Toxic teams affect patients too: A veterinary behaviorists view

RazoomGame/Shutterstock.comThe personal damage team toxicity can cause is significant, but the suffering doesn't always begin and end with people. Although not officially part of the veterinary oath, “First, do no harm” is arguably as much of a guiding principle in veterinary practice as it is in human medicine. And because patient care can be inhibited by the side effects of team toxicosis, including disputes or lack of communication among team members, toxic environments cannot be ignored.

But don't take it from us. You see the effects yourselves. As noted in the 2017 dvm360 Toxic Teams Survey, 65% of you think a toxic environment you've worked in has contributed to less-than-top-notch clinical care. Some comments from a few of your colleagues on how patient care suffered when they were in a toxic environment:

“Patient was affected on some level at least daily. Not giving meds or doing treatments. Rudeness to staff and clients. Temper tantrums causing stress on everyone and that stress is sensed by the patients. Rough handling of animals.”

“Animals can sense tensions and become more fractious as a result. Technicians and doctors will cut corners or perform below standards when distracted by conflicts. Resentments between colleagues will cause them to focus more on their hostility towards each other and not on the patient's care.”

“When a nurse or doctor is frustrated and/or distracted by interpersonal conflicts, I have seen them approach patient care with much less patience and a heavier hand in restraint, which in turn causes stress to the animal, often leading to the animal becoming defensive/aggressive and causing harm to staff and to the animal.”

A behavioral perspective

The suffering of patients in toxic veterinary environments noted in the examples above are not isolated incidents, as is evident from our survey. Beyond missed dosages of vital treatments, several survey takers commented that animals can sense environmental distress and experience discomfort as a result.

To learn more about whether or not workplace tension can damage the animal psyche, we sought the counsel of a veterinary behaviorist, Dr. Lisa Radosta, the owner of Florida Veterinary Behavior Service in West Palm Beach, Florida. First, we asked how much pets pick up on people's attitudes or moods in general.

“I think that it is less than people think, frankly,” says Dr. Radosta. “In other words, if I am feeling sad, but hiding it, can my dog pick up on that? Will he become sad? Unlikely. Now, if I am acting sad by being mopey and lying around when I would usually be buzzing around the house, my dog can see that and may act differently.”

More outward manifestations of a bad mood are more readily felt by the animal. “Patients can pick up on the ambient sound level (yelling, slamming things down) and most certainly will be aware of changes in restraint due to lack of patience,” says Dr. Radosta. “Patients may exhibit signs such as barking more (more sound in the environment can stimulate them to bark), hiding more (especially true of cats) and increased heart rate and respiratory rates.”

The enduring harm

So once a pet experiences a toxic environment, is the damage done? Pretty much yes, says Dr. Radosta. “Unfortunately, the long-term effect may be that the patient develops a negative conditioned emotional response to the practice or a person in it,” she says. “This will require treatment. Just being gentle with the patient in the future may not be enough to change the patient's emotional state when he is in the hospital.”

The crucial take-home: If you sense a toxic environment in your clinic, don't ignore it-for the sake of yourself, your co-workers and your patients. Go to dvm360.com/toxicteams for advice on identifying a truly toxic environment and more.