Overwhelmed communication

When the usually even-tempered Dr. Morales throws her purse at the wall when she returns from lunch, her employer, Dr. Rowdewald, chooses to keep quiet. It is obvious that the outing with her old friend had not been the enjoyable experience his associate had anticipated. However, although Dr. Rowdewald does care about his associate’s welfare, he has no desire to become involved in his employees’ private lives. He considers that none of his business. Two past experiences with other distressed employees early in his career that did not go well changed his mind about interfering.

In one case, his offer of help following an associate’s emotional outburst for reasons unknown so embarrassed the already overwhelmed employee that it undermined her ability to work comfortably in his presence. Ultimately, she left the practice.

“She was a skilled practitioner and the clients, animals, and staff loved her,” added Dr. Rowdewald. “Had I stayed out of her affairs, I’m sure she’d still be working here.”

Dr. Rowdewald’s second experience left him feeling so embarrassed, he feared he would be forced to leave an area he loved just to get away from a staff member. In this situation, the distraught employee did not recognize Dr. Rowdewald’s concern as that of an employer who perceived himself a source of practice-related advice. Instead, he interpreted Dr. Rowdewald’s neutral “What may I do to help” to mean the practice owner wanted to be his best friend and confidant.

“I quickly discovered this employee’s distress resulted from a break-up with his partner. He told me way too much about that so fast I couldn’t get a word in edgewise,” recalled the practice owner. “As soon as a he stopped to take a breath, I confessed my complete lack of expertise in such matters and suggested he and his partner see a couple’s therapist.”

In this case, the employee took the practice-owner’s advice. However, the young man felt sufficiently embarrassed by the highly personal details he had shared with his employer that he, too, soon left the practice.

Consequently, and as much as Dr. Rowdewald considers himself a caring person, the unanticipated negative consequences of these two interventions caused him to change his approach. Regardless of what caused Dr. Morales to throw her purse at the wall, he now believes that this is something that she should discuss with the person who caused her anger. Barring that, she should discuss it with a close friend or counselor in whom she can confide her personal problems.

When Dr. Rowdewald mentions the incident to his hospital administrator though, she disagrees. She believes that there is no one-size-fits-all approach to these situations. Whatever so upset Dr. Morales during her lunch with her friend almost certainly would have affected her work when she returned. The administrator also adds that several other staff members and a client had mentioned that Dr. Morales seemed troubled lately. Although not fully convinced himself, the practice owner recognizes the validity of this input and arranges a meeting with his associate.

From the beginning it is apparent that neither Dr. Morales nor Dr. Rowdewald feels comfortable in the other’s presence. Both are friendly, but more reserved people who do not like to meddle in others’ private affairs. However, it also is apparent to Dr. Rowdewald that, as both the practice owner and more experienced practitioner, it is his responsibility to initiate the dialog.

“You seemed very upset when you returned from lunch yesterday,” he begins somewhat tentatively. “Normally you’re so upbeat, I wondered if there was anything I could do to help. I know the practice has been busy and that not all the clients and animals are as cooperative as they could be. But I don’t want to pry into your personal life either.”

He stops talking because he cannot think of anything else to say. There follows one of those communications black holes dreaded by practice owners and employees alike. Fortunately, neither veterinarian feels obligated to say something just to fill the void. After a period of silence that seems much longer than it actually is, Dr. Morales speaks.

First, she thanks Dr. Rowdewald for his concern. Next, she apologizes if her intermittent moodiness has undermined the quality of work. When he assures her that such is not the case, she continues.

“Sometimes I feel overwhelmed by others’ expectations,” she says. “I expected a fun lunch with a childhood friend who’s now a practicing therapist. Instead, she lectured me about how I should be observing my clients for early signs of spousal or child abuse. She said I was ideally placed to do this because people often confide in their veterinarians.

“I understand it’s my duty as a concerned citizen. But lately it seems like every time I turn around, there’s also another veterinary article telling me about something else I should be doing to provide the highest standard of health and behavioral care for my patients. There also are more articles or people telling me what I need to do to take care of my own physical and mental health needs,” she adds. “I feel guilty enough that I don’t have the wherewithal to do a fraction of what others apparently believe I need to do to meet the basic needs of my own patients and myself. I don’t see how I could possibly properly monitor clients and their kids for early signs of physical abuse, too.”

Dr. Morales then admits that she felt so overwhelmed — and betrayed — by her friend after their lunch that she decided to throw her purse to clear her head. When Dr. Rowdewald asked if it helped, she smiles and tells him it did, although not as much as trail-running or even cleaning her home — anything completely unrelated to veterinary medicine — for a few hours. However, she also admits that it took her months to learn to enjoy even those activities without guilt.

When she asks her employer how he deals with similar circumstances, he first congratulates her for learning a vital lesson at a much younger age than he did: the importance of taking — and enjoying — time away from work without guilt.

“We can’t give our patients, clients, or work the attention they deserve if we’re angry, frustrated, or exhausted. As far as requests from people like your friend go,” Dr. Rowdewald continues, “it takes time, energy, and skill to collect a history, conduct a thorough physical, and formulate and implement a viable diagnostic and treatment plan for an animal during a routine office visit. But you may do all this so smoothly your friend doesn’t realize how much concentration this requires. Or how little time that leaves to scrutinize clients for evidence of problems outside your areas of expertise.”

Dr. Rowdewald also notes that most practitioners naturally would contact the appropriate human medical professionals if they noticed obvious signs of human abuse or other problems. However, they also realize that they lack sufficient knowledge and skill to evaluate a person for less obvious signs such as those his associate’s mental health provider/friend wanted her to detect. Additionally, doing so would divert veterinarians from their obligation to ensure the best care for their patients.

The circumstances that overwhelmed Dr. Rowdenwald’s 3 employees were quite different, but they also all shared 3 things in common. When someone made or wanted to make what they considered unreasonable demands on them, they initially hoped the problem would resolve itself. When it did not and became worse instead, they became angry and frustrated. And when those negative emotions spilled over into the workplace, the practice owner addressed them with more or less success.

All the overwhelmed employees in these examples also suffered from the same communications problem — they were hesitant to discuss the cause of those overwhelming negative emotions with the perceived source of them. Instead, they took these negative emotions to work where they had a negative impact on others.

Third and as Dr. Rowdewald discovered, people overwhelmed by frustration and anger may misinterpret the intention of those who offer to help. Instead of being grateful, some may be offended or embarrassed by these offers. Others may perceive such offers as signaling the source’s desire to establish a long-term, close friendship instead of providing the short-term support intended.

To avoid similar problems in the future, Dr. Rowdewald enlisted his staff ’s input to address his and their respective obligations when overwhelming events occurred outside the practice. He stressed that he had no desire to interfere with their private lives. The staff agreed that quality communication with the perceived source of the problem should be their first step. The office manager provided a list of qualified counselors to help those who wanted additional support. Ultimately, this and other relevant information was added to a new mental health section in the employee’s handbook. By doing so, the practice owner did more than provide useful information for overwhelmed employees: He also signaled that he considered these problems legitimate and worthy of attention.