Hospital Detox, Part 1: The Sensory Environment

Like many of us in the veterinary industry (I’d even venture to say, most of us), I have worked in toxic environments. Admittedly though, those experiences are not limited to vet med.

The word “toxic” is, like most other emotionally and culturally charged terms, overused and misused to the point that it often loses its original meaning and power. Worse, this overuse and misuse allows many organizations to retreat to platitudes and posturing, claiming to care about the well-being of its workforce. With this, all they succeed in doing is failing to make the uncomfortable but necessary changes. When I think about toxicity, I substitute the phrase Bad For You. Our bodies usually (if not always accurately) involuntarily reject things it thinks are bad for us. So why don’t we listen a little more closely to this instinct as we look at our toxic work surroundings?

By focusing on the undeniable effects of the sensory exposure of working in the hospital, we can truly understand the impact of decisions made by leaders who create those hospital environments. Their decisions determine whether the environment ends up being supportive or toxic, safe or hazardous – and whether workers’ senses are spared and enhanced, or are under constant assault.

Breaking Down Toxicity

We’ve all heard of a person (usually through gossip) having a “toxic attitude.” In some anecdotal and qualitative studies (see further reading, below), we find lists of traits associated with such an attitude; things like needing to be the “ringer” on the team, so-called “mood polluters,” and the usual labels of bossy, dominant, reclusive, and so on. Rarely is the question asked, “where does a toxic attitude come from?” We get nearer to the answers by removing the person from the center of the issue and observing what is actually going on around us.

I believe the most toxic attitude is one that accepts the crippling impact of daily exposure to the average veterinary hospital work environment. The impact I’m talking about could be chronic stress from exposure to poisons, radiation, microbes, teeth, claws, hooves; upset clients, each other, and sharp pointy things (imagine the Venn diagram). It is an attitude that refuses to acknowledge and reflect upon what is actually going on, and lacks the courage to make the changes that make real differences in our workers’ quality of life.

The Seven Senses

There are seven senses that need equal attention if a healthy veterinary work environment is to be possible. In addition to sight, hearing, taste, smell, and touch, we must also consider proprioception (awareness of the position and movement of the body) and time. These two senses affect our interpretation of the situation in terms of physical discomfort and feeling rushed or interrupted. Here are some questions to ask as you assess the quality of your workplace’s sensory environment:

• Visual: What’s the ratio between natural and artificial light and darkness? Do the colors attract or repel the gaze? Can you see outside? Can you see the sky?
• Auditory: What is the average decibel level in reception, treatment rooms, exam rooms, and the OR? For how much of the time does the level exceed healthy limits? (Do I need to remind anyone that our patients have ears many times more sensitive than ours?
• Olfactory: The sense most closely linked with emotion. Bad smells make us less tolerant, less empathetic, and more close-minded.
• Gustatory: How often are we required to refuse our bodies nourishment while on shift? Is the issue addressed with vending machines and pizza?
• Tactile: Do I have the proper tools and equipment to keep my hands safe?
• Proprioceptive: How much physical contortion and effort is required to do basic tasks?
• Temporal: Do I find myself multitasking, rapidly switching tasks, or giving energy to interruptions? Do I need to squeeze in basic essential work tasks like documentation, cleaning and restocking, phone calls? Worst of all, do I need to squeeze in eating and bathroom breaks?

Practical Suggestions

To improve our profession’s quality of life, we need strong, durable, and basic agreed-upon assumptions. The critical importance of human comfort should be one of them. The more our workplace confirms and reminds us that we are a part of nature, the better we will feel and the better our work will become.

• Prioritize natural light and darkness over artificial. Provide high-quality, wearable personal lighting as basic equipment.
• Post decibel meters readily visible to all workers.
• Provide high-quality, fitted hearing protection as basic equipment.
• Provide high-quality, wearable personal communication devices as basic equipment.
• Eliminate ringing phones.
• Introduce diffusers, dehumidifiers, flowers, or anything to banish the stench…
• Provide a permanent catered snack station (think craft services in the entertainment industry) with a rotating selection of fresh (not processed) calorie-dense items constantly available. Keep your staff well fed.
• Examine ergonomics down to the millimeter. Eliminate the need for unhealthy movement or effort. Invest in assistive devices.
• Carve out “sacrosanct” time as a policy, to eat together, for documentation, for movement, and to re-set the treatment area, OR, workspaces, etc. (think mise-en-place in the restaurant industry). Multitasking is pathogenic.

Further Reading:

Epp T. & Waldner C. (2012). Occupational health hazards in veterinary medicine: Physical, psychological, and chemical hazards. Canadian veterinary journal 53, 151-157.

Fowler H., Holzbauer S., Smith K. & Scheftel, J. (2012). Survey of occupational hazards in Minnesota veterinary practices. JAVMA 248(2) 207-218.

Moore, I., Coe, J. B., Adams, C. L., & Sargeant, J. M. (2015). Exploring the impact of toxic attitudes and a toxic environment on the veterinary healthcare team. Frontiers in veterinary science ‌58(2) 1-9.

Szabo, R., Dumitras, A., Diana-Maria Mircea, Doroftei, D., Sestras, P., Boscaiu, M., Brzuszek, R. F., & Sestras, A. F. (2023). Touch, feel, heal. The use of hospital green spaces and landscape as sensory-therapeutic gardens: a case study in a university clinic. Frontiers in Psychology, 14.