Addressing the emotional impact of veterinary practice
Schwartz Rounds provide a safe, reflective forum for clinical and non-clinical staff to come together and discuss the emotional aspects of their job. Following the success of Schwartz Rounds in the NHS, the Mind Matters Initiative is currently developing a pilot to explore their effectiveness in a veterinary context.
Here, Amy Martin (pictured) writes about how a Schwartz Round helped identify and address themes of guilt and anger among colleagues at her veterinary hospital group.
Amy Martin BSc (Hons) RVN, DipAVN, DipHE CVN NCert(BusDev) MBVNA General Manager.
Amy is a Registered Veterinary Nurse with 12 years management experience. Her passion is the wellbeing of staff, it is her belief that happy staff deliver phenomenal patient care.
Addressing the emotional impact of veterinary practice
Back in 2017 we decided that Schwartz Rounds would be useful for our organisation, a veterinary hospital group of three practices. Schwartz Rounds are a unique forum that enables clinical and non-clinical staff to come together to discuss the emotional and psychological impacts of our work. As an organisation focused on the wellbeing of its staff this seemed like a good fit for us.
This Round, our fifth, was called ‘Bad Endings’ – a title that was sure to inspire a powerful Round, but just how powerful was a surprise to me. The stories were very different but it quickly became apparent during the group discussion that many of us had not reflected on our emotions with regards to euthanasia and death in our patients. Operating as we do in a busy first opinion practice, taking both emergencies and referrals, it can be hard to take any time between cases to examine the emotional impact what we have just witnessed has on us as people.
Themes emerged, such as guilt over calling the right time for euthanasia, anger with the situation and ultimately sadness that we had to let another one go. Deep bonds are formed with our patients over many years. We first see them as babies and let them go as (mostly) as old pets. What also emerged was the bonds we also form with the owners of our patients and when we lose a patient this can often mean saying goodbye to old friends.
All our staff, clinical and non-clinical, have been invited to Rounds and we have had good attendance from all disciplines. It has helped us to see our work from one another’s point of view and has already begun to effect change in our organisation as a ripple from the issues discussed during Rounds.
Facilitating is not an easy job and this time I found myself swept away remembering stories from my own clinical practice and shed tears along with a number of other staff members. The great thing about this is that I didn’t feel awkward, I felt as though I was among friends. Hopefully showing my vulnerability has helped to indicate that no matter what your position these feelings are normal, can and should be discussed and acknowledged.
We have noticed during other Rounds, in our short history of running them, that euthanasia is a topic which has been revisited many times and we have a feeling this will continue in future Rounds. It will be important to keep exploring this to enable us to continue to be compassionate caregivers. The support and encouragement from The Point of Care Foundation has been invaluable as we embark on being the first veterinary practice to offer Rounds to its staff.
Amy Martin, August 2018
What are Schwartz Rounds?
Schwartz Rounds are a safe, confidential, voluntary, reflective forum for all staff, both clinical and non-clinical to come together to discuss the emotional and social aspects of their jobs. Rounds follow a standard model determining how they should be run, ensuring that they can be replicated across different settings. They normally take place once a month, for an hour at a time, usually at lunch time with food provided. The basic format of a Round is that a panel of three or four staff members from different disciplines present stories of personal experiences, based on a topic or case. After the stories have been told, two trained facilitators open the discussion to the audience, inviting audience members to reflect on the stories and their own experiences. Rounds are purely reflective, and the intention is that outcomes or solutions are not discussed.
The Rounds are licensed by The Point of Care Foundation who provide assistance and training in embedding Rounds with organisational practice.
For more information on Schwartz Rounds contact schwartz@pointofcarefoundation.org.uk
In theory this may be a good idea for some people, in practice reliving the strong emotions of euthanasia and other challenging parts of veterinary practice can be overwhelming. To have to do this in front of other people and absorb all of their emotions would be unbearable for me. I have had nearly 2 years of EMDR to help me deal with PTSD from working in veterinary practice.
The whole area of veterinary work, value of animals to an individual, practice, society etc is such a cluster**** of emotions, morals, double standards rolled up into financially limited situations. Of course it plays havoc with anyone in this veterinary world with one ounce of compassion. Burying how you feel and trench humour are such common ‘coping strategies’, but in a politically correct society it is harder to make light of a situation with colleagues or tread the sensitivities of clients when we are all so diverse in our opinions, morals and expectations for an animal. This is the crux of the dilemma, dealing with so many other people, when the real focus should be doing the best for the animal. But the best for the animal is different according to who you ask, when you ask, how you ask, what type of animal you are asking about(pet/farm/laboratory/wildlife/parasite) and who is going to pay for it.
Fran I agree with that sentiment. The great thing about rounds is that we offer them in practice monthly and they are not mandatory. Some people choose not to attend however the ripple effect throughout our organisation has been great. It provides us with understanding of one another and an opportunity to discuss difficult situations in a confidential, non-judgmental forum. It is building links between clinical and non-clinical staff. There is also a lot of silent reflection where we can just be still and think about our experiences which we may not have time to do during busy practice life.
It’s true rounds may not be for everyone but if it helps just one person I think it’s worthwhile.