How to Survive (and Thrive) in Veterinary Practice
World Small Animal Veterinary Association Congress Proceedings, 2019
M. Holowaychuk
Critical Care Vet, Calgary, AB, Canada

Veterinary care providers commonly struggle with strategies to “stay sane” and maintain work-life balance. Given the difficulties faced by veterinary professionals on a regular basis, practical strategies for setting boundaries, saying no, and daily debriefing are needed to foster wellness and resilience. These function to expand awareness of a person’s needs, as well as conserve their limited physical and emotional resources. They also foster life balance including separating work from play and rest.

Building Better Boundaries

Unhealthy boundaries occur when we do not set limits on ourselves or others. Some examples include going against our personal values or rights to please others, letting others direct our life, letting others describe our reality, looking to others to define us, or expecting others to think, feel, and behave the same way we do. Healthy boundaries are essential to healthy relationships and leading a healthy life; however, boundary-building can be a challenging concept for many people. Having healthy boundaries basically means knowing and understanding what your limits are and not allowing them to be compromised.

Name your limits. To set boundaries, you must first identify your physical, emotional, mental, and spiritual limits. In veterinary medicine, this also means identifying your moral stressors. Know what you can tolerate and accept versus what makes you feel uncomfortable or anxious. Identify where you need more space, self-respect, energy, or personal power.

Tune in to your feelings. Feelings of discomfort or resentment are “red flags” or cues that a boundary has been crossed. Pay close attention to when you lose energy, feel a knot in your stomach, or want to cry. If you notice these feelings coming up for you in certain situations or interactions, ask what it is about the situation, interaction, or expectation that is bothering you. Resentment usually stems from a feeling of being taken advantage of or not feeling appreciated and can be an indication that you are pushing yourself beyond your limits.

Be direct. If people have similar communication styles, views, or personalities, they tend to approach each other similarly and maintaining healthy boundaries does not require a direct dialogue. However, when dealing with people who have a different personality or background, you will need to be more direct about your boundaries. Give yourself permission. Fear, guilt, and self-doubt can inhibit our ability to set boundaries even when we feel drained or taken advantage of. Boundaries are a sign of self-respect, so give yourself the permission to set boundaries and work to preserve them.

Practice self-awareness. Boundaries are all about tuning into your feelings and honoring them. If you notice yourself slipping and not sustaining your boundaries, consider what has changed, what you have control over, and what you can do about it.

Consider your past and present. If you have a history of ignoring your own needs and focusing on others, you have probably previously let yourself become drained emotionally and physically. Consider this when setting boundaries, especially in relationships, and ensure that they are reciprocal.

Make self-care a priority. Give yourself permission to put yourself first, such that your motivation to set boundaries becomes stronger. This also means recognizing and honoring your feelings, which serve as important cues about your wellbeing and what makes you happy. Remember that putting yourself first also gives you the energy to have a more positive outlook and be a better co-worker, friend, partner, etc.

Seek support. If you’re having a difficult time setting boundaries, consider seeking support, whether it’s from a support group, counsellor, therapist, life coach, friend, or mentor. Also consider sharing your boundary-setting goals with friends or family so that you can be held accountable.

Be assertive. It is not enough to create boundaries; we must abide by them as well. Do not expect others to read your mind and know when they cross a boundary. You must assertively communicate with that person to let them know. There is no need to defend, debate, or over-explain your feelings. Be firm, gracious, and direct, and when faced with resistance, repeat your statement or request. Remember that if you give in, you invite people to ignore your needs.

Start small. As with any new skill, assertive communication of boundaries takes practice. It is best to start with a small boundary that is not threatening or overwhelming you and then slowly increase to more challenging boundaries. Setting boundaries takes courage and practice but is a skill that anyone can master.

When to Say No

It can be difficult to determine which activities in our lives deserve our time and attention and what we must say no to. To evaluate opportunities and obligations that come your way, consider the following:

Focus on what matters most; examine your obligations and priorities before making any new commitments. Ask yourself if the new commitment is important to you. If it’s something you feel strongly about, then do it, and if not, pass.

Weigh the yes-to-stress ratio; is what you are considering a short- or long-term commitment? Do not say yes if it will mean months of added stress. Instead, look for other ways to contribute.

Take guilt out of the equation; do not agree to a request that you would rather decline, out of guilt or obligation. Doing so will inevitably lead to additional stress and resentment.

Sleep on it; before you respond, take a day to think about the request and how it fits into your current commitments. If you cannot sleep on it, at least take the time to think the request through before responding.

Imagine saying yes and then tune into your feelings; visualize what life will be like if you commit to the request and then become aware of your thoughts and feelings as they arise. If you feel anxious, resentful, or stressed, then consider saying no.

How to Say No

Saying no is often not as simple as we would like it to be. Here are some simple strategies to help.

Say no. The word “no” is a complete sentence and has power. Do not be afraid to use it. Be careful about using wimpy substitute phrases, such as “I’m not sure” or “I don’t think I can.” These can be interpreted to mean that you might say yes later.

Be brief. State your reason for refusing the request, but do not go on about it. Avoid elaborate justifications or explanations.

Be honest. Do not fabricate reasons to get out of an obligation. The truth is always the best way to turn down a friend, family member, supervisor, or co-worker.

Be respectful. Good opportunities will arise and it can be tough to turn them down. Complementing the person’s effort while saying that you cannot commit shows that you respect what they are trying to accomplish.

Be ready to repeat. You might need to refuse a request several times before the other person accepts your response. When that happens, just hit the replay button. Calmly repeat your no, with or without your original rationale, as needed.

Other Things to Consider When Saying No at Work

More than ever, people are expected to do more work in less time. People say yes to requests because they want to be a team player, look eager, or simply be nice. But saying yes all the time can lead to burnout.

Take time to consider the request; determine how much time you will need to perform the task well and how the request fits into your existing demands. Before you say yes, you want to think clearly about the advantages and disadvantages.

Offer an alternative; while saying no, try to help the other person who approached you with the request. Ask if you can do something else to help or offer to comply with the request later.

Say no in person; email or text messages can be misinterpreted, and the willingness that you express through your tone of voice might be missed. To avoid insulting the other person, call them on the phone or schedule a meeting, if possible.

Avoid details; keep your explanation short and simple. By describing your entire calendar or other commitments, you run the risk of seeming defensive about your choices, and the person might question the importance of your other obligations.

Consider the consequences; weigh the risks and benefits of each refusal, both personally and professionally. If you are a new employee, you might have less leverage when it comes to declining a request. However, saying yes to an opportunity might get in the way of other professional goals. If you have concerns about that, voice them.

Do not respond with self-deprecation; the person making the request might respond with flattery and insist that you oblige the request. Instead, lay out your current assignments or lack of availability as an explanation.

Ask for help; if needed, explain that you have a real conflict and are trying to resolve it. For example, if a colleague asks you to take on an extra call shift say “I’d love to cover your shift, but I made a commitment to my family to have one day off each weekend. Can you cover my Sunday shift in lieu of my covering your Saturday shift?” Keep your explanation as simple as possible.

Debriefing

Personal debriefing is a means of recognizing how an experience was for an individual and aims to help integrate the experience into their life, perceive the experience more meaningfully, and bring a sense of closure. It requires personal reflection and can help with disengaging from work at the end of a shift. Essentially, it gives closure to work and work relationships, while acknowledging the good work that was done. Personal debriefing should be performed on a daily basis when completing a shift or other work done that day.

Steps of Daily Debriefing

Check that tasks are finished and that documentation is completed, then deal with any outstanding issues. If items are essential, then complete them. Otherwise delegate or write them down to complete the next day.

Acknowledge the day and recall what went well and what did not. Try to focus more on the positives and less on the negatives. Recognize that the best work was done with the time and resources available.

Hand over responsibility for the care of patients. Be conscious during case transfers that total responsibility is being passed along to colleagues.

Close computer or paper files with intention.

Say goodbye. This is closure for the day on relationships with patients, clients, and colleagues.

Debrief and de-role by talking through any distressing events. If time does not allow this, then arrange for a debrief later if needed. Take off ID badges/name tags, scrub tops, work shoes, etc. or use other personal rituals to signify that work is done. Use any reminders to signify that work is complete and it is time to shift from work to home life.

Make the journey home a final separation between work life and home life.

If on-call or work from home is required, create a specific space at home for professional work, and try to keep to this space only for working. Then develop a ritual that signifies when work is completed (e.g., closing the door to the office).

If thoughts of work come up at home, write them down and keep them in the workspace or work bag. If they are still present the next day, consider talking them through with someone or scheduling a debrief with a colleague if needed.

Ensure that no matter the circumstance at work, others can be contacted for support if needed. Isolation, loneliness, or lack of belonging can lead to psychological distress during a difficult time. Have the names and contact information of trusted co-workers or colleagues who can be called to talk through difficult situations should the need arise.

 

Speaker Information
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M. Holowaychuk
Critical Care Vet
Calgary, AB, Canada


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