Practicing psychological safety

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Philip Richmond, DVM, CAPP, CPHSA, CCFP, founder and CEO of Flourishing Phoenix Veterinary Consultants, LLC, shared an anecdote about the importance of psychological safety during his lecture on the topic at the Fetch dvm360 conference in Atlantic City, New Jersey. He described a situation that occurred early in his career in which an assistant saw a need to reassess a patient he had treated on a busy workday. After listening to the team member and re-examining the patient, he concluded that his colleague made the right call in pulling him aside to discuss the case.¹

“Had I not listened to what that assistant said to me…that dog wouldn't be here. [The patient] would have died because I was absolutely treating that dog wrong. And the thing is, in that moment, a lot of things [had to have] happened over the previous 2 to 3 years where a certified veterinary assistant could say to me, ‘you're making a mistake and I need you to stop what you're doing.’ It was a collaborative thing,” said Richmond.

The case was an example of how a team member was empowered by feeling psychologically safe at work in the clinic. “There's a lot of confusion around that term because it's kind of wonky. It puts 2 words together that we kind of sort of know what they mean individually. And you slam them together and it's like, ‘oh, you're just talking about, like, safe spaces and being nice.’ And that is not what psychological safety is,” said Richmond.

So, what is psychological safety? According to Richmond, psychological safety is an environment where there is a feeling that it is safe to take interpersonal risks with the team. “I feel like I can make a mistake and not be raked over the coals. I feel like I can challenge myself and step into something that I would normally do, and I'll be supported and lifted up. It does not mean that I'm not held accountable for what I do,” he continued.

For more on psychological safety, check out this article on psychological safety in the veterinary clinic

During the lecture, Richmond provided a framework for creating psychological safety in the workplace that included generosity, honesty, conquering incivility, listening appreciatively, and growing from failure. He noted that some staff behaviors that can lead to a negative environment, which can also affect patient care. These include judgmental attributes such as assuming the worst, biting your tongue (and not speaking up when needed), complaining, and shaming or throwing blame. According to Richmond, that negativity can become an “emotional contagion.”

“Our evolutionary adaptation is to match the emotion of others, and so that spreads that that emotion. So that absolutely happens. If we can make the charitable assumption, it does negate [that emotion],” said Richmond. Actions of curiosity such as slowing down and asking questions, lifting up other team members, assuming others are capable, and providing supporting accountability, are helpful.

“It doesn't mean that we just let people totally off the hook, but we try to get curious about why there's a challenge with that person doing a task. That's what the support of accountability means; assuming we share a responsibility, we create a safe space of each of us to be accountable,” Richmond continued.

According to research published in Vet Record, veterinarians exposed to uncivil behavior from clients also have their psychological safety affected.² “If we go into a room, and a client is mildly discouraging, if you will, and I come out of that room and go into treatment and go, ‘Oh, that Mrs Smith. She's a piece of work. She's this, she's that'….All that negativity, it's what's called emotional contagion,” said Richmond.

These types of negative interactions can affect mental health and lead to stress and withdrawal from clients. However, emotional support from colleagues and constructive responses to incidents can help mitigate negative interactions with clients.²

“We have to have emotional intelligence around how we deliver a message. That makes an impact, it's not just the message itself, it's [also] how we deliver it,” said Richmond.

References

1. Richmond P. Psychological safety. Presented at: Fetch dvm360 conference; October 14-16, 2024. Atlantic City, NJ.
2. Irwin A, Hall D, Ellis H. Ruminating on rudeness: exploring veterinarians’ experiences of client incivility. Vet Record. November 9, 2021. Accessed October 14, 2024. https://doi.org/10.1002/vetr.1078