This article was originally printed in the West Coast Veterinarian Summer 2020.
In May 2019, the World Health Organization included burnout in its International Classification of Disease (ICD-11) but later issued an urgent clarification stating, “burnout is an occupational phenomenon, not a medical condition”. According to Christina Maslach, a social psychologist and foremost expert on burnout, this is an important distinction, because if we view burnout as a disease as it causes us to see conditions like burnout and compassion fatigue as an individual problem rather than a problem with the workplace. The following metaphor illustrates her point with impactful imagery: picture a flock of happy, healthy canaries singing as they fly into a coal mine. “When the bird come out full of soot and disease, no longer singing, can you imagine us asking why they canaries made themselves sick? No, because the answer would be obvious: the coal mine is making the birds sick” (Moss, 2019).
Burnout and compassion fatigue are common in the helping professions and veterinary medicine is no exception. I suspect the canary and the coal mine example hits home with many of us. If we truly want to help individuals in veterinary medicine flourish, we need to focus on transforming the coal mine. Imagine what it would feel like to work in a veterinary hospital with a thriving culture. Inspiring leaders who empower employees towards a greater purpose. A place where ideas flow freely, collaboration rather than competition is the norm and everyone feels safe, appreciated and able to bring their true self to work. Where egos, blame and shame are replaced by authenticity, transparency and trust. It is time for leaders in the veterinary industry to take note and shift the responsibility for managing burnout from the individual to the organization.
As I write, the world around us is changing rapidly. Two weeks ago, Prime Minister Trudeau’s address focused our nation on the grim reality of Covid-19. By the time this article goes to print, phrases like “flattening the curve” and “social distancing” will not only inform our decisions and behaviour, they will be part of our collective vocabulary. To put it simply, on March 16, 2020 our leader was asking us to change our individualist, Western mindset to a mindset committed to the greater good. To move beyond our individual needs, past our personal discomfort and think about safeguarding our health care system and protecting the vulnerable individuals in our society.
In light of a growing pandemic, few can argue that we do not live in a global community. Humanity is more interconnected than any other period in our shared history.
Wolf, D., Sheth, J., & Sisoda, R. (2007) described Western Society as entering an “Age of Transcendence”, a time where people are looking for meaning in their lives. This shift in our collective consciousness means that “companies are being held accountable for their humanistic as well as economic performance” (p. 4). I believe this reflects humanity’s desire to align with organizations that reflect their own deeply held values to find congruence and meaning in a world where we feel increasingly disconnected. The desire and, I would argue need, for leaders and organizations who actually want to “do”the right thing and not just be “seen” to do the right thing, has never been more relevant than in our current era. It is time to move our mindset from the individualistic view of Western society to a collective mindset reflective of the global community we now inhabit.
People today want to have a voice in choosing the values that govern their personal and professional lives. They want to experience equality, accountability and transparency in their workplace and feel proud of the organization they work for. Increasing employee engagement is not only key to increased employee wellbeing and improved workplace culture, it drives productivity and profitability. Daniel Pink, author of “Drive: The Surprising Truth about What Motivates Us” lists three key factors that influence employee engagement:
- Autonomy or freedom to make choices regarding how, when, with whom and where we work. Companies that give their employees high levels of autonomy report faster growth and lower staff turnover.
- Mastery or the ability to improve at something that matters to the individual. The desire for intellectual challenge and the ability to master something new and engaging is a driving force behind productivity.
- Purpose or a cause that is larger than the individual. Intrinsic motivators – to help others, to learn or improve, is associated with greater levels of satisfaction and subjective well-being than extrinsic motivators – to achieve fame or financial success.
What does this have to do with the image of a thriving veterinary team? I believe we need to change our “coal mines” if we want to create a flourishing veterinary community. Cultural transformation is a complicated process, in part because culture itself is an intangible concept. Much like an individual’s personality, the culture of an organization is the unconscious set of assumptions, attitudes and principles that are manifest in the decisions, actions and behaviours of the people that work there. Cultural transformation is a slow process requiring commitment and patience to succeed.
- Awareness: The first step in transforming culture is understanding what needs changing in your practice. Recognizing a problem in your hospital’s culture can be difficult. Often unhealthy attitudes and behaviours are so deeply entrenched in a teams’ way of doing things, they are unaware that a problem exists. However, if a team has established a high level of trust and psychological safety, leaders can initiate open dialogue to better understand the positive and negative aspects of their practice culture. Open ended questions, survey tools and team brainstorming sessions can be methods to facilitate conversations on culture (see inset: It Takes a Team). In some instances, enlisting outside consultants with an unbiased perspective may be helpful to guide cultural change initiatives. Understanding what is working for your team and what is holding them back provides practice leaders with a “road map” to guide the process.
- Planning and Purpose: In leadership culture there is an outdated myth in leadership culture, involving a charismatic leader who will “save the day” by the sheer force of their personality and will. In reality, in any organization creating sustainable change requires a group effort. Every team member needs to understand the need for change and see the benefits inherent in that change. Creating a shared vision or mission that brings a sense of excitement and purpose to your team and is the critical to success. Consider the hopes, desires and the frustrations your team shared with you previously and enlist their help to co-create a vision based on the strengths identified in your existing practice culture. Dig into your values and those of your team. Does your vision align with these values?
- Walking the Talk: Team members look to their leader(s) for both inspiration and direction. There must be alignment between the practice’s values and the words, actions and behaviours of the practice leader. Inauthentic leadership will destroy any change initiative before it begins. Veterinary practices, like any organization, need leaders with high levels of self-awareness and emotional intelligence. Leaders who are willing to do the difficult work of self-reflection, challenge their assumptions and change behaviours that negatively impact their practice and team. Investing in leadership development training is essential to create cultural change in our industry (see inset: Leadership Development Resources).
- Implementation: Your hospital’s new mission and values need to be internalized with your team. The process of embedding the new values and behaviours into daily decision making and practice life is perhaps the most challenging part of the process. Look for opportunities to reinforce values in action. Recognize the cultural ambassadors on your team and reward the behaviours that embody the culture you desire. Believe in the power of people to do the right thing and take time to celebrate your team’s success together. Be sure to take time to revisit your hospital’s policies, procedures and incentives and ensure they reflect the new organization values. Finally, recognize that change is often met with resistance. Focus on the benefits a thriving culture will offer the entire team and be clear, consistent and fair during the change process. Help your employees see how they fit, offer them support and be patient.
- Evaluation: Culture is constantly evolving. Rather than a final destination, it is a process that needs continual evaluation and nurturing to stay relevant. Internal forces (changes in the team) as well as external forces (new technology and evolving standards of care) will impact hospital culture. Leaders need to look for ways to measure the effects of change initiatives and evaluate whether it is having the desired effect. A variety of parameters can be employed in the evaluation process. As improvement in culture will positively impact customer satisfaction, evaluate feedback from clients. Both formal tools like employee surveys and feedback forms, as well as informal observation of team interactions and behaviours, can provide insight into the effectiveness of change initiatives. In our industry, an empowering and caring workplace culture attracts attention. The ease with which you attract new employees is another metric to gauge the health of your practice culture.
Changing the culture of a profession is an overwhelming task. In the wake of a global pandemic, most of us long for a return to the status quo. The comfort of certainty over the uncertainty that Covic-19 thrust upon all of us. While this mind-set is understandable, I challenge you to ask yourself how well the status quo has served your team. Is the vision of a flourishing veterinary culture something you have achieved or something to which you still aspire? Avoiding problems in the culture of our veterinary practices does not make them go away. Your practice and your people deserve better. Through shared purpose, alignment and commitment you can create a healthier coal mine where the all the canaries that enter come out singing.
Barrett, R. (2017). The values-driven organization. Cultural health an employee well-being as a pathway to sustainable performance. (2nd Edition) New York: Routledge.
Moss, J., (2019). Burnout is About your Workplace, not your People. Harvard Business Review Digital Articles 12/11/2019, pp. 2-6.
Pink, D., (2009). Drive: The Surprising Truth About What Motivates Us. New York, NY: Penguin Group.
Schuijt, L. (2018). A New World is Already Here: Lessons from Radically Different Organizations. In Handbook of personal and organizational transformation. pp. 1131-1165. NewYork: Springer.
Wolfe, D., Sheth, J. & Sisodia, R. (2007). Firms of endearment: how world-class companies profit from passion and purpose. Upper Saddle River, NJ: Wharton School Publishing.