Post-pandemic – now is the time to add a new skill for your whole team

Teaching at Thrums Vets in Kirriemuir. It’s a whole team approach – teaching the surgeons, but also supporting the nurses with the patient and equipment considerations, and the client‑facing team with how to discuss procedures with clients.

We have been living under the cloud of COVID-19 for almost two years now, and are all acutely aware of the pressures this has placed on our veterinary teams across the country and world. There is a light at the end of the tunnel with the pandemic, but our profession has undoubtedly changed permanently.

Our teams have been through a lot – whether holding the fort in practice or stuck at home on furlough, the first lockdown took its toll on everyone.

Since then vets, nurses and support staff alike have been under significant pressure with changing attitudes of clients and constant staff shortages.

As a leader of colleagues who are to be ambitious and energetic, I have learned the best way to mitigate recent challenging experiences is to introduce a new advanced skill to your team; give everyone the chance to refocus on his or her skill set and that of the whole team.

But is now really the right time to look at adding a new service to the practice’s repertoire?

The answer is, absolutely, yes. We need to look to the future. Leaders of practices need to start showing their team where they are going next, and allow the team to help them get there.

Opportunities

The easing of pandemic restrictions brings new opportunities for stimulating in-house training. This offers huge benefits by involving the whole team – rather than sending one vet off to learn something new, get the experts in to allow the whole team to learn, ask questions and collaborate.

The past year has shown a huge increase in pet ownership in the UK, with new owners often a different breed themselves – attentive and proactive. Their pets are their babies and they will actively seek out veterinary practices offering gold‑standard care for their beloved babies.

Give your team the ability to provide that care with the opportunity to learn new skills. This can ground the team members, and make them feel valued and progressive, providing relief from the exhausting firefighting that we have all been doing for the past 18 months.

The possibilities to introduce new skills are endless, involving varying numbers of veterinary roles.

In this article, I would like to draw your attention to laparoscopy. In human medicine, the knowledge surrounding the benefit of laparoscopy has been building for a number of years – many clients will have experienced keyhole surgery for themselves, or heard about it from a friend or family member. These clients desire the same minimally invasive standards for their pets.

Laparoscopy is not a new concept in the veterinary space, with the first laparoscopic ovariectomy on a dog being performed in 1985. Studies show significant reduction in postoperative complications, shorter recovery periods and reduced postoperative pain for laparoscopic neutering when compared to open surgery.

Training for a keyhole service involves engaging the whole team, re-energising everyone from the surgeons to the care assistants; and especially front of house staff recommending the procedure to your clients.

Interestingly, one of the main reasons for clinicians being reluctant to introduce laparoscopic surgery is the perceived prolonged surgical time. However, Shariati et al (2014) showed an average surgical time of 19 minutes for laparoscopic neuters versus 36 minutes for open surgery.

This is certainly our experience of keyhole surgery; with the right setup and staff training, a keyhole procedure takes no longer – and is often quicker – than an open ovariohysterectomy.

This knowledge, combined with the proven benefits for our patients and clients, means that keyhole surgery really is one of the best things you can bring to a veterinary practice.

Options

Laparoscopy is not only beneficial for bitch spays – it can extend surgical capacity to a wide range of procedures, such as cryptorchid castration, abdominal biopsy and gastropexy, which would otherwise require invasive surgery.

With a few additional bits of equipment, thoracoscopy, otoscopy, cystoscopy and rhinoscopy can also be performed – vastly increasing the range of medical and surgical therapeutic options that can be offered to patients in-house.

It’s not just dogs, either – Gauthier et al (2015) proved cats show significantly reduced pain scores postoperatively for laparoscopic ovariectomies when compared to both flank or midline approaches.

Paediatric instruments are available to aid with performing laparoscopy in cats and small dogs, but these are not essential.

How

Whether you decide to start laparoscopy, or bring a different new skill to the team, the next challenge is how to do so.

For keyhole surgery, the traditional way has been to send a surgeon on a cadaver course, navigate the terminology and ordering of equipment yourself, and try to talk reception through what to say to clients when they enquire. This does not result in the efficient introduction of a service.

Over the years, we have learned how to support the entire team in setting up laparoscopy. Even in the current times when staff shortages barely leave space for the daily work, Simply Keyhole has been active during the pandemic – training clinics that are proactive about the puppy boom and engaging their teams.

With experienced whole team trainers visiting your practice, you don’t need to figure it all out for yourself – take free and impartial advice on costs and equipment options to make sure you set up well from the start. Online resources and a laparoscopic simulator for the surgeons allows them to take control of their own learning initially.

Practice culture has changed – all team members should be involved in big developments. In-practice visits allow training of the surgeons on live patients, and support for the nurses with patient and equipment care.

We also present to the client-facing team so they know about keyhole surgery and are confident talking to clients about it.

As surgeons and keen teachers, we have really missed being able to visit practices during the lockdowns, and we are so glad travel has opened back up to allow us to restart. There really is nothing better than hands-on teaching for everyone involved.

Ahead of the game

Many vets have diversified over the past couple of years, due to the pandemic and other reasons.

If you are looking for help, someone out there will already be providing it – just look and ask around.

You do not need to struggle through supporting your team, or bringing in a new service, by yourself in the modern day. We are very lucky to be part of a profession with members who want to help and support one another, and we should all make the most of this going forward.

The pandemic has undoubtedly presented one of the biggest challenges of this generation, but now is the time to create a brighter future.

Let’s focus on the positives – the increase in pet ownership, a new mindset of clients, and a new drive of our colleagues to want to feel individually motivated and valued. What better way to comprehensively achieve all of this? Ensure your practice stays ahead of the game and consider introducing a new service like laparoscopy with live in-house training for the whole team.