A 2018 article published in Veterinary Sciences synopsized a dissertation examining the connection between owner loyalty to their pets’ veterinarians and their perception of the communication from the veterinarian and staff. The study found that good communication delivered all kinds of benefits, from customer loyalty to trust in the veterinarian to likelihood of following treatment instructions to perception of a greater value for services rendered.
But good communication can be difficult, and it can feel nearly impossible in times of crisis–when a pet is ill or injured, when an animal is dying, or when a client doesn’t understand or can’t afford care options, for instance. While many communication tools are available, one promising model for veterinarians to help calm pet owners is Nonviolent Communication (NVC).
What is NVC?
The goal of NVC is to communicate and express yourself clearly, then receive what you hear back without judgment. The communication model avoids language that promotes disconnection, such as blaming, comparing, judging, or doling out advice.
Leslie Ritter-Jenkins, a certified trainer with the Center for Nonviolent Communication, says NVC is being practiced in the human medical field and fits veterinary medicine well. “Because veterinarians, like many people in the medical world, are people of authority, we tend to give them a lot of power,” she says.
Being mindful of language used matters because people tend to either rebel or submit to perceived authority. This is critical in times of crisis because when a client is triggered–by fear, anger, grief, and so on–that lack of control makes communication more difficult. As the “authority” in the room, using NVC tools can establish trust and confidence between the veterinarian and client while avoiding or mitigating conflict.
It’s just one framework for clear communication, but its principles fit veterinary medicine because the foundation is built on one thing: compassion. In times of crisis, especially when life and death decisions must be made, a compassionate response can shift the tone of the conversation.
The NVC Process
According to the Center for Nonviolent Communication, the model consists of two sides: empathetically listening and honestly expressing. You can’t control what your client says–or hears–especially while facing stress or fear, but you can control your listening skills and your response. Here are the four steps to the NVC process to employ:
- Observations: without judgment
- Feelings: underlying emotions
- Needs: universal and what makes us human (e.g. mutuality, respect, freedom, choice, partnership)
- Requests: a clear, doable ask
Ritter-Jenkins points out that what a client poses as a feeling is more often a need, so the NVC skill involves drilling down to identify what’s really going on. She says, “If someone says, ‘I feel disrespected,’ their feeling isn’t disrespect. The feeling is probably hurt or scared. Their need is respect.”
Listen closely to the data your client provides either overtly or through your observations and consider whether there’s an emotion or need masked by the language. It’s a skill that takes time to hone. Practice sessions during staff meetings may be helpful.
How Can NVC Help in the Exam Room?
“All humans share the same feelings and needs. When we get out of right and wrong thinking, better or worse, appropriate or inappropriate, and we speak this language of feelings and needs, we have a language that connects us universally. When a vet can hear behind what the customer, the human customer, is saying and then use a sentence or two of empathy, it’s very efficient connecting with feelings and needs. You can get to the heart of things, what’s really happening with the customer, fast,” Ritter-Jenkins says.
She shares an example from her own life when she faced an end-of-life decision with one of her cats. Her cat suffered from an undiagnosed GI disorder. They tried various approaches, and she ultimately went to the vet for help because her cat wasn’t eating, he was losing weight, yet he was acting completely normal.
“She could hear in that data and say, ‘It sounds like you’re feeling torn because you know that there’s something physiologically wrong and the cat is likely in pain and suffering, and you’re torn because you’re seeing some normal behavior and you’re needing clarity about what’s going on.’ That would’ve been exactly right–an empathic guess,” she says. “Or she could have said, ‘It sounds like you’re feeling exasperated and want some clarity or want some support in this decision.’”
When faced with a potentially costly procedure, a devastating diagnosis, or an end-of-life decision, client reactions run the gamut, but people often shift swiftly into panic or crisis mode. Listen, then present the data, the science, while being clear that you’re not telling the client what to do. Jumping in with unsolicited advice, especially when a client is in crisis, creates a barrier to empathy, as does judging, storytelling, one-upping, and philosophizing.
One of the easiest ways to achieve this? A quick question.
Take some time during or toward the end of an appointment to ask, “Have your questions been answered? Do you have anything else that you’re concerned about that we haven’t covered?”
The science supports this model of communication. “What happens is the vagus nerve that goes from our brain and feeds our heart, our lungs, and our digestive system, empathy calms that. When someone empathizes with us, our whole body relaxes. We have the beauty of this connection, and it’s not just emotional. It’s physiological,” Ritter-Jenkins says.
Earlier this year, VIN offered a course on empathy and reflective listening, which included the Nonviolent Communication text as recommended reading. The concept is gaining traction in veterinary medicine. On its website, the Center for Nonviolent Communication posts practice group meetups open to anyone wanting to learn and practice the skills. Or pick up a copy of the book, Nonviolent Communication, and practice with your staff.
Bottom line: It’s a worthwhile endeavor to communicate well with your clients, especially during times of crisis, and it might even help build your business by increasing customer loyalty. The NVC model provides a framework to achieve those goals.
This article was reviewed/edited by board-certified veterinary behaviorist Dr. Kenneth Martin and/or veterinary technician specialist in behavior Debbie Martin, LVT.