Peer Support As A (Partial) Antidote To Workplace Stress

We all know using alcohol to settle down at the end of a workday or soldiering on and pretending that everything is okay when actually you are a tangle of emotions and stress, are unhelpful in managing workplace stress. And most of us now also know it can actually amplify it. So, how can we as veterinary workers, manage the emotion and stress that our work creates as we deal with suffering and loss, unrealistic clients, ethical dilemmas, workload, financial pressures etc.?

How can we counter the high levels of mental distress that our profession is dealing with?

As more becomes known, the answer will surely be multifactorial. However, one thing we do know is that seeking support from colleagues is a super effective and readily accessible coping strategy.

Numerous studies in veterinary and non-veterinary workplaces, highlight the role of co-worker support in increasing well-being and job satisfaction while buffering the potentially negative effects of workplace stress. (eg Wallace and Lemaire 2007, 2013, Wallace 2014, 2017, BVA Voices 2018)

And, unlike alcohol and avoidance, talking with people that listen, understand and empathise with our work-related problems, and offer support and encouragement, helps us to feel better BOTH in the short term and the long term.

“A problem shared is a problem halved” – as the old saying goes.

Talking with our colleagues can help to;

Normalise the challenges we face. We are not alone in both loving and loathing veterinary work at times. It helps to know that other people are challenged too, and often by similar things to you.

– Structure our thoughts – the simple process of taking the thoughts that are swirling around in your head and arranging them into a coherent “story” to impart to another person helps to structure and make sense of what has happened.

– Understand and label how we are feeling – reducing the intensity of the emotions experienced and giving us insight into our actions

– Get another perspective on what happened from somebody who will have experienced something similar in the past. They may help to widen your view and see other factors that contributed to the events, increasing your tolerance and compassion.

– Brainstorm solutions to the problem

Informal, on the fly conversations are great and these are ideally supplemented by regular, more structured debriefing sessions. Maybe, you could set aside a part of your staff meeting to talk about a challenging ethical dilemma or client communication around finances? This helps to get everybody on the same page and reduces uncertainty when faced with a similar situation in the future. Maybe, you could buddy up with a safe person in the workplace and spend 15 minutes after work once a week talking through your work-related challenges and successes? Maybe, you feel safer or more comfortable sharing with a prior work colleague or friend from uni/TAFE?

Could scheduling a regular time to debrief work situations be the one thing you do differently in 2019 to actively manage your stress and increase your work satisfaction and longevity?

Why don’t you join Dr Cathy Warburton at Makeheadway for the Veterinary Balint Group held monthly across 6 sessions between May 6th – October 6th 2019? The Veterinary Balint Group Program is for all members of veterinary health care teams who want a better way to process and understand difficult clinical or communication experiences.  For more info, check out the brochure. Register HERE.

Written by Dr Cathy Warburton

How Do You Manage The Tough Days In Practice?

There are some days in practice that are amazing – you see patients making progress, the team works well together, the clients love you and you even get time to have lunch and a bathroom break before you leave on time. You head home to enjoy your time with family, friends, pets and/or hobbies. Amazing!

There are other days though, that don’t feel so good and others again that can be downright emotionally demanding.

1.Maybe you are having a run of Doctor Death and you feel like it would be better for that nice owner with their nice pet to see another vet – one that deals in life rather than death.

2.Or maybe your schedule looked OK until you had those couple of emergencies which, whilst fun and satisfying, threw everything else into disarray.

3.Or maybe you had just one too many of those clients that want everything done for their pet and money is no object (red flag, red flag) or want you to provide treatments that you feel are not in the best interests of their animal or were just plain difficult to deal with.

What do you do at the end of those days? Days where you feel sucked dry and have nothing left to give.

Do you withdraw – sitting on the couch distracting yourself with Facebook or Netflix in an effort to turn your brain off? Or do you head straight to pour yourself a glass (or two) of your tipple of choice?

Avoidance and alcohol consumption are examples of coping strategies that we can use to reduce the discomfort we feel after a stressful day in the clinic. And using strategies such as these makes sense, as they can make us feel better in the short term and they take little effort and energy.

The problem is that whilst these coping strategies provide an escape and can make us feel better in the short-term, they don’t go to the source of the stress and therefore are not helpful in the long term.

The stress and emotion is still sitting there, it is just masked – dulled by the effects of the alcohol or perhaps nicely compartmentalized into a little box – but there all the same. Ignoring it does not make it go away! It builds up inside us and eventually will escape the boxes we are trying to contain it in.

But unfortunately, the problems don’t stop there. A recent study1 in veterinarians has shown that frequent use of avoidance and alcohol as coping strategies to manage workplace stress can actually amplify the harmful effects of some job demands and increase levels of emotional exhaustion, burnout and suicidal thinking.  

Avoidance and alcohol don’t just not help, they actually hinder our response to workplace stress.

The good news is that we can all learn to use more helpful coping strategies. Having supportive relationships with your work colleagues and talking about work stresses, challenges and successes with people that understand what you are going through is a good place to start and we will pick up on this theme in subsequent blogs.

So as we move into another year, now may be the time to take stock of the coping strategies that you are using to recover from tough days in the clinic.

If you are frequently using alcohol to cope with the stress of the day and/or internalizing the stress  – what is one thing you could do differently in 2019 to actively manage your stress and increase your work satisfaction and longevity?

Why don’t you join Dr Cathy Warburton at Makeheadway for the Veterinary Balint Group held monthly across 6 sessions between May 6th – October 6th 2019? The Veterinary Balint Group Program is for all members of veterinary health care teams who want a better way to process and understand difficult clinical or communication experiences.  For more info, check out the brochure. Register HERE.

Written by Dr Cathy Warburton

1.Wallace (2017) Burnout, coping and suicidal ideation: An application and extension of the job demand-control-support model, Journal of Workplace Behavioral Health,32:2, 99-118
DOI: 10.1080/15555240.2017.1329628

Dr Stanley Kim Turning Fearsome Fiddly Surgery Enjoyable

Does the surgical repair of an antebrachial fracture in a Chihuahua fill you with fear? Dr Stanley Kim, a Sydney graduate who’s been part of the furniture for 12 years at the College of Veterinary Medicine, University of Florida, can turn that fear into fun and make that fearsome fiddly surgery enjoyable!

Like many vets, Dr Stanley Kim grew up with animals and had always admired the veterinary profession, but it was an orthopaedic research externship that he undertook as a veterinary student at the Surgical and Orthopaedic Research Laboratory, UNSW, that inspired Stan to follow a path into small animal surgical specialisation. Stan is still passionate about research in the veterinary orthopaedic domain; his research interests are in the field of minimally invasive orthopaedic surgery, fracture repair, joint replacement and orthopaedic biomechanics.

Florida has been Stan’s home since 2007, when he started a residency in small animal surgery at the College of Veterinary Medicine, University of Florida, in Gainesville. After graduating from the University of Sydney with a Bachelor of Veterinary Science (First Class Honours) in 2003, Stan spent a year in small animal practice in Sydney before heading overseas, initially doing locum work in the UK, and then to Canada where he completed an internship in small animal medicine and surgery at Ontario Veterinary College, University of Guelph in 2005-2006.

Stan’s current role is Associate Professor, Small Animal Surgery at the College of Veterinary Medicine, University of Florida. As well as his research activities, Stan teaches both under- and post-graduate veterinary students at the University of Florida and has a clinical case load there.

Stan enjoys using highly detailed precisely crafted instrumentation for surgery to toy breeds, and at the University of Florida, routinely sees cases in these toy breeds with previous failed attempts at repair of antebrachial fractures. In Stan’s opinion, most of these could have been avoided with proper implants and good surgical technique. According to Stan, the challenges associated with repair of fractures in toy breeds include a higher risk of stripping screws and a smaller margin for error, and limited bone stock means you typically only have one good shot at repair. Another factor influencing success is that pound for pound, cats are stronger than dogs and therefore put more stress on the repair.

VetPrac believes that with the continued global trend towards smaller pets, the demand for newer technologies in fracture repair will only increase. There is no doubt that in Australia pets are getting smaller and the homes they live in are getting higher. While the fundamentals of orthopaedics don’t change, fractures in smaller animals have a unique set of considerations. We are also seeing newer technology in fracture management having a huge impact on the success of our surgeries and comfort of our patients. Smaller, lighter implants make a big difference to these tiny patients. Stan is the perfect specialist surgeon to teach Australian vets about orthopaedic surgery in this rapidly growing subset of our small animal patients. Stan has been recognised widely for his teaching prowess, and, in 2017, received the Zoetis Distinguished Teacher Award.

Why not take advantage of a rare opportunity to share Stan’s vast knowledge and great teaching skills at the VetPrac Fine and Fiddly Fractures Workshop in Gatton on April 12-13, 2019. Stan is sure to equip you with invaluable skills to improve the outcomes of surgery in these toy breeds. Register TODAY. For more information, check out the brochure.

Dr Stanley Kim can be contacted at stankim@ufl.edu

Written by Alison Caiafa

VetTips: Fine and Fiddly Fracture Repair

We asked Dr Stanley Kim to give us some useful tips on fracture repair for toy breeds and cats.  This is just a taste of the amazing skills you’ll learn at the Fine and Fiddly Fracture Repair Workshop.

Tip 1: THINK TWICE before recommending external coaptation for antebrachial fractures in toy breed dogs

Distal diaphyseal antebrachial fractures in toy breed dogs are very common, and typically the result of a low impact injury such as a jumping of the couch or falling from a low height. The radius of the toy breed dog is particularly prone to injury because of its unique cross-sectional shape.

It is very tempting to recommend external coaptation for these injuries because they are distal, the animals are small, and the costs are low. While successful healing has certainly been documented with external coaptation, there is a high risk of non-union, malunion, and skin ulceration. The fracture configuration is typically highly unstable, and the small size of the segments translates to a very high strain environment. Furthermore, there is evidence that the vascular pattern of toy breed dogs is poorer than that of larger dogs. Collectively, these factors translate to a high-risk scenario, and salvage of the limb after failed coaptation becomes very challenging.

Tip 2: BEWARE of implant failure with tibial fracture using plates in cats

Pound-for-pound, cats are much stronger than dogs. In certain fractures, cats may therefore stress implants relatively more than dogs. In a recent study, high failure rates were documented following tibial diaphyseal fracture repair using plate-screw fixation. Special consideration of plate and/or rod selection and application should be given to avoid plate bending following tibial fracture repair in cats.

Tip 3: Lacking confidence with sacroiliac repair? Opt to do no harm

Sacroiliac luxation is a common injury. It is also remarkably well tolerated in many animals. Surgery is not always the treatment of choice. Indeed, repair is challenging, especially in small animals. The corridor for safe screw placement is small, and poor positioning can result in catastrophic iatrogenic injury. While the recovery period can be prolonged, conservative management of most sacroiliac luxations typically results in a satisfactory outcome.

To develop your practical skills, join specialist surgeon Dr Stanley Kim in April 2019 for a two-day focus on small fractures and develop your skills to treat your patients better. Register TODAY for the Toy Breeds Workshop. This workshop will be helpful to veterinarians with a foundation in orthopaedics who want to extend their skill set and master techniques with support from Australia’s finest and friendliest surgeons. For more information, check out the brochure.