If you’re anything like me then you have had interactions with co-workers that were less than desirable. I think you know what I’m talking about. The eye rolls…the rude comments…the standoffish behaviour. These can all create a lot of discomfort and tension in the workplace.

Veterinary medicine attracts a lot of different personalities and it simply isn’t realistic to think that we will jive with all of them. However, when behaviours impacts the client experience, patient care, or our own mental health and wellbeing, then intervention is required.

Let me share an example from a locum shift at a small animal specialty hospital some time ago. I was covering as an emergency and critical care specialist and at this hospital we (pre-COVID) participate in hospital-wide cage-side rounds. It gives the specialists, emergency veterinarians, interns, and other team members the chance to discuss in-hospital cases and seek advice.

During the rounds, I presented one of my cases that would likely require surgery. It was an adult large breed dog with spontaneous pneumothorax (accumulation of air around the lungs) and, while the treatment remains controversial, very often surgical exploration of the chest cavity is required to find and fix the source of the air leak.

Now given the controversial nature of managing these cases, I knew that this situation would require some discussion, consideration, and negotiation with the surgeon. I was fully prepared to share ideas and experiences, discuss scheduling, and negotiate the terms of the case transfer, assuming the owners consented to move forward.

What I wasn’t prepared for was the harsh and unfriendly response characterized by crossed arms, eye-rolling, and the simple response “that case doesn’t need surgery”. Open-ended requests to elaborate such as “tell me more about how you manage these cases?” or “what has your experience been in the past?” were met with defensiveness and push-back.

Not the sort of thoughtful and collegial discussion that I was hoping for and not comfortable or appropriate either in front of technicians, interns, and other specialists. Reluctance to answer questions, dismissive or abrasive body language and tone, as well as unprofessional conduct are considered toxic behaviours that must be addressed if they are expected to improve.

So, the question remains, how do you deal with situations when co-workers exhibit behaviour such as this?

And, my answer is, to use the DISH script.

This acronym has been helpful for me in breaking down what I might say to a person who is behaving inappropriately. And here’s how I would use it in this situation:

D: Describe the behaviour using objective explanations of what you heard and saw first-hand. Time this discussion as soon as possible (once you have your emotions in check) and in a private location away from other team members.

“When we were in rounds this morning and I asked your opinion about the pneumothorax case, you rolled your eyes and refused to answer my questions.”

I: Identify how you felt using “I” statements. Avoid “you” statements, which can cause others to become defensive.

“I was surprised and felt embarrassed to be addressed this way in front of the entire team. I was also nervous because I didn’t feel that we came to a consensus on the best way to handle this case.”

S: Suggest how you want the situation to be handled next time. Focus on what is right, not who is right.

“I would like for us to be able to share our thoughts and experiences freely and with open body language and a kind tone of voice. While I don’t always expect us to agree, I do still want us to come to a decision that we are both comfortable with.”

H: Highlight the benefits of changing the behaviour. Frame the problem in terms of what is best for the clients, patients, and team.

“If we can remain thoughtful and considerate during these exchanges in rounds, it will keep the lines of communication open, thereby improving patient and client care. We both want what is best for our patients and keeping our relationship collegial will allow us to do that.”

Very often and depending on the person’s response, I will also try to include an empathy statement. For example, “I know it’s hard when we don’t see eye to eye on a case and it feels uncomfortable to have that conversation in front of others.” After which you can circle back to your intention for the discussion. “And I suspect that if we keep practising this, it will get easier and easier.”   

Now, you might not always get the response you want during conversations like this, and that’s okay too. Try not to take the person’s reaction personally and know that you are doing the right thing by addressing the conflict directly and trying to negotiate a more appropriate exchange. I know it’s not easy, but I promise it’s worth it.

And remember, it is important to let others know how we want to be treated. This is an example of a personal boundary and is one of the key foundations to resolving a toxic culture.

So, when you feel stuck, use the DISH script to get yourself back on track and help plan what you want to say.