been produced to examine and demonstrate how communication could be improved within the veterinary practice.
Many factors affect how we communicate within the veterinary practice, and as professionals, we must understand how important communication is when dealing with clients and other members of the veterinary team.
We must understand how a clients’ relationship with their pet can affect how they communicate with us and how this can affect the treatment that their pet receives. A clients’ emotional state will undoubtedly affect how we communicate with them. Communication can be uni-directional (flow of information is in one direction), bi-directional (flow of information is passed between two people), multi-directional (flow of information is passed between a number of people).
Within the veterinary practice both direct and indirect communication are used daily. Indirect communication (written) includes: letters, emails, text messages, facsimiles, leaflets, sympathy and thank you cards. The practice receives letters of thanks from clients when treatment has been successful and conversely, there can be letters of complaint. The surgery also communicates by sending reminders for boosters and text reminders for worming treatments. Staff communicate with each other by writing handover sheets, completion of hospitalisation charts and sometimes text messages. Direct communication (verbal) includes speaking face to face and via the telephone with clients, members of staff and sales representatives. Speaking face to face with clients is an important and unavoidable form of …show more content…
communication. When communicating face to face with a client or colleague, several communication factors can be utilised. Such factors include kinesics. The term Kinesics was coined by Ray Birtwhistell in the 1940s (Wainwright 2003). Kinesics is described as “the systematic study of body motion – the meanings associated with movements of the hands, head, and legs, the postures we adopt, and our gaze and facial expressions” (Hargie 2006 p48). We all use kinesics, quite often subconsciously; we alter our ‘body language’ depending upon the situation. For instance, in the surgery, when discussing with a new client (Client A) that her cat had a perforated diaphragm and the prognosis was not good, the kinesics adopted were completely different than when greeting another new client who was in the practice for a 16 week health check on a new puppy (Client B). With Client A, a subdued approach was necessary; facial expressions were utilised to reinforce the message (lack of smile), and eye contact was important. This helped to reiterate that the situation was serious and also helped to see that she understood what she was being told. Posture was altered to be more hunched to show sadness. When comparing this to meeting Client B, the kinesics was completely different. The facial expression was opposite to that with Client A (smiling) and posture was more erect. When detailing information to Client B regarding the puppy’s health, eye contact was maintained showing the client that they were being paid attention to and that they were also invited to speak. When Client B asked questions, head movement was used whilst maintaining a smile (nodding in agreement of the puppy’s good health).
When speaking to Client A, the surgery was very busy and the waiting room was full, and as the cat’s condition was potentially upsetting to the client, it was necessary to take her into the consult room which was quieter and more private. This meant that the information could be conveyed more easily and if she became upset it could be dealt with sensitively and privately. Had the client brought her young child with her, this would have altered the social factors of the situation. Children have tendencies to interrupt, and want attention; this would have made it more difficult for the client to listen to what she was being told about the cat’s condition. When Client A was informed of the cat’s poor prognosis, she restated some of the information that was explained, therefore giving us feedback that she understood how serious the situation was.
Communication styles fall into three main categories: Passive, aggressive and assertive. According to Carol Vivyan (2010), the passive style is defined as being compliant, submissive, and talks little. She defines persons of the aggressive style as being sarcastic, superior, they interrupt, are critical, patronising and disrespectful; the assertive style, she defines as their actions and expressions fit with the words spoken, they are firm but polite and deliver clear messages, they are respectful of self and others. From these definitions, my style of communication would be assertive; within the surgery when discharging patients I am clear with instructions to owners and am firm though polite when discussing adherence to strict rest.
For most people a pet is a big part of the family (human-animal bond) and for this reason, when a pet becomes ill, injured, dies or must be euthanased, the situation is very emotional; the staff at the practice must appreciate this, understand it and communicate with the client in the correct manner. Compassionate communication therefore allows the combination of professionalism and care. This aids the enhancement of trust between the veterinary practice and the client. (Gray and Moffet 2010). By having an active awareness and understanding of the human-animal bond we can recognise the related human emotions. Emotions to grief are the reactions to the loss or potential loss of their pet; it can be behavioural (crying), psychological (depression), cognitive (thoughts of blame) or physical (insomnia). The types of loss fall into four categories: 1. Primary (loss of actual pet), 2. Secondary (associated anxiety and disruptions caused by the primary loss i.e. if the pet was relied upon for social assistance), 3. Ambiguous (unanswered questions as to the whereabouts of a missing pet) 4. Symbolic (The only remaining link between the owner and a dead spouse) (Gray and Moffett 2010) An owner may feel that their emotions on losing a beloved pet are irrational or that others may perceive their reaction as sentimental; by verbally acknowledging that what they are feeling is normal, can help towards maintaining the client-practice bond and demonstrating that as a practice we can empathise. When Client A’s cat had to be euthanased, she was very emotional – this was demonstrated by her crying and blaming herself (by saying if she had only gone home earlier and seen the cat, it would have had a better chance of survival) and repeatedly apologising for crying. By verbally acknowledging that how she was feeling was normal and that most likely the situation wouldn’t have altered, the client recognised that we understood and cared.
Communication can be affected by a number of variables. Culture is one area that can affect how we communicate. Allan and Barbara Pease (2004) describe research by Eckman carried out on people from different cultures who were to discern facial expressions. Eckman showed photographs of people showing different emotions (anger, sadness, happiness, disgust and surprise) to people of different cultures. His results showed that on the whole, most cultures could recognise each emotion correctly though Japanese subjects saw fear as surprise. According to Samovar et al. (2010), intercultural communication involves interaction between people whose cultural perceptions differ enough to alter or influence a communication event. Non-verbal communication is very important in this area as people from different cultures express themselves in slightly different ways. Gordon et al. (2006) discusses studies carried out that demonstrate cultural differences between Japanese, Finnish and American subjects. Variation is seen in the amount of facial expression, gesticulation and proxemics (the analysis of spatial distance adopted in different social situations). Japanese subjects show little facial expression, less eye contact and increased gesticulation than Finnish and American subjects.
Another area of culture to be considered is the human-animal bond (HAB). Blazina et al. (2011) discuss how the meaning of pet ownership and the place of animals in society differ between clients from diverse cultural backgrounds. The HAB is a mutually beneficial relationship between animal and human influenced by behaviours essential to the health and well-being of both (Gray and Moffett 2010). Animals are provided with food, shelter, companionship and veterinary treatment in return for the fulfilment of emotional and social needs; the costs of which should not outweigh the perceived benefits of the HAB (Mills 2010). A pet owner may choose not to have their pet neutered due to their cultural or religious beliefs. It can be the case for blood transfusions and euthanasia. If Client A had different cultural beliefs, it may not have been possible for her cat to be euthanased as it was her decision and not that of the veterinary practice. A breakdown in communication through cultural beliefs can therefore impact on a pet’s care. When a pet becomes ill and the cost of treatment cannot be covered, this may put the owner in a difficult situation and result in the euthanasia of the pet due to costs in excess of what can be afforded; this is seen many times in practice.
Differences in nationality can lead to communication breakdown; some people may find it difficult to understand a foreign accent. This can either be a foreign client or a foreign member of staff. When dealing with a new client, it is important that they feel confident in the veterinary team and communication is very important in this area. Had either Client A or Client B communicated with a foreign member of staff, it would have been possible for the clients to lose some of the information that was being communicated and therefore leading to problems in the animals’ care. Another area regarding language is the use of clinical jargon. It is important when dealing with any client that clinical jargon is kept to a minimum so that clients understand the ailments and treatment that their pet is going through.
When dealing with an elderly client it is important to communicate with them in a positive manner and to not make assumptions regarding their age, and likewise with young clients. Hargie (2006) discusses how simplification strategies in communication can have a negative affect when dealing with an elderly person. Using a slower delivery of information, lower grammatical difficulty and increased volume of speech may be seen as humiliating and undermining. If a client is hearing impaired, they are more likely to inform you, meaning that you can increase the volume of your speech appropriately. It is important when dealing with a client who is blind, to approach them from the front and speak directly to them so that they are aware of your position and that you are speaking to them. If the surgery is noisy, it would be appropriate to take them into a consult room so they can hear exactly what you are telling them with fewer distractions.
When communicating with clients by telephone, it is important that communication with them is effective as it is the first port of call. The only non-verbal form we can use is paralinguistics. Paralinguistics is defined as the ways words are spoken which include pitch, tone, speed, volume, accent and pauses (Hargie 2006). It is important particularly when speaking to new clients via the telephone that staff must sound welcoming, helpful and be knowledgeable. Relevant information must be gained about their pet so that the database is up-to-date. When speaking to Client B whose dog breed was less well known, knowledge of the breed was shown and any questions were answered fully. Client B informed us on his first visit that he had called several vets for prices and other information. Our practice seemed the most friendly and knowledgeable and he therefore came back to us. The telephone should be answered promptly – if the phone is just ringing out, the client may decide to choose a different practice. The same can be said for putting clients on hold; this must be kept to a minimum and they must be asked if they are happy to hold.
When discussing communication within the veterinary surgery, it is important to discuss the relationship between staff members. When veterinary professionals are not communicating effectively, animal safety is at risk for several reasons: misinterpretation or lack of critical information, unclear telephone instructions, and overlooked changes in an animal’s condition. This can also lead to ill-feeling and cause rifts between colleagues which can make communication even more difficult. All staff members should be aware of their role within the team. For example if a student staff member does not complete the necessary paperwork for an animal’s treatment; it must be questioned whether or not the student has been informed that following a routine operation it is their responsibility to complete notes, so a more complete report can be given to the owner. Also the team must be aware of each others’ limitations and expertise to prevent any mistakes being made. By communicating efficiently, the patient is at much less risk from mistakes being made.
The veterinary practice would not exist without clients. It is therefore important to ensure that the practice fulfils the clients’ needs. The concept of the value chain as described by Ackerman and Lowell (2006) may be one way of identifying the clients’ needs and ensure client retention. The value chain has eight points: 1. Identify the client needs 2. Identify the market 3. Create the service 4. Introduce the service 5. Promote the service 6. Deliver the service 7. Customer need is satisfied, 8. Post-service care. By completing each step in the chain, the clients’ needs will be met. The easiest way to identify the clients’ needs is to ask them! A questionnaire to be completed whilst sitting in the waiting room is ideal.
In order to provide good customer service, preparation is important; ensuring a smart appearance communicates a professional image which gives the client trust and confidence in the practice staff. Not only should the staff look smart but so should the practice. Staff should always be courteous to clients. By speaking courteously it shows that clients are respected and that we value them. By using ‘please’ and ‘thank you’, and ‘yes’ instead of ‘yeah’, and phrases such as ‘sorry to keep you waiting’ if the surgery is busy can make a big difference (Evenson 2012) . When speaking to clients, it is also important to provide them with the necessary information. If the surgery is busy and no member of staff has informed clients that the vet is running late, this can cause an inconvenience to the client and cause them to become angry and frustrated. In turn, this can lead to confrontation with staff members. An example of this occurred when a new client (Client C) arrived early for an appointment. She was not informed that the vet was running late and after a wait of twenty minutes she got up and was aggressive towards the nurse covering on reception. The nurse apologised and told her that she would speak to the vet and get her in to be seen next. This was not good enough for the client and she left. The client later phoned the practice to inform us that she was disgusted with the customer service and that she would not be returning to the practice. This situation could have been avoided had the nurse informed her on her arrival that there had been an emergency which had caused appointments to run late and asking her if she was happy to wait or did she want us to rearrange the appointment.
No matter how hard we try to provide good customer service, there will inevitably be complaints. How these complaints are dealt with determine client retention. The Veterinary Defence Society (2003) state that when dealing with a complaint remaining calm is essential. Take the client to a private, seated area or transfer their call to somewhere quiet and thank them for bringing the matter to your attention. Listen - if the client feels that they are being listened to this can sometimes be enough to deal with the complaint. Show empathy – this shows the client that you care. Take notes and check the client agrees with what you’ve written. Summarise for the client what has been said to make sure you haven’t misunderstood or missed anything. By fulfilling these points, the client can see that you are taking the complaint seriously.
In conclusion, communication affects every part of the working veterinary practice; how we communicate non-verbally and what is actually stated are important. The emotional state of clients and staff are also important in communication. These can all affect customer service and the number of complaints received. By listening to clients and giving them the required information will aid client retention. One area to improve within the practice that has been identified through this assignment includes asking clients what they actually require from the practice. By creating a questionnaire covering billing, service improvements, stock, appointment structure (keeping to time), information conveyance etc. would aid client retention and resolve issues such as that discussed with Client C. Another area for improvement is inter-professional communication; being aware of others’ abilities (or lack of with student staff) and providing them with more guidance will make the practice run more efficiently and lead to better communication and increase staff confidence. Keeping communication channels open will keep staff happy.
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References
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