Hitting patients - is it ever acceptable?

RE: Hitting patients - is it ever acceptable?

Iain Richards — Mon, 01 Feb 2016 19:46:34 GMT

Also from Uxbridge: niche, Sean Connery's sister's daughter

RE: Hitting patients - is it ever acceptable?

Thomas Johnson — Mon, 01 Feb 2016 10:37:15 GMT

[quote user="Iain Richards"]

[quote user="Hannah Wynne Richards"]

The name comes from the Welsh word "buddugoliaith" meaning victory -

Wynne

[/quote]

Curious. I always thought buddugoliaith meant "Big Lad's Mate"

[/quote]

Ah yes, from the Uxbridge English Dictionary

RE: Hitting patients - is it ever acceptable?

Iain Richards — Thu, 28 Jan 2016 09:38:22 GMT

[quote user="Hannah Wynne Richards"]

The name comes from the Welsh word "buddugoliaith" meaning victory -

Wynne

[/quote]

Curious. I always thought buddugoliaith meant "Big Lad's Mate"

RE: Hitting patients - is it ever acceptable?

Gillian Mostyn — Wed, 27 Jan 2016 20:24:37 GMT

[quote user="Michael Woodhouse"]I was smacked as a child and it never did me any harm.[/quote]

Even you, Michael, have got to see the humour in this comment!

RE: Hitting patients - is it ever acceptable?

Nicola Cole — Wed, 27 Jan 2016 20:10:42 GMT

[quote user="Nhombokisheni"]

[quote user="George Cooper"]

It is never, ever, justifiable to hit a patient.

No - never hit them, understand them, then deal with them.

[/quote]

Can I just say, "tap" and "hit" are very different words. Unless I missed something.....did anyone actually advocate hitting patients?????? [/quote]

The initial post that prompted this tangent said 'whacked it across the nose for trying to bite me'. This tangent is 'hitting patients-is it ever acceptable'.

So I would think that that is what most of the people are responding to passionately-that hitting a patient is wrong. Tapping as a means of distraction was brought into the tangent later....

So yes, tap and hit are very different words-although I do think that if you've tapped a dog to show who's boss this is again very different to tapping it to distract.

Where to draw the line with restraint? Well I think that's different for each individual animal and situation, and obviously time constraints have to play a part. If it's elective eg vaccination and the dog is nervous aggressive, book the dog lots of time to bond or have the dog come regularly for treat in waiting room etc. If it's something that just has to be done there and then then dont faff and just get it done.

P.s. I'm always surprised that you are told to hold a baby/toddler very firmly for vaccinations...but owners don't think anything of letting go of the dog as soon as they try and wriggle and wonder why you can't vaccinate it if it's then leapt across the room.....

RE: Hitting patients - is it ever acceptable?

Bob Russell — Wed, 27 Jan 2016 17:26:36 GMT

I suppose the key thing is to define the term hitting.

A tap that creates surprise/shock to distract attention from an unacceptable form of behaviour might be justifiable in some cases.

Hitting as punishment or to relieve frustration is bullying and should be grounds for disciplinary action.

RE: Hitting patients - is it ever acceptable?

Evelyn Barbour-Hill — Wed, 27 Jan 2016 15:17:45 GMT

[quote user="Hannah Wynne Richards"]

Anthony and Bob. The name comes from the Welsh word "buddugoliaith" meaning victory - so Queen Victoria was actually Victoria II! The way I was taught British history in the 1st millenium was that we were all British, until 1st the Romans came and went, then they were followed by the Angles, and Saxons. (origin of East ANGLIA- you illegal immigrants). The wimps stayed, and intermarried. Those who wouldn't submit to an alien culture retreated, until the only true Britons were pushed back to Wales, and the north of Scotland.

Wynne

[/quote]

The Ancient Britons (of whom we know very little) were there before the Celts. And were, of course, pushed out.

A wholly native 100% Welsh nurse, if short and dark with brown eyes, is quite likely to be descended from a shipwrecked Spaniard.

These Spaniards get in everywhere

RE: Hitting patients - is it ever acceptable?

George Cooper — Wed, 27 Jan 2016 12:28:22 GMT

Hauling this thread back on course, using the strength genetically imprinted by my Norwegian/Shetland/Scottish ancestry, I had forgotten that we did, in fact consider "hitting" an animal to be a sacking offence. This was written in stone in the contracts and protocols.

There are many ways to deal with the uncooperative types. (PS in a practice discussion here, now, I was mis-heard by our Ayatollah who thought I meant hitting the CLIENT. I wish........)

RE: Hitting patients - is it ever acceptable?

Hannah Wynne Richards — Wed, 27 Jan 2016 10:54:13 GMT

You obviously agree we're not the "roll over" sort

Wynne

RE: Hitting patients - is it ever acceptable?

Anthony Dennison — Wed, 27 Jan 2016 10:39:52 GMT

[quote user="Hannah Wynne Richards"]

Wynne

[/quote]

Celts, the 'wilder' tribes in Cornwalum (Cornwall/Dorset), Wales, and the Picts in Scotland, were always in the area they were in, they just liked fighting amongst themselves a lot more. The tribes in what became Wessex, Mercia and Northumbria just were a bit more peaceful (or rolled over, dependiong on how you want to look at it).

Quite a few Irish Norse came across the Irish Sea to Wales and the Wirral to settle in Wales Wynne after they got kicked out of Ireland, if you want to talk about illegal immigrants!

RE: Hitting patients - is it ever acceptable?

Hannah Wynne Richards — Wed, 27 Jan 2016 10:24:17 GMT

Wynne

RE: Hitting patients - is it ever acceptable?

Iain Richards — Wed, 27 Jan 2016 09:51:29 GMT

Spot on George.

I hesitate in putting forward this observation The RMB types are often dismissed as misguided by many vets as their opinion is based on limited observation. The same argument could be applied to physical remonstration (irrespective of force) of patients by ourselves. Those that advocate it are positive it brings good results, but there is no evidence, just personal observation. Looking back, when I hit, it was frequently due to a loss of patience/temper on my part. Or fear.

It may work, but potentially hurts the animal and probably hurts the trust between you and a client. Refraining from hitting has no potential harmful consequences. I see it as a fairly simply equation.

Back to George's tale of the nurse - I've never seen a nurse hit a patient. Scruff, hold firmly, use a strong tone, yes, but never hit.

RE: Hitting patients - is it ever acceptable?

Bob Russell — Wed, 27 Jan 2016 09:38:26 GMT

No direct links with the Welsh that I can find beyond the fact that many of the Romans were off fighting the Welsh at the time she caused them grief!

Actually Boudica/Boudicca pronounced Boudika as our rather bizarre history teacher insisted! We got a clout on the hand with a ruler if we used any other pronunciation! That punishment was acceptable in those days!

(also from an East Anglian!)

RE: Hitting patients - is it ever acceptable?

Anthony Dennison — Wed, 27 Jan 2016 09:29:20 GMT

[quote user="Hannah Wynne Richards"]

George. When dealing with a Welsh woman, always wise to remember she may be a lineal descendant of Boadicea.

Wynne

[/quote]

No she won't. Boadicea was Iceni, which was an East Anglian tribe, not Celtic. Other side of the country.

(From a proud East Anglian)

RE: Hitting patients - is it ever acceptable?

Hannah Wynne Richards — Wed, 27 Jan 2016 09:21:59 GMT

George. When dealing with a Welsh woman, always wise to remember she may be a lineal descendant of Boadicea.

Wynne

RE: Hitting patients - is it ever acceptable?

Virginia Campbell — Tue, 26 Jan 2016 23:52:18 GMT

I would use a tap on the muzzle in a lot of situations in preference to other methods if I thought it worked, but I don't think it would for most. I don't know - haven't tried- but in lots of cases I've had to stop the owner from doing it as I think it just winds the animal up. Granted the ones tapping or outright smacking their unsocialised untrained unhandled beast in the muzzle or bopping it in the face with the end of the lead are usually performing other unhelpful behaviours at the same time. The last one I had was an Akita with a history of unruly behaviour in the consult room: Mr was bopping it with the lead and scolding it; at the same time Mrs was patting it (or trying to, as it surged about), trying to feed it treats and squeaking "Mummy's baby! Be good for mummy! Mummy's baby!"

I managed to dissuade Mr from the lead bopping, but had been working all day, didn't have time to teach them how to own an animal properly, and am 7 months pregnant so the notes read:

"Exam limited due to temperament. Heart sounds OK between growls. Abdo palp OK, though limited as tense. Moving well. Coat looks good. Did not attempt to examine mouth, eyes or ears. O reports in good form, no problems. Vax in hindq's with male O holding front end. Strongly adv training, gave list behaviourists"

They almost certainly won't go, but honour is satisfied. If there is time, the animal seems somewhat workable-with and the owners show some interest in learning, I will explain more about dogs' body language and handling with this :

[quote user="George Cooper"]One has to consider what exactly one wishes to achieve by this act, and then reflect upon whether those wishes are likely to come true. [/quote]

very much in mind for this consult, future consults and the dog's home life and management. Otherwise I just do as above - get it over with reasonably quickly and record the limitations on the record, which also serve as a warning for whichever unfortunate colleague sees it next.

RE: Hitting patients - is it ever acceptable?

Nhombokisheni — Tue, 26 Jan 2016 22:28:23 GMT

[quote user="George Cooper"]

It is never, ever, justifiable to hit a patient.

No - never hit them, understand them, then deal with them.

[/quote]

Can I just say, "tap" and "hit" are very different words. Unless I missed something.....did anyone actually advocate hitting patients?????? And I note some very passionate and sincere comments, which begs the question.....what is acceptable restraint?

Muzzling a "frightened" dog actually makes it even more scared......chemical restraint requires holding it down to complete jab, which must totally unnerve the poor pet before the chemical puts it into dream land.........long back used to give acp tabs to facilitate handling, but again you could see the animal struggling to understand what's going on........we all know animals do have memories....just how chafed do you think they are when coming around, or they have their mouths gagged....your only man's of voicing your opinion????????

Also practically speaking, how long is a consult.......long enough to allow you to bond with the animal, understand it, then deal with it?????????? I don't think so.....

Is it possible that a tap is a form of restraint that dogs actually understand.........and as I started out, everyone can tell the difference between a tap and outright hit......

In my experience the one who brings an aggressive dog or cat.....it's the one who gets most exposed to the animal when it comes to physical handling......where the owners failed, I used tabs or a cage........which reminds me....long before these wonderful modern cat cages came about....we used to trap the cat against the cage wall with a broom to facilitate injection......required a substantial amount of force, the wails of the cat where secondary......so yeah....if a tap on the nose works for that cat....it's a million times better option.....

Would I hit a patient......not as long as there are numerous options out there.....

RE: Hitting patients - is it ever acceptable?

Nicola Cole — Tue, 26 Jan 2016 20:47:43 GMT

[quote user="Linda Filshie"]

[quote user="Michael Woodhouse"][quote user="Linda Filshie"] I'd be pretty f'ing pissed off if anyone hit mine or a client's dog - whether present or not. [/quote] Like children - a little tap does no harm. Depends how much of a little shit the dog or child is. I'm not advocating beating them within an inch of their life, but a tap on the nose is fine by me.[/quote][/quote]

IMO it's never ok to hit an animal (or a child-as they were also mentioned). I think there are very few dogs you can't deal with (with a good nurse, rather than the owner, and a muzzle if required) and for those that are a nightmare (still probably just scared or very poorly socialised) I don't see that a tap/hit is going to change things. Plus it would just 'feel' wrong.

RE: Hitting patients - is it ever acceptable?

George Cooper — Tue, 26 Jan 2016 13:17:38 GMT

It is never, ever, justifiable to hit a patient.

One has to consider what exactly one wishes to achieve by this act, and then reflect upon whether those wishes are likely to come true.

Presumably the reason for wanting to hit a patient is because there is a lack of control somewhere, and perhaps a lack of self control into the bargain. Let's consider what it is you wish to hit. It is probably an animal that is out of its normal place, perhaps feeling frightened or apprehensive and wanting to defend itself in the face of perceived danger. As we all know to the one doing the perceiving - that perception is reality. This to me says that the animal is merely reacting in keeping with being an animal - and that for a VS or a VN to strike as well, that is lowering themselves to that very same animal response. Surely we have greater understanding, compassion even, for it? And as for the outcome, invariably it can make the situation worse, escalating to stupid levels.

As an alternative, quiet assertive behaviour when faced with gnashing teeth and lashing claws would surely lead one straight to the muzzle wardrobe where a selection can be made of an outfit to secure the situation? And if that is not workable, a calm march to the medicaments department will allow a choice of fine pharmaceutical potions with which the miscreants can be rendered impotent in the injurious stakes. Problem solved. There is always the ultimate sanction whereby the animal - if it is SO uncontrollably unreachably dervish-like - is requested to be removed from the premises as the protection of all staff rises above the treatment of the thing. One could quote H&S. After all a bitten vet is useless to his next on the list of patients.

I have two anecdotes. The first involves a pair of Rotts that were commercially kennelled permanently as the owner could not risk them at home. He would visit, walk, feed as required - and fetch them in to the surgery if ever they needed examination which was performed at a safe distance often using some sort of binoculars (OK I made that bit up) and when "proper" clinical was needed we sent for the Warden at the local Safari park who would turn up and dart the bugger for us, and wait until it did relax upon its side and allow a good look. On the single occasion when surgery had to be done my armpits, feet, and groin were saturated. Not pleasant. For some reason sacking the owner didn't appear to be an option.....membership of the SAS might have played a part in decision making.

My second anecdote involves a locum and a feisty Welsh Veterinary Nurse who was never afraid to mince her words to anyone, even her boss (me), castigating (rather - p**s-taking) me for "going in them internet chat rooms" when it was, actually a tiny spell of using online dating instead of wearing a Post-it note on my forehead saying "I'm Free!" in the consult room.

I digress. She was helping the unfortunate locum in the execution of his duties in the prep-room and dental room and while holding a little JRT for him to administer the propofol, it wriggled and wriggled and squirmed and grumbled whereupon he walloped it across the head. Suddenly the dog was released and he was sent flying by a meaty thump to the side of HIS head (something her rugby team could emulate) accompanied by the words " See? It fuckin' hurts, dun nit?". She then pointed out calmly that "we don't do that here, see".

Oh - and a third one, from LA times. I'd a real grumpy old toby jug of a Scottish boss years ago who, when de-budding calves used to grind his thumb into their eye if they wriggled as he was injecting the local in to the groove. Quite WHAT he imagined he was "teaching" those calves I never could work out, or what he hoped would improve following his grinding.

No - never hit them, understand them, then deal with them.

RE: Hitting patients - is it ever acceptable?

Hannah Wynne Richards — Mon, 25 Jan 2016 10:11:40 GMT

That can be the case with fear aggression, and a Corporal Jones type pwner, who's terrified of needles, and starts "don't panicking" before you've even touched the dog. Tell the owner to wait in the waiting room, let the dog calm down, and often your cool calm and confident nurse will restrain it with no difficulty.

Wynne

RE: Hitting patients - is it ever acceptable?

Robin Grimmer — Mon, 25 Jan 2016 09:50:14 GMT

[quote user="Robin Grimmer"]

[quote user="Bob Russell"]

Some dogs would probably benefit from a bit of discipline but generally not our place to do that, however feeble the owners may be!

[/quote]

Yep, you've hit the nail on the head there. Just as you wouldn't expect your GP to clip your child round the ear if they were misbehaving!

Often those dogs that are badly behaved with the owners present are much better if you take out the back with the nurse restraining.

[/quote]

RE: Hitting patients - is it ever acceptable?

Robin Grimmer — Mon, 25 Jan 2016 09:48:55 GMT

[quote user="Bob Russell"]

Some dogs would probably benefit from a bit of discipline but generally not our place to do that, however feeble the owners may be!

[/quote]

Yep, you've hit the nail on the head there. Just as you wouldn't expect your GP to clip your child round the ear if they were misbehaving!

Often those dogs that are badly behaved with the owners present are much better if you take out the back with the nurse restraining.

RE: Hitting patients - is it ever acceptable?

Bob Russell — Mon, 25 Jan 2016 09:38:09 GMT

As this thread is a tangent from events that happened in my practice about 20yrs ago, it is probably appropriate to clarify!

I was not present and the vet and owners had a completely different memory of events. Owner considered it a beating, vet and receptionist nothing more than a smack sufficient to surprise the patient. The vet was a locum and from what I remember he was very competent. He had my support despite my view that this is rarely a constructive thing to do. I was not there!

This was all in the days before Mikki type muzzles and tape muzzles have never been that straight forward in brachycephalic breeds.

Some dogs would probably benefit from a bit of discipline but generally not our place to do that, however feeble the owners may be!

RE: Hitting patients - is it ever acceptable?

J G Wray — Mon, 25 Jan 2016 09:37:07 GMT

[quote user="Wren"]Coming from the horse camp[/quote]

My father is fond of the naval term "donkey-walloper" for anyone connected to riding, a non naval activity. This is, I am glad to say a corruption of "donkey-wallah". Senior Service joke.

RE: Hitting patients - is it ever acceptable?

Wren — Mon, 25 Jan 2016 08:46:40 GMT

Coming from the horse camp, yes I do use a twitch. Along with lots of other methods. I have a very long experience of working with horses in a non-veterinary capacity - I rode for a racehorse trainer for years, have competed many of my own to a decent level, and have backed and broken in countless horses, all completely on my own.

I have a lot of tricks up my sleeve for recalcitrant patients, of which a twitch is one. I generally find that the easiest horses to deal with are those in professional yards - racehorses, big hunting yards, eventers, show-jumpers etc. which have been handled by people who both know what they are doing and aren't afraid to be firm (firm, not nasty). If I am going to get killed I have long said it will be by a coloured cob owned by a middle-aged pony-patter who has allowed the horse to walk all over her. Many of them will not let you use a twitch or a chifney. Chemical sedation is all very well, a godsend to be honest, but you still need to get the needle in the vein somehow in the first place!

Firm but fair is the key. I get a lot of people who ask for me as they know the job will get done quickly and with minimum stress (and that applies to both horse and owner!). I have even had a couple of people crying with relief after a straight-forward vaccination as they had been so worried about having it done as it took half an hour and blood, sweat and tears the previous year!