When we throw the word culture into a conversation about work-based improvements, there are often a mix of reactions. To the word itself. The concept. The frustration at a term so general being used. What even is culture?

To me culture is in the small things. The feel of an environment. The ethos a business is built on. The beliefs and the way people treat each other. The laughter in a prep room, the care of a stray patient and the way that the brilliant receptionist always arrives with a hug at the right time. The knowledge that there is real importance in the small things. Those tiny adjustments creating impact.

Which brings me to impact and chronic illness.

Many people, like myself, battle with chronic health conditions on a daily basis. Some of those are visible, others almost impossible to recognise to the untrained eye, to those who don’t have to think about it and that’s ok. I would like to make a point of saying here, that allies have enabled me to continue in my career on days when I was ready to throw in the towel ( if I’d had the energy). To the people who have stood with me on days and attempted to problem solve to make things easier, the impact you have had is not measurable with mere words.

The BVNA chronic illness campaign has started some much-needed conversations surrounding this very subject which got me thinking about the small changes practices may consider that others have found helpful. These don’t necessarily involve big financial investments but they do encourage people to appreciate that small adjustments matter.

  1. Split lunches

The idea of split lunches may seem really small but the effects can be huge.  While some staff enjoy an hour lunchbreak – I know it doesn’t always happen but that’s a whole other story, imagine on days every muscle hurts, how the safety net of knowing you’ll split that into rescue chunks. Say 2 x 15 mins and half an hour lunch? It’s also far easier to make sure these actually happen and are protected.

2. Kneepads, floor cushions

A quick search found examples of these beauties for under £10. Cleanable, disinfectable and lightweight. They have a very small footprint allowing for easy storage and could, without doubt, be kept in every consult room and ward. Something so cheap and simple helping to save knees and provide comfort to staff that are often crawling around on the floor.

3. Adjusted start times

Sometimes as simple as starting half an hour later. Does everyone REALLY need to be in at 8am? Would it actually be better to stagger start times anyway? For some people with chronic health issues and fatigue, the mornings can be incredibly hard. On a bad day , a shower could take 45 minutes, making an 8am start even more daunting. Knowing you will finish half hour later may be preferred by some to knowing you’ll have to be up 2 hours earlier just to battle traffic.

4. Ergonomic computer desks

So, these may be one of the pricier adjustments, but they help everyone, not just those with mobility and fatigue challenges. These brilliant additions allow for height adjustments to keep computer screens at the correct height for sight and prevent strain injuries and fatigue.

5. Compression socks

Ok, I hear you – they aren’t going to win any awards for looking good, but don’t underestimate the power of compression socks. Benefits include reducing vascular hypertension, support of veins, improve lymphatic drainage, and help to ease varicose vein pain. For less than a £10 investment, that’s pretty darn good.

6. Uniform that can be put on with ease

On bad days, I struggle to move my shoulders comfortably enough to put a tunic on and off. They are also, generally less breathable. Neither of these are desirable . Scrub tops can be far more tolerable to some for these reasons but it’s worth discussing uniform with each staff member as slight tweaks can really help with comfort.

7. Theatre fatigue measures (mats, footwear, chairs)

Never underestimate the fatigue that can be felt in theatre: long surgeries standing, leaning or sitting in the same position can be incredibly painful, exacerbating challenges further. There are some brilliant anti-fatigue mats for operating personnel to stand on, which I’ve found an excellent aid for those needing to stand. Let’s also talk about chairs. Why on earth do we remember to get a potential ‘work-experience-fainter’ a stool, but not the permanent staff, who will undoubtedly be in theatre much longer? A stool or comfortable and adjustable seat is a must.

8. Stools and chairs (literally everywhere please)

Seating is so important that I added it again. Why are we so bad at providing seats? Something so simple and low cost. Instrument prep, theatre, dispensary, prep, wards, consult rooms – all could benefit from a place to take the weight off. This will help to conserve energy and simply allow some rest while we work and fulfil our role. We need stools and chairs.

9. Subsidised physio/massage

Please note the word subsidised. I’m not expecting practices to start employing a masseur, but what if we considered trying to protect and retain the veterinary nurses we have? If there was a small incentive in place, perhaps staff may find self-care more affordable. One practice in Yorkshire books a physio therapist once a month, allowing staff to book a slot and care for their bodies. The schedule is managed accordingly, rather than rejigging the schedule at short notice. The practice have found that this lessens time off attributed to staff carrying injuries and in pain due to continuing to work while their body isn’t at its best. Not only is being in pain not ok but the way it makes people feel hugely impacts practice culture adversely. This adjustment has proven to be a huge asset.

10. A safe space

Lastly, but by no means least. Never underestimate the power of a safe space. An area for anyone in the vet team to be able to sit, rest, gather thoughts and recalibrate. This space should be free of pet carers and patients, comfortable and with privacy. It’s important that it’s an area not used for meetings, clinical issues or any formal chats, and separate to a lunch space. This could be as simple as a bench outside the practice with some privacy. An unused office, break room, or unused accommodation. Sometimes just knowing there’s somewhere to go, when the world feels heavy, is safety enough.

When we begin to consider the possibilities of small adaptations, we start imagining how we can build better work-based culture. How we can build places where staff may want to stay and feel supported.

Small adjustments create better culture – Article by Lacey Pitcher RVN