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Veterinary Forum January 2007 (Vol 24, No 1)

Business Skills: Managing Job Stress and Burnout

by Amanda L. Donnelly, DVM, MBA

    Editor's Note: In this month's column, our Business Skills consultant, Dr. Amanda Donnelly, discusses the dif­ferences between stress and burnout and how both can be minimized in veterinary settings. In addition, she reviews how to recognize and deal with these potentially negative situations. — Stephen Fisher, DVM, Column Editor

    By its very nature, veterinary practice can be stressful. Veterinarians and staff may experience work overload and chronic stress leading to exhaustion and fatigue. Without proper coping mechanisms and a work"life balance, individuals can become depressed and suffer from burnout. Although stress and burnout can be attributed to many causes, ineffective management of a practice can contribute to the likelihood of whether owners, managers, and staff experience stress or burnout.

    Have you ever stopped to think about whether the management of your practice affects the level of stress or burnout experienced by your veterinary health care team?

    Differentiating stress from burnout

    Stress should be differentiated from burnout, especially a specific type of burnout known as compassion fatigue, which is discussed later.

    Stress is typically thought of in negative terms. However, many people thrive on a certain level of stress. For example, emergency room doctors and staff may enjoy the adrenaline rush of working in a fast-paced environment that others perceive as stressful. Some people who procrastinate perform better under the pressure of looming deadlines. Stress in these situations can be referred to as positive stress.

    Stress becomes harmful when individuals experience negative emotions and physical symptoms as a result of chronic stress. Negative emotions linked to stress include irritability, depression, and lack of concentration. Many physical symptoms have been associated with stress, including fatigue, headaches, gastrointestinal disorders, and hypertension.

    Individuals who are suffering from burnout experience mental, emotional, and physical exhaustion as a result of their work environment. Burnout is a gradual process, and although it may include symptoms of stress, it is not simply the end result of chronic stress.

    Burnout is characterized by a feeling that work efforts are not matched with rewards, recognition, or job satisfaction. Individuals who are experiencing burnout develop a pessimistic outlook regarding their work environment and become less productive. Symptoms of burnout may include feelings of hopelessness, powerlessness, resentment, and cynicism. Ultimately, burnout can lead to depression, unhappiness, and negative emotions that can affect an individual's personal life and health.

    Compassion fatigue is a type of burnout that often affects people in the medical profession. It occurs when individuals care for others but do not take care of themselves. Compassion fatigue can result when people become so invested in helping others that they eventually have nothing left to give. Veterinarians and staff who work in emergency hospitals or specialty practices are at increased risk because of the high morbidity and mortality rates and the high-stress environment.

    Symptoms of compassion fatigue include the same ones that develop in people who are dealing with stress and other forms of burnout. In addition, individuals who are suffering from compassion fatigue may experience decreased feelings of joy and personal accomplishment, low self-esteem, diminished ability to balance empathy and objectivity, and obsessive worry about not being able to do enough for clients and pets.

    Causes of job stress and burnout

    Some causes of stress that affect veterinary health care teams cannot be eliminated, including emotional or angry clients, pet emergencies, mortality, dealing with pet owners' financial constraints, and concerns related to personal financial security. Many other causes of stress in veterinary practice environments are management issues that can be controlled or minimized, including insufficient staffing, lack of leadership, poor communication, lack of organization, lack of clear job expectations, lack of training, and nonsupportive management.

    The causes of job stress listed above also can lead to burnout if measures are not taken to lessen the environmental stress. Other work-related causes of burnout include unrealistic or impossible job requirements. Both veterinarians and their staff may experience burnout when they feel as if they can never finish all their work or satisfy all clients. In addition to work-related causes of burnout, there are important lifestyle factors that can subject someone to increased risk for burnout, including a lack of work"life balance, lack of stress-relieving or fun activities, lack of sleep, and inadequate support system.

    Providing effective leadership and an open line of communication

    One of the best ways to minimize stress and burnout is to focus on effective leadership and management of the practice. Employees who are stressed usually voice concerns ­regarding:

    • Lack of direction
    • Disorganization
    • Inefficiencies
    • Understaffing
    • Poor communication
    • Lack of appreciation
    • Nonsupportive management

    To reduce stress related to these issues, practice owners should recognize employee concerns and act to improve management of the practice. Owners should start by providing staff with a clear vision of practice goals and identifying the most pressing management challenges.

    Effective communication can ease stress for the entire health care team. Management should establish open lines of communication with staff members so their concerns can be addressed. It also is important to clearly communicate job expectations to employees. Doing so can help alleviate stress associated with confusion about job responsibilities and priorities.

    In addition, regular feedback about job performance should be given to employees. Employees experience less stress when they are given information on how to succeed in their job. Another critical aspect is praise and recognition. Practice owners need to remember that veterinary practice settings are inherently stressful, and staff members who are suffering from burnout feel underappreciated. Practices that cultivate a culture of genuine appreciation for the hard work and dedication of team members can minimize stress and burnout.

    Emphasizing employee relations

    Employees are less likely to suffer from stress and burnout in a practice that encourages employee development. All too often, practices have annual employee reviews and assessments but no real plan for developing each individual's full potential. Development plans should focus on employee empowerment, opportunities for growth, and continuing education.

    Job stress and the likelihood of burnout are reduced when employees have some autonomy in the workplace and are afforded the opportunity to learn new skills. Practice owners and managers should afford themselves the same opportunities by attending both scientific and practice management continuing education programs.

    To help avoid compassion fatigue or burnout, it is also important for all staff to develop an individual program of self-care. It is not enough to talk about work-life balance, flexible schedules, and adequate staffing; there needs to be management support of and commitment to team members who are working reasonable hours while engaging in outside hobbies or activities. Management should look for warning signs that team members are not taking care of themselves. These may include excessive tardiness, fatigue, physical ailments, irritability, and depression.

    Seeking help when needed

    When stress becomes excessive or burnout progresses, individuals should consider seeking outside assistance. For staff members who are affected by depression, other mental disorders, or substance abuse, a physician or qualified medical professional needs to be consulted. Many people who are suffering from job stress and burnout have found therapists, career counselors, consultants, or personal coaches to be helpful. In addition to providing assistance regarding how to minimize stress and alleviate burnout, qualified professionals can help individuals decide when they may need to switch jobs or even leave the profession.

    Recommended Resources

    AVMA Group Health and Life Insurance Trust: Managing and avoiding burnout. JAVMA News Online, Aug 15, 2004, pp 492-493.

    Web source: www.helpguide.org/mental/stress_signs.

    Web source: hobbes.ncsa.uiuc.edu/jobstress.

    Web source: publicaffairs.uth.tmc.edu/hleader/archive/mind_body_soul/2005/ compassionfatigue=1115html.

    Web source: stress.about.com/od/burnout.

    NEXT: Clinical Ethics — Profiling: Two Sides of the Issue


    Did you know... The process of writing standard operating procedures (SOPs) can help improve how procedures are performed and can be used for staff development in combination with SOP training and employee performance reviews.Read More

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