A GUIDE TO ENHANCING WELLBEING AND MANAGING WORK STRESS IN THE VETERINARY WORKPLACE
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A GUIDE TO ENHANCING WELLBEING AND MANAGING WORK STRESS IN THE VETERINARY WORKPLACE
Psychological wellbeing at work is a of work-related stress and the reasons why
focus of attention for the veterinary it should be addressed. We then describe
profession. In particular, we recognise a range of approaches to managing stress
the importance of addressing work- at work, and provide some suggestions for
related stress to protect the wellbeing how these might be applied in veterinary
INTRODUCTION of the veterinary team. Work stress
can affect physical and psychological
workplaces. The guide finishes with advice on
how to maximise the effectiveness of stress
TO THE GUIDE health, and can also lead to poorer
work performance, increased
management initiatives in the workplace.
absenteeism and employee turnover. The guide has been developed by Dr Elinor
The ethical and business reasons for O’Connor, Senior Lecturer in Occupational
tackling work stress are clear. Psychology at Alliance Manchester
Business School, University of Manchester,
This guide provides advice to veterinary in association with the Royal College of
workplaces, including clinical practices Veterinary Surgeons’ (RCVS) Mind Matters
and other settings in which veterinary Initiative (MMI), and is illustrated with
professionals work, on approaches to examples from the three winning practices of
managing stress and promoting wellbeing. It the 2016 MMI/Society of Practising Veterinary
is designed for everyone who has an interest Surgeons Wellbeing Awards: 387 Veterinary
in the wellbeing of the veterinary team, in Centre (Small Practice Category), Valley Vets
particular practice managers, line managers (Medium Practice Category), and White Cross
or health and safety officers. Vets (Large Practice Category). We hope that
you will find the guide helpful for identifying
The guide begins by outlining the root causes steps to support wellbeing in your workplace.
We would welcome your feedback on the guide, as
well as examples of how your workplace supports
wellbeing and seeks to tackle stress in veterinary
work. Please email Lizzie Lockett at
lizzie@vetmindmatters.org with your comments.
2
“Common stressors
WHAT IS include high
workload, limited
WORK control at work,
and conflicting
STRESS? demands or unclear
performance
expectations”
Well-organised work and a good working these challenges can be motivating and
environment are beneficial for our help us to achieve our goals.
wellbeing. However, even for those
who normally enjoy their work, every Sources of stress vary across different
job involves difficulties or less pleasant professions and occupations, but
experiences at times. Stress occurs when common stressors include high workload,
the person feels that work demands limited control at work, and conflicting
exceed their capacity to deal with the demands or unclear performance
situation. expectations. In addition, our personality
characteristics and coping style influence
Stress differs from work demands that how we respond to demanding situations
we experience as challenging, but with at work and, in turn, the degree of stress
which we believe we can cope; in fact, we experience.
3
WHY SHOULD HOW CAN
WORK STRESS WORK STRESS
BE ADDRESSED? BE MANAGED?
An RCVS survey of veterinary surgeons found Techniques for managing work-related All staff at 387 Vets were asked
that almost 90% reported that veterinary stress have either an organisational focus, to take personality tests, helping
them to engage effectively and
work is stressful (Institute for Employment involving changes to the workplace or working
calmly with their colleagues
Studies, 2014). Frequent or prolonged practices to target sources of stress, or an
exposure to stressful situations at work can individual focus, which involves strengthening
affect physical and psychological health and people’s resilience to stress. It is also useful to aim to describe some of the key principles
reduce job satisfaction and commitment. In think about stress-management interventions for managing work stress, and make some
the UK, stress is the second-largest cause of in terms of what they seek to achieve. Some suggestions for how you might apply them in
work-related ill-health diagnosed by general interventions aim to remove or reduce the your workplace.
practitioners (Health and Safety Executive cause of stress, some seek to reduce the
(HSE), 2016). impact of stress on the person, and some Individual-level interventions
seek to support and rehabilitate people Individual-level interventions are designed
Effective stress management not only has experiencing stress-related ill-health. to help people increase their resilience and
benefits for workers’ health and wellbeing, but to cope with stress at work. Some examples
there is also a clear business case for reducing In practice, the interventions most often used include mindfulness programmes, relaxation
stress. Work stress is associated with reduced for managing work stress are individual-level techniques, and training in specific skills such
performance and productivity, increased techniques, and research evidence supports as time management.
absenteeism, and higher employee turnover. their effectiveness. Organisational-level
In 2015-16, 11.7 million working days in the UK interventions can also be effective. However, • Mindfulness is increasingly being used as
were lost to work-related stress (HSE, 2016). there are relatively few ‘off-the-shelf’ versions a technique for managing work-related
In addition, employers have a legal duty under of organisational-level interventions; these stress. Research shows that mindfulness
the Health and Safety at Work Act (1974) and interventions usually have to be tailored to improves psychological wellbeing and
the Management of Health and Safety at Work each specific workplace. reduces feelings of stress. The MMI
Regulations (1999) to protect the health and mindfulness-based stress management
welfare of workers, which includes managing Finding solutions to work-related stress might programme is available from
hazards to psychological health. seem challenging, however, in this guide, we www.thewebinarvet.com. Other courses
4
and structured programmes are available,
including apps such as Headspace;
• Relaxation techniques for reducing stress
include muscle relaxation and controlled
breathing techniques. These techniques
are straightforward to use, and research
indicates that they can be effective in
reducing feelings of stress;
• Healthier lifestyle programmes that
support exercise and better diet can also An RCVS survey of veterinary surgeons
help with stress management and improve found that almost 90% reported that
psychological wellbeing, such as the NHS’s
Five Steps to Mental Wellbeing guidance at: veterinary work is stressful
www.nhs.uk/wellbeing
(Institute for Employment Studies, 2014)
For people experiencing prolonged or intense
levels of stress, or who are experiencing
stress-related ill-health, additional support absence is available from the Chartered High workload
measures can be helpful. Institute of Personnel and Development at: High workload, including unpredictable
www.cipd.co.uk/knowledge/fundamentals/ surges in workload from day to day, is a
• Employee assistance programmes provide relations/absence/factsheet common feature of veterinary work. An
support and counselling for personal or important step in managing workload is
work-related difficulties. For example, Organisational-level interventions to obtain accurate estimates of typical
Vetlife offers free and confidential advice Organisational interventions aim to change daily workload levels, including workload
and support to veterinary professionals on the workplace or work practices to remove during peak and emergency periods, and
a range of issues, including work-related or reduce sources of stress at work. In this to consider if the amount and pace of work
stress and mental health concerns www. section, we describe some of the main sources are appropriate and whether staffing levels
vetlife.org.uk of stress at work and offer suggestions on how are sufficient. Key principles for managing
• Sickness absence support and return- they can be lessened. workload are:
to-work schemes are recommended for
managing long-term sickness absence Workload and work/life balance • Scheduling a variety of tasks with differing
whether due to physical or psychological ill- Veterinary work can involve high workload, physical or mental demands during the
health (long-term absence is usually defined long working days, and working unsocial working day can help to maintain people’s
as continuous absence for four weeks or hours, including on-call working, all of which alertness and reduce fatigue;
more). Guidance on managing sickness can affect wellbeing. • It is best if demanding tasks are scheduled
5
when people are less likely to be fatigued,
for example, try to avoid scheduling them
at the end of the working day, although it “In managing the
is appreciated that emergencies will come
when they come;
impact of workload,
• If possible, enable people to have a say it is important to
in scheduling their duties, for example, consider not only staff
attending consulting and operating periods;
• Encourage regular breaks during the
numbers, but also the
working day and ensure that there are mix of experience and
facilities for breaks to be taken away from skills required to meet
the immediate place of work, ideally away
workload demands”
from ringing phones or allowing a chance for
some fresh air; White Cross Vets have their
• Monitor individual colleagues’ workload own currency system, the ‘Alfie’,
at regular intervals and revise their work letting colleagues thank or
allocation if appropriate. congratulate each other on a
particularly good job
In managing the impact of workload, it is
important to consider not only staff numbers, reliance on sedatives or stimulants, disruption
but also the mix of experience and skills of domestic and social life, and poorer work
required to meet workload demands. An HSE performance. Some good-practice guidelines
guide on ensuring appropriate staffing levels, for the design of work schedules that may be
including advice on managing in circumstances helpful for veterinary work are:
of reduced staffing, is available at: www.hse.gov.
uk/humanfactors/topics/staffing-levels.htm • When work demands concentration, is
safety critical, or involves exposure to
Working unsocial hours, including physical hazards to workers’ health, it is
on-call working preferable for shifts not to exceed eight
‘Shift working’ is defined as on-call duties, hours;
work that is scheduled outside the hours of • Ensure work schedules permit a minimum
White Cross Vets contributes to all
07.00-19.00h, work periods of 12 hours or of 11 hours off between the end of one of their team’s gym memberships
more, or rotating hours of work. Shift work, shift and the start of the next; and Fitbits, and even created
particularly where it involves early morning • Ensure schedules allow adequate rest time a White Cross Fitbit group to
encourage participation
starts or working at night, can lead to fatigue, for those undertaking on-call duties. This is
6
particularly important during periods when
call-outs are more likely, such as lambing and
calving;
• If possible, avoid ‘split’ shifts, as they tend to
lengthen the working day;
• When people are switching from day to night
working or vice versa, ensure that their work
schedule incorporates a minimum of two
nights’ full sleep;
• If colleagues commonly ‘shift swap’, it is
recommended that details are recorded and
monitored to ensure that it is not resulting in
insufficient rest time and increased fatigue.
A useful HSE guide for organisations on
designing work schedules is available at:
www.hse.gov.uk/pubns/priced/hsg256.pdf
In the UK, stress is the
Work demands and job conditions second-largest cause of
By its nature, veterinary work involves a
work-related ill-health
number of features that are potentially
stressful, such as exposure to animal diagnosed by general
suffering, cases in which challenging practitioners
complications occur, working with clients
who may be upset or distressed, and lone (Health and Safety Executive, 2016)
working.
techniques for helping colleagues cope with emotional, demanding or discourteous
Where possible, changes to the workplace these, such as specific training programmes people. In veterinary work, potential client-
or working practices to remove or reduce (for example, dealing with compassion related stressors can include animal owners’
risk associated with these demands are fatigue) or more general stress management high expectations of vets and vet nurses,
recommended (for example, protocols for methods (for example, mindfulness training). complaints, and exposure to verbal abuse or
lone working). In the case of stressful features threatening behaviour.
of veterinary work that are unavoidable Working with clients
or difficult to target, such as exposure to Any job that involves interaction with clients • Training in working with clients can be
animal suffering, it is appropriate to consider can, at times, require workers to deal with beneficial for members of the veterinary
7
team who deal directly with clients, and breaks together during the working day
a range of specialist training courses enables them to be a source of support
for working with veterinary clients are for each other;
available; • Social events outside working hours
• With regard to managing abusive and can also foster positive relationships.
threatening behaviour specifically, However, try to ensure that people who
guidance developed by the HSE can be might prefer not to participate do not
found at: www.hse.gov.uk/violence/ feel obliged to attend. Similarly, consider
toolkit/customers.htm and: www.hse. a range of social activities, for example,
gov.uk/violence/preventing-workplace- events that are alcohol or food-based
harassment.pdf might not be appropriate for everyone;
• Consideration could be given to a single • It is helpful to have in place measures for
point of contact for the handling of identifying and resolving difficulties or
complaints. conflict in relationships at work and to
387 Vets provided compassion ensure that people are aware of these.
Lone working and bereavement training for For managers, dealing with conflict in
Lone working includes circumstances in the whole team relationships at work can be challenging –
which a person works alone at their usual and stressful – and specific training in this
workplace (for example, during out-of-hours may be helpful;
work) or at other locations (for example, managing relationships at work are: • With regard to harassment and bullying
undertaking house calls and farm visits). • Fostering positive relationships and social specifically, it is helpful to have a
support not only removes or reduces clear policy stating that these are not
• A HSE guide on assessing and managing a potential source of stress in its own acceptable and outlining how allegations of
lone-working risk is available at: www.hse. right, but can also help people to cope unacceptable behaviour will be managed.
gov.uk/pubns/indg73.pdf with other aspects of their work that are Useful guidance on reducing the risk of
• Information about lone-worker safety stressful; bullying and harassment, as well as dealing
protocols and devices, and training for • Mentoring schemes and peer support with them when they do occur, is available
managers and lone workers on reducing groups can be helpful for developing social from the Advisory, Conciliation and
lone-working risks are available from the Suzy support within the team; Arbitration Service: www.acas.org.uk;
Lamplugh Trust: www.suzylamplugh.org • Informal approaches to fostering social • It is important to create an open and
support can be effective; these are based learning culture where team members feel
Work relationships on creating opportunities for people they can discuss things that have not gone
Lack of social support and difficulties or conflict to spend time together and to develop well in a non-judgemental environment,
in relationships at work can be significant relationships with each other. For and the whole team can develop and
sources of stress at work. Key principles for example, ensuring that people can take improve systems as a result.
8Valley Vets vary their outings
as a team, arranging for group
cinema viewings, speed boat
outings, and summer barbeques
Personal and career development
Unclear performance expectations, ‘role
conflict’, and concerns about career
In 2015-16, 11.7 million working days in
development are potential sources of stress at the UK were lost to work-related stress
work. Key principles for addressing these are:
(Health and Safety Executive, 2016)
• Ensure that people know what is
expected of them at work in terms of
their responsibilities and the standards of role conflict; this can include conflict those taking on new roles at more senior
performance required; between the person’s capabilities and levels or returning to work after a period
• Provide constructive feedback about the requirements of their role, or of absence. In addition, mentoring can be
performance. Feedback is most effective conflicting demands arising from different good for the wellbeing of the mentor as
when it is timely and appropriately frequent responsibilities within their role; well as the person being mentored;
(providing feedback only during an annual • Mentoring and supervision are beneficial • Veterinary workplaces usually fund and
performance review might not be sufficient); not just for recently-qualified or new provide leave for continuing professional
• Be aware of and address potential colleagues, but may also be helpful for development (CPD), but it is important to
9be aware of and address potential barriers
to people undertaking CPD, such as high
workload.
MAXIMISING THE
Control at work
Not having enough control over work EFFECTIVENESS
matters is a common source of stress. Key
principles for addressing this are: OF STRESS
• There are unavoidable constraints on how
MANAGEMENT
veterinary work is undertaken, but enabling
people where possible to be involved in
INITIATIVES
decisions about how work is organised and
carried out is beneficial to wellbeing;
• Good communication is fundamental Following an avoidable patient
to people having a sense of control at Research has identified a number of factors death at Valley Vets, the practice
manager visited all branch sites to
work. It is helpful to have a number of key to the effectiveness of work stress discuss the rationale for a change
communication channels in place, for management initiatives: in procedures
example, meetings, newsletters, suggestion
schemes etc. It is important that people • Stress management is most effective work is key to ensuring that stress
are kept informed of what is happening at when it is tailored to the specific management initiatives are appropriately
work, but communication should not just organisation. This means identifying resourced and are implemented;
be ‘top-down’ from those in management the sources of stress in your work, • Similarly, stress management measures
positions; ensure that everyone is able to establishing who in the team might be are most likely to be effective when
have a say; affected by them, and deciding what all colleagues have an opportunity to
• Change at work can be unsettling. In approaches to targeting stress are most contribute to the planning, development,
the event of change taking place, it is appropriate for your workplace; implementation and evaluation of
important to give people opportunities • It can be helpful to use a number of wellbeing initiatives. A participative
to ask questions and comment on what is stress management initiatives – perhaps a approach to stress management helps
happening; mix of organisational-level interventions people feel involved, which can have a
• Team working can enable people to or a combination of organisational- and positive effect on wellbeing in its own
contribute to decision making. For individual-level approaches; right, and also increases the likelihood
example, when new projects arise, it is • Senior and middle management support of the initiatives being accepted by all
helpful if they are undertaken by groups for the importance of wellbeing at members of the team.
rather than single individuals.
10ADDITIONAL
RESOURCES
SOME FINAL In addition to the sources of further advice listed throughout
this guide, useful general resources relating to stress
THOUGHTS management and psychological wellbeing at work include:
• The Health and Safety Executive provides a comprehensive
guide to assessing and managing stress at work:
www.hse.gov.uk/stress/standards
• The mental health charity, Mind, provides guidance on
supporting work colleagues who have mental health
conditions:
To reduce stress and promote wellbeing at work, you www.mind.org.uk/workplace/mental-health-at-work/
do not need to implement all of the suggestions in taking-care-of-your-staff/useful-resources/
this guide. Indeed, just one or two simple initiatives • The RCVS Mind Matters Initiative website has details of
to support wellbeing at work can make a difference to resources, including training courses, to support wellbeing
psychological health. in the veterinary profession:
www.vetmindmatters.org
A good example we have come across is a small animal • The charity Vetlife offers a confidential, 24/7 Helpline
practice that makes sure that the team has a shared which is available to any member of the veterinary team,
lunchtime. Not only does this give colleagues a chance for and a Health Support Service:
a break and some food during the long working day, but it www.vetlife.org.uk
also enables them to offer a listening ear and be a source of • The SPVS/MMI Wellbeing Awards website includes useful
support and advice for each other. case studies and tips: www.vetwellbeingawards.org.uk
We hope this guide is helpful in identifying steps for
supporting wellbeing and reducing stress in your
workplace.
11The Mind Matters Initiative is run by the Royal College of Veterinary Surgeons www.vetmindmatters.org @vetmindmatters lizzie@vetmindmatters.org
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