Compassion Fatigue in Veterinary Medicine

Caring for animals if often well-regarded. However, caring for sick patients and dealing with distressed clients on a daily basis can come at a cost. Also known as secondary traumatic stress and vicarious traumatization, the cumulative stress and symptoms that results from providing these levels of care is known as “compassion fatigue” (DeNayer, 2014). Compassion fatigue is a condition involving a variety of physical and psychological symptoms that result from providing intense levels of care to sick or injured patients without the use of self-care or the presence of a proper support system for the provider.

This is a preventable condition that affects many veterinary professionals at great costs.

Employees in the veterinary medical field are exposed to unpleasant, stressful, and somber situations every day. Compassion fatigue is caused by lack of a support system and proper self-care when dealing with such circumstances. Working in the veterinary field, employees often work with the same patients from a young age to their last breaths.

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Repeated exposure to death and supporting clients’ emotions for extended amounts of time can be emotionally and mentally exhausting (Durrance, 2007). Recurring contact with dying animals can cause an employee to dread coming to work. Veterinary professionals can also become numb or indifferent to clients’ emotions after having to repeatedly become a support system for a patient’s owners. Supporting others’ emotions while forcing down your own can cause an employee to grow insensitive toward clients and their wishes over time. This can lead to a decreased work drive and poor work performance.

Additionally, veterinary workers often perform or assist with euthanizing animals. Euthanasia can “create a sense of failure or of having betrayed a contract of care with animals” (Hewson, 2014), and results in personal grief that is often left unexpressed. Furthermore, some hospitals and clinics allow for a “convenience euthanasia” to be performed on a healthy pet for the client’s own personal reasons. This can cause additional internal moral conflict in an employee who has chosen their profession in order to care for and benefit animals. After dealing with such a grim experience, most employees are expected to return immediately to other work. Often times employees move on to see the next patient without taking a break to process their own emotions or even to discuss the situation with a coworker. Also, many employees have not had training in how to deal with the emotional distress that comes with euthanizing animals or dealing with unhappy clients (Rank, Zaparanick, & Gentry, 2009). Many school programs lack training and education for these topics. If employees are already feeling discouraged and are losing sight of their job responsibilities and goals, lack of training can contribute to the development of ongoing problems for the individual, hospital, client, and the patient. Therefore, lack of a support system and the absence of the use of self-care techniques greatly contribute to the development of compassion fatigue in the workplace.

Compassion fatigue is caused by extended acts of both empathy and sympathy, which leads to a variety of physical and psychological symptoms for the provider. Common physical symptoms include gastric upset, inappetence, lethargy, and headaches (Hunt, 2017). Stress, guilt, and many other emotions that are often experienced by veterinary professionals can interrupt their daily lives outside of work. Some employees have reported experiencing trouble eating or even falling asleep at night. Psychological symptoms that are often described include anxiety, depression, frustration, numbness, shame, diminished morale, and feelings of dread or loss of hope (DeNayer, 2014). Experiencing one or multiple of these psychological symptoms can lead to isolation and even avoiding work. In extreme cases, veterinary workers have even left the career field and/or committed suicide. Collectively, symptoms can lead to poor work performance including clinical errors, documentation errors, absenteeism, being late to work, and client complaints (Hewson, 2014). Suffering from these symptoms is the result of a hard-working and dedicated employee who has forgotten or failed to put their own well-being first. The result of suffering from this condition is the loss of the very compassion which drove the provider to choose such a career field. The prevalence and signs of compassion fatigue should be discussed among professionals during staff meetings. It is vital for employees to be able to recognize the causes and symptoms of the condition in order to provide a proper support system and to incorporate proper self-care techniques for others and themselves.

Compassion fatigue is often confused with burnout. Although the two conditions are not the same, they are in fact related. Continuing to work while suffering from the effects of compassion fatigue, and without seeking support or experiencing change, can lead to the development of a condition known as “burnout.” While compassion fatigue is a form of emotional depletion, burnout is a form of general, overall exhaustion caused by the demands of work and day-to-day life. More specifically, burnout involves loss of drive and morale caused by being unable to achieve one’s goals (Hewson, 2014). Lack of resources and support are common causes of burnout in the workplace. Being unable to perform your job at your desired standard of care can quickly lead to increasing frustration and a sense of lack of control for the individual. Other effects of burnout include physical and mental symptoms such as the inability to concentrate or perform simple work tasks. This also leads to negative interactions with coworkers and clients within the workplace. Some individuals have reported experiencing changes in personal social behavior as well. Over time, depression and anxiety may develop, as well as negative coping strategies such as drinking, overeating, and the use of drugs. In some cases, suicidal thoughts and/or harmful actions may occur. In fact, professionals within the veterinary field are at a higher risk for suicide than those within the general public. One study shows that the average age of employees who leave the field is 30 years old, which is very young compared to other trades and professions. A large contributing influence towards this number is the lack of mental well-being among veterinary professionals (Hunt, 2017). These results stress the importance of proper training and support systems within the workplace. They also show the need for employees to apply proper self-care techniques on a regular basis. Both burnout and compassion fatigue involve the “failure to achieve the desired result, and both involve a feeling of running on empty” (Hewson, 2014). It is important for these conditions to be discussed so that employees are able to recognize signs and symptoms in themselves and amongst one another. Proper knowledge about the signs, symptoms, and prevalence of both of these conditions make preventing their development easier.

Although compassion fatigue affects many individuals in the veterinary field, multiple steps can be taken to reduce its prevalence. Unexpressed grief is one of the most common causes of compassion fatigue, and employees should take steps to address these emotions by confiding in family members or friends rather than pushing internal frustrations aside (Durrance, 2007). It is also a good idea to confide in coworkers outside of work, or when time allows. Peers and coworkers in your career field will be the most understanding of what you are experiencing and are sometimes more capable of providing support. Employees should recognize that the death of a patient not only affects the clients, but the hospital staff as well. Individuals should allow themselves to grieve when the time becomes fitting. It is also important to acknowledge and take care of your own needs while at work, which includes taking breaks, saying “no” as appropriate, and asking for help when needed (Hewson, 2014). As mentioned before, many employees do not allow themselves to take small breaks between patients when dealing with stressful cases. This can lead to a buildup of emotions and frustrations that influences an individual’s attitude during the next appointment or even for the rest of the work day. As a result of compassion fatigue, many employees lose passion and interest in their work. To fight this condition, employees should review both their personal and career goals (DeNayer, 2014). Veterinary professionals should also be firm and clear when expressing their needs to others. Experiencing the symptoms of compassion fatigue can quickly cause a veterinary worker to lose sight of the purpose of their work. Individuals should recognize this loss and take steps to identify and achieve their motivating factors and career goals. It is also a good idea to seek a professional outside support system if necessary. Another vital step in preventing compassion fatigue is to step out of the work role at the end of the day. Employees should clear their minds of thoughts and worries about work once they finish their shift each day. It is important to take time every day to perform personal rituals and recreational activities in order to clearly separate work and personal life.

Although workers in the veterinary field are often admired for providing for sick and injured animals, they often suffer both physically and psychologically due to a condition known as compassion fatigue. This condition results from providing empathy and sympathy for long periods of time without using self-care techniques or support systems. By educating employees about the importance of recognizing self-needs and by providing a professional support system, hospitals can reduce the prevalence of this dangerous condition, as well as burnout, among veterinary professionals. It is also important for individuals to recognize the symptoms and signs of compassion fatigue and to respond by seeking personal or outside professional support. Veterinary professionals can reduce the presence of ongoing symptoms by taking steps to maintain self-care. It is imperative for employees to clearly separate their work and personal lives. Workers should define their career goals and reward themselves for accomplishing them. The combined use of self-care and support systems can be incorporated into workers’ daily lives in order to deal with the stress and other underlying causes of compassion fatigue. Proper training and establishment of an appropriate support system within the workplace can be significant in preventing the occurrence of this dangerous condition. At the end of the day, it is most important for veterinary professionals to put themselves first in order to be able to continue the important work and to provide the substantial care for animals that they do each day.

References

1. DeNayer, S. (2014). Are You At Risk for Compassion Fatigue? Veterinary Team Brief, 21-23.
2. Durrance, D. (2007). Overcoming Compassion Fatigue. DVM: The Newsmagazine of Veterinary Medicine, 44-46.
3. Hewson, C. (2014). Giref for Pets - Part 2: Avoiding Compassion Fatigue. Veterinary Nursing Journal, 388-391.
4. Hunt, G. (2017). Understanding and overcoming the effects of compassion fatigue within the veterinary profession. Veterinary Nursing Journal, 141-143.
5. Rank, M., Zaparanick, T., & Gentry, J. E. (2009). Nonhuman-Animal Care Compassion Fatigue: Training as Treatment. Best Practice in Mental Health, 40-61.