Help! I want more joy and less stress. But how do I get that?

You join a Reflective Practice group utilising the Balint framework – that’s how!

We know that we have problems in our profession. Here is an intervention aimed at those difficult interactions, the emotional burden we carry and the ethical dilemmas we navigate.

Cathy is collaborating with Renske van den Brink and Prue Bonifant from NZ in offering TWO joint Australia/NZ groups for the rest of 2020. Renske is a medical doctor who co-wrote an article on veterinary well-being published in the NZ vet journal in early 2020.

The evidence from other medical contexts shows that increased satisfaction and decreased stress and burnout can be achieved by participating in a regular Reflective Practice group using the Balint model. These groups are small (up to 10 people) and create a safe space where challenging or troubling encounters can be discussed. The focus is on the veterinarian–owner/client relationship, and facilitation is by 2 trained Balint leaders.

For more information on how Reflective Practice Balint groups work;

  • Click here to read the “Beating Burnout with Balint” article written by Cathy and Renske and published in VetScript.
  • Click here to see an interview with Cathy, Renske and Seton Butler from the Veterinary Council of New Zealand.
  • Please note that these groups are suitable for veterinary nurses and veterinarians.

Both groups will meet monthly and online via Zoom. Two day/time combinations are available and you are invited to join for the remainder of 2020 with the option of continuing on an on-going basis.

  • Tuesday evenings at 7-8.30pm NZ time/5-6.30pm AEST from August to November (18/8, 15/9, 20/10, 17/11) .The group leaders will be Cathy Warburton and Renske van den Brink
  • Sunday afternoons at 4-5.30pm NZ time/2-3.30pm AEST from August to November (2/8, 13/9, 4/10, 1/11).  The group leaders will be Renske van den Brink and Prue Bonifant.

The cost will be $240 for the 4 sessions  (which equates to $60 per session inc GST).

This is a great way of experiencing the benefits that a monthly reflective practice group can bring you.

Why invest in the well-being of your veterinary team?

Are you tired of putting out the fires?

Would you prefer to invest in your or the teams well-being and avoid a lot of angst, time, expense, grey hair and fire-fighting?

This research has been swirling around us for some time and now it is all captured into a short document specifying the reasons why you want to manage or work in a mentally healthy workplace – as do 91% of your fellow Australians.

  • You might think it is the right thing to do.
  • You might recognize the advantages to people (yourself, the team, the clients, your family and friends) and animals.
  • You might be thinking about the businesses duty of care to the physical and psychological health of their employees.

Click here to view and/or download the digital version.

Delicious Delegation – clawing your way out of overwhelm

“If you want a thing done well, do it yourself”

There is definitely some truth to this idea, commonly attributed to Napoleon Bonaparte.

Only you truly know exactly what you want done, the pitfalls to avoid and the most efficient way for you to complete the job.

And you also know how just how annoying and disappointing it is when you;

  • Feel like you are constantly chasing people up
  • Think of all the time that is wasted when the job isn’t done well enough or quickly enough.
  • End up doing or redoing the task yourself anyway.

Sometimes it really is easier to do it yourself.

But here’s the problem – there is only one of you.

If you do everything yourself, then each hour of your effort will create an hour of output. It is a 1:1 relationship.

You will get better and more efficient over time, but ultimately your output is limited by the number of hours you have available, which might lead you to putting in more hours or packing the ones that you have so full that you are running around like a headless chook. Neither of these scenarios are sounding very tasty. 

Delegation is the answer. It really is delicious as you watch your one hour of time being turned into 2, 5 10 or even more hours of output.

A 1: Multiple relationship. Now, that is tasty.

And delegation is not all that difficult. Follow these five steps and you too will be on the way to Delicious Delegation.

  1. Consider what can be delegated – delegation is appropriate for repetitive tasks where the consequences of failure are not life-threatening (so you may delegate taking of radiographs but not a CSF tap!)
  2. Consider what is needed in terms of resources – time (yours and theirs), skill set, training, initiative, authority, guidance
  3. Marry that up with the people available and involve them in the decision to delegate
  4. Make time for a conversation – This is a key step that is often overlooked. You need to invest time to set up the process – just as you do when you implement any time-saving system. Have a discussion where you set up and document clear expectations of the outcome required, the time frames, the available resources and the schedule of progress checks. Consider together, the consequences of the job not getting done – to the practice, animals and to your delegatee, as appropriate.
  5. Follow-up regularly – encourage, support, assist to problem solve, recognize and reward what goes well.

Yes – other people are likely to be slower than you to begin with.

And yes, they may get to the outcome by a different route than you would.

But when you take the time to communicate, coach and give constructive feedback, they will feel more empowered and happier. Meanwhile you will have more time for the activities that are the most important and meaningful for you. De-licious!

Having troubles with delegation and feel like you are doing it all on your own?

Why don’t you book a personalized coaching session with Cathy or Cheryl to help you to delegate more effectively?

From graduation to happily ever after…

First of all – CONGRATULATIONS! Your hard work and dedication over many years has led you to this point – the culmination of what for many of us, was a childhood dream – to be able to help animals and improve their quality of life. You will have forged deep connections with your peers and your brains will be packed with all of the knowledge that a vet degree provides. The years ahead hold much promise and excitement for you.

But what now?

Up until this point, your primary focus has been on achieving the big, hairy audacious end goal of being a vet. Whilst you set the end goal, the pathway to achieving it lay in jumping through all the hoops (think exams and assessments) that other people decided were important for you. In the process of hoop-jumping, you may well have created some habits of thinking and behaving that will not be helpful to you as you move into the profession. 

From my point of view, two of the habits that can be dangerous are;

  • You may have got into the habit of doing what other people expect of you. This is not a recipe for long-term satisfaction and career success. It is time to make a transition to being self-directed and negotiating a career that has meaning and fulfillment for you.
    How will you do that?
  • With your eye on the end goal, you may have got in the habit of discarding or downplaying anything that got in the way of passing the next assessment  – throwing it to the side with the thought that this can be picked back up later. Maybe this included self-care and the development of your non-technical competencies.
    How do you think your habits of self-care will support your transition to work? Do you feel confident that you have the necessary base-line of non-technical competencies to allow you to effectively utilize your clinical skills and knowledge? Or do you have a plan to upskill?

Graduation is now imminent. Later has come.

  • It’s time to redirect your focus.
  • It’s time to take personal responsibility for your career choices and pathway.
  • It’s time to take a more holistic approach to your ongoing personal and professional development.

And as you prepare to make this monumental move into the veterinary workforce, there are some important questions to ask of yourself – questions that are bigger than do I want to go into mixed or small animal practice or do I want to work in urban Melbourne or rural South Australia?

 

1. What sort of vet do you want to be?

What is important to you? What do you want to stand for as a vet, as a team member, with your boss, with clients, with family, friends and community? What are your values?

2. What sort of work is going to suit you best?

What do you love about work? What do you find easy and energizing? When do you lose track of time? Where can you make the best use of your strengths and interests?

3. What sort of workplace culture will suit you best?

Do you like a big team or a smaller one? What do you want the teamwork to look like? How are people’s contributions recognized and rewarded? Are team members thoughts and opinions heard and acted on? Is work considered to be a part of life rather than being life?

 

Answering these questions takes time and reflection.  And only you know what is right for you.

Taking the time for reflection helps creates self-awareness and self-awareness is at the centre of the veterinary employability framework created by the vetset2go project. This framework outlines the “personal and professional capabilities that enable a veterinarian to gain employment, and develop a professional pathway that achieves satisfaction and success” (https://www.vetset2go.edu.au/).

Self-awareness allows us to negotiate a career that is personally congruent – one that is consistent with our values and beliefs and the way we want to live our life. It allows us to live a life that matters. It allows us to achieve our own personal ideals of satisfaction and success.

How are you going to grow your self-awareness and achieve long-lived satisfaction and success?

What does your happily ever after look like?

 

Why there is more to mentally healthy workplaces than an employee assistance program (EAP)

What??? Have we at Make Headway gone mad?

Maybe, but the above equation is definitely true. Having an employee assistance program (EAP) available and sending a team member on a Mental Health First Aid (MHFA) course will NOT make a mentally healthy workplace (MHW).

Don’t get me wrong, these are amazing initiatives and will definitely help to support the estimated one in five Australians that are currently experiencing mental ill-health. It may allow you to catch them earlier plus you will have resources to offer them in their recovery. Excellent!

But recognising and supporting mental ill-health is not the same as creating mental health and different strategies are needed to build the mental health of our profession. We know that treating a case of mastitis does not make for a healthy cow; or that giving a diabetic cat insulin is not the only thing that is required to return it to full health. It just doesn’t make sense. Keeping our animal patients physically healthy requires a multifactorial approach, as does keeping your veterinary team mentally healthy.

So, what can you do to enhance your mental health at work and the mental health of your workplace?

Creating a mentally healthy workplace is about systems and culture, and these need to take into account :

  • Job design that supports well-being
  • The importance of teamwork
  • The leadership leading by example
  • The necessity for work/life balance
  • Support of individual well-being

“Workplaces that support the mental health of all employees can reduce absenteeism and presenteeism and increase employee engagement and productivity.” (National Mental Health Commission)

 

Mental Health can be supported by helping staff to find their own work/life balance

So, where do you start?

Get proactive using some of the following suggestions

  1. Learn the truth about what contributes to positive mental health. VetPrac runs a beautiful course called How High Achievers Succeed and Keep Succeeding that can fill you in on the science of well-being and how this relates to the veterinary industry. The next course starts in October led by Cathy Warburton.
  2. Look at the number of hours that you or your staff are working. We have a 38 or 40 hour week for a reason. Regularly working more than 40 hours a week will have negative impacts on your mental and physical health in the long term.
  3. Take breaks. Does your workplace encourage, even enforce breaks? Nobody can work at maximal capacity all of the time. We are not computers, we are human beings and when we are maximally scheduled all of the time, the constant time pressure has negative effects. It is important to rest and regroup, ready to go again. Even just one 15 minute break in a shift will make a difference. Ideally we should have more.
  4. Be open about some of the difficulties you have experienced in your life and how you have managed them. When we are open about these things, we allow others to talk about them and they are no longer a secret and a source of shame. If you share your vulnerabilities as a practice leader, it is even more beneficial.
  5. Give specific positive feedback to your colleagues (yes, even your manager) – thank them for what they have done and for how it has helped you or the animals or the clients. The reciprocity rule says that the positive feedback will circle back to you. Everyone loves to be shown appreciation, and it is often lost in the busy work day.
  6. Encourage a compassionate and supportive work culture. This is where leading by example is key – happiness is infectious (the reverse also holds true). Making a change in yourself will help others to make a change. When you work on your personal well-being, you indirectly improve the well-being of those around you, both at home and in the workplace.
  7. Seek support and help if you need it, and encourage others to do the same. This may be finding a great professional mentor to allow you to learn new things; or working with a coach to improve your overall personal well-being; or utilising the EAP in times of stress. Showing others that it is OK to reach out when you are struggling or need support, sets a great example.

 

By making small and consistent daily changes you can have an impact on the overall well-being in your workplace. You have taken the first step by reading this article, which shows your commitment to mental health. Why not continue the momentum and choose one of the above suggestions to work on today.

 

What next?

Developing a mentally healthy workplace is a continuous and ongoing process (Harvey 2014). Ticking the box on an EAP and sending somebody to a MHFA course may have been steps one and two.

What is your step three?

What are the mental health issues in your workplace?

When are you going to do something about them?

If you are stuck answering those questions, make the time for a call with Cathy or Cheryl at Make Headway so that we can assist you in getting started on creating your mentally healthy workplace.

“Businesses that invest in mental health are also more productive, innovative and likely to recruit and retain the best and the brightest people” (Prof Allen Fels – Chair, National Mental Health Commission)

Are you ready to create new healthy habits?

Join us in a 4 week well-being challenge – starting this coming Monday the 17th September.

Most of us know the things that we should do to be healthy. But when it comes to it, our mind often talks us out of it.

  • I should go for a walk at lunch-time but….
  • I want to learn to be more mindful but I never seem to have the time.
  • Today has been madness, a glass of wine will wind me down

We want to help you to cut the thinking brain out of the equation and to program the habit centre of the brain. Once a habit has been embedded in the habit centre (located in the basal ganglia if you are interested), then the action happens easily and repeatedly, with minimal effort on your part.

What could be easier than an App designed to enhance mental and physical wellbeing with simple and time effective healthy rituals?

Cheryl and Cathy at Make Headway have joined up with the team at “Ritualize” to introduce their Well Being App to the veterinary industry.

  • It is easy
  • It is science-based
  • You can join as an individual or a practice

At last count, 44 people from the veterinary world were joining us the for the inaugural quest. You have until Sunday to be a part of this.

Click here to register.

Or find out more on our face-book page.

Or email Cheryl – cheryl@makeheadway.com.au if you would like more information.

What does reading the death notices say about me?

Maybe I am a morbid voyeur? Maybe I am simply weird?

  • I don’t know somebody that is sick that is likely to die soon.
  • Nor am I in the age group where friends are regularly popping their clogs.
  • And no – this is not a recent thing. Reading the death notices has been a regular thing for many years and it is only now that I have reflected on it and thought about why I do it.

So why do I read the death notices?

Picture the scene – it is a peaceful Sunday morning in Melbourne and I am sitting in bed with a cup of tea and my favourite newspaper (OK – so maybe I am also weird in that I still read a hard copy of the paper). I flick through the front part of the paper and read the articles of interest. And then I go to the death notices and do a scan. What is that about? What exactly am I looking for?

Good question. And one that I have been asking myself.

Once I started thinking about it, I realized that there are two key things I look for;

1. Evidence of a life well-lived – I love reading the death notices that talk about a person that has been a great support, friend or mentor to other people and who has made a positive contribution to the world. I am that stereotypical achievement-oriented vet and these notices inspire me to focus on the important things in life rather than filling my life from dawn to dusk with busy and maybe unimportant work.

2. A reminder to put my problems in perspective and be grateful for what I have.  I have problems – doesn’t everybody? But I also have great people and experiences in my life and every day I have the opportunity to enjoy what I do, to live a worthy life and to make a difference. The people I am reading about no longer have this opportunity. They may have died before their time, before they got to realise their dreams or their potential –  that makes me sad.

Reading the death notices makes me realise just how lucky I am.

(Please do yourself a favour and read the blog on luck if you haven’t already done so – I definitely believe that winning the lottery is lucky!)

So maybe reading the death notices is a weird way to be inspired, to have perspective and to be grateful. Maybe going out in nature and marveling at the natural world is a more socially acceptable way of doing it.

But I am going to keep reading them. We only have so much time and energy in our lives and this is a strategy that keeps me on track to make sure that my time and energy counts.

And it gets me wondering;

  • What do you do to remind yourself to have perspective and to be grateful for what you have?
  • What would you like people to say about you in your death notice?
  • What is the change you are wanting to make in this world?

Please share. We would love to hear from you.

Compassion fatigue – does it really exist? By Cheryl Fry

 

Compassion fatigue is a term that is often mentioned in conjunction with stress and burnout in the Veterinary world. It is defined as the combination of the emotional, physical, psychological, and spiritual exhaustion that can result when veterinary staff are repeatedly exposed to another’s pain and suffering. It suggests that caregivers are tired of feeling too much compassion.

But what if it isn’t too much compassion that is the problem after all? What if, in fact, compassion may be the antidote to burnout?

The work of Dr Olga Klimecki and Dr Tania Singer suggests that a new model to describe the interactions between empathy, compassion and burnout should be considered.

It may not be compassion fatigue that we are experiencing as carers, but instead empathic distress or empathy fatigue.

 

Recent research shows that compassion is a positive thing

  • Compassion is defined as a strong feeling of concern for another person’s feelings of sorrow or distress and the motivation to alleviate suffering and/or help.
  • When you feel compassion for the suffering of someone else, the neurological pathways that are activated in your brain are those associated with positive emotions such as loving kindness and warmth.
  • Compassion can stimulate feelings of courage and determination, and a desire to want to help others. This is relationship building.
  • When you feel compassion for someone, it is not exhausting because you are not personally distressed. You can feel positive emotions such as loving-kindness even during those times that you witness suffering.

It is the excess of empathy that can cause problems in carers

  • Empathy is defined as the ability to understand and share the feelings of another.
  • When you feel empathy you share in another person’s emotions. While you understand that the pain is not yours, the pathways that activate in your brain are the same network that would activate when you personally experience pain. This process allows you to have a shared understanding of the suffering of others, but can also lead to personal suffering and stress.
  • Empathy may develop into compassion, but doesn’t always. It may not lead to any action to help the person that is actually suffering.
  • When you feel empathy for suffering, it is very emotionally draining, as you are also suffering.
  • Being empathetic with someone in distress produces negative emotions such as sadness or anger, and can lead to mental and physical exhaustion – or burnout.
  • Empathic distress, where you continue to feel the suffering of others, tends to be isolating. You become overwhelmed by all of the negative emotions you are feeling, and seek refuge in being alone.

 

Empathy is a vital first step in the chain of emotional responses that lead towards feelings of compassion, or empathic distress. The trigger for both pathways in your brain is the same, but it is how you respond that will determine whether you are exhausted from empathy overload.

 

 This illustrates the difference between empathy (sharing someone’s feelings), and the consequences of empathy, that can take 2 different paths – the compassion pathway with the associated positive emotions; or the empathic distress pathway with its negative and draining emotions. (Dr Olga Klimecki and Dr Tania Singer)

 

An example

  • Imagine a client is sad because their dog has just been diagnosed with terminal cancer.
  • As a caring Veterinarian, your first reaction would be empathy. You share the feeling of sadness with your client.
  • Empathy is the first step connecting you to the emotional state of your client. This is both normal and desirable for building the client relationship.
  • The next step depends on your personality, your emotional state, the situation, and your self-awareness.
  • Do you focus on your own sadness and allow it to overwhelm you, or do you focus on trying to make things better for your client? By shifting the focus away from yourself and onto alleviating the suffering of others, you activate the compassion pathways.
  • If you react with compassion, you will feel concern for your client and attempt to alleviate their suffering in any way that you can. Your tone of voice, the way you explain their options, your simple acts of kindness during this difficult conversation, may all help make this moment easier.
  • If you react with only empathy, you may be overwhelmed with your own sadness and are therefore unable to support your client, and may in fact need to withdraw from the situation.

 

If empathy fatigue is the problem, how do we avoid it?

  • Drs Klimecki and Singer have found that both the empathy and compassion pathways in your brain are open to change – there is neuroplasticity. This means that your emotional responses to the distress of someone else are not set in stone – you can change how you respond.
  • Simply noticing your own empathetic response to a client’s distress is very empowering. You can acknowledge to yourself that you are sad along with your client, and that this is both a normal and valuable response in a caring veterinary environment. It is OK to feel sad – it makes sense given the situation.
  • The key is deciding to not focus on your own sadness, but instead to focus on how you can make a positive difference to this client’s experience. Ask yourself, “What can I do to make things easier for them?” Take the empathy and add compassion.
  • By cultivating compassion as a response to the distress of others, you are helping not only your client, but also yourself.
  • Training yourself to be more compassionate is possible. You can change your brain, your emotions and your actions in response to the suffering of others.
  • Compassion training has been shown to help overcome the empathic distress (empathy overload) often shown by people in caring professions. It may be the antidote to burn out.

 

Instead of reducing our compassion in the veterinary world, we should be actively cultivating it.

A compassionate person has the capacity to help because they are not overwhelmed by their own distress, but are instead guided by concern and affection for others.

 

Perhaps it is time for “compassion fatigue” to be more accurately renamed “empathy fatigue”?

 

References

 Klimecki, O & Singer, T (2012) “Empathic distress fatigue rather than compassion fatigue? Integrating findings from empathy research in psychology and neuroscience.” Pathological Altruism – chapter 28; pgs. 368-380

Matthieu Ricard (2012) “Happiness – a guide to developing life’s most important skill”

Kristen Neff (2011) “Self Compassion – stop beating yourself up and leave insecurity behind”

Are KPIs really Key PERFORMANCE Indicators or are they actually Key PROFIT Indicators?

There is plenty of noise in the wider world around the way that KPI’s have driven staff behavior – but not in the way that the companies involved were probably envisaging!

The stories that hit the news head-lines are the ones where the focus on particular KPIs has driven unethical behavior harming reputations and/or company value.

Which is your preferred story of woe?

  • That Victorian police have been reported to have blown into breathalyzers themselves in order to meet their targets – and to have done this more than 250 000 times.
  • That employees of one of the big banks fraudulently activated children’s bank account to meet their new account targets.
  • That a prominent and well-regarded car company doctored their cars to show falsely low emissions during testing to sell more cars.

So are KPI’s uniformly bad and what should the veterinary world learn from the transgressions reported in the media?

Fact 1 – KPIs can definitely drive behavior.

Yep, there is no doubt about that.

Well designed KPIs can drive positive change. And they come with other benefits. KPI’s can;

  • Provide a succinct snap-shot of the financial health of your business
  • Highlight trends in your practice and allow early intervention if there is a problem
  • Measure your progress on important goals
  • Allow you to set an outcome whilst allowing team members autonomy on how to achieve it
  • Identify opportunities for training or coaching
  • Assess the response to training and coaching
  • Be used to benchmark against similar practices
  • Be an objective measure of success and a cause for celebration

You can see why many practices and businesses have adopted KPIs.

But the question is, has the pendulum swung too far on KPIs? Are they driving the right behavior? And are they motivating people and creating positive change?

Fact 2 – Poorly designed KPIs may drive the wrong behavior. 

It is often said that what gets measured gets done. When people feel pressured and unsupported to achieve numbers, they may choose to take the shortest and most direct route to the number that is being tracked – with big effects on other behaviours that may not be measured. You need to consider the knock-on effects when designing your KPIs.

For example, think of the “procedural vet”. They may do a lot of the surgery in the practice and hence their $$/visit are high. But this person does not work in isolation – it takes a team for a procedural vet to be able to get through a lot of surgery – from reception to nursing to other vets who may take on the client interface or the hospital care of the surgery patients. All of these people allow the procedural vet to kick the $/visit goal.

How will these other people be recognized and rewarded? And what is stopping the procedural vet from discouraging the support team from taking breaks or from helping other people in the practice if it interferes with the flow of surgery or from cutting corners which may compromise the safety of the patients? Is the vet profession free from the bad behavior seen in other industries?

Fact 3 – Poorly designed KPIs can be demoralizing and demotivating.

This happens when people don’t believe in the validity of what is being measured. A good example is when a KPI is set around the percentage of dogs in the practice on heartworm prevention in a geographical area with incredibly low incidences of heartworm.

How can a person believe that this KPI is truly about doing the best by clients and their pets and not about making profit?

So, what are we to do? How can we maximise the good and minimise the bad in KPIs?

Here are our best tips.

1. A KPI is only as good as the relevance of what it measures and its ability to create positive change. Your KPIs should include measures of what is important to your practice. Hopefully this is reflected in your clinic values or mission statement. Do your KPIs reflect the fact that you think integrity or teamwork or excellence or compassion is important? Or are these just words you have on the wall?

2. Set achievable targets and support/train people to achieve them. Competition is rarely helpful.

3. We can not all be superstars – Probability theory suggests that the KPI numbers for a group of individuals or teams are likely to be normally distributed. Most of us will fall in the middle of the Bell curve. We cannot make everybody perform at the level of the highest KPI.

4. Be curious about the outliers. Numbers that fall at the top and the bottom are the outliers. Have a conversation and aim to identify what it is that the positive and negative deviants are and aren’t doing. Here is your training opportunity.

5. Set KPIs for the team rather than the individual. Veterinary practice is a team sport. Behaviours that help the team such as being a fun and positive person in the workplace or supporting your team mates or training people or providing feedback will increase the more financially based KPIs for everybody.

6. Compare apples with apples. If you are benchmarking against other practices, ensure that they are measuring their KPIs in the same way and that the practices are similar in their management practices, policies, staffing ratios etc

If it is true that what gets measured gets done, what is getting done in your practice? Are you measuring good performance or are you measuring profit?