On average, a person will spend one-third of their life at work. This is the equivalent of 90,000 hours – a huge amount of time to spend simply surviving rather than thriving. But how can veterinary leaders help ensure their teams and colleagues are thriving in the workplace? This question underpinned the entirety of SPVS Congress 2023, with the impact of “good” practice culture repeatedly cited as the answer.
In the simplest terms, if your practice is armed with the right culture, you will see an improvement in recruitment and retention. But if you dig a little deeper, you’ll find a host of reasons why you should focus on improving and developing your practice culture, from diversity and inclusivity to delegation and flexible working.
Why should we care about practice culture?
Not only is there significant suffering of perfectionism and imposter syndrome in the profession, observed Paul Horward (Sandstone Communications), but the most recent Voice of the Veterinary Profession survey revealed that 67 percent of vets said their job-related stress is “terrible” (25 percent) or “not very good” (42 percent). As such, the most successful practices are “taking people as seriously as the animals they treat”, declared current British Veterinary Association president Malcolm Morley in the welcome speech he shared with Paul.
When it comes to thriving in the workplace, practice culture should be the first and last step, in Malcolm’s opinion. And because the leaders set the tone of a workplace’s culture, and, after all, “it’s all about culture”, “human-savvy” leadership is the way to go in his eyes.
Sixty-seven percent of vets said their job-related stress is “terrible” (25 percent) or “not very good” (42 percent)
Even putting some simple but effective structures in place can make the world of difference in building a practice culture that supports people to thrive in the workplace. For example, ensuring your practice has regular feedback beyond a “no feedback is good feedback” mindset or implementing practice-wide training on understanding and employing the languages of appreciation (covered by Major Cathie Gregg in an informative session at SPVS Congress) could be a brilliant place to start.
Can practice culture make your workplace more inclusive?
According to Malcolm, your “canary in a coal mine” for good practice culture is whether your team can assimilate any EMS student in a heartbeat in spite of race, gender, religion, etc. But how can you reach this point? British Veterinary Ethnicity and Diversity Society (BVEDS) co-founder Issa Robinson and British Veterinary LGBT+ student president Tobias Hunter tackled how to support your whole team to thrive and succeed in their session at congress.
Although part of active allyship is about going through a personal, educational journey, another aspect comes from changing at an organisational level. “It’s important to understand that the systems we’ve built do oppress certain people, and if you continue to uphold those systems, you are part of that oppression,” disclosed Tobias.
People often feel uncomfortable, unsure or awkward talking about and approaching issues of discrimination. This is normal, reassured Issa, and it is a phase you can progress through, as any allyship journey begins with awareness. In fact, their take-home message was for delegates to understand that making mistakes is OK; instead, the way you respond to making a mistake matters most. This is because, as Issa explained, “how we respond when we realise we have misspoken has the power to immediately reduce harm”.
Have the uncomfortable conversations!
However, because lots of people are fearful that they don’t have the answers or don’t know about the issue, they shut down these conversations. But this is not the sort of environment that helps people thrive. By avoiding the difficult conversations, “we trade short-term discomfort for long-term disfunction,” observed Tobias. So, it is crucial to have these discussions surrounding discrimination early and bring everyone to the table when you do, as being proactive and prepared can help empower your staff and provide them with the necessary skills to feel comfortable acting if an incident occurs.
It is crucial to have these discussions surrounding discrimination early and bring everyone to the table when you do, as being proactive and prepared can help empower your staff
During these conversations, consider the policies you have in place, not only for reporting incidents but for requesting reasonable adjustments as well. Are they detailed and accessible, and is everyone, including your wider team, aware of them? Communicating with your team is key. The “best chance to mitigate […] the impact of discrimination” is to create a climate where people are comfortable bringing forward and discussing any issue before they become a huge incident, concluded Issa.
Can practice culture help you make the most of your nursing team?
As long as you’re not asking your nurses to “prescribe, diagnose or enter a body cavity,” revealed Jo Oakden during a panel discussion on effective delegation, legislation allows a huge amount of flexibility in what they can do. Despite this, many veterinary practices are not making the best use of their nursing team through effective delegation.
This conundrum was addressed during a panel discussion with Jo, Lyndsey Hughes (practice director at Drove Vets), Liz Cox (IVC Evidensia group veterinary nursing advisor), Andrew Whitfield Roberts (head nurse at White Cross Vets) and Helen Swift (vet surgeon and SPVS Board member). Throughout the discussion, several barriers to delegating to nurses were addressed, with the influence of practice culture repeatedly mentioned as a way to break them down.
Client communication can be complicated
The first barrier was client communication and how we convey the value of veterinary nurses to them. Lyndsey explained that it all comes down to practice culture. If the norm is an internal, practice-wide understanding of the value and role of veterinary nurses, your clients will reflect this as well. To create a practice-wide accord, you need to break down the divide between clinical and front-of-house staff; Jo suggests having nursing and client-care teams shadow each other. This helps foster understanding and appreciation, preventing a breakdown in trust and leading to effective delegation, with receptionists feeling more confident when booking clients for nurse consults.
A simple, effective way to begin this change is to mind your language, said Steph Writer-Davies, who […] suggests using “complementary” instead of “free” for nursing consults, as well as discussing how to price them properly
It is important, therefore, to ensure your team is not devaluing your nurses’ time and skillset. And a simple, effective way to begin this change is to mind your language, said Steph Writer-Davies, who chaired the event. She suggests using “complementary” instead of “free” for nursing consults, as well as discussing how to price them properly. Liz added that it’s easy to talk of “vets” and “nurses” as separate parties, but why not refer to them as the “clinical team” instead? The aim, said Steph, is to “change the whole perception of what veterinary nurses can do and [send the message that] the fact that they are skilled, qualified, knowledgeable professionals”.
Complications, complaints and liability
Fear of complications and complaints was also referenced as a factor holding vets back from delegating to the nurses in their team – fears grounded in worries over liability. But, as Helen pointed out, if you are not giving your nurses chances to grow and follow their passions, they’ll go somewhere that will. So, how can we overcome this barrier? Once again, practice culture can be our saving grace.
There could be a vast number of reasons why a vet is worried about delegating their work, but as Jo stated, “you won’t know [why] until you ask”. Taking the time to do this will help you understand why vets feel this way and allow nurses to discuss their competencies, confidence level and where they feel they need (or want) further training.
Safari nursing – with the vet on hand in the consultation for prescriptions – is a great way to empower nurses, reduce liability and show clients that nurses really are trained professionals
Safari nursing – with the vet on hand in the consultation for prescriptions – is a great way to empower nurses, reduce liability and show clients that nurses really are trained professionals, suggested Andrew. “The empowerment comes from the consultation itself, not from the actual task of giving the injection”, he continues.
Ultimately, combatting these fears is about being secure in our teams and knowing how they work, observed Liz. If you understand the roles, competencies, skills and confidence of the members of your nursing team, it will be easier to delegate. Thus, Jo believes creating a safe space to give and receive objective feedback is crucial “because [it] helps people learn and grow and develop and gain confidence”.
Does practice culture play a role in flexible working?
In the current climate, 43.7 percent of veterinary professionals are considering leaving their job at any one time, according to the most recent Voice of the Veterinary Profession survey. But as Flexee co-founder Silvia Janska (Figure 1) and Rachel Kyle, interim head of flexible working for NHS England, exposed in their congress session, embedding flexible working into your practice culture can help combat this.
Teamwork makes the dream work
Ultimately, Rachel states that teamwork is key, no matter how you define flexible working. “We really underestimate the power of teamwork and camaraderie, especially in frontline services,” she observed. And at the end of the day, flexible working only works if there is give and take in equal measure: “It’s not about getting what you want. It’s about balance.”
Because implementing flexible working hinges on balance and teamwork, ensuring that everyone is on the same page is an essential first step. So, start having these conversations with your whole team, not just your line managers, advised Rachel. Gauge each person’s feelings, desires, needs and, ultimately, their flexibility. It is, however, important to bear in mind that flexible working will not resonate with everyone. There may also be those who have imagined barriers against it but have desires that can potentially be filled by looking at things a bit differently. After all, “the biggest barrier” to flexible working, observed Rachel, “is us – how we think and how we behave”.
Compromise is key
Danger occurs when flexibility becomes inflexible, said Silvia. One way to avoid this is to “onboard the whole team and be practical about what flexible working means for the business”. By putting flexible working in this perspective, it can be easier to understand that although flexible working stems from finding equilibrium, fairness of opportunity is not necessarily about complete balance but compromise in general. For example, if someone needs to leave on time during the week, can they work on Saturdays or make time back in other ways? If someone is OK with regularly coming in for OOH because they live nearby, can they take the more sought-after long weekend leave?
So, the solution to implementing good flexible working in veterinary practice is to embed flexibility into your workplace culture. Ensure you are having regular conversations, so everyone stays informed and up to date and has the opportunity to voice complaints if there are problems. This allows you to remain proactive and dynamic, rolling with the punches and changes within your practice and wider society as well.
Ensuring your practice culture promotes open communication and understanding while being a safe space for objective feedback, discussion and education seems to be a great place to start
Managers and leaders play a crucial role in creating and maintaining a practice culture that allows and encourages employees to thrive. But it is hard to put these systems in place when, as Paul said, you are working “flat out 24/7, just trying to get to lunchtime or the end of the day”. Unfortunately, no one will come “racing in on their white charger” and fix it for us. Instead, we must do it for ourselves. But ensuring your practice culture promotes open communication and understanding while being a safe space for objective feedback, discussion and education seems to be a great place to start.