Stress & Anxiety in Practice

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*For simplicity, the author uses the terms stress and anxiety interchangeably to refer to various states of agitation, tension, pressure, worry, frustration, and other feelings of uneasiness.

Who has not pulled into the parking lot at work with tight neck muscles, a racing heart, or a sinking feeling in the pit of the stomach? Life is stressful, and part of that stress* shows up at the practice.

Part of the individuality of stress and anxiety in veterinary medicine is that various practice team members may have drastically different experiences of the same event.

Every day we handle the stress of working with illness, suffering, death, strong emotional attachments, financial issues, and time pressure. We must also address the emotional and psychological health and stability of ourselves and our clients. No matter how excellent our stress management and coping skills, we still have moments that can emotionally knock us off our feet.

Related Article: Signs of a Stressed Team Member

Part of the individuality of stress and anxiety in veterinary medicine is that various practice team members may have drastically different experiences of the same event. Five dentals with extractions, 3 spays, and 2 tumor removals on the same day may make the practice owner happy, give the technician and veterinarian nightmares, and be a nonissue for the receptionist and kennel team.

3 Categories of Workplace Stress

In my experience, causes for workplace stress can generally be divided into 3 categories—structural, individual, and interpersonal. Following is an overview of each category that will provide a framework to identify what causes stress and ways to manage it.

1. Structural Factors
Structural factors refer to things that probably cannot be changed—ie, the bigger picture issues in any given practice. One of the most powerful, and potentially insidious, structural factors is practice philosophy or ethos. I have been around my share of practices that seem to encourage, for lack of a better term, “martyrdom” among team members. This means the longer hours members work, the more lunches they miss, and the less money they charge, the “better” they are. An associate, technician, kennel staff member—anyone except the owner—will have little or no power to correct the practice structure and likely will feel stress and anxiety.

Another structural issue is the extent to which practice leadership has a sense of its vision and mission and whether that has been clearly communicated to the team. Lack of clarity of purpose often leads to everybody pulling in opposite directions, which causes stress and anxiety.

A subset of structural factors is whether management has policies in place to handle team concerns. Is it clear what one team member should do to handle a conflict with another? Is confidentiality assured? Do team members feel heard when they voice complaints? Do they feel that management treats them fairly and equally? Are changes made or are reasons provided when change cannot be made? My experience has been that if practice management cannot handle these issues professionally and sensitively, higher levels of stress and anxiety result, leading to lower team member morale and greater turnover.

Only the practice owner or office manager can address these structural issues, and they truly have a profound effect on how well the team functions.

Related Article: 4 Tips for Stress Management

2. Individual Factors
This category includes “the voices inside our heads” that may contribute to anxiety and stress in the practice. Are you the type of person who needs to be liked by others? When holding a patient for Dr. Jones, do you take it personally if he does not thank you? When Mr. Starbuck is annoyed because he was kept on hold for a moment, do you feel guilty (even though you are trying to get 10 other things done at the front desk and Dr. Jones is being crabby)?

To help determine your individual factors, try listening to your self-talk. Developing awareness can help you realize how much you may be contributing to your own stress. Take a few minutes at the end of the day to check in with yourself. Do you think, I’m such a failure or I should be a faster worker? Such self-talk can dramatically increase feelings of stress and anxiety. Unless you are aware of your own beliefs and self-judgments, they will forever plague you. A trusted friend, counselor, or support group can help sort through these issues.

Once you are aware of your internal factors, you will know how much you need to change as opposed to how much the job needs to change. This will not be a quick fix, but important changes rarely are.

3. Interpersonal Factors
Think of interpersonal factors as Can’t we all just get along? Veterinary medicine is a people-oriented business as much as it is animal-oriented. Stress results when you cannot get along with people.

We all have unique personalities, and certain people may rub us the wrong way (and vice versa). Sometimes just accepting this truth relieves some stress. Focusing on treating your team members with professionalism and respect without needing them to like you—and you to like them—can be a big step in the right direction.

If there are multiple personalities at work who cause you stress, take a look at the constant in the equation: you. If more than one team member says you contribute to relationship problems, consider this an opportunity to grow both personally and professionally. Seek constructive feedback from a supervisor, counselor, or mentor.

Conversely, if through self-reflection and counsel you conclude that you are not the problem, you are possibly in a mix of people who are not a good fit for you.

An important caveat: If a superior (eg, supervisor, manager, veterinarian) treats you disrespectfully or abusively, you have a problem. Then, consider the structural issues mentioned earlier. Will management handle this issue professionally, respectfully, and confidentially? If not, you will need to evaluate whether the situation is tolerable.1

Interpersonal issues among practice team members can be one of the biggest challenges. Healthy interpersonal relationships at work start at the top, and if you are a manager or owner constantly struggling with these issues, seek help. Without strong yet empathic leadership, the team can end up being a dysfunctional unit.

Related Article: Your Work Can Make You Sick or Well!

Now What?

Getting to the root cause of stress in the practice is a difficult process that takes time and self-reflection. Learning about our own personality and listening to our self-talk can be painful, yet ultimately extremely helpful (especially considering how much of our life we spend at work). Talk things over with someone who has a level of detachment or objectivity—not another team member.

Finally, if you find yourself working in a practice that has significant structural issues with no indication of changing, the best plan may be to find a position better suited to you.

These resources may be helpful if you are feeling stressed and anxious at work:

  • Nonviolent Communication: A Language of Life. Rosenberg MB—Encinitas, California: PuddleDancer Press, 2003;
  • Full Catastrophe Living. Kabat-Zinn J—New York: Bantam Books, 2013.
  • The Relaxation and Stress Reduction Workbook. Davis M, Eshelman ER, McKay M—Oakland, CA: New Harbinger Publications, 2008.
  • The Stress of Life. Selye H—New York: McGraw-Hill, 1984.
References Show

1. Nonviolent Communication: A Language of Life. Rosenberg MB—Encinitas, California: PuddleDancer Press, 2003.

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