Hello everybody and welcome back to Vet Chat. Thank you so much for listening in today, and today I am excited to welcome a brand new guest to the show, Doctor Marie Holloway Chuck. For those of you who don't know Marie, let me tell you a little bit about her before we get started.
Marie is a board certified small animal emergency and critical care specialist, and she's very passionate and advocates for veterinary team wellbeing. She's an avid writer, speaker and researcher, and has authored dozens of articles and recorded lots of podcast interviews relating to personal and professional well-being. She also hosts reviving VetMed podcast and writes a monthly blog and newsletter on pertinent issues relating to mental health and wellbeing.
Marie lives in Calgary and is a locum emergency doctor for VEG. As a yoga and meditation teacher and wellness coach, she facilitates well-being workshops and retreats for veterinary clinics and organisations and offers individual and group coaching and online programmes for veterinary team members. She also runs the website RevivingettMed.com, which contains well-being resources for veterinary professionals.
In her spare time, Marie enjoys adventuring with her daughter and standard poodle and stays active with strength and hit training classes. So welcome, Marie. Welcome to Bet Chat.
It's great to have you here with us today. Thank you, Catherine, it's wonderful to be here. So I was having a little look at your website earlier, which is brilliant, and it's clear you are on a mission to really help and try and improve mental health and, well-being in the veterinary profession, which is fantastic, and at the webinar that, you know, we're very aligned with that as well, which is brilliant.
So thank you for being here. And today we're gonna look. At navigating burnouts in the veterinary profession, which is obviously so we needed right now.
So perhaps to start us off, could you share some of the common signs and symptoms of burnout, from your experience that we should be aware of? Mm, yeah, it's one of those syndromes that can be a little bit tricky to spot. I think sometimes we see behaviours in others or we recognise those behaviours in ourselves, and we think, well, that's not the typical for me.
And we sort of brush it off, you know, that we're maybe just feeling really stressed or going through a tough period. And really the research demonstrates that there's 3 main symptoms of burnout. So the first is emotional exhaustion.
So this is that sense of, you know, I don't really care what happens to my patients. I'm, you know, feeling tapped out emotionally. I don't have anything left to give.
If there's one more emotional client that walks through the door, I don't want to deal with them. Mhm. The second symptom is cynicism or depersonalization.
So this is just having like kind of that distance at effect, right, where we just really don't want to engage with our team members or with our clients or with the patients. We're just seeing everyone as, you know, objects and not really connecting with them as animals or as people. And the last symptom is reduced personal accomplishment.
So this is the sense that, you know, it doesn't matter what I do, nothing good comes of this, or, you know, no matter how hard I try, I feel like I'm not accomplishing anything, I'm not helping anybody. So an individual who's experiencing burnout can experience any one of those symptoms and be categorised as having burnout. So, That's typically what we're looking for when we're thinking about a burnout diagnosis.
Mhm. OK. And what's the kind of, how do people kind of think or recognise rather that it's burn out rather than just work related stress?
Is there a difference? Yeah, that's such a great question and it's, it can be really hard to tell. You know, I think of stress and burnout.
On a bit of a continuum. So there's, you know, graduations between the different levels of stress, you know, one starts out as having just intermittent stress that usually turns into chronic stress, and then from there, individuals can experience burnout if they don't really take steps to mitigate their stress and to prevent that burnout. And then the burnout can even become what we refer to as habitual burnout, where it's just chronic and embedded in that individual's life.
Usually when we think of stress, we think of, you know, maybe a person can't sleep as well, you know, they're struggling, maybe a little bit with their emotional regulation, they're feeling a bit anxious, maybe even they're having some physical symptoms like headaches, you know. Those stressful, you know, body, tension, you know, that kind of thing that we experience. With burnout, it really tends to move more into those symptoms that I shared, really characteristic, experiences of that emotional exhaustion or that cynicism.
Or that, you know, low sense of personal accomplishment, and those behaviours really do tend to over, you know, overstep or supersede what that person's typical behaviours would be. So I think we've all seen each other. Stressed out, but we still see, you know, the person's typical behaviours underneath that.
With burnout, we really start to look at another person or ourselves as like, wow, this is like a different person. You know, this is more than just stress. I hope that makes sense.
Yeah, no, absolutely it does. Definitely does. And Do you have any tips for our listeners, you know, for managing stress?
I know it's never, you know, there's not one size that fits all, but do you have any sort of tips that you could share that you would suggest that people could try if they are feeling stressed or burnt out. Yeah, your point is important, right? I think it's every person has to find what works for them.
You know, when some of us think of stress relief, we think of going for a run or, going to a yoga class. And for other people, they're like, oh, like I, I can't think of anything more stressful than going for a run or going to yoga. So, you know, different things certainly that the research shows can be beneficial for stress management are things like moving your body.
So whatever that looks like for you, maybe it's going for a Walk, getting outside, going to a kickboxing class and punching something. You know, whatever helps you to discharge that energy. There's definitely research to support different breathing techniques to, mitigate stress.
So, especially things like lengthening the exhale or breath holds are shown to really stimulate the parasympathetic nervous system. So it takes us out of that fight or flight response and into that more rest and digest response. Visualisation techniques can be helpful for some people.
So if you're feeling stressed, for example, going into a procedure that you haven't done in a long time or you've maybe never done before, you know, visualising it from start to finish and seeing yourself be successful can be helpful. And then counselling, I think, is huge, you know, speaking to a mental health professional, letting them know, like, these are all the things that I'm, you know, feeling stressed about right now and not quite sure how to manage it. Oftentimes that outside unbiased expert perspective can really help to allow us to just put things into perspective and recognise what do we have control over, what do we don't, where can I focus.
You know, what seems to be the root cause of the stress here. So I think those are the big things for stress management, although there's, I mean, the list is so long and really, you know, if you know what works for you with stress management, that's what you want to do. When it comes to burnout prevention.
Any way that you can manage stress is gonna help to manage burnout because stress very often does flow into burnout, that chronic unmanaged stress. I think there are some unique things that have been shown in the literature to really help with burnout prevention specifically, especially among caregiving professionals. One of those things is boundaries.
So making sure that you recognise, you know, what are your limits and what do you need, right? I know for me, I need As often as I can get it, 8 hours of sleep a night. I need after 5 12 hour shifts to have at least a couple of days off.
You know, my, that's my limit, right? I've, when I get to my limits, then I need to be able to voice that and set boundaries around that. So I think really, you know, coming to grips with, where are my limits, what are my needs, and how can I communicate that to others, especially in the work environment.
Mindfulness is another really important skill. So, there's a lot of research in the human health care field linking mindfulness practises with reduced stress, better patient satisfaction, lower risk of burnout, more engagement in self-care, and I think it's because this mindfulness, this ability to really be present in the here and now is really allowing us to see, like, OK, I haven't, you know, stopped to take a breath all day. I need to hydrate, I need to eat something.
I need to, you know, take a moment, or, wow, I have been working so hard over the last two weeks. I'm recognising I need a day off. I need some time just for myself or Gosh, I'm recognising I'm getting really short with my family, like I'm not showing up at home the way I want to.
Something needs to change. So it's that present minded awareness that really allows us to recognise more deeply and intentionally what we need and and go from there. I think, you know, managing our workload, which we don't always have control over, you know, other things like making sure that our values, that the things that are most important to us are in alignment with where it is that we're working, that can be also a, a helpful tool for mitigating burnout.
So there's lots of different things, but definitely the, the boundaries, the mindfulness, and all the stress management techniques come up pretty strongly. Yeah, OK, brilliant, really good advice there, thank you. And you touched upon self-care just then.
How important do you think self-care is in preventing burnout? I think it's, you know, it's one of those foundational skills that we as individuals have control over. I'm not gonna say that if an individual practises self-care, that there's no way they can experience burnout because it's just not that simple.
Burnout is a pretty complex thing, just like any aspect of our mental health or well-being. There are workplace factors that are outside of our control that can still contribute to burnout, even in the face of like the best self-care. The reason why I like to emphasise self-care is because we, at the end of the day, don't have control over anybody else, right?
We have a hard time outside of setting our own boundaries to really control our environment, so to speak, unless we move to a completely different environment. So for that sake, I really do encourage people to, you know, recognise what you have control over and do your best to take the best care of yourself. So for me it's foundational, you know, getting enough sleep, setting those boundaries, you know, engaging in work-life separation so that there's time away from work where you're not thinking about work.
These things really are important to preventing burnout and at the end of the day, we also still need to rely on others, namely our leaders and owners and and managers to be able to also create an environment that's conducive to. Preventing burnout, mhm, yeah, so I guess workplace culture comes into it a lot as well, doesn't it? Do you have any sort of, anything, you know, linked to burn out in terms of workplace culture, anything that you've experienced or any sort of research that you've found?
Yeah, you know, I've, I've certainly experienced some unhealthy workplace cultures that have really, honestly, as a locum, it's, I have the privilege of being able to choose where I work and so some of these places I've just chosen not to go back to simply because I could feel myself burning out. It was just too much energy directed at managing the toxicity or avoiding the toxicity, having tense conversations all the time. It was just really draining for me.
There is a lot of research in this area, believe it or not. So there was some work that was started about 10 years ago now in Canada, and then it was replicated in the US that demonstrated that all members of the team, they surveyed, veterinarians, nurses, animal care attendants, everyone in the practises. These were companion animal practises.
And they asked them questions pertaining to the culture in the workplace, how healthy it was, how, you know, how people communicated, etc. And then they measured their burnout scores. And across the board, regardless of your position, if you felt that you worked in a toxic environment, your burnout scores were higher.
You also had a higher desire to leave your job, which is not what we want, right? In a healthy workplace. So we know that to be true.
And then in, in the past few years, Merc Animal Health has teamed up with the ABMA, in the US to also conduct some research. Looking specifically at workplace contributions to burnout and distress, and an unhealthy work environment is one of the strongest predictors. So that means things like not having open communication, team members feeling like they don't have enough time to do good quality work, you know, those types of factors.
So we definitely know that. Having a healthy environment, you know, open communication, sufficient time to do the work in, in a, in a good quality way, good leadership skills, feeling rewarded for your work, those things are gonna be associated with lower burnout. Mhm.
OK, interesting. So if if I was an employer or like a veterinary leader listening in now. And they really wanted to, you know, support their team and, you know, improve things in practise.
What would be the sort of tips you'd have for them? Yeah, there's so many things that leaders can do, and none of these things are really easy. So it's one of those things where we're in such a tough spot in VettMed right now because resources are low, right?
Everybody, but for the most part, is short on team members. Everyone is feeling stretched with high caseloads, so I know that it can be challenging and I know that there Research shows that it's really important that leaders do their best to, you know, offset some of these things. So it really comes down to a few variables that have been strongly associated with burnout.
One of those is workload. So making sure that there's sufficient team members to meet the workload. If there's not enough team members, the workload has to be adjusted.
Otherwise, you're just gonna run your team ragged. And they're gonna want to leave. Same goes for those resources.
It's not just about personnel. It's about making sure you have enough computers, workspaces, the printers are working, the Wi Fi is fast, you know, like the, the fluid pumps are all working properly. All the things that your team needs to do their job well and efficiently is also going to prevent burnout.
As leaders, skills like managing toxicity, holding people accountable, resolving conflict, that is really strongly represented in the literature as a means to prevent burnout. I know a lot of our leaders aren't comfortable with these things. A lot of our leaders are nurses and vets that have moved into those leadership roles, and they didn't get any leadership training formally, and it's important to recognise.
If I'm gonna be a leader and I'm gonna have a healthy workplace, these are skills I must cultivate. So that's really important. There's a lot of research too to show that team members really need some sort of sense of control over their work in order to prevent burnout.
Those who, especially those who work in ER and don't have a lot of control over their environments, this can be challenging, but as much control that you can give to your team members, you know, How many surgeries do they feel comfortable doing on their surgery morning or what do they want their appointment schedule length to be? You know, how many drop offs are they willing to see rather than just kind of piling it all on. Not that I'm suggesting if a person says, I only want to see 2 cases a day, that we should go along with that, but, you know, finding that happy medium or team members feel they have some bit of control, even if that's just over their schedule.
And then the last thing I'll say for leaders is reward and recognition are so important for mitigating burnout. Team members need to feel that their hard work is being acknowledged, that they are being rewarded for that. Whether that's with appropriate compensation, with benefits, with kudos that are in other ways, but I think one of the number one reasons in all industries why people leave their job is because they don't feel recognised for the work that they're doing.
And so we want to make sure that we're mitigating that as well. OK, brilliant. So I guess it's just a lot of open communication as well, isn't there right?
And just a culture where people feel like they can have those conversations with their, with their managers. 100%, absolutely. It is building that culture like you said, of that open communication, that psychological safety, you know, if something's not sitting well with me, I feel comfortable to go to my boss, go to my leader, go to my manager and let them know, you know, I, I don't agree with this, or I would like to suggest this change or this isn't working for me.
I need to set a boundary, whatever that might be. So it really is a bidirectional relationship. Yeah, absolutely.
OK, wonderful, . And just thinking about veterinary students or new graduates specifically, would you have any advice for them on how to avoid burnout as they kind of enter into the profession for the first time? Mhm.
I'm so glad you asked this question. So the really interesting information to come out of that Merck veterinary well-being research that was done has been done in the US every other year for the past, I don't know, at least 5 years now. It's been It really keeps demonstrating over and over that those individuals who engage in activities that are non-work related, hobbies, healthy coping strategies, that they have higher levels of well-being and lower levels of burnout.
So what I would counsel new grads on, or even ve, you know, veterinary students while you're in school is recognising the difference between a healthy and an unhealthy coping strategy, right? So when we think of unhealthy coping strategies, we think of, you know, heavy drinking. We think of numbing out, playing video games or scrolling through social media.
We think of, you know, binge watching Netflix, staying up late instead of going to bed early, you know, lots and lots of different things. Which can feel good in the moment, but then don't serve our health and well-being in the long term. So the flip side of that is healthy coping strategies.
You know, when things get tough, or even before they get tough, I'm gonna go to bed early. I'm gonna, you know, prioritise my sleep. I'm gonna fit in exercise.
I'm gonna spend lots of time with friends in real life, not engaging with people on social media. Unless it's being done actively, you know, active engagement. Just really recognising that having a life outside of the work that we do in vet school or in veterinary medicine and practise or wherever it is that a person works, is really, really foundational.
So start that soon. Don't feel that you're caught in a trap of studying and then You know, unhealthy coping strategies. You wanna make sure to create those habits early on, that you're intentionally thinking about how you cope with stress, and you're trying to do that as often as you can, not always, we're not perfect, but as often as we can in ways that are gonna serve us long term.
Yeah, OK, wonderful, thank you. And are there any resources that you'd like to sign people towards or any like support networks for people who are listening who might think, do you know what I'd love to learn more about this or you know, get some support. Yeah, you know, I think there's many great resources out there.
Like you said, I know there's more and more online programmes that people can take that give information and advice on mitigating burnout. I've certainly run some of my own programmes in the past. I really am a big believer in utilising mental health services.
You know, there's so much overlap between burnout and depression and anxiety and other mental health challenges. So, you know, Take advantage of employee assistance programmes, that life, you know, regional programmes, your employee benefits, and talk to a mental health professional. You don't have to be in a crisis to do that.
You don't have to be burnt out to do that. But I think, you know, finding someone you trust that you can talk to and just find productive ways to manage your stress and manage your emotions, I think is really, really important. And then I think coaches have Become a really important, helper as well.
You know, a little bit different than a mental health professional, more so coaching around that values congruence that I mentioned briefly earlier, or, you know, making sure this job is right for you. If there's something not right about the job, but you want to stay there coaching you to communicate boundaries or, you know, figure out what it is that you need to make it sustain. So I know that Vettago Diversify has a number of great coaches on their team.
I'd offer some coaching as well. So lots of resources. Certainly my website, revivingettMed.com would be another one.
I just encourage people to check it out and check it out now, you know, before you're in dire need of support, figure out, you know, what could be helpful for you, and then you know where to go when you think that you need it. Yeah. Brilliant, Marie, thank you so much.
That's great. And if people want to reach out to you directly, is your website the best way for them to do that, or what's. Yeah, my Marie Holloway.com.
You can email me at info@marie Holloway.com. I love connecting with people, so please do reach out and and find me that way.
Fantastic. Oh well, thank you so much Marie for joining us. It's been lovely to chat and you've given some really great insights there and some really good advice.
So thank you very much. Oh my pleasure Catherine, thanks again for having me. No problem.
See you soon.
