Taking Care of the Team

• Taking Care of the Team (296.2 KB)

Fact: the higher the level of communication and camaraderie in a business, the more efficient employees become.¹ Common sense, supported by a growing body of evidence, suggests the same is true in veterinary medicine.² To sustain a dedicated, stable workforce, emotional support for staff in the clinic is as important as continuing medical education.³ While you may think about your team as an entity, remember that each member is a unique individual; appreciating their differences can guide them to becoming the most efficient team they can be. The following scenarios illustrate this point.

Scenario 1: Mrs. H. comes in with her 10-year-old Chihuahua, which has been irritable and snapping at her for weeks. Mrs. H. is frustrated by her dog’s behavior. Within 5 minutes, she is complaining about having to wait for the doctor and about how much money the visit is likely to cost, and begins talking about euthanizing her animal. A staff member comments to another that the client has no right to such a display in the reception area.

How should other team members respond?

First, take a moment to consider the reason for Mrs. H.’s distress rather than responding directly to the behavior itself. It is rare that returning a client’s anger will help the staff, client, or patient.

Mrs. H. is upset about her animal’s condition, but the staff member who made the comment likely does not see the subtext. Besides the obvious (taking Mrs. H. away from the public waiting room, talking to her gently), the best approach is to imagine yourself in the same situation. What would make feel you most comforted in a similar situation? How can Mrs. H.’s reaction be explained to the staff member who was upset by her behavior?

The most appropriate response would be the empathetic one. Merriam-Webster defines empathy as “the action of understanding, being aware of, being sensitive to, and vicariously experiencing the feelings, thoughts, and experience of another … without having the feelings, thoughts, and experience fully communicated in an objectively explicit manner; also: the capacity for this.”

Empathy and sympathy are not synonymous. Sympathy implies understanding the client’s situation as a result of having experienced something similar. Empathy involves putting oneself in her place and imagining how that would feel. Strategies for empathy can be taught (although some people will be better at it than others).

Further, the dictionary defines compassion as: “…consciousness of others’ distress together with a desire to alleviate it.” Compassion, unlike empathy, involves acting on one’s feelings, not merely experiencing them. It is important for staff to be empathetic. It is imperative that they have compassion, taking action by verbally or nonverbally (ie, via body language) providing comfort and support.

And just as these concepts should be applied to client interactions, it is important for the practice owner and manager to encourage staff to apply them to each other. Talking about the situation as a group (without singling out the person who made the comment, which will only increase tension) will be enlightening without being threatening. The more proactive these conversations, the better; the time to discuss understanding the root of a person’s distress is before a problem arises.

Scenario 2: It has been an exceptionally busy day—two trauma cases, a euthanasia, and a full-out patient schedule. One of the technicians comments how tired he feels. The doctor pulls the technician aside and launches into a loud commentary, saying that if the tech isn’t prepared to work as hard as everyone else, he should leave. The rest of the staff is startled, and no one says anything for several minutes.

How should other team members respond?

Understanding different communication styles can help avoid this kind of inappropriate interaction. Many practices recommend that staff take a “personality inventory” survey, such as the Myers-Briggs Type Indicator personality assessment offered through EVT (go to myEVT.com), to help understand their own strengths and weaknesses. Understanding one’s individual style increases personal awareness and improves our ability to understand the way others respond to their environment.

Clearly, the office routine would not have been disrupted had the situation been handled with the doctor’s recognition that he too is tired, and is responding inappropriately as the result. The ability of the staff to empathize, to understand why the doctor reacted in such a way, can deflect what might be an initially angry response on the part of the technician to one of “enlightened analysis” of the situation. Take advantage of a program such as Teams that Work, a DVD presentation that allows staff members to watch and comment on a variety of office situations, with an emphasis on conflict resolution.⁴

Scenario 3: A client with more than a dozen cats comes in with a dying kitten she has found. The only humane avenue is euthanasia. The client agrees, but is distraught. A receptionist (out of the client’s hearing) remarks that the client would be better off if she stopped picking up strays, and that there must be something wrong with her for getting so upset when she has so many other cats at home. The receptionist responds sharply when others try to explain the client’s point of view.

How should other team members respond?

Compassion is crucial in any of the helping professions. There is a point, however, when “compassion fatigue” sets in and an individual is overwhelmed by the emotions of others, and can no longer control his or her own feelings.⁵

In veterinary medicine, we identify strongly with our patients but cannot ask them how they feel or what they want. The constant requirement to imagine what the patient wants and needs produces stress, which can damage any workplace. When stress becomes overwhelming, it turns to anger.

Anger, clearly, is not conducive to a pleasant working environment. Compassion fatigue can contribute to high turnover among clinical staff, because it can easily turn into burnout.⁶ Understanding that this is most likely the cause of the receptionist’s sharp response will allow other team members to offer sympathy rather than harsh judgment. “I understand how you feel” is more appropriate than, “How can you say that?”

It is imperative to make sure that each individual on the team is a part of a cohesive whole. Read as much as you can on teamwork and communication and hold regular staff meetings; their importance cannot be overemphasized.

Tips for the Team

Following are ideas to make staff comfortable and help make the clinic day flow easily.

1. Make sure everyone understands his or her role; develop a job description for each category of work and provide a copy to everyone on the team.

2. Schedule regular staff meetings at a time when everyone is able to listen (not at the end of the workday.) Provide some kind of refreshment, even if it's just candy. Offer a prize for the person who tells the funniest office story since the last meeting.

3. Develop a standard greeting for front-office staff, both for the telephone and for client appointments or pick-ups.

4. Use the scenarios from this article as a jumping-off point to discuss what each staff member would do in a similar situation. Talk about problems that you routinely encounter in your practice.

From an EVT Reader - “Dave & Darlene”

“Our staff had gotten into the habit of calling clients ‘Dave’ or ‘Darlene,’ as in, ‘This client is a real Dave, he won’t listen to a thing I’m saying.’ One day a client told our receptionist that his name was Dan, not Dave, ‘Like he heard the technician call him in the hallway.’ Of course, that was devastating to hear! "

“That was our wake-up call about the importance of using appropriate communication control when discussing a client (or a coworker) in our professional setting. We now hold a ‘data dump’ at the end of a shift. We spend 10 or 15 minutes talking about what went right, what went wrong, and what we can do to improve. Staff members share their triumphs or frustrations and get group coaching from others to help things go better next time. It has had a tremendous positive effect on staff and their relationships with one another.”

References
1. Linking Customer and Employee Satisfaction to the Bottom Line. Allen D, Wilburn M. ASQ Quality Press, 2002.
2. Team Satisfaction Pays: Organizational Development for Practice Success. Smith C. Smith Veterinary Consulting, 2009.
3. Principles and Practice of Veterinary Technology, 2nd ed. Sirois M. Elsevier, 2004, pp 43–66.
4. Teams that Work (CD). Vande Linde M, Lifelearn/aahanet.org, 2004.
5. Healthy Caregiving: A Guide to Recognizing and Managing Compassion Fatigue, Presenter’s Guide Level 1. Smith P. Create Space, 2009.
6. Compassion fatigue and the veterinary health team. Cohen SP. Vet Clin North Am Sm Anim Pract 37:123–134, 2007.

Dr. Sturtz directs the Veterinary Technology program at LaGuardia Community College (City University of New York). She is an adjunct professor at Mercy College, an associate veterinarian at The Cat Hospital in Williston Park, New York, and a member of the Association of Veterinary Family Practice’s board of directors.