Compassion Fatigue: How Do You Deal?

As veterinary professionals, we experience the entire range of human emotion—often in a single day or hour. There are high fives after a sick pet pulls through a difficult procedure and moments of sorrow after a favorite patient passes away. Our careers are a series of peaks and valleys, highs and lows, a rollercoaster ride of successes and failures. We thrive on a mixture of messy emergencies, life-affirming miracles, and daily surprises that range from the sublime (an especially adorable puppy on a wellness visit) to the horrific (an abuse case). Everything that walks, hops, or flies through the clinic doors is our responsibility—a heavy burden to shoulder. After euthanizing an elderly woman’s dog recently, a pet that had been her companion for years, the woman looked at me through tear-filled eyes and asked, “How do you do this every day?”

Her question still haunts me—how do I do this every day? I am naturally a sympathetic person. I find it easy to empathize with people and their situations, good or bad. This has its advantages as I’m able to more rapidly connect with my clients and relay that I genuinely care about their pet, their situation, and the outcome. I grieve when they grieve and I celebrate when they celebrate. The disadvantage is that it sometimes makes it difficult for me to start with an emotionally clean slate at the next appointment or emergency.

I recently had an emergency case where the patient was doing poorly. Although I recommended euthanasia, the owner refused and shortly after our conversation the patient arrested. The owner was emotionally distraught and hysterical, but finally agreed to stop CPR and let him go. I was extremely upset over the outcome as this was a young puppy and his situation had taken an unexpected turn for the worse leading to his death. At that moment, I needed to take a moment to gather myself and calm down in a quiet place so that I could regain my composure to tackle the next case.

It was not to be. Less than 5 minutes after the puppy’s death, a vomiting pet with a very concerned owner came in. I had to suppress the emotions I was still feeling over the loss of the puppy and walk into another exam room. I had to paste on a confident smile, give the owner a firm handshake, and be present enough to provide knowledgeable and informative answers. I was able to stay composed, discharge the client, and finish the paperwork. But I barely made it to my car before I broke down into tears.

For whatever reason, I had become intensely emotionally invested in this young puppy’s case and I found it very difficult to let his passing go. I felt powerless with this pet and his condition—there was nothing more that could have been done. I knew this intellectually, but emotionally I was searching for one more thing I could have done that might have saved his life. I never should have allowed myself to become so emotionally invested in this case. If it had been at the beginning of the day—the story would have been much different. I don’t think I could have kept my composure in the hospital or treated the rest of the patients that came in afterward.

Although this is the first time I allowed myself to become this emotionally invested in a case, the question remains the same. How do I do this every day—and how do you do this every day? As a relatively new veterinarian I am still developing my level of professional detachment. My goal is not to become so detached that I am complacent and lose my passion for veterinary medicine and the pets I care for. My goal is to learn to develop a balance in which I maintain my compassion and passion for this career but also develop the skills necessary to save myself emotionally from burnout.

It is a commonly known fact that veterinarians are prone to burnout and compassion fatigue. As a result, it is important that we maintain a balance between our work and personal lives. This will help ensure that we find ways to release the stressors we experience at work in a healthy way. Research in this area of veterinary medicine has indicated that there are some steps we can take to help with compassion fatigue. ^1,2

• Be aware compassion fatigue is a possibility in this profession.
• Balance work and personal life: Do not give clientele our home phone number, do not go into the office on days off, respect family time and do not stay over at work.
• Take time for yourself: Eat right and exercise, relax or mediate, soak in a bath or get out in nature, go out and have fun!
• Maintain close relationship with family members: Find someone you can talk to about your feelings, and also talk about other issues non-work related.
• Maintain a healthy work environment: If possible allow yourself short breaks in the day, maintain humor.

I am still working on developing this balance for myself, on how to be present for the clients and yet not take that emotion home with me. I also am still working on how best to release the emotions I do take home. In time I have confidence that I will develop this balance but right now some days are certainly harder than others. How do you handle all of these emotions?

1. Cohen, Susan. Compassion Fatigue and the Veterinary Health Team. Vet. Clin. of North Am. Small Anim Pract. 2007;37(1):123-34.
2. Mitchener, Kathy, Ogilvie, Gregory. Understanding Compassion Fatigue Keys for the Caring Veterinary Healthcare Team. J Am Anim Hosp Assoc. 2002 Jul-Aug; 38(4):307-10.