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Chapter 5

Integrating Concepts from Veterinary Social Work into Our Practices to Improve Workplace Wellbeing

Elizabeth Strand, PhD, LCSW

In a recent study, 41% of veterinary students stated they had wanted to be a veterinarian “for as long as they can remember.”1 This vocational commitment can be found almost universally in veterinary team members. People choose veterinary medicine because they care about animals and people. It is not surprising that difficult cases affect the hearts and minds of these dedicated professionals.

Veterinarians report distress about ethical conflicts in practice.2,3 Some clients blame and say hurtful things to veterinarians when their own financial resources are insufficient to save their pets.4 Highly bonded, anxious, lonely pet owners facing end-of-life decisions and euthanasia can cause veterinarians to worry about the safety and wellbeing of the owner. Sometimes veterinary teams have to face suspected animal abuse5 or concern for a colleague’s wellbeing and competence.

These situations involve varying degrees of emotions like anger, sadness, fear, and guilt for everyone involved. These situations cause moral distress and require emotional labor from the veterinary team.

MORAL DISTRESS: WHEN EXTERNAL FACTORS PREVENT TEAM MEMBERS FROM DOING WHAT THEY FEEL IS “RIGHT”6

Moral distress often arises when there is conflict among team members or with clients about end-of-life decisions, pet quality of life, and standard of care. Over time, repeated morally distressing situations and negative emotions cause compassion fatigue, which arises from the emotional labor these situations require.

EMOTIONAL LABOR: THE PROCESS OF MANAGING AND CONCEALING EMOTIONAL EXPRESSIONS7

Emotional labor is a large part of practicing veterinary medicine successfully. Team members may need to express emotions publicly that do not match their private emotions, such as hiding their anger with a client’s inability to pay for treatment or concealing distressing emotions from their past to empathize with clients facing the euthanasia of a beloved pet. Emotional labor and moral distress can be exhausting, often creating “short fuses” and team conflict. Veterinary team conflict is expected and normal; however, when not managed well, it can impact morale8 and patient care.9

PROCESSES FOR MANAGING MORAL DISTRESS, EMOTIONAL LABOR, AND TEAM CONFLICT CAN OVERCOME OBSTACLES10

These processes allow a team to spend more time in the rewarding emotions of being veterinary medical professionals. These rewarding emotions include gratitude, happiness, confidence, and pride!

HOW TO GET STARTED

Steps your practice can take for helping with moral stress, emotional labor, and team conflict including the following:

Hold a weekly one-hour “Moral DE-stress Meeting” to discuss the following questions in this order:

  1. What are the situations this week that made it hard to sleep or put aside thoughts of work when you were at home?
  2. What did you do well in that situation?
  3. What do you wish you had done differently?
  4. What did you learn?
  5. Is there anything you are grateful for in this situation, or just in general?
  6. Is there anything that was humorous about this situation or in this week that you remember?

Provide yearly team training in communication skills and conflict resolution techniques.

Establish relationships with mental health resources in your community and have a list of numbers available for clients and team members to help with difficult emotions that are beyond the scope of the veterinary team.

RESOURCES

  • American Animal Hospital Association “AAHA Human Support in Veterinary Settings.”
    https://www.aaha.org/public_documents/professional/resources/humansupport.pdf
  • RISHI: The Remen Institute Healer’s Art Course
    http://www.rishiprograms.org/programs/medical-educators-students
  • Participate in a Healer’s Art group
  • The Schwartz Center
    http://www.theschwartzcenter.org
    Learn about Schwartz Center rounds to guide your practice’s approach to managing moral distress
  • Veterinary Communication for Professional Excellence
    http://csu-cvmbs.colostate.edu/academics/clinsci/veterinary-communication
    970-297-5051
    cvmbs-clinsci@colostate.edu
  • Veterinary Social Work Program
    www.vetsocialwork.utk.edu
    865-755-8839
    vetsocialwork@utk.edu

REFERENCES

  • Strand, EB, et al. Adverse Childhood Experiences Among Veterinary Medical Students: A Multi-Site Study. J Vet Med Educ 2017;44(2):1–8. doi:10.3138/jvme.0816-123R
  • Batchelor, CEM, and McKeegan, DEF. Survey of the Frequency and Perceived Stressfulness of Ethical Dilemmas Encountered in UK Veterinary Practice. Vet Rec 2011;170(1):19. doi:10.1136/vr.100262
  • Crane, M, Phillips, J, Karin, E. Trait Perfectionism Strengthens the Negative Effects of Moral Stressors Occurring in Veterinary Practice. Aust Vet J 2015;93:354–360.
  • Tran, L, Crane, MF, Phillips, JK. The Distinct Role of Performing Euthanasia on Depression and Suicide in Veterinarians. J Occup Health Psychol 2014;19:123–132.
  • Robertson, I. Legally Protecting and Compelling Veterinarians in Issues of Animal Abuse and Domestic Violence. NZ Vet J 2010;58:114–120.
  • Tran, Crane, Phillips, 123–132.
  • Grandey, AA. Emotional Regulation in the Workplace: A New Way to Conceptualize Emotional Labor. J Occup Health Psychol 2000;5:95.
  • Moore, IC, Coe, JB, Adams, CL, Conlon, PD, Sargeant, JM. Exploring the Impact of Toxic Attitudes and a Toxic Environment on the Veterinary Healthcare Team. Front Vet Sci 2015;2:78.
  • Riskin, A, et al. The Impact of Rudeness on Medical Team Performance: A Randomized Trial. Pediatrics 2015;peds.2015:1385. doi:10.1542/peds.2015-1385
  • Thompson, A. How Schwartz Rounds Can Be Used to Combat Compassion Fatigue. Nurs Manag 2013;20:16–20.

ABOUT THE AUTHOR

Dr. Elizabeth Strand is the founding director of Veterinary Social Work and a clinical associate professor at the University of Tennessee Colleges of Social Work and Veterinary Medicine. She is a licensed clinical social worker with a mission to encourage the humane treatment of both people and animals and to care for those professionals who care for animals.

Take-Home Message: All veterinary teams face moral distress (when external factors prevent them from doing what they feel is right), emotional labor (the process of managing and concealing emotional expressions), and team conflict. It is important to recognize and understand these challenges and develop skills to better address them.

Want to share with the entire team?

Pick up free copies of AAHA's Guide to Veterinary Practice Team Wellbeing and the roundtable discussion, The Link Between a Health Workplace Culture and Optimal Personal Wellbeing at these locations:

  • AAHA@VMX ( Rosen Centre Hotel)
  • Health & Wellbeing Center ( VMX Expo Hall)
  • AAHA booth ( VMX Expo Hall)
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