Burnout: Causes and Solutions—Conclusion
Burnout: Ideals in the Face of Trauma
When it’s time to look at the “emotional” aspects of the work we do in veterinary medicine, there aren’t a lot of resources available.
For the most part, the focus has been on the technical skills and medical knowledge that are necessary to help patients and their families.
We’re just beginning to realize the emotional toll of this work on us as individuals, and collectively as practice teams. There is one place we can look for resources, and that is our counterpart, “human” healthcare. They know all about occupational stress, burnout, and compassion fatigue. I imagine like us in veterinary medicine, people in human healthcare had to learn the hard way that these topics must be addressed. In fact, these emotional aspects play a role in our ability to communicate with clients and patients, determine the proper medical course of action, and work together as a team in delivering our service. There is a really good book from human healthcare that I have found particularly helpful, Overcoming Secondary Stress in Medical and Nursing Practice by Robert. J. Wicks. Here is one jewel from this resource regarding self awareness:
Self-awareness is especially important for persons working in high-stress settings that require great intelligence and high standards. In such professions, “perfectionism and its associated demon, fear of failure” can be quite dangerous to the types of persons attracted to health care…It is believed that they should always be at the peak of technical proficiency, emotionally available, straightforward, clear, and compassionate.
~ Robert J. Wicks, Overcoming Secondary Stress in Medical and Nursing Practice
Wow, that is a large tall order to fill, don’t you think? We can all relate to the fact that we work in high-stress settings, regardless of the type of practice or position we fill. We certainly agree that this work requires great intelligence and high standards, both for ourselves and collectively as a team. I’ve know more than a few veterinary professionals that admit they are perfectionists, and this is a difficult trait to balance with providing efficient service. But here’s the kicker, that last sentence is full of nearly contradictory adjectives that we are expected to deliver on a daily basis! Let’s take a closer look at this part, because it mirrors the seventh and final factor in stress and burnout within our profession.
Cause #7: Idealistic people, exposed to traumatic material
We’ve admitted we are idealistic people; we want to save animals, as many as possible, and we have high ideals for what we can contribute and what we expect of those around us. We certainly are exposed to traumatic material, in various ways. One note about the type of “trauma” you may be exposed to on a regular basis. If you work in an emergency practice, you quite often see the sudden trauma of illness or injury, where both the patient and client need immediate attention and comfort. If your job exists within a specialty or referral practice, then you are often seeing the “worse of the worse”, those cases that go beyond the capability of the general practitioner. So you have families that are awaiting bad news, and cases that are often quite critical or advanced. Does this mean that only professionals in those practices experience trauma? Absolutely not! For one thing, every general practice sees an emergency from time to time, some more often than others. And in fact if that practice team sees trauma LESS often, then they are likely MORE affected by it when it does happen! Plus, we can’t forget that even what we consider mundane or routine visits can put us face to face with a client who is feeling a variety of negative emotions which require our response: the new pet owner who is scared that they don’t know how to raise their pet to be healthy; the pet owner of an elderly animal, who is already worrying about the short years to come; the animals who are just beginning to show symptoms of an illness, and the beginning of that worry process in their owners. So we must look at “trauma” in a comprehensive fashion, to appreciate the trauma we are all exposed to within our practices.
So while we idealistic people are exposed to traumatic material, we go back to the quote above to note that our duty, our responsibility, is to provide veterinary care that is the peak of technical proficiency, emotionally available, straightforward, clear, and compassionate. Veterinary medicine is changing every day, so we are expected to stay up with the advances and be the most proficient “technicians” we can be, whether we are indeed a technician, or a veterinarian, assistant, or front office professional; “technician” here just relates to the actual tasks or duties we perform. We know our clients want us to be emotionally available; they want to know we care, about them AND their pet. We must demonstrate our compassion, while maintaining enough subjectivity to get through the day. Truly, if we responded in a completely emotionally available way to every case that comes through the door, we would be off in a corner crying by lunchtime!
So there is a delicate balance to be maintained between protecting ourselves emotionally, and responded in an emotional way to our clients. Straightforward and clear don’t seem that difficult, until you pair them with the requirement to BE emotionally available AND compassionate. If I have to deliver bad news to client, I have to tell it to them straight, but in a way that respects the client’s emotional response to that bad news. If we are straightforward without the compassion, then we are heartless. If we are compassionate without being clear, then we have been misleading.
This ultimately becomes a much more difficult set of parameters when they are clumped together like this, yet we know this to be true of our professional responsibility. Just as with human healthcare where this quote originated, we know as patients ourselves that we expect and at times demand this set of traits in our own medical caregivers. Unfortunately we don’t always receive the information we get as patients in a compassionate way, or feel our physician or nurse is emotionally available, but we also know that when we DO receive this combination of qualities, we feel much more comfortable with following the recommendations given to us. The same is true of our clients, who of course are expected to be an extension of our care when treating their beloved pet at home.
It is no wonder that by the end of the day, we are exhausted! Look at what we must do all day long, besides the manual tasks we perform and information we process! Also we must realize, that no other profession creates the mixture of events that take place in veterinary medicine; there is no other profession that may require a compassionate response in an exam room where a longtime patient is being euthanized in from of a family you care for, then having to turn around and enter the next exam room with a smile to greet a new client with a puppy in tow. What is asked of us by the work we do is staggering, yet we’ve taken on this responsibility so that we can be at the end of the journey with one family, and the beginning of the journey with another family. We are incredible people, doing incredible work!
Resource: Compassion Fatigue in the Animal-Care Community by Figley & Roop, (Humane Association 2006)