VETGirl just posted a podcast episode this week interviewing a clinical social worker, Jeannine Moga. It's definitely worth a listen as it will give a few tips on how to take care of yourself.
Jeannine Moga mentioned that we need to tend to our Physical Health first. Hydration! Grab a fancy water bottle and fill it with ice first thing, then keep topping up with water as you go. I use the Klean Kanteen with the straw, just grab and sip.
I think a lot of people know that they need to breathe through stressful situations. You can try Box Breathing (this is something that I also found on the AbilitiCBT app - which fortunately my workplace covered the cost of this) or breathing 4 seconds in, then 6 seconds out - a longer out breath than in breath. Don't forget to pause for a few seconds between.
I'm also really grateful that several of our 'famous' veterinarians are speaking about their own mental health struggles. Once you are aware that you are suffering, it is easier to find help. In my first blog post, I mentioned that I got diagnosed with anxiety and depression and started on Zoloft. I had no idea that I had been suffering this way for years until I started the medication and realized that - this is what I should feel like. It gave me a whole new perspective of what life is like without feeling anxious and depressed all of the time. I just never thought I was depressed because I have never had thoughts of suicide. That was my naïve thinking, or perhaps because suicide is the worst symptom you can have with your mental health condition, that mine is not justified, as others have it worse than I do.
I’ve been going through the Podcast episodes by Dr. Dave Nichol, ‘Blunt Dissection’ and there are a lot of episodes that include destigmatizing mental health illnesses in our profession.
Most veterinarians get anxious over something, but it’s how we cope, or the lack of the ability to cope, that determines our ability to function.
I was exhausted, irritable, and on my days off from work I spent a lot of time laying around. I started to feel indifferent to the things that used to give me pleasure. I started to not feel compassion or passion while at work, and the stress bled into my home life. My husband felt the brunt of my low energy and intolerance, because being empathetic and compassionate at work was exhausting, and I had no more compassion for him when I was at home.
People call this compassion fatigue. Veterinarians feel compassion fatigue, but it’s taboo to have depression or an anxiety disorder.
When do you know when you should be medicated?
Most veterinarians have high-functioning anxiety. Anxiety that stems from wanting to be perfect, being a Type-A personality, and taking alllll those bad online reviews as personal attacks.
But does that mean you should be medicated?
Maybe you just need someone to talk to. There are a lot of options for telehealth appointments from social workers, counsellors, psychologists etc.
I started medication on my family doctor’s advice.
I thought it was normal to become fatigued and irritable - that was my normal.
My husband admitted himself into a mental health institute when he was in his 20’s after he attempted suicide. He spent many years with therapy. Being prescribed the wrong medications and switching medications. Nowadays, there are more standardized testing for mental health disorders. So when my husband mentioned that I should maybe talk to someone because it wasn't normal for me to be laying around, or crying so much. I first took an online questionnaire, which was very similar to the one my family doctor had me take.
There are several online tests. I can’t seem to find the one I did in 2019. But here is a link to one for the PHQ-9 questionnaire. I scored Moderate for depression and anxiety, and I got medicated. After I started my medication, I started understanding what real normal feels like!
There is an increase in information on suicide in the veterinary profession. We are more likely to commit suicide than the general public - but also, we know how to kill things really well. So, a veterinarian who intends to put themselves out of misery, will more likely to be successful at it than someone in the general public.
The general public may think that it’s euthanasia, or ‘putting animals to sleep’ that is the hardest part of our profession. Most veterinarians will say it can be a difficult part of our jobs. However, there are other more stressful parts of our careers that contribute to our on-going or chronic stress.
1) Dealing with difficult clients:
This can be part of the development of compassion fatigue.
Clients are more educated nowadays, through online sources, and therefore client expectations are much higher than they were in the past, and we have to learn to manage these high expectations.
When you do not meet these high expectations, they will post an ugly review online about the interaction.
2) Financial pressures:
There can be a huge student debt, more so in the U.S. than in Canada, and those trained overseas as ‘international students’. Veterinary students come out of school with $300k in debt and make $60k a year.
If you decide to intern your first year out, you can look to making $35k that year.
3) Overworked and Understaffed:
If you work in a busy practice, how often are you your own technician? Taking blood and urine samples, drawing up and administering your own patient’s medications, placing IV catheters? It means you are understaffed because veterinary technicians are also overworked.
You have scheduled work hours for appointments, procedures or surgeries, but where is the time to call pet owners with results of diagnostics, to see how the treatment is working or to finish your medical records.
Many take their medical records home with them, cutting into their time off when they should be relaxing to regenerate for the next work week.
How to help with compassion fatigue?
Start by talking about your feelings and experiences with your colleagues. Have a good vent. (As per Dr. Bree Montana) Develop a ‘wolf-pack’.
I feel badly, when I start venting. My colleague who I vented with has just left the practice, so I need another person to vent to! Husbands are not good to vent to, because they don’t understand. Non-vets don’t get it.
If you do not have a “wolf-pack” a group of colleagues to vent to, then you can go to Vets4Vets by VIN foundation for help.
One thing that I need to pay attention to more is recognizing my own burnout or compassion fatigue before I become so agitated that I take it out on my team or my husband. It’s true, when I start snapping at my team, I know that I’m struggling with managing my stress. This year and a half of COVID restrictions has not helped.
April was the hardest time for me in this new job. I worked 7 of 8 days, went immediately from curb-side only appointments to in-person appointments, and didn’t sleep well.
“Not healing the little wounds that come up along the way“ leads to compassion fatigue.
Veterinarians are good at medicine and surgery, but we have minimal training in dealing with the people who own the pets.
You as the vet and the pet owner need to work as a team for the better health of the pet. You will gain more respect if you listen to your client and what their needs are. It will only make you more frustrated if you make all the recommendations and the client says no.
Set Boundaries.
What does that even mean? Ensure that you leave work at work. Yes, you have to do your medical records, but you do not need to do them at home. Ask for help or time to do your records during your work hours. If your manager is unable to accommodate, know that you are valuable, and you will be able to negotiate for your personal time, there or elsewhere. Do not give out your personal phone number or email address. People need to respect your time off.
Learn how to say no. If you are not comfortable doing something, you can say no.
If you need someone to talk to, there is no shame in reaching out to a therapist. There are people who can help, without having to pay an arm and a leg. Counsellors with a sliding-scale. Some employers will give you health benefits that cover therapy.
Check Out DVM360 for some resources