Dr. Wendy Hauser is the founder of Peak Veterinary Consulting. She writes extensively and speaks frequently about hospital culture, communications, leadership, client relations and operations. She is a member of the AVMA Veterinary Economic Strategy Committee.Read Articles Written by Wendy Hauser
It’s one of those days. The phones won’t stop ringing, patients keep arriving, and you haven’t completed a single medical record. Finally, one hour until closing, you’re looking forward to eating your long-overdue lunch, charting and going home. At that moment, the receptionist asks if you can squeeze in one of your favorite clients, who has a sick pet. Your technician agrees to stay and help you. Before you know it, another “favorite client and pet” must be seen. Even worse, the phone is ringing again. What do you do? The more interesting question is, “How did you get into this situation?” The simple answer is a lack of boundaries.
Many veterinarians and team members are willing workaholics. However, because they love what they do and feel a deep sense of purpose in their work, they are agreeable participants in a vicious cycle of overwork.
What are boundaries exactly, and more importantly, how can veterinary professionals set and maintain boundaries to stay in bounds?
Here’s what personal boundaries mean to three veterinary professionals:
- Erin Preston, CVPM, the owner and practice manager at Onion River Animal Hospital in Berlin, Vermont: “Setting limits to safeguard my own space.”
- Apryl Steele, DVM, CAWA, the president and CEO of Dumb Friends League in Denver: “Understanding the difference between what I can do and what I am willing to do. My personal boundaries vary between ethical boundaries I will not cross to boundaries I create, with varying levels of success, to ensure I show up as my best self.”
- Jennifer Denton, DVM, the senior regional medical director at Veterinary Emergency Group: “The limits or rules around relationships and how I want to be treated. There are physical, emotional and mental boundaries, and my limits for each will vary from situation to situation.”
As you see, all three women use boundaries to create healthier relationships. They understand that boundaries are a choice and a mechanism to help them be true to what’s essential in their lives and honor their self-imposed ethical, physical, emotional and mental limitations.
Dr. Denton said boundaries are hard to set and enforce in veterinary medicine for two reasons.
“One, veterinarians tend to be people-pleasers,” she said. “It is our nature to help others, so our instinctual response is to give in, to make the other person feel better even if it goes against our personal desires. Second, veterinarians, in general, tend to be conflict-avoidant. Maintaining boundaries means standing up for ourselves or engaging in conflict. Realizing that conflict isn’t necessarily bad helps with overcoming this.”
Dr. Steele said veterinary professionals are often pulled between work and life obligations.
“Boundaries are difficult because the work we do is so important and because we truly care about the animals and people we serve,” she said.
Compounding those emotions, Preston said, are the “sense of urgency and expectations in veterinary medicine to give an immediate response.”
Veterinary professionals are engaged in work they love and feel passionately about, creating meaning in their lives. Non-veterinary studies have found that 70% of employees believe their sense of purpose is defined mainly by work. I suspect that the 70% figure drastically underrepresents the veterinary workforce, based on workplace surveys I conducted as part of my consulting services and my experiences. Simply put, what we do is a huge part of who we are.
The cost of non-existent or poorly enforced personal boundaries is high in veterinary team members. Research into employees driven by purpose has identified heightened stress levels and lower scores for well-being, resilience and self-efficacy, all factors that can contribute to burnout.
Why Boundary Setting Is So Hard
A sense of personal responsibility impedes Dr. Steele’s ability to establish functional boundaries.
“There is so much that needs to be done to support animal welfare, and I tend to take on the big issues myself instead of sharing ideas and letting others run with them,” she said. “This leads to many very important issues being on my plate and a strong sense of responsibility to achieve a resolution to them. It is challenging to take time for myself when the repercussions of doing so seem extreme. I also have, until very recently, struggled with disconnecting when I am away from work.”
Dr. Denton’s challenges involved realizing what a personal boundary is and then deciding what hers are.
“We all have boundaries, but we don’t necessarily take the time to evaluate what they are,” she said. “We tend to try to create boundaries that control someone else’s actions. As an example, I might think, ‘I don’t want people to call me for help when I am off the clock.’ It seems simple, but it isn’t possible. People are absolutely going to call, as we can’t control others’ actions.”
Dr. Denton learned that she must reframe her boundaries to align with her needs. For example, recognizing her need for time off to recharge, she doesn’t answer after-hours phone calls from work.
The dual responsibilities of practice ownership and management created different barriers for Preston in that she brought work home, blurring the boundaries between her job and life. Another obstacle is her tendency to become “too emotionally involved with employees,” she said.
How to Set and Enforce Boundaries
Dr. Denton’s first step in setting functional boundaries was to “recognize what my boundaries are and then determine what the result will be if someone crosses one.”
Her response to stress, including broken boundaries, is often worsened when she feels a lack of control. She manages the issue by “taking dedicated time to think about situations that created frustration or anxiety for me.”
“Am I upset that this person asked for help, or am I upset that they asked for help at a time that I wasn’t available?” she said. “Is my boundary that I don’t want to be asked for help, or is the boundary that I don’t want to be asked for help at a specific time? Or maybe, is the boundary that I don’t want to be asked for help by this specific person or I don’t want to help in this specific situation?”
For Preston, setting effective boundaries requires self-regulation. “There are times when I need to reflect and neutralize my thoughts before reacting,” she said.
Boundaries work best for her when she sets clear expectations, knows her limitations and delegates more. For example, to overcome her challenge of taking work home, she consciously chooses to leave work at work and enforces it by “placing my cell phone on silent, and I don’t answer calls, emails or text messages.”
Dr. Steele has found that disconnecting from work physically and electronically is an effective way to set boundaries.
“I have made it clear to my team that if they need me when I am on vacation or off, they must call or text me and not expect me to check my email frequently,” she said. “Every time we check our email, we see something that needs attention.”
She learned that undisturbed time is critical to help her recharge and that failure to disconnect is a vicious cycle.
“Also, I have learned to occasionally say, ‘No!’”
How Leaders Can Help
Veterinary hospital leaders impact personal boundaries directly and indirectly. A recent study reported that almost two-thirds of the respondents would like hospital leadership to help them set better boundaries.
Dr. Denton assists her team members with functional boundaries by having each person clarify their actual limits. She respects their boundaries and accepts the responses when she crosses one.
“Most importantly, maintaining the personal boundaries I have set for myself helps my team feel confident and encouraged to do the same for themselves,” she said.
I asked veterinary teams what they would change about their workplace. Their answers included:
- Their work-life balance.
- Their schedules, so that everyone can take a lunch break and spend more time with their family.
- “Don’t expect me to check emails and respond to texts on my time off.”
One of Preston’s successful tactics for helping her team set effective personal boundaries is creating a company email address separate from the personal one and encouraging everyone to check work email only during work hours.
Boundaries are tricky. They require self-awareness, self-reflection and determination. Dr. Denton’s self-awareness included an understanding that “I am the one responsible for maintaining my boundaries.”
“Setting personal boundaries means setting an expectation for myself of how I will respond when a boundary is crossed,” she said. “This puts the power and responsibility of maintaining my boundaries back onto me. If I allow someone to cross a boundary, that is on me, not them.”
Dr. Steele said not having one’s boundaries respected is easy to resent.
“We must value ourselves enough to understand the boundaries we need to do our best and sustainable work, and we must proactively work with our colleagues to figure out how our boundaries fit in with others’ needs.”
DON’T LET STRESS BE A BOUNDARY BREAKER
To establish effective boundaries, you need to understand and manage the causes of your stress. Try this four-step process:
- List the stressors in each of the four domains of your life: work, family/home, community and self. These represent barriers to setting boundaries.
- For each domain, make two circles. Title the first circle “Things I can’t control” and the second “Things I can control.” Then, put the stressors from step one into the corresponding circles.
- Put an “X” over the “can’t control” circle to represent areas where large amounts of negative energy are expended. To lessen the stress you feel in these areas, figure out how to move your attitude toward acceptance.
- In the “can control” circle, choose one item and identify a single action you can take to create a positive change in it.
Now, repeat the activity when you or others don’t respect your boundaries. This will teach you to manage your stress and set enforceable limits.
Here are examples for the work domain.
WHAT I CAN’T CONTROL
- When clients are angry.
- When an emergency disrupts my entire day.
- My coworkers’ moods.
- When a client can’t afford recommended care.
Outcome: I will let these stressors go.
WHAT I CAN CONTROL
- How I communicate with clients.
- My mood and reactions.
- How I treat coworkers.
- How I complete my medical records.
Outcome: I will seek ways to change my attitude toward these stressors.
Taking positive action on one of them — how I communicate with clients — I will:
- Ask at least three open-ended questions during appointments.
- Pause after a client speaks, at least twice.
- Use two empathetic statements.
- Ask my exam room assistant to measure my efforts.