Dear Second Opinion,
I’m a recent graduate, and I’ve felt increasingly confident in my medical knowledge and surgical techniques thanks to an excellent mentor; however, I often don’t know how to convey difficult news to clients. Giving bad news is not something routinely practiced in vet school, and I’m not sure even the best mentor could hold my hand through these challenging conversations in real time.
I’m unsure what the actual verbiage and phrasing should be and how best to respond to client reactions, which are often heightened. I even feel awkward with my body language. Do I stand? Sit? Pet the patient? Hand the client tissues? Everything I do feels uncomfortable and inorganic, especially when I’m not sure how the client will respond.
I understand having tough conversations is part of the job, and I hope to convey the most salient information and provide the best support and guidance during these challenging discussions as my career progresses.
—Can’t seem to find the right words
Dear Can’t Seem to Find the Right Words,
Relaying bad news can be difficult, especially if you don’t know the best way to present the subject, you tend to get sucked into other people’s emotions, or you become uncomfortable when your words elicit negative emotions in another person.
Before You Talk to the Client
Look at the client’s perspective. Put yourself in the client’s place, and imagine your beloved pet has been given a grave prognosis or you cannot afford the treatment your pet requires. This exercise is for informational purposes only. You should not join the client in a negative emotional space, but you should try to understand (to the best of your ability) what they might be experiencing.
Prepare yourself. Understand that you are about to communicate information that is sad and frightening. An emotional response is normal. Take a breath, and check in with your emotions. Remaining calm and in control of your mind, body, and emotions allows you to be clear when confronted with negative emotions or words from the client. You may even be able to positively influence the client’s emotional state with a clear, calm, and empathetic presence.
Talking to the Client
Avoid judgement. The client’s reaction reflects their perception in the moment. What they are feeling has little to do with you.
Adjust your body language. Hold yourself in a way that feels comfortable to you, maintain eye contact, and try not to fidget or play with the computer. You might sit on the floor with the client and their dog, stand and pet a cat on table, or sit next to the client on a bench. Adjust for what makes you feel relaxed, connected to the client, and able to convey the necessary information. Experiment with different positions. What feels right will come with time.
Mind your verbal language. Avoid using too much medical terminology, and minimize percentages because those can be overwhelming. Write everything down in discharge instructions, or provide a handout that explains the condition in layman's terms. Use clear, simple language, and expand if the client asks for more details.
Practice empathy and compassion. If the client expresses negative emotion, allow them space and freedom to work through their emotions. Empathetic statements can help emotional clients, especially those who may feel embarrassed by their emotions.
This is hard. If I were you, I would feel the same way.
It’s okay to cry. Crying is normal.
I understand you’re concerned. We’re going to do everything we can to help.
Convey the next steps. Letting the client know what can be done next may help them gain a sense of control over a tough situation.
Take cues from the client. Some clients are uncomfortable displaying negative emotions and remain stoic; others may cry or project frustration. Your goal should be to be authentic, calm, and clear, regardless of the response. Doing so means you have done your job while also caring for yourself and likely helping the client feel more calm.
Sincerely,
Sarah Wooten, DVM, CVJ