena Carnell — Thu, 08 Dec 2016 17:07:09 GMT

OMG - i missed Arlo's post somehow lol! You have my sense of humour! - my be an alternative thread.. Euthanasia mishaps.

RE: How to behave during euthanasias

Arlo Guthrie — Thu, 08 Dec 2016 10:34:51 GMT

[quote user="Dove"]

Arlo - love the suggestions![/quote]

Why thank you, Dove :)

I think they could catch on

RE: How to behave during euthanasias

Dove — Thu, 08 Dec 2016 10:26:53 GMT

Arlo - love the suggestions!

RE: How to behave during euthanasias

Sal the 1st — Wed, 07 Dec 2016 21:38:54 GMT

[quote user="steph fursland"]

Things that have happened to me during PTS that are more distracting:

cat projectile vomits on owner after medetomidine

Hamster bites me and I drop it on the floor

cat still trying to eat me after medetomidine

entire family come, bring CD player, play the dogs favourite song throughout euthanasia

stick needle into own finger rather than bung, spend rest of home visit wondering if I will be too sedated to drive home

owner asks me (horrified) if the clippers are an electrical device used to stun the animal

owner wants other dog to be present during euthanasia - other dog is a 2yo Lab, thinks pentoject is food

PTS performed under a Christmas tree, illuminated only by fairy lights

[/quote]

Thank you for posting this - I desperately needed a little humour today

your reminded me of a pts I had many years ago - PTS went very well but the vet suffered. We had a house call booked for a PTS only the 'house' was a yacht and the owner wanted the dog to have a good send off, to literally 'sail off into the sunset' (Client was a friend of the vet and myself and the dog did usually live on the boat)

....So there we were in the Humber estuary, quite close by the Bridge,the sun was setting into a red sky, there was a bit of a breeze (bit of an understatement) and a slight swell(an even bigger understatement) with the vet getting greener by the minute trying to hit a vein on a moving target which was a very elderly Jack Russell with the typical 'Queen Anne' legs......

RE: How to behave during euthanasias

Nicola Smith — Wed, 07 Dec 2016 20:38:59 GMT

Why not suggest the compassion understood training? It sounds like he sounds uncomfortable but if clients aren't happy with euthanasia they won't come back to the practice so he is also losing business.

RE: How to behave during euthanasias

VetNurse Anon a/c — Wed, 07 Dec 2016 19:20:20 GMT

Thank you everyone for your replies! Some of them certainly cheered me up!

I'm still waiting for the next euthanasia with this particular vet. I want to (and plan to) respect his views but I know I will struggle to stay completely silent as I'm so worried about appearing cold-hearted to the client (also I truly believe animals benefit from us talking to them as everything else we do must seem so alien, talking at least is a familiar human behaviour).

He doesn't have the best people skills sometimes and I often cringe to myself as the euthanasia can feel quite rushed, so I can envision the whole episode being a bit awkward. I try to book in a double appointment for euthanasias but he will quite often change it to just the one slot.

He is pretty anti IV placement in euthanasias, as feels this extends it unnecessarily. Same with sedation unless the animal is obviously stressed.

He is the boss and an experienced vet (rarely has problems hitting a vein from what I've seen although I realise there is more pressure during put to sleeps)

I'm just finding it quite hard as my previous practice went above and beyond for animals being put to sleep, always giving owners plenty of time and even having them in a separate room with cups of tea and making sure both a nurse and vet were free to talk things through before and after if the owner wanted to (of course there are many who don't want the process dragged out, which is fair enough). At my new practice we just don't have the time/staff/space to do all of those things which I completely understand but I feel uncomfortable with the current situation.

RE: How to behave during euthanasias

Arlo Guthrie — Wed, 07 Dec 2016 12:49:10 GMT

[quote user="PSA-David"]have the entire practice out side the consult room with party poppers, when vet leaves all pop them saying "well done you hit the vein".[/quote]

Priceless

RE: How to behave during euthanasias

PSA-David — Wed, 07 Dec 2016 12:40:40 GMT

[quote user="Arlo Guthrie"]Ask the rest of the practice staff to line up outside the consulting room for a surprise honour guard.[/quote]

have the entire practice out side the consult room with party poppers, when vet leaves all pop them saying "well done you hit the vein".

RE: How to behave during euthanasias

Arlo Guthrie — Wed, 07 Dec 2016 07:50:08 GMT

A few suggestions as regards the title of the OP: How to behave during euthanasias:

Dress in black, with a veil
Get out trumpet and play The Last Post (this should be done after the VS has found the vein):
www.youtube.com/watch
Buy a thurible and walk round the consulting room swinging it from right to left, chanting (I didn't know this thing was called a 'thurible' either, see below for a 'how to'). www.youtube.com/watch
Ask the rest of the practice staff to line up outside the consulting room for a surprise honour guard.
Organise a 41 gun salute in the waiting room (cap guns will do if you don't have any spare rifles / cannons).

RE: How to behave during euthanasias

Selena Carnell — Tue, 06 Dec 2016 18:20:44 GMT

Sorry Steph, I did laugh at some of those! Our vets did a PTS yesterday and the owner facetimed the husband so he could say goodbye, the VN really struggled to hold it together for that :(

RE: How to behave during euthanasias

steph fursland — Sat, 03 Dec 2016 21:51:58 GMT

I think everyone behaves a bit differently in euthanasias, but you have to do what is natural for you, and what you think the owner/pet will appreciate.

As for you being distracting to the vet... obviously we all want to hep our colleagues as much as we can, so be sensitive to their needs, if they struggle that much with getting a vein, use sedation/catheters/EMLA to make it as smooth as possible. BUT a nurse giving a kind word to the owner is possibly the least distracting thing I can think of happening during a PTS. Things that have happened to me during PTS that are more distracting:

cat projectile vomits on owner after medetomidine

Hamster bites me and I drop it on the floor

cat still trying to eat me after medetomidine

entire family come, bring CD player, play the dogs favourite song throughout euthanasia

stick needle into own finger rather than bung, spend rest of home visit wondering if I will be too sedated to drive home

owner asks me (horrified) if the clippers are an electrical device used to stun the animal

owner wants other dog to be present during euthanasia - other dog is a 2yo Lab, thinks pentoject is food

PTS performed under a Christmas tree, illuminated only by fairy lights

.....my point being, our job is never performed in silent, sterile conditions. By all means take note of your colleague's preferences, but don't forget that your first responsibility is to the animal/owner and their needs/preferences/odd requests should come first!

RE: How to behave during euthanasias

Nicola Smith — Sat, 03 Dec 2016 17:43:57 GMT

We previoualy did this but our compassion understood training told us we should never take the patient away to iv catheterise as it's the owners last few moments with their pet and that some will get very concerned at what is happening that can't be done in front of them. Maybe if your nurses are comfortable doing ivs they could place catheter in the consultation room with owner there - vet doesn't need to be present for this part and less stress for them if they are not that comfortable with ivs in front of owners.

RE: How to behave during euthanasias

Alison Clare Hickman — Sat, 03 Dec 2016 16:53:42 GMT

My answer is... it depends. Obviously as your vet feels that his approach is correct for his client and patient then that's what you must respect. As said previously, it could be a discussion topic for change, moving forwards...

I have worked with similarly non-touchy feely vets and unsurprisingly the clients who preferred this approach were more comfortable with the same approach 'at the end' as well. On the other hand, there were some occasions with clients and pets who didn't naturally choose the vet; this created quite a stilted atmosphere. Almost awkward. At these times, I would (where possible), take the client to another room afterwards and see if they needed some time with me to talk, perhaps further discuss the cremation/disposal process or perhaps simply receive those comforting words, "Yes, you have done the right thing". Of course, that approach doesn't provide the physical/mental comfort to the patient at the time of euthanasia...

It is never easy and every euthanasia is different; from what the pet requires to their owner and indeed, as you say, the vet. It's up to us to be flexible and professional and compassionate;(whoever said nurses are Angels was right!).

One way a few practises I've worked at overcame the 'getting the vein first time' worry was to iv catheterise the patient beforehand. This was usually done in Prep and away from the owner. Much less stressful for all concerned at the critical moment. Perhaps this is something your vet might appreciate? They may be stressed with the thought of missing the vein and not want to muck-up, hence the 'Quiet Please' dictat?

Hth

Ali h

RE: How to behave during euthanasias

Nicola Smith — Sat, 03 Dec 2016 15:59:29 GMT

I always talk to patients during euth and owners do too so is he also against owners talking to them? We as a team have recently all completed training from compassion understood so this may be worth exploring. They strongly advocate the use of sedation prior to euth to avoid animals wriggling off the needle - we now offer this as standard to all. They discuss sedation techniques which won't result in a flat vein!! I do think this needs to be discussed as a team as to not talk to the animal could come across very cold to some owners.

RE: How to behave during euthanasias

Celine — Sat, 03 Dec 2016 14:40:26 GMT

Are there other nurses in the practice you can chat to about this? Do you know how they act during euthanasia with this particular vet? You may find when you raise the topic they all roll their eyes and know what you're about to say before you say it - you also may find they are actively avoiding doing a PTS with him!

I don't think what you have described sounds excessive or unreasonable but as we know there are some vets who don't necessarily have great people / communication skills and perhaps your behaviour makes him feel as though his inadequecies are being highlighted! Perhaps very very subtly raising the topic with one of the other vets to find out if they feel the same - something like "Oh it was a shame fluffy had to be PTS last week but I made sure he was being tickled under the chin as he went..." in case it opens up the subject for a wider chat about it.

Could also look into / suggest to practice manager some kind of in-house CPD for the whole team on how to handle euthanasia to make it a good experience for the owner (does anyone do this?) as it's such a crucial appointment and really determines how the owner feels about your practice in the future and if they are likely to recommend to others...

RE: How to behave during euthanasias

WelshyNurse — Sat, 03 Dec 2016 12:26:22 GMT

If that particular vet finds it distracting the I would just do as they ask.

Him struggling to hit he vein would be more traumatic for the pet and owners than you not petting them.