My friend told me, \u201cWe\u2019re having a team debrief tomorrow to talk about how everyone is feeling after our recent-graduate veterinarian lost a patient under anesthesia.\u201d I looked at him for a long moment, processing my thoughts before responding, \u201cYou\u2019re having a team debrief to do what?\u201d He replied right away: \u201cYou know, to process trauma and give everyone space to talk about how they are feeling.\u201d<\/p>\n
I love that my friend is committed to making his team feel heard and supported. I also understand that younger generations are far more comfortable talking about their mental health than previous generations have been. I can\u2019t help but wonder, however, if my friend’s good intentions offer the most beneficial solution.<\/p>\n
Are we increasingly comfortable meeting the normal hardships of the veterinary profession with mental health language and tools? Should everyone in the building be encouraged to stop and share their painful feelings about the recent past? Is the relief that some feel worth the pain that might be inflicted on others \u2014 for example, the recent graduate, the people who want to put an event behind them, and the people who weren\u2019t involved and would rather not know the details? Can\u2019t other approaches better meet the needs of our teams, patients and clients?<\/p>\n
In 2019, I had a bout of clinical depression that lasted roughly six months. It occurred about a year after I began loudly encouraging tighter drug-control methods in veterinary clinics to reduce the risk of suicide by veterinary professionals.<\/p>\n
I felt terrible back then, I was miserable to be around, and I didn\u2019t want to get off the couch. I came to understand how J.K. Rowling would find inspiration for the dementors in her struggles with depression. Explaining how awful depression can be is challenging, and I know many people have experienced far worse and longer episodes than I did. If you\u2019ve never been depressed (or had a similarly unpleasant mental health episode), please take my word for it: Depression is terrible. I do not recommend it.<\/p>\n
I\u2019m writing about my experience for three reasons.<\/p>\n
A few years ago, I signed up for a free service that sent text messages throughout the day during Wellness Week. I wanted to support wellness in our profession and was curious what the messages might say.<\/p>\n
As the week kicked off, the texts started rolling in. They said things like \u201c1 in 6 veterinarians have considered suicide. Your mental health is important\u201d and \u201cHow stressed are you feeling today?\u201d I asked a friend who also signed up for the service what he thought. He replied, \u201cThis isn\u2019t Wellness Week. It\u2019s Sickness Week.\u201d<\/p>\n
I unsubscribed less than 48 hours into the program.<\/p>\n
Just now, as I am writing this article, I received a mass email from a group wanting to support veterinary wellness<\/a>. The subject line was: \u201cHow are you, really?\u201d The body of the email offered resources on how to overcome compassion fatigue and avoid burnout. It gave me the same negative feelings as the Wellness Week texts. While it’s important for resources to be easily accessible for those seeking help, I don\u2019t think blasting email messages like those into our community makes us healthier or happier.<\/p>\n How we think about our days and the stories we tell ourselves are important. If race personnel continuously remind marathoners to stretch, drink fluids and be proud of themselves for their accomplishments, the runners will have a certain experience. On the other hand, if they\u2019re continuously reminded about the dangers of ligament injuries, plantar fasciitis and being hit by a car, their experience is likely to be quite different.<\/p>\n Of course, no one should ignore an injured runner, but that doesn\u2019t mean the racers should be reminded again and again about the hazards of jogging. Relatedly, I\u2019m not convinced that interviewing all the runners at the 19-mile mark about how they feel will be productive or helpful in maintaining their overall enthusiasm for the event.<\/p>\n The same is true in veterinary practice. While mental health issues are genuine and shouldn\u2019t be taken lightly, the majority of people in our profession don\u2019t suffer any. In fact, according to the Merck Animal Health 2023 Veterinary Wellbeing Study, more than 53% of veterinarians say they have a high level of well-being and are flourishing. They do, however, have hard days, worries, stresses and periods of sadness. Those are normal and healthy human emotions, especially for people working in health care and with animals.<\/p>\n I can\u2019t help but wonder if framing our professional challenges in medical terms and encouraging group therapy activities negatively impact people who are coping adequately. Is talking to someone continuously about mental illness, burnout, anxiety, depression or compassion fatigue beneficial when that person feels the normal emotions of being tired, stressed, worried or frustrated? Are we telling joggers to remember that 1 in 150,000 marathoners will die within 24 hours of a race instead of handing them water and cheering them on? What if how we talk makes work for most veterinary professionals more challenging than it would be otherwise?<\/p>\n I recently worked with a practice owner who told me she wanted to improve her team\u2019s psychological safety. For those unfamiliar with the concept, psychological safety is the belief that you won\u2019t be punished or humiliated for offering ideas, asking questions, or speaking up about concerns and mistakes. This practice owner was looking for group exercises because a few staff members thought the training would benefit the team.<\/p>\n \u201cWhat exactly do you think is motivating the request?\u201d I asked. \u201cDo people in your practice really feel unsafe?\u201d<\/p>\n \u201cMaybe, kind of,\u201d she answered. \u201cTwo technicians are the most senior members of the staff, and they get prickly if people want to change things or if they are criticized in any way. Other staff members don\u2019t know how to talk to them without getting in trouble, and that\u2019s where this is coming from.\u201d<\/p>\n I think we know that some incredibly toxic veterinary practices are out there. These are places where abusive behaviors are tolerated and where employees worry about their physical and mental safety. There are clinics where shame and shouting are common, destroying any psychological safety. It pains me to think about our colleagues who work in such places.<\/p>\n However, the owner I spoke with doesn\u2019t run one of those practices. When we talked, she was researching how to run the psychological safety meetings that a few team members requested. I\u2019ve known this person for years, and she cares deeply about her employees\u2019 work experience and building a strong culture.<\/p>\n I love that the practice owner takes her team\u2019s wishes seriously and that her employees are comfortable communicating with her about their feelings (which is what you would expect in a psychologically safe environment). That is why I can\u2019t help but question whether psychological safety was the issue she needed to address. To me, the issue seemed to be a basic management problem involving senior personnel who were averse to change and feedback and who responded to their colleagues inappropriately.<\/p>\n Perhaps the better approach to reinforce psychological safety would be to address the issue individually. That intervention is much easier and more direct than bringing the entire team together and potentially skirting the issue. Wouldn\u2019t we all rather work at a veterinary practice that needs to fix a single HR issue than a practice with a generalized psychological safety problem?<\/p>\n I use that example because it\u2019s easy to understand why the staff might lean into the language behind psychological safety. If it\u2019s true the practice has senior technicians who get nasty when they feel criticized, it\u2019s not hard to understand why their co-workers might not want to point a finger at them to identify the problem. Instead, communicating to management that the team needs to work on psychological safety emphasizes that the problem is pervasive and needs immediate attention, which then opens a path to plausible deniability if the bullies decide to retaliate.<\/p>\n From a communication standpoint, the practice owner\u2019s preferred approach turns a fairly straightforward HR issue involving two people into a quasi-medical issue affecting the entire group. And now, everyone has to meet to discuss their psychological safety and how they feel at work.<\/p>\n My point is not to say that the staff shouldn\u2019t use phrases like \u201cpsychological safety\u201d in voicing their concerns or that veterinary hospitals shouldn\u2019t build strong feelings of psychological safety. My intention is to encourage management to investigate such phrases pragmatically and address the underlying issues rather than embrace language that doesn\u2019t serve employees or deliver the changes they request.<\/p>\n None of what I\u2019m saying here is meant to detract from the experiences of people who don\u2019t feel psychologically safe or from people who feel depressed, anxious or otherwise mentally ill. It\u2019s important to realize that framing mundane problems as mental health challenges sends us down a medical path instead of a communication or management one. Dragging people into emotional experiences that they didn\u2019t ask for negatively impacts those who are coping effectively with the situation and aren\u2019t empowered to fix the problem.<\/p>\n If a young kitten hurts its leg, we don\u2019t radiograph the littermates. If a dog gets bacterial pyoderma, we don\u2019t give antibiotics to every pooch in the kennel. The same logic should follow for how we address mental health issues in our veterinary teams. We should take steps to keep everyone safe, not ignore those who seem to be in pain and encourage appropriate treatments by trained professionals. We should not, however, treat every workplace challenge or interpersonal conflict as a mental health problem to be engaged by the entire team.<\/p>\n We should address individuals\u2019 concerns privately and be wary of including those who didn\u2019t ask to be included.<\/p>\n Finally, we should avoid encouraging our colleagues to apply medical labels to experiences without good cause or to ruminate on their feelings in an effort to evaluate how their days are going. Numerous studies have shown that people are more likely to complete difficult tasks if they focus on what they are doing and less likely if they focus on themselves. Just as healthy joggers are more likely to finish (and enjoy) a race by thinking about what they are doing instead of how they feel, healthy veterinary professionals are more likely to push through busy days and feel good by focusing on the tasks at hand instead of their current emotions.<\/p>\n Not everyone wants or needs the same kinds of support. It\u2019s possible to help individuals struggling with mental illness without blanketing the entire team or profession in medicalized language. We can encourage people who are coping with challenges without continuously reminding them (and ourselves) of the risk of mental illness. We can be there for our colleagues to help them as individuals without drawing the entire team into experiences that aren\u2019t helpful for them. We can solve problems without ruminating on how those issues make us feel. And we can continue to destigmatize mental illness without baking it into our weekly staff meetings.<\/p>\n Sometimes, unchecked issues can spread and become systemic. Check these signs to tell if an isolated problem has infiltrated your clinic\u2019s culture.<\/p>\n SIGNS OF PSYCHOLOGICAL SAFETY<\/strong><\/p>\n SIGNS OF PSYCHOLOGICAL DANGER<\/strong><\/p>\n Read more at bit.ly\/3vTqmwI<\/a>.<\/p>\n According to veterinary industry consultant Josh Vaisman, psychological safety is also about \u201ccultivating a culture of productive candor.\u201d Learn more at bit.ly\/safety-net-TVB<\/a>.<\/p>\n Dr. Andy Roark has partnered with VetFolio to release the Uncharted Leadership Essentials Certificate. The program provides training appropriate for anyone who leads or manages others. The topics covered include setting a team\u2019s vision and values, building trust, achieving team buy-in, delivering feedback, understanding communication styles, setting priorities, delegating effectively and managing time. Learn more at bit.ly\/Uncharted-VetFolio<\/a>.<\/p>\n Veterinarian and award-winning columnist Dr. Andy Roark has contributed to Today\u2019s Veterinary Business since 2017. Among his articles are these:<\/p>\n Framing mundane problems as mental health challenges sends us down a medical path instead of a communication or management one.<\/p>\n","protected":false},"author":47,"featured_media":76362,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"iawp_total_views":0,"footnotes":""},"categories":[522],"tags":[],"class_list":["post-76361","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-june-july-2024","column-dicharge-notes","clinical_topics-personal-wellness"],"acf":{"hide_sidebar":false,"hide_sidebar_ad":false,"hide_all_ads":false},"yoast_head":"\nMedicalizing Management Issues<\/strong><\/h3>\n
Where Do We Go From Here?<\/strong><\/h3>\n
\nIS IT A WIDESPREAD ISSUE?<\/strong><\/span><\/h3>\n
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\nTEAM DYNAMICS<\/strong><\/span><\/h3>\n
\nBE A BETTER LEADER<\/strong><\/span><\/h3>\n
\nSTORY ARCHIVE<\/span><\/h3>\n
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