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Health

Can Paperwork be Life-Saving?
August 13, 2012 (published)

Paperwork.

The word doesn’t exactly conjure up images of heroics and close shaves with death. It’s a little more likely to invoke images of grey, pasty-faced bureaucrats slaving away in cramped cubicles, counting widgets until the cows come home. (Note to self for future editions: check how often bureaucrats work in barns. Also, find out exactly what time cows come home.)

But there is a way that this word can save lives – and even if the effects are not quite that dramatic, the right kind of paperwork at the right time can certainly lead to improved health and fewer complications.

I have always found it easier to grasp things if you break them down into their component parts (PLEASE NOTE: To avoid a lengthy jail sentence and a potentially embarrassing courtroom scene, this principle does not apply to hitchhikers or zoo animals. Please learn from my mistakes).

We’ll start with paper. A seemingly innocuous word – a flat, white sheet of mashed fiber, bleached into submission, waiting to be written upon. Perfectly utilitarian, save for the tragedy of paper cuts.

Now, onto work. Work implies organized effort, changing energy from one form into another, or more to the point changing slothfulness into utility. Possibly breaking a sweat or a fingernail in the process. What genius thought this one up? Happily tucked into the couch cushions, hurting no one except an innocent bag of Bugles, work seems to go against the very fabric of the universe (as long as this fabric is denim and has some greasy chili-fries stains on it).

So, we take one word that just sits there, blankly, or perhaps could cut you, and one word that seems to throw a rubber chicken in the face of the heavens, and what happens when we combine them?

Magic.

I don’t mean Doug Henning, beautiful assistant and let’s-hide-the-Statue-of-Liberty magic. I mean the magic that happens when you get to save a life (or at least improve health) with very little effort.  Very little effort – now we’re talking my language! Waitress! Another order of chili fries please!

So what, exactly, am I talking about?

I am talking about that moment that comes at the end of the visit to the veterinarian’s office. Right after you have asked your last question, right before the nice lady behind the counter asks “Cash or credit?”

When you have just taken your pet home from the hospital, how do you know what to do once you get there?

I am strong believer in a form of paperwork known as discharge instructions. This simple, usually one-page document can help decrease mistakes, eliminate questions and bring back some of the love to the veterinarian-pet owner relationship that has dropped off a bit in recent years.

I have heard of many cases where a patient was sent home to heal up and the pet owners were not given any sort of idea of what to expect or what to do to help in the healing process. As an example, our own editor here at ANIMALicious, Phyllis DeGioia, took her new, adorable dog home from the shelter the day after a spay with nary a scrap of info about how best to care for her. They’d told her that the stitches were absorbable and did not have to be removed, but they didn’t mention how long to stop her from running and jumping, and there wasn’t a word about wearing an Elizabethan collar to prevent her from chewing at the incision. Luckily, Phyllis knows one end of a dog from another and already knew what to do here, but the lack of information could have led to disaster. I have seen several cases of dogs ripping out their sutures after a spay surgery, and in a few cases this has been severe enough to allow their insides to come outside for a peek – not a pretty sight!

Discharge instructions are written by veterinarians and cover nearly every aspect of a pet’s care at home that a pet owner would have to worry about. Diet? It’s in there. Activity level? It’s in there. Does he have to wear one of those horrid collar-gizmos and for how long? Yup! It’s in your discharge instructions.

And do you have to remember it? NO! It is all written down! All you have to do is be able to read, so as long as you are reading this right now, you’re pretty much golden. If someone is reading this to you right now – hang on to that person, as you are very likely to need them when it comes time to read your discharge instructions.

When I have the happy honor of sending a patient home from the hospital, I always take the time to make sure a pet owner’s questions are answered. Those 5 or 10 minutes spent with the owner can help make sure they are clear on what they have to do for the pet at home, and make sure that all the healing that happened in the hospital doesn’t come to a screeching halt once the patient, now back to being a pet, gets home. The only downside to this is that repeated studies have shown that people only remember a tiny fraction of things that they hear – while they take to heart and retain things they read to a much greater degree. We may spend a long time in the exam room covering things like wound care, suture removal, activity restriction and what time they are supposed to syringe the yucky yellow medication into the cat’s protesting mouth, but if it not written down, lots of that information gets lost.

With a good set of carefully written discharge instructions, I know that the owner has the information needed to properly take care of their pet at home – and I know that they have a written record of what needs to be done to ensure success. It doesn’t happen often, but I have had some complications arise wherein people claim they were never told that they needed to do something (come in for a splint or bandage change, for example) and the only thing that has saved my hide and that of my patient is that it is written down in the discharge instructions.

Not every veterinarian provides discharge instructions; some rely on just those few minutes spent with an owner when a pet goes home. I think a good set of discharge instructions works well for everyone – pet owners know what to do, and veterinarians know that they have given the pet owner the right information to refer to. They are a great idea, and, as I said – magic! They help everyone: the patient, the owner and the doctor. Since win-win has gotten to be such a tired and overused saying of late, I am gonna just coin a new one; win-win-win.  You read it here first.

Why doesn’t every veterinarian do this? Honestly, I am not sure. You might say it’s due to the oft-quoted fact that most veterinarians don’t have thumbs, and you’d be partially right. We don’t have opposable thumbs, but we do have a sort of rudimentary grasping stub that we can use to type, climb trees and hail taxis. It could be due to the eternal time crunch that veterinarians are under, trying to heal the world’s sick animals and also be home in time for dinner – now that one makes a little more sense to me.  But with a little time and through the magic of cut and paste, many discharge instructions can be written from templates stored on a computer. Once the basic format has been stored on the hard drive, it can simply be updated for the specific patient, and then conveniently printed (mind you – watch out for paper cuts!).

Veterinarians and pet owners take note: every pet that goes home from the hospital should have a set of discharge instructions written out so everyone knows just what to do. It’s one piece of paperwork that could save a life!


 
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