Lauren S. Grider, DVM, CCFP
When we last saw Katie,* a young veterinarian whose demanding job was significantly interfering with her life satisfaction, she had decided to improve her physical and mental wellness by adding her favorite hobby back into her routine. She used the S.M.A.R.T. Goals paradigm to create a realistic initial goal of running with a friend for thirty minutes, two evenings per week. To meet this goal, Katie needs to leave work on time – or at least within thirty minutes of the end of her shift. But how can she establish this important workplace boundary when the precedent of overwork has already been set?
Establishing Healthy Workplace Boundaries
Boundaries are the limits we set for the purpose of protecting our own wellbeing.1 Boundaries are not necessarily “rules.” Rather, they represent a collection of best practices. Boundaries are the mental, emotional, and physical guidelines we set for ourselves and others, both in the workplace and in our personal lives.1 They serve to protect us, to safeguard our physical and emotional energy, and to define both our own responsibilities and the responsibilities of others.1 Understanding which boundaries to set and under what circumstances to set them is critical.
Cultivating Awareness of Self and Others
While setting and maintaining appropriate boundaries may come naturally to some, many of us struggle when faced with the task of establishing limits at work. Knowing which boundaries to set in the workplace requires both self-awareness and an understanding of the factors that control workplace dynamics.1 Self-awareness is important because feelings of discomfort, resentment, or guilt associated with work situations are prime indicators that a boundary should be set.1 Tools such as the Boundaries Signal Scale, in which feelings of discomfort are ranked from 1 (low) to 10 (high), can be used to practice identifying and rating these uncomfortable emotions.1,2
Both self-awareness and situational awareness are helpful in identifying the source of the pressure to push past limits and make exceptions to boundaries. Sometimes external pressures are the culprit. Common external forces might include overbooked appointment schedules, mountains of unfinished notes, or dozens of callback requests. Bosses, managers, and peers may make persuasive arguments about staying late or coming in early to accommodate more patients and generate more revenue. Clients may have unrealistic expectations of a clinician’s availability. However, sometimes the problem starts closer to home. Idealistic and perfectionistic veterinarians may place unreasonable demands on themselves. Positive feedback regarding performance in extraordinary circumstances may be misinterpreted as a request to continue an unsustainable level of production. Practitioners might hold themselves to unrealistic standards of efficiency and overestimate the amount of work that is possible with the hospital’s staffing levels and resources. In short, it’s possible that some of the pressure to perform is self-imposed. So, when boundary signals like resentment and guilt begin to fire, it’s worth reflecting on recent workplace interactions to determine how much of the pressure is external vs. internal.
There’s No Time Like the Present
Ideally, workplace boundaries and expectations would be created and communicated at the outset of a working relationship. However, many employees and employers avoid these conversations, either because they experience anxiety about setting boundaries or because they assume that their preferences are universally understood. Leaving boundaries unstated creates room for the development of misunderstandings and dysfunctional working relationships.
Boundaries, Workplace Engagement, and Burnout
Veterinary clinic owners and managers have a responsibility to help their employees set and maintain healthy workplace boundaries. Boundary violations in the workplace are associated with an increased risk of burnout.1 Individuals in management positions have the power and influence to create workplace policies that encourage career satisfaction and foster engagement. Highly engaged individuals are energetic and optimistic, accomplish goals, experience community connection, and find meaning in their work.3,4 Workplaces with highly engaged employees tend to provide a sustainable workload, offer choice of control, recognize and reward achievement, and treat employees with fairness and respect.3,4 Disengaged individuals experience exhaustion and negativity, and they may be ineffective at work, feel disconnected, and perceive that the rewards gained from work are insufficient.3,4 Workplaces are in danger of experiencing employee disengagement when the workload is unsustainable and when employees perceive a lack of control, absence of fairness, and value conflicts.3,4 Workers experiencing burnout are 2.6 times more likely to leave their current employer, 63% more likely to take a sick day, and 23% more likely to visit the emergency room.5
Employers and managers must understand that a power imbalance often exists between themselves and their employees, and this may make boundary setting difficult or intimidating for workers.1 Exploitation of this power imbalance – whether purposeful or not – is harmful to workers’ wellbeing and damaging to a business’ bottom line in the long run.
Putting the Pieces Together
In Katie’s case, staying at work more than thirty minutes after the end of her scheduled shift creates a moderate to high level of resentment, which is an indication that a boundary should be set in this area. Expectations surrounding overtime were not discussed when Katie started this job, but it’s not too late for her to set this important boundary! She will need to meet with her boss and explain that, while she was amenable to pitching in and working longer hours in the short-term when the hospital was understaffed, she is not prepared to do so long-term. She will then need to communicate her specific boundary in this area, and she will need to continue to engage in open communication with management regarding expectations moving forward. Naturally, some negotiation and flexibility may be needed. In the medical field, it is unrealistic to expect to never have an emergency that causes delays or late nights. However, it is completely reasonable for Katie to expect to complete her shift at or near the scheduled time most days.
After reflecting on workplace interactions over the past year, Katie acknowledges that some of the pressure to stay late comes from her own anxiety about leaving non-urgent tasks incomplete. She also recalls that it is her boss’ habit to leave work at a reasonable hour most nights of the week. Katie has a fair to good relationship with her boss, and though she has never directly addressed a boundary at work before, her boss seems to have an even temperament and has responded favorably to requests from the staff in the past. Finally, Katie realizes that management has never directly told her that staying late is expected or required. However, her boss occasionally makes negative comments about the work ethic of young veterinarians in general, and Katie recognizes that she has been hesitant to address her unsatisfactory work schedule for this reason.
Ultimately, Katie discussed the need to set this important work boundary with her therapist, who helped her practice what she wanted to say to her boss. They paid particular attention to managing tone and delivery until Katie could consistently convey the message in a calm, assertive manner. The therapist also addressed Katie’s anxiety about the situation and her fears that establishing this boundary would anger her boss or create a confrontation. Katie was able to see that management’s reaction to her boundary would provide very important insight into the clinic’s values and culture. This would, in turn, allow her to decide whether she wants to remain in her current position or search for another job. A positive reaction would increase her level of workplace confidence and satisfaction, whereas a negative reaction would be a sign that the job is a poor fit for her long-term.
In the end, Katie had a productive conversation with her boss about her concerns, and she decided to stay in her current role. After a few tweaks to the daily schedule and some changes in callback procedures, Katie soon found herself leaving on time most days of the week, and she is now happily working as an Associate in the same clinic.
This is the final part of a multi-part series on compassion fatigue in veterinary medicine. View the previous part here. The next article will focus on emotional and spiritual wellness.
*Name changed to protect anonymity.
References:
1. Gionta, D. & Sweigart, L. (2022). How healthy boundaries build trust in the workplace. Strategy + Business, 107(1).
2. Gionta, D. A. & Guerra, D. (2015). From Stressed to Centered: A Practical Guide to a Healthier and Happier You. Sea Hill Press, Inc.
3. Fonken, L. (2019). A view from the edge: Understanding the challenges to veterinary wellbeing. 2019 Pacific Veterinary Conference Proceedings.
4. Halifax, J. (2018). Standing at the edge: Finding freedom where fear and courage meet. Flatiron Books.
5. Wigert, B. & Agrawal, S. (2018). Employee Burnout, Part 1: The 5 Main Causes. Gallup. https://www.gallup.com/workplace/237059/employee-burnout-part-main-causes.aspx
