In an age of advancing communication methods are we becoming better at communicating or are there just multiple means that we now have to master? Have these new communication means actually made communication more impersonal? The pandemic has taught us that good clinical outcomes are not necessarily reliant on being in a consulting room with a client facing us, but can be through many other, often remote means. Having less client contact has pleased some, but has it had a negative impact on the public's view of veterinary professionals and has it impacted on our wellbeing?
The way in which we communicate is very important, not just in terms of the content but the way in which the communication is conducted. Narrative medicine is making large in-roads into veterinary practice, it is something that is not new, and that we have been doing for years, but its importance is not widely recognised. The restrictions of the pandemic have made veterinary medicine more impersonal. That connection with the pet owner has diminished and with many practices not being able to undertake more preventative medicine consultations this has caused a reduction in opportunities to connect with the owner, patient and their combined story.
Narrative medicine considers all aspects, not just the medicines and the diagnostic tests that are required. The owner and pet's narrative needs to be understood to work together towards a treatment plan. Each owner and pet will have a unique narrative that needs to be understood.
As veterinary nurses we are excellent at acting as advocates for our patients and their owners. There are many elements to being a superb veterinary professional — practicing evidence-based and gold standard medicine being a couple of them. These elements can in some cases be very difficult to achieve, and this is not a failure of the veterinary professional or the pet owner. The treatment plan (gold-standard or not) simply may not comply with narrative of the pet or their owner. Balance is vital in order to achieve the best clinical outcomes for the patient. Gold standard treatment can mean different things to different cases, it will depend on their narrative. Understanding of the narrative will help with compliance to the treatment plan. This means that we, as veterinary professionals, are providing treatment plans that are achievable. This all goes back to good communication skills — it does not matter what form of communication is being utilised (in person, telemedicine), if we are not considering the owner/pet narrative there is a potential that we will not achieve our clinical goals.
Decisions have been made on the influence this has on the wellbeing of the veterinary professionals. Narrative medicine has been shown to help reduce burnout and fatigue within practitioners. It helps to provide tools and strategies to help reduce burnout and compassion fatigue, minimise guilt and manage distress. With student programmes having limited time to teach students content, should we be focusing on narrative medicine communication means rather than theoretical conceptual models of communication. We should be equipping new veterinary professionals with skills that can be readily utilised in practice to help both the clinical outcomes for the patient, patient welfare, support the owner's narrative and our own wellbeing.