Vets are used to dealing with wriggly and reluctant patients. But as the UK plunged into Covid-19 lockdown in late March, this was among the least of their challenges.
Veterinary practices up and down the country have scrambled to find ways to continue to look after their patients. Almost overnight, my whole profession had to invent new ways to provide essential urgent and emergency care, and develop new approaches to providing critical services for livestock farmers, safeguarding animal welfare and protecting the integrity of the food chain. Speaking with fellow veterinary friends and colleagues in the South West about their experiences during this period, I’ve been asking what they’d want their clients to know.
The recurring message is summed up by Matt Thomas, veterinary owner of Cornish Paws, a practice in Penryn in Cornwall: “It has been a very unusual few months, but everyone should be reassured that there has been no break in the provision of veterinary care and we are still able to offer your pets all of the services they need, even though we may have changed the ways we do things.”
During the first few days and weeks of Covid-19 restrictions, practices dramatically cut back their activities to provide only emergency and urgent care, with almost all preventative and routine work cancelled. Teams were reduced to the smallest possible size to minimise close contact between staff within practices and to accommodate shielding needs and inevitable childcare difficulties.
Emergency guidance issued by the Royal College of Veterinary Surgeons (the body that registers and regulates all vets working in the UK) temporarily allowed remote prescribing, meaning that under certain circumstances we could supply prescription medicines for animals without seeing them in person. Video consulting, and other forms of so-called ‘telemedicine’, became a part of clinical practice overnight, bringing with them a new array of clinical challenges including poor video quality, camera-shy patients, unhelpful lighting and some unusually angled views of animals’ body parts.
The reality of veterinary work is that reliable social distancing is impossible. The biggest risk to any practice’s ability to continue to serve their clients and care for their patients is a Covid-19 outbreak within their clinical team. I can’t examine a cat while someone helps me to hold it and be more than arm’s length from my assistant. Neither can someone help me lift a Labrador from floor to table without us being shoulder-to-shoulder. When patients are particularly wriggly or reluctant, the nurses and vets working with them can find themselves almost hugging one another.
Mask wearing, along with other PPE, scrupulous hygiene, and changes in team working patterns, may grant us a buffer of safety, but cannot provide 100 per cent protection. If a significant number of the clinical staff needed to self-isolate – and it’s likely that any members of staff who had worked alongside an affected colleague would be regarded as high exposure risks – it could become temporarily impossible for a practice to provide any services at all.
Most clinics have, for the time being, stopped allowing members of the public into their premises, instead bringing unaccompanied animals inside while owners wait in their cars. This has replaced a usually efficient and well-practised ten or 15-minute in-person consultation process with a time-consuming, awkward back-and-forward dance between the patient and the telephone, as we first discuss the client’s concerns, then bring in and examine their animal, a process which sometimes identifies issues that require follow-up questions.
Once we’ve come up with a clinical plan, it’s back on the phone to discuss that with the client and gain their approval. That done, treatments can be administered and agreed tests undertaken, medication dispensed, and the patient can finally be returned at the doorstep. Clients with nervous pets have naturally been worried about how they would cope with being examined and treated away from them, but working gently and patiently and taking our time, many of us have found that even certain usually anxious patients have seemed relaxed and accepting of the new approach.
Client reactions to these changes have sometimes been mixed – a picture mirrored in the experiences of friends and colleagues working in different practices in the South West and beyond. Many have been genuinely understanding and appreciative of the efforts we continue to make to provide necessary care for their animals, despite the awkward circumstances. But, sadly, we’ve also witnessed an increase in clients reacting with anger, frustration and even aggression towards our practice staff.
Not everyone understands why they can’t come into the waiting room, and clients reluctant to comply with distancing requests have become more frequent since lockdown restrictions began to ease. The gentleman shouting at the reception team through an open window that we were being ridiculous, with our mask wearing and social distancing, that the pandemic was over and Boris had said so, will not soon be forgotten.
I’ve heard from receptionists and nurses, on the front-line of the care we provide in practice, that during this strange period they’ve come almost to expect to be shouted or sworn at by clients at least once a day. We understand that many people are struggling at the moment, and it’s always difficult when you’re worried about a pet. But veterinary teams have for several months now been working really hard, often short-staffed and with a case-load of disproportionately complex, sick patients. Unreasonable and aggressive client behaviour only adds to workplace stress in a profession which can already struggle with poor mental health, and which experiences suicide rates three to four times the national average.
Veterinary surgeons in the UK all swear an oath when they join the profession, which concludes: “ABOVE ALL, my constant endeavour will be to ensure the health and welfare of animals committed to my care.”We have, despite sometimes intensely difficult circumstances, so far collectively managed to provide the care our patients and clients needed – and for that I think our profession can feel proud.
Collaboration between local practices, and the guidance and advice provided by local and national veterinary organisations, have contributed greatly to this, as has the mutual support – and sometimes lively debate – amongst vets and nurses from all corners of the country on veterinary social media forums. With the continuing support and understanding of our clients, we hope to be able to continue to care for you and your animals, whatever the future might bring.
Dr Kate Stitt MRCVS is Senior Veterinary Surgeon at Plymouth Veterinary Hospital, a general practice and emergency veterinary clinic in Plymouth, Devon.