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tvpjournal.com | January/February 2016 | Today's VeTerinary PracTice PracTice BUiLdinG 127 We are not taught to be good at carrying out death: no one taught us how to walk into an examination room for a euthanasia appointment, what to say to a crying teenager, or whether to hug the elderly man who just lost the pet that was the last link to his late wife. We never received direct guidance about proper verbal and nonverbal techniques that make this "most diffcult appointment" just a bit easier on everyone, including the veterinary professional. From numerous discussions with new graduates, we have found that about 75% of veterinarians graduate without ever administering a life-ending medication. Therefore, it's no wonder that conference lectures about this topic are packed and why our hospice practice has more requests for externs than we can handle. as the only medical profession licensed to euthanize, veterinarians have an incredible privilege and responsibility to handle this procedure properly. The entire euthanasia process can be broken down into the following 5 stages. STAGE 1. Setting Up the Euthanasia Appointment Be the First to Say the "E" Word clients hate to be the frst ones to bring up euthanasia. They think you will judge them for not caring about their pets, or that you will be angry at them for giving up too early. so you need to be the frst to say it. and even if they are upset about the suggestion, at 2 am, when clients are stressed because a geriatric dog has been pacing all night or an elderly cat has peed outside the litter box for the third time that day, they will know that you have given them permission to think about the next step. Making the Appointment Many clients feel they are making an appointment that will kill their best friend; therefore, how your support team handles this scheduling with the client is crucial. • The receptionist should have nothing else on his or her mind other than assisting the client: the client should not be put on hold, and the receptionist should not be checking out another client at the same time. • if at all possible, background noise should be kept to a minimum. • Most important, empathy must be conveyed: instruct your team to say, "i'm so sorry you're facing this." support staff should not be scared to show some emotion—clients want to know they care. • When scheduling the appointment, support staff should retrieve as much information from the client as possible. This is generally the time when clients are most capable of making difficult decisions—emotions will only get more painful from this point on. Gathering Information The support team should ask the name of the pet and use it often. Here are some suggestions for how to phrase this important conversation, in this order: 1. "I'm so sorry you're facing this, I know it's tough." 2. "Tell me what's going on with Max." For this delicate conversation, use open-ended questions because it invites the owner to share information, with no judgment being passed on the pet's condition. it's best to get this information up front and record the client's Handling EutHanasia in Your PracticE Mary Gardner, DVM, and Dani McVety, DVM Lap of Love Veterinary Hospice, lapofove.com t he 3 most important things that improve the euthanasia appointment: 1. Show love for the pet. 2. Acknowledge the decision to euthanize by telling the family that "We are doing the best thing for him." 3. Physically touch the owner. This conveys more empathy than words ever will. If there is one thing to think about when approaching the euthanasia appointment, it is, "What would I do for my own pet?" That is the minimum standard of care you should give your patients and their caregivers.