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Vet mindfully: another example

Using the technique of mindfulness I have overcome an aversion to administering intranasal kennel cough vaccinations.

The Problem

Along with many other vets I really did not like giving intranasal vaccinations to dogs. It was always a struggle in my mind and often in practice. If I saw that a kennel cough vaccination was booked on my list for the day, I would find myself imagining the struggle that it would be to administer it and this lead inevitably to becoming anxious by the time the patient presented.

The Mindful Practice

I decided that there must be a more satisfactory approach to giving the intranasal vaccines so I started to focus on the process.

The initial step was to stop paying attention to the negative thoughts of how disastrous the consultation was going to be. I am sure by overthinking the past bad experiences my anxiety levels climbed and these were picked up on by my patients who became nervous in turn making the whole process more difficult from the start.

Secondly, I focussed on the actual process. What was it that the dogs did not like? I realised that it was the placement of the applicator in the nostril and holding the muzzle tightly that were the biggest problems.

By paying close attention to every intranasal vaccination that I gave, I have been able to develop a more successful technique. Firstly I support the muzzle from underneath, gently lifting the head. I rest my other hand on the hand that is supporting the muzzle and hold the syringe with applicator in close proximity to the nostril. This technique means that the dog is being comfortably restrained and less able to open its mouth and that the syringe is in a stable position in line with the nostril. I then quickly squirt the vaccine slightly medially into the nostril.

The Results

I have found this technique to be successful in the majority of cases, although not infallible

The Importance of Being Mindful

An important concept in mindfulness living in the moment. We tend to spend too much time ruminating on what has happened and running through imaginary scenarios of what might happen and completely ignore what is happening in the present.

The present is the only moment that we live in and is the only opportunity to experience life. Practicing mindfulness helps as to stay aware of this moment enabling us to make the most of our lives.

When I started to practice mindfulness I wrote a poem to help to remind me of this concept.

Every Moment Infinite

Our thoughts

Our choices

Our Actions

Bring us to

A timeless point

Of infinite possibilities

 

All our past

All our potentials

Held in

Every moment infinite

Yet so often ignored.

copyright  2014

Consulting Mindfully

The beginning of the day can be a time of great anxiety. The consultation slots are full and as you look through the diary you see clients and patients that give you a feeling of dread and you mind starts racing writing and rewriting imaginary scenarios of how the consultation will go and you cannot concentrate on what you are doing at the time. I am guessing that this is a familiar image to many readers, and it is an opportunity to practice mindfulness and get more out of your day.

 

Take a minute to look at what is happening here. You are looking at a daunting list of consultations and your mind is running away from you creating thoughts of not being able to cope with the workload, and creating anxiety about consultations that have not happened yet. If you find yourself in this situation, take a couple of minutes to watch your breathing, concentrate on the movement of breath in and out and take the time to observe how this calms both the body and mind.

 

After two to three minutes, take in your first client, ignoring the rest of the list. You can only deal with one thing at a time so let yourself concentrate on the patient in front of you. Focus on listening to the client’s concerns, ask appropriate questions, listen carefully to the answers, focus on examining your patient from head to toe, don’t take any shortcuts, mentally note your observations, and if it helps, verbalise your findings which will have the benefit of letting your client know how thorough you are being. Stay focussed as you formulate your treatment plan.

 

Once the client has left the consulting room, take a moment to mentally review how the consultation went and how it has made you feel. Hopefully you will have a feeling of a job well done and if so allow yourself to acknowledge the positive feeling this brings. If you feel that the consultation could have gone better recognise this too and make a note, preferably written, on how you think that you could have improved the consultation.

 

Repeat this process for each consultation and I am confident that you will get through your consultation list more efficiently, will have satisfied clients and a feeling of satisfaction of a job well done. If during the day you find your anxiety levels rising, take a short time out and go back to watching your breath for two to three minutes again and do not let yourself be distracted by the length of the list or any difficult consultations.

The benefits of a mindful approach to consultations will help to improve your clinical awareness and consultation skills, your clients will be grateful for how well you have listened to them and how caring you have been and you will find that the imagined “difficult” consultations went far better than any scenario your mind created.

Mindfulness in Practice

As I called a client in to the consulting room yesterday morning, their face broke into a smile and she said, “Oh, you’re back”. This was a bit surprising as I hadn’t been away but they carried on to explain that their cat really liked me, and that last time they were in the surgery they saw another vet. I checked through their records and noticed that I had only seen this client once, two years previously! It was so nice that this client had remembered me and that I had made such a positive impression on them.

By being mindful, I was able to acknowledge the little glow of satisfaction that this brought to me. It is by being aware of these moments that our self-esteem and resolve can grow stronger, better enabling us to deal with situations that are not going as well.

Practical Tip

After you have completed a successful procedure, give yourself a minute to be aware of the feelings you are experiencing. I am sure that there will be a mixture of relief and satisfaction of a job well done, but as you maintain your practice of mindfulness you will become more and more aware of the feelings of satisfaction and accomplishment.

The Mindful Bitch Spay

For many years I would get extremely anxious when I knew that I had a bitch spay to perform, which resulted in an enormous amount of stress which lead to difficulty in carrying out the procedure. After being introduced to the technique of mindfulness I started to ask myself why I felt so anxious. So each time I performed a bitch spay, I focussed my awareness on what I was doing, concentrating on each moment of the operation.

The anxiety came from past experience as a recent graduate when my more experienced colleagues made a big fuss of bitch speys and all the possible complications. But, as I thought about it more, I realised that I had seldom had any serious problems whilst performing bitch spays, and any time that I or a colleague had, it was always corrected successfully.

 

The Thought Process

 

So I started to focus on what the complications were. As you will be aware the most common problem is bleeding, but why does bleeding occur? It occurs because of inadequate ligation of the ovarian and uterine arteries. Why does inadequate ligation occur? It occurs because of poor exposure of the ovarian pedicles making visualisation of the ligature difficult and not ensuring that the cervix is exteriorised and a transfixion ligature is not used.

How are these problems avoided? They are avoided by being mindful and aware of the potential problems and by focussing on each step of the surgery.

Firstly, by making the initial incision in the correct place and of the correct size. Secondly, ensuring that the ovaries are exteriorised sufficiently to triple clamp the pedicle. This means spending time on breaking the ovarian ligament in some cases and not being tempted to attempt ligation with insufficient exposure.

Thirdly, transfixing the cervical end of the uterine body.

 

The Practical Process

I started to ensure that I focussed entirely on each step of the surgery, not being tempted to take short cuts. After each surgery I reviewed how the procedure had gone and how I felt before, during and after the operation.

Initially I still felt the anxiety that I had always felt before the surgery, however following my mindful approach, I did not have any issues, and procedure after procedure went well. I felt relief following each procedure, but more importantly I realised that this approach was allowing me to improve on my technique each time, and that the mindfulness aspect of the process was becoming second nature, I did not have to concentrate on being mindful, it just happened. After each successful operation I took a minute to experience the feeling of a job well done and held on to this feeling.

Gradually the anxiety faded until a point where I do not experience it at all now. I know that I can perform bitch spays well, I know that by being focussed on each step I am minimising the chance of complications occurring and at the same time knowing that I can react to any unexpected occurrence and deal with it if one occurs.

The Long Term Benefits

By using mindfulness techniques, I experience significantly less anxiety, I have ensured that I follow a sound surgical technique and have good outcomes on the procedures that I carry out with patients recovering quickly.