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Issue: 56 - Aug 15, 2013
Want Less Aggressive Patients? Change Just One Thing
By: Dr. Sally J Foote CABC-IAABC
Dr Sally Foote

Change does not come easy for many of us. Habits are deeply entrenched and our brains even go to a default setting to that habit which makes change even more difficult.  At some point, we see an undesirable result from our habits - then we are open to consider that we need to change. But how?

Change is big and looks complex.  It looks like we have to do a lot of things differently in order to have any effect.  As I speak and write to veterinary groups, I can hear and see the interest in gentle handling and rewarding during veterinary visits. The push back and doubt from staff is wondering how to make the change.  Where do you start? How to you get the boss or other staff to try?  What is the training plan?  Low stress handling is such a big topic   it can be over whelming. 

There are authors in business and leadership writing about the effectiveness of changing just one thing when you want to improve a situation. Peter Bergman from Harvard Business review blogs about this here http://blogs.hbr.org/bregman/2009/10/i-lost-18-pounds-in.html. In this author's case it was cutting sugar that lead to his 18 lb weight loss. In my case it was setting one hour, one day a week to pay bills. Not that difficult or overwhelming especially when I tracked the result (better relations with my vendors!). Even if you don't keep track of the results, you will likely see the benefit and stick with it because it was limited to just one thing. 

So apply this "Just one thing" concept to using some low stress - rewarding techniques. First think about what situation do you want to have less aggression in.  Is it examining ears?  Taking blood tests?  Mouth exams on a cat? Less barking in the waiting area? 

Now that you have chosen your one situation - learn one technique to achieve the goal you want - fewer struggles, less barking, or not getting bitten in the exam.  These pets may not be up to happy but if they are not biting, fighting or crying they are behaving better! 

Some ideas for "Change one thing" program:

  • Reception area: When a barker comes in, step right up to that client, take the leash and in a very happy voice say " Hey mom and puppy let's find a place to settle"   move the dog and the owner to a hallway, exam room or area where there are not other dogs, cats or whatever had the dog barking like crazy.
  • Ear Exams: use rewards as a treat mask - I have a you tube video showing this technique  here http://www.youtube.com/watch?v=xptNF1ghz1c&feature=c4-overview&list=UU3vAEOe7paSPQ9vJc-3lPMA basically you put peanut butter or other food treats in the muzzle and continually give rewards as they wear the muzzle.
  • Cat mouth exams: Try using a tongue depressor with liver paste to open the mouth.  Keep your hands out of the mouth and avoid cranking the mouth open. 
  • Stop Scruffing:  use food rewards right away for injections and keep your hands off.  Here is another video showing how to use a reward timed with injection  -http://www.youtube.com/watch?v=KTYChCNKS-4&list=UU3vAEOe7paSPQ9vJc-3lPMA works at least 50% with cats that have never been to the vet at all. 

The list can go on, but the point is start simple. Give yourself the time and ability to learn one technique and experience how it makes handling better.  Even if just one staffer does just one thing - see the how there is a difference!  Then build upon this. Enable this staffer to lead the other staff in change.  Even if your clinic does not embrace all the techniques and strategies for gentler handling, it will still make life better for you, your patients and owners.

Dr. Sally J Foote 

www.drsallyjfoote.com