Turning challenges into opportunities

Mindful May Webinar Q&A with Dr Sarah Hoggan

Dr Sarah Hoggan, DVM is the Medical Director of VCA California Veterinary Specialists in Murrieta. She oversees the daily operations of the critical care and emergency services departments. With over 18 years of veterinary experience, Dr Hoggan continues to be a fierce driver for wellbeing in the veterinary industry. She is also well known in the industry for her passionate TEDx talk on The emotional costs of euthanasia.

As part of our 2021 Mindful May series, Dr Hoggan spoke about Turning challenges into opportunities. Here’s a snippet of the Audience Q&A. 

What does wellness look like in Emergency Medicine?

The challenge with the ER is that good news does not come to see you. You don't get to have the nice respites in the day like a wellness puppy or kitten exam. What's coming through your door consistently, is somebody’s worst day. So it’s challenging to look for the good and keep the team focused when trauma after trauma turns up on your doorstep.

Bring it up with your team, that even if the owners elected to make the hard decision to say goodbye to their puppy that’s been underwater for 3 minutes, you can still acknowledge great teamwork and that you’ve given the owner the opportunity to make an informed decision to say goodbye.

Hold each other up, celebrate even the small victories, and remind each other of the good you are doing, every single day that you come to work. That's how you have wellness in an emergency-focused veterinary field; take every little victory.

What are the most successful approaches to your experience implementing wellness and wellness initiatives into a 24-hour operation?

Truthfully, I think the best thing I've done for wellness has to do with food. One time, I went to the grocery store and bought 25 boxes of sugar cereal, put out the milk and bowls for everybody and said ‘Remember how fun it was when we were kids and we would get a box of sugar cereal because we didn't usually get it? Well, now you're adults so you've earned it!”

Another time, I got loaves of bread, a variety of jams, honey and food industry-sized tubs of Nutella, set up a toast bar and said, “This is a toast to you!”. So I combine praise from a verbal standpoint along with food reward and then share pictures on our social media and share with the world about what a great team we have. I've also gone to Starbucks before and ordered 50 drinks and we bring that in on a gurney.

"Would you like to live in a world where giant humanoids devour humans or would you rather live in a world where you can ride a unicorn up to a bunny and swim in the rainbow?"

Sarah Hoggan

DVM, Medical Director, VCA California Veterinary Specialists, Murrieta

How can you turn around negativity on the floor, be negative talk about clients, colleagues or ourselves?

This comes down to the culture of your hospital. How I would change that is I would start with a meeting of the entire hospital. First, I would play a two-minute snippet of something from anime that is horribly violent, graphic and upsetting. Then right after, play something that's much more wonderful like bunnies and unicorns and rainbows. Follow up by asking your team which one felt better and which one got your adrenaline up, would you like to live in a world where giant humanoids devour humans or would you rather live in a world where you can ride a unicorn up to a bunny and swim in the rainbow? Have the team recognize that one does feel better and say ‘let's make that our culture now’ and that you make the area you work and live.

If you do hear someone being negative, then I think it's valid to take that person aside privately and tell them that might be how you used to do things but you are changing the culture. I'd like everyone to be more thoughtful about how you refer to clients, your team and patients. Because if I was a client and I heard you describing me that way, I personally would be horrified. I don't think your goal is to make anyone feel terrible so let's work towards making everyone feel better on the team.

How do you deal with toxic bosses and co-workers, including microaggressions and passive-aggressive bullying?

Unfortunately, that does exist. I've had experiences in my career, you know previously where I didn’t get to have the team that I love. The first thing to recognize is that you can't control anybody else's behavior; what you can do is control your own.

Do your best to find Techs, Doctors and Assistants that are your confidence and strengths and are supportive of each other. Make yourselves as strong as you can together. And if that isn't enough, find somewhere you feel comfortable enough to feel emotionally safe where you can be vulnerable, let your guard down and cry in front of them if you need to.

The best thing to do is to look inside and recognize your own value. Recognize that you deserve to work somewhere where you are loved, valued and appreciated. There are thousands of wonderful hospitals around the world where you will be appreciated, recognized and treated the way that people should be treated.

Don't worry if you don’t find a place right away, it may take some time but when you do find somewhere that feels good, you'll know. It'll be so beneficial to you in the long run.

How do I stay calm when I’m angry with a co-worker? How do I not snap?

First of all, recognize that anger is a valid emotion. You’re allowed to be angry, but you may need to take a step back from the situation and do your best to calm yourself. Ask yourself what you’re angry about, was it being spoken down to in front of other colleagues or clients, or was it because you were treated in a disrespectful way?

Once you have identified the specific thing and are authentically calm, then you can talk to that person. People can't modify behavior they don't know about. They might think that they were doing something helpful to you and came from a place of helping. Be specific when telling them what you were upset about, and listen to their response.

Communication is key, so let them know your goal is mutual understanding, behavior modification and that the situation doesn't happen again.

"Remember the magnificent job we did on the Great Dane with Pheochromocytoma? As a team, we kept his heart beating for 45 minutes, so that owner could leave work and say goodbye while his heart was still beating. I’m honored and proud to be a part of that process.”

Sarah Hoggan

DVM, Medical Director, VCA California Veterinary Specialists, Murrieta

How can I support my teammates without neglecting my own self-care?

With Covid, this has become difficult because one of the things that my teammates and I would consistently do is plan mini vacations. I’m blessed to live in Temecula where we have 25 wineries within a 25-mile span and it was very easy to schedule outings to have some fun and decompress.

Now, as we can't meet socially, I try to send out consistent email blasts and basically talk to them straight from the heart. I would share and tell them, “Boy, this last week was really, really hard. BUT remember the magnificent job we did on the Great Dane with Pheochromocytoma, we kept him alive for 45 minutes, with a hole in his venae cavae big enough that the surgeon could put two fingers in it. As a team, we kept his heart beating for 45 minutes, so that owner could leave work and say goodbye while his heart was still beating. I’m honored and proud to be a part of that process where we were able to give that person closure.”

If somebody's having a harder time, I do my best to set aside time for them, promise to listen without judgment and if there's something I can do to help, I will do my best to help. If there's something I can't do to help, then I will do my best to find someone who can help. I let them know that we can work on this together, and remind them they are not alone in a team that supports each other.

How do you set boundaries? How do you say ‘no’?

I am absolutely the first person to own that I have a horrible Wonder Woman complex and have extended myself on more than one occasion. What I do now is to take a look at my own life and decide what is most pressing, basically like a life triage. You are 100% valid in setting a boundary and saying “I can't do that”, but you don’t have to be crisp about it. For example, if someone wants you to work an extra Saturday, reply back by saying “I appreciate your call and am really flattered that you thought of me. I want to help the team but I have to do something for me because that's going to make me a lot better for my shift on Sunday.” You are allowed to say no in kind and thoughtful way.

You're also allowed to have conflict with people in kind and thoughtful ways. Unfortunately, that's not one of the things that are taught in schools, especially in veterinary school. It's alright to say no.

In what ways can we best support the mental health of our teams, doing what we're calling the new normal in terms of Covid-19?

At our hospital, we converted an exam room into a relaxation room with a massage chair. We provide coffee, hot chocolate and a variety of teas as well as a little refrigerator with sodas and treats.

Staff can freely go in at any time, there’s even a Do Not Disturb sign if someone is wanting alone time to recharge. There’s also a Lending Library in our break room with some good books or fluffy magazines.

You have to speak to your team to find out what would work best for them. Whether it be through one-on-ones or an ideas forum via email. We try to make it feel as comfortable and normal, in times that aren't normal. When you lose so many parameters of ‘normal’, you rely on the things that can be consistent. Snicker bars always taste good, a fresh edition of People magazine is great mental novocaine and quiet time on the massage chair always feels good.

Veterinary Hospital Relaxation Room

May 26, 2021