Mental wellbeing

1. Mindfulness: Though we may not have full control over the demands put upon us, we can practice mindfulness.

• Mindfulness is a mental state where we focus our awareness and pay attention to ourselves in the present moment without judgement.
• It can help us identify where we may need to direct our self-care tools and increase acceptance of our present-moment reality.
• For many, mindfulness is a useful way to help to change the way they think and feel about our experiences – especially stressful ones.
• We can achieve mindfulness through the practice of meditation (see below for more detail and tips).

2. Boundaries: We can put in mental boundaries to allow us to switch off. These may include:

• Taking leave to disconnect from work, including sick leave.
  • It is helpful to build time into our diaries before we take planned leave to allow handover of cases, finish outstanding paperwork and make treatment plans for ongoing cases. Though this may feel aspirational it can allow us to mentally switch off from work when we are away and make the return to work easier.
  • Deciding as a team that is it a useful approach to build in time to allow for this by planning ahead, can help make this more possible.
• Putting our phones on slumber mode when we are away from work.
  • Silencing work group WhatsApp messages and work emails when we are not at work.
  • Have a personal phone and turn off your work phone when you are not on duty.

3. Stress management: To counter experiencing stress, we can either reduce the demands upon us or develop healthy coping strategies to manage them. See this article by Bartram and Gardner for a useful veterinary-specific overview of managing stress.

4. Support at work: foster a psychologically safe working environment where mistakes and cases that didn’t go as planned can be discussed. Employers play a role in providing mentally healthy working conditions.

We can achieve mindfulness through the practice of meditation. To get in the habit of incorporating this into your everyday life start with small expectations, aiming to be mindful daily but for only a few minutes and gradually increase it as you feel able to.

Remember meditating is not about stopping our brains having thoughts. That would be like asking our eyes to stop seeing, or our nose to stop smelling: out of our control. Instead it is about being aware of our thoughts and taking control of them in a non-judgemental way.

An analogy for being in a mindful state during meditation is a train station, where each of your thoughts is a train. Sometimes we get on the same train (or have the same thought) over and over again, but we already know where it will take us. So when we next find ourselves on this train (or having this thought) we don’t need to ride all the stops, instead we can bring ourselves back to the train station (present moment, or a mindful state) using mindfulness exercises.

Some people find it useful to join group sessions for more guidance and support with this. Visit the Mind website to find classes in your area or access an online course you can do at a time convenient to you.

The Traffic Light Stop:

• Stop what you are doing. Pause for a moment.
• Take a breath: Breathe, it’s easy, we do it all of the time, we just don’t think about it. Really notice how the breath feels entering your body and how it feels as you exhale.
• Concentrate only on your breath.
• Observe: Now you’ve had that pause and breathed a little, how do you feel? What’s going on for you? Just notice, observe it without judging.
• Proceed: Time to continue on your journey.

The One Minute Breath:

• This doesn’t have to be done sitting down in a quiet space. This could, for example, be whilst out on a walk or run.
• Set your stopwatch or sit in front of a clock and just breathe for one minute. Your aim is to focus on your breath for one whole minute.
• Notice how the breath feels as it enters the nostrils, how it feels cool as you inhale, how it’s a little warmer as you exhale.
• Getting distracted? That’s ok, it’s part of the process. What did you think about? Now, bring your thoughts back to the breath.

Mindful Eating:

• Get rid of distractions like the TV, newspaper, mobile phone, radio or talking and sit down to eat.
• Give your full attention to your food:
  • How does it smell?
  • What does it look like?
  • What are the textures like? Perhaps put it on your lips and hold it there for a few seconds.
  • Now put it in your mouth and chew it slowly thinking about the flavours and how it feels to swallow it.
• When your mind wanders, notice where it has gone and come back to the food.

Being mindful during work

Another way to make mindfulness achievable is to practice it whilst doing routine tasks. Here are two accounts of how mindfulness was incorporated into a routine task, the mindful consult and the mindful bitch spay. The technique used here can be applied to any routine task, such as brushing your teeth, folding the towels and bedding in the kennels, driving to our next appointment, mucking out a stable, giving a vaccination or cleaning out a cage.

from the Vetmindfully blog

The beginning of the day can be a time of great anxiety. The consultation slots are full and as you look through the diary you see clients and patients which gives you a feeling of dread. Your mind starts racing, writing and rewriting imaginary scenarios of how the consultation will go and you cannot concentrate on what you are doing at the time.

I am guessing that this is a familiar image to many readers, and it is an opportunity to practice mindfulness and get more out of your day.

Take a minute to look at what is happening here. You are looking at a daunting list of consultations and your mind is running away from you, creating thoughts of not being able to cope with the workload and creating anxiety about consultations that have not happened yet.

If you find yourself in this situation, take a couple of minutes to watch your breathing, concentrate on the movement of breath in and out and take the time to observe how this calms both the body and mind.

After two to three minutes, take in your first client, ignoring the rest of the list. You can only deal with one thing at a time so let yourself concentrate on the patient in front of you. Focus on listening to the client’s concerns, ask appropriate questions, listen carefully to the answers, focus on examining your patient from head to toe, don’t take any shortcuts, mentally note your observations, and if it helps, verbalise your findings – which will have the added benefit of letting your client know how thorough you are being. Stay focussed as you formulate your treatment plan.

Once the client has left the consulting room, take a moment to mentally review how the consultation went and how it has made you feel. Hopefully you will have a feeling of a job well done and if so allow yourself to acknowledge the positive feeling this brings. If you feel that the consultation could have gone better, recognise this too and make a note, preferably written, on how you think that you could have improved the consultation.

Repeat this process for each consultation and I am confident that you will get through your consultation list more efficiently, will have satisfied clients and a feeling of satisfaction of a job well done. If during the day you find your anxiety levels rising, take a short time out and go back to watching your breath for two to three minutes again and do not let yourself be distracted by the length of the list or any difficult consultations.

The benefits of a mindful approach to consultations will help to improve your clinical awareness and consultation skills, your clients will be grateful for how well you have listened to them and how caring you have been and you will find that the imagined “difficult” consultations went far better than any scenario your mind created.

from the Vetmindfully blog

For many years I would get extremely anxious when I knew that I had a bitch spay to perform, resulting in an enormous amount of stress which led to difficulty in carrying out the procedure. After being introduced to the technique of mindfulness I started to ask myself why I felt so anxious? So, each time I performed a bitch spay, I focussed my awareness on what I was doing, concentrating on each moment of the operation.
The anxiety came from past experience as a recent graduate, when my more experienced colleagues made a big fuss of bitch spays and all the possible complications. But, as I thought about it more, I realised that I had seldom had any serious problems whilst performing bitch spays, and any time that I or a colleague had, it was always corrected successfully.

The Thought Process:

So I started to focus on what the complications were. As you will be aware the most common problem is bleeding. But why does bleeding occur? It occurs because of inadequate ligation of the ovarian and uterine arteries. Why does inadequate ligation occur? It occurs because of poor exposure of the ovarian pedicles making visualisation of the ligature difficult and not ensuring that the cervix is exteriorised and a transfixion ligature is not used.
How are these problems avoided? They are avoided by being mindful and aware of the potential problems and by focussing on each step of the surgery.

Firstly, by making the initial incision in the correct place and of the correct size.

Secondly, ensuring that the ovaries are exteriorised sufficiently to triple clamp the pedicle. This means spending time on breaking the ovarian ligament, in some cases, and not being tempted to attempt ligation with insufficient exposure.

Thirdly, transfixing the cervical end of the uterine body.

The Practical Process:

I started to ensure that I focussed entirely on each step of the surgery, not being tempted to take short cuts. After each surgery I reviewed how the procedure had gone and how I felt before, during and after the operation.

Initially I still felt the anxiety that I had always felt before the surgery, however following my mindful approach, I did not have any issues, and procedure after procedure went well. I felt relief following each procedure, but more importantly I realised that this approach was allowing me to improve on my technique each time, and that the mindfulness aspect of the process was becoming second nature. I did not have to concentrate on being mindful, it just happened. After each successful operation I took a minute to experience the feeling of a job well done and held on to this feeling.

Gradually the anxiety has faded to a point where I do not experience it at all now. I know that I can perform bitch spays well, I know that by being focussed on each step I am minimising the chance of complications occurring and at the same time knowing that I can react to any unexpected occurrence and deal with it if one occurs.

The Long Term Benefits:

By using mindfulness techniques, I experience significantly less anxiety. I have ensured that I follow a sound surgical technique and have good outcomes on the procedures that I carry out with patients recovering quickly.