I’m buzzing with excitement after this year’s IAAHPC animal hospice conference. There were dynamic topics related to palliative medicine, hospice care, business, and of course, pet euthanasia. During one of my talks on the latest in euthanasia research, I found myself looking into the crowd wondering how the energized faces looking back at me were going to teach their coworkers what they’ve learned. Will their fellow associates be as eager to hear and embrace these new ideas? Turns out it can be very challenging to bring about veterinary protocol improvements that last, regardless of how important they are. The trick is to introduce change strategically.
Many years ago a CAETA student told me it was like pulling teeth to get the lead medical director to listen to her ideas about better pet euthanasia. The hospital had paid good money to get her to a conference I was speaking at, in the hopes she would learn the latest in everything from surgical techniques to euthanasia. Learn she did, but that was the easy part. Getting her colleagues to bite was difficult, and it left her feeling deflated.
Another recent CAETA student wrote to me about her desire to improve euthanasia protocols. She writes, “In my first job, I was not allowed to sedate or place IV catheters prior to euthanasia. This practice was not open to changes in their protocols. I had many less-than-ideal euthanasia procedures and started looking around to see what other veterinarians were doing. I moved to a different practice 18 months later and prior to signing, made sure they would support sedation/anesthesia prior to euthanasia, along with placement of an IV catheter. They agreed and I started to use different combinations of medications to get patients deeply sedated. Each new veterinarian in that practice was highly encouraged to sedate prior to IV cath placement. Many accepted this and used their own variety of sedation, but most still wanted to remove the patient from the room for the IV catheter placement. I moved 10 years later to another practice with 2 DVMs. One in particular would remove the patient to the treatment area to place an IV, then return and give propofol prior to euthanasia solution. Her own elderly cat was rapidly deteriorating and she requested for me to perform euthanasia for her with her family present. I anesthetized her lovely old girl, placed the IV while she was being held, and performed the euthanasia of her old baby in her arms. She was so moved by the procedure, she asked for all my doses and any other tips I had. Within 2 weeks she was doing everything in the comfort room, sedating patients and having the techs place the IV catheters right there with the owners.” This last example speaks to the power of seeing a better way first hand, aka seeing is believing.
So what can believers of the Good Death Revolution do to ‘move the needle’ and create positive euthanasia protocol upgrades within their veterinary hospitals/services? Here is a short list of things I’d try.
- Ask management to promise to make improvements post-CE events – tell them you are going to be ready with at least 10 new ways to make the practice better and they promise to take things seriously.
- Put your good ideas in an easy to understand handout or list. Keep them short and concise but still robust with evidence/proof of concept.
- Find time to train what you learned. Perhaps you have an end-of-life improvement month where your new protocols are described and implemented.
- Promise to help carry the torch forward. Your recommendations may need continuous nourishment to take root. So often, good ideas fade because everyone gets too busy. Stick with it. If you really feel something is worth improving, don’t give up.
- Show them the fruits of their labors. All work with no reward gets old quick. Make sure the team sees the thank you cards from grateful clients, read the social media posts and reviews, and even better yet, invite coworkers to join you in your euthanasia appointments so they can see first hand what good euthanasia looks like…and how easy it is to get right.
We all know change can be draining. I encourage you to create anticipation of the change before it comes. Help others get excited with you and changes to euthanasia procedures you seek should be easier to implement. And when in doubt, pull out the research to show them that what you say is accurate and important. You will help create an amazing team culture that declares “Endings matter and we want euthanasia to be one of the best things we do”.