Align-ju HEALTH MATTERS

Why run Schwartz Rounds ?

The nature of veterinary work , especially in highpressure environments such as an emergency and critical-care setting , means teams often deal with the unexpected , which can create stress . Williams and Kemp ² detail sources of stress , which fall into three broad groups :

• The nature of the work done

• The culture in which staff work and the way employers govern , lead and manage services

• Practitioners ' professional training and development , their personal circumstances and their relationships outside work .

Schwartz Rounds are known to affect the culture of an organisation and could therefore help to negate some of the cultural stress and stress associated with the type of work conducted by individuals .

Williams and Kemp ² also go on to say that primary stressors stem from tasks or events employees face at work and can accumulate over time , such as challenging cases , mistakes and complaints . Secondary stressors are circumstantial : events or policies that affect the conditions in which they work or live . These include decisions employees feel are morally or professionally unfair . An example of this is cognitive dissonance , when one ’ s actions are at odds with one ’ s beliefs . This can manifest itself in anxiety , stress , embarrassment , sadness , shame or regret . It may affect how individuals view themselves and affect self-esteem , resulting in longer-term poor mental health . ³ Morally challenging situations require resilience , which can be supported by social support and social connectedness . ² There is a wealth of information about the importance of supporting and developing individual resilience . Coupled with striving to assist individuals ’ resilience , organisations that create conditions and time for social connectedness are better able to support their teams . Schwartz Rounds aim to add value in providing contact and connectedness and so help resilience . There is limited time in a busy veterinary environment and it is difficult to manage workloads that can rarely be planned in advance . Ringfencing time for group reflection therefore enhances social connection and ensures that team members have opportunity to prioritise this .

Veterinary professionals are at risk of stress ( both primary and secondary ) and often have exacting standards – set by themselves and their clients . Working in a high-pressure environment requiring emotional labour , which is the pretence of , or suppression of , feelings used to sustain an outward appearance that helps others to feel safe and cared for , ⁴ can lead to compassion fatigue and burnout . Enabling clients and patients to feel contained is essential in veterinary medicine , but the cost of emotional labour is high . This is especially so when team members are unable to switch off or process the emotional difficulties experienced during a shift , a working week or even over an entire career .

Without time for reflection , team members at all levels can become estranged or alienated from the aspect of self used to perform the role , in this case the emotions , causing compassion fatigue . Schwartz Rounds can help to mitigate this by allowing time and space for veterinary teams to unpick , experience and discuss the emotional response to the work they do .

Compassion fatigue and burnout overlap somewhat ( Table 1 ). Compassion fatigue is characterised by physical , emotional and spiritual exhaustion . ⁵ It is caused by exposure to someone else ' s trauma or suffering and can occur from one case or can be cumulative over time . Compassion fatigue causes clinicians , who are required to be empathetic , to keep giving themselves fully to their patients , overusing their skills of compassion . The ability to feel and care for others is eroded , resulting in a downward spiral in which it becomes increasingly difficult to preserve

Insomnia Physical and mental exhaustion Fatigue

Isolation from others

Volume 37 ( 5 ) • November 2022

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