How small changes can save veterinary careers

After a wide-ranging veterinary career in the UK, RVN Kelly now works in the Channel Islands. She shares how small but thoughtful workplace adjustments - such as flexible duties and seating options - alongside open communication and a supportive team have empowered her to continue her career despite the challenges of living with endometriosis.

My journey with endometriosis has been a lot of trial and error. My understanding came mostly from self-guided research as I wasn’t provided with healthcare resources or support paths prior to or after diagnosis. 
 
Before I continue, I think it's important to provide a brief overview of endometriosis for context.  

What is endometriosis?

Endometriosis is a disease in which cells which appear similar to those from the uterus are found elsewhere in the body. They create inflammation, pain and adhesions and are found in every organ. It affects one in ten people assigned female at birth (1).  

Common symptoms

Symptoms vary widely depending on the depth and location of the endometriomas. They may include include nerve or muscular pain, heavy menstruation, pain during bladder or bowel movements or sexual intercourse, bloating, fatigue and mental health challenges. (1).

Spoonies and the Spoon Theory

The term "spoonies" is an affectionate term to describe people who experience a depletion of daily energy due to chronic illnesses or fatigue that significantly impacts their energy levels.

For example, a healthy person might start the day with 20 spoons of energy, and everyday tasks such as taking a shower, making breakfast, driving to work and making a phone call might each take a single spoon.

However, someone with a condition like endometriosis may wake up already tired, with only five spoons of energy available. Simple tasks such as showering are exhausting, and it may take three spoons just to stand upright for periods of time.  

Common treatments 

The cause of endometriosis is unknown, which is why there is no cure. It can be managed through hormone therapies which aim to reduce the symptoms, including the pill, coil, progestogens, Gonadotropin Releasing Hormone (GnRH) analogues and surgeries. Pain relief can also be administered in a variety of ways, including heat, analgesic medications, physiotherapy, pain modification drugs, TENS machines and alternative therapies (1). 

How it started 

When I suspected I had endometriosis but had not yet been diagnosed, my colleagues understood my condition and advocated for my health. Despite being a student nurse at the time, they enabled me to take time out of work to go to A&E and recover from surgery appropriately. I had already noticed that extended periods of physical activity would worsen my symptoms or prolong flare-ups. 

The importance of open communication 

With management 

After receiving diagnosis with surgery, I had regular meetings with my manager. These meetings prompted official performance and health reviews, and also allowed us to pre-empt triggers where possible. For example, lifting heavy animals alone or standing for over two hours without a break would cause me severe pain later - sometimes resulting in sickness absences - so having help from colleagues with these tasks increased my overall productivity. 
 
The meetings also enabled me to update my line manager on disease progression, new medications and any side-effects. 

Team discussions helped me educate colleagues on the effects of
both my condition and its treatments.

With the wider team

My meetings with my manager led to team discussions, helping me to educate my colleagues on the effects of both my condition and its treatments. For example, at one point I was receiving injections to induce the medical menopause and quickly discovered how unpleasant hot flushes can be. I chose to broach the taboo regarding my own hygiene concerns with the team, to ensure they felt comfortable talking about my supplies of spare uniform, my horde of deodorant and my occasional need to run either to the air-conditioning unit or the toilet. 

This meant the entire team could understand my needs, ensuring patient welfare was never compromised. I had colleagues available to back me up during anaesthetic monitoring, and I was spared a summer of feeling anxious about body odour.

Removing the taboo 

Creating a psychologically safe environment where taboos were removed resulted in colleagues being open when their own health waxed or waned. We became more open to supporting each other and sharing tips, tricks - or just sympathy and cake as appropriate. This level of camaraderie acted as a great check-in for the mental health struggles that often come with chronic conditions, and helped us all - despite the additional pressure and stress of the COVID pandemic on a small team.   

Finding balance 

After I qualified as an RVN, I moved to an emergency and critical care hospital where I thoroughly relished the professional challenge. However, I soon found that my body was unable to cope with the 13-hour night shifts and permanent understaffing. I was able to have ample drink and toilet breaks, which are vital for my wellbeing. I was also able to choose which area of the hospital I worked in: surgery nursing allowed me to remain seated briefly during anaesthetics, as did lab and admin work, while ward nursing and inpatient care did not. 
 
This alteration of duties was dependent on workload but was often for a half or full shift. At the time, I was unable to permanently alter my role, reduce shift length or utilise split shifts due to company needs and the working patterns of a large but understaffed team. 

I took a chance on a referral clinic role, which saved my career. 

As my health continued to decline and my treatment was delayed indefinitely, I considered leaving the industry. I was unable to see how I could ever be a valuable member of the workforce when my condition meant I was unable to keep pace with colleagues.  
 
I took a chance on a referral clinic role, which saved my career. 
 
I gained a more predictable daily routine, with seating for anaesthetic monitoring, consulting nurse duties and admin roles providing ample rest. Appropriate staffing levels meant I had support with moving large patients, and the flexibility of a close-knit team helped me feel useful and valued again. 

What changed? 

The clinic was airy and air-conditioned. This helped me deal with the menopausal side-effects of medication. The less aggressive lighting also reduced fatigue and headaches. Height-adjustable seating and desks for consultations reduced my pain and inflammation, while the rural environment meant lunch breaks were restful, helping to assist with good mental health practice. The large clinic size, CPD days, lunches that accommodated my dietary requirements, and diverse team-building activities made a huge difference to inclusivity and my mental health.  

What now?

I accidentally stumbled across what I consider my unicorn charity clinic:

• I am able to work shorter days, so I run out of 'spoons' less often and my fatigue is less pronounced. 
• I work in a small team who are a great source of compassion and empathy. 
• I feel no embarrassment in bringing my heat pad, TENS machine, herbal pain patches or balms into the workplace with me. 
• I have management who appreciates and advocates for me. 
• I was able to order a larger uniform that helped make me feel less restricted on days where my bloating is severe. 
• I can sit down during consultations and surgeries. 

I have learnt that if I conserve my energy on some activities, such as not standing for too long, I can accrue it for the moments where expenditure is unavoidable. Then, after work, I can recover some of my spent energy with a sea-swim to fuel my endorphins.  

Key takeaways

The biggest physical adjustment has been sitting during large stretches of the day, which reduces my energy output and delays the onset of fatigue. However, the ability to discuss with a manager and team how my condition affects me, and to still be treated like a valuable and appreciated team member, has undoubtedly kept me in this career.

With so many leaving the veterinary industry due to the daily pressures we face, those who have overcome challenges related to their own poor health bring a resilience and empathy that should encourage any clinic to increase their retention and value their skills, experience and commitment.
 
 Reference 
1: www.endometriosis-uk.org  
 

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