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Burnout and health promotion in veterinary medicine

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Brenda L. Lovell at Independent Researcher
Brenda L. Lovell
Raymond Lee at Nottingham Trent University
Raymond Lee
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3711171/
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790 CVJ / VOL 54 / AUGUST 2013
Veterinary Wellness Bien-être vétérinaire
Burnout and health promotion in veterinary medicine
Brenda L. Lovell, Raymond T. Lee
Burnout is on the rise among the helping professions such
as human and veterinary medicine, and negatively affects
personal and professional wellbeing, and the provision of qual-
ity care to clients and animals. Even more significant is that
veterinarians are reported to have the highest incidence rate of
suicide among all occupations, and twice as high as physicians
and dentists (1). Indeed, 85% of American Veterinary Medical
Association convention attendees indicated that stress and
burnout (includes compassion fatigue) were the most important
wellness issues affecting the veterinary community (2). Seventy-
six percent believed that there were not adequate resources to
deal with wellness issues (2).
Much research attention is now being focused on the emo-
tional exhaustion component of burnout, as it has been increas-
ingly shown to be correlated with physical and mental health.
Progress is also being made to relate other variables such as
work/life conflict, and communications with burnout. A case
in point was our research study among Canadian physicians.
We found that having positive emotions and responsive com-
munications with patients reduced burnout, but when difficult
emotions were kept hidden or insincere, burnout increased (3).
Of the 3 burnout dimensions, emotional exhaustion contrib-
uted to symptoms of strain. We also found that less experienced
physicians reported higher stress levels than those who were
more experienced, and female physicians reported higher stress
than their male colleagues. Comparable findings are drawn
for veterinary medicine in which Australian female veterinary
surgeons and those with less experience also reported higher
stress levels (4).
Many clients regard their companion animals as cherished
family members; consequently, they have high expectations
that emotional and medical needs will be met (5). Recognition
of the human-companion animal bond is the very core of the
bond-centered approach for veterinary practice. It involves rec-
ognizing and responding to the unique emotional interchange,
in a way that benefits all of the participants involved (6). Thus,
good communication is likely to result in strong client relation-
ships, and an indicator of those more likely to follow treatment
recommendations (5–6).
To be engaging and responsive to clients often involves
intense and constant emotions, along with other forms of verbal
and non-verbal communications. This is no easy task, as the
skills needed to manage people and emotions, emotionally vola-
tile clients, and the feelings that arise from euthanization require
practice, time, and patience (4,7). This deep form of caring has a
potential to be a risk factor for compassion fatigue and burnout
if mental, spiritual, and emotional balance is not maintained (1).
Compassion fatigue then is the emotional burden that occurs
as the result of continued and excessive exposure to traumatic
events that patients and families experience (8).
How can veterinary practices provide
bond-centered care yet prevent burnout
and/or compassion fatigue?
Effective health promotion strategies need to be implemented
to reduce the risk factors for burnout and compassion fatigue,
and should include efforts from the organizational, practice/
collegial, and individual levels (7).
Organizations can provide resources such as lifelong learning
and continuing professional development workshops. Much can
also be done by the individual to develop the resilience and emo-
tional competence needed to keep compassion fatigue at bay (8).
Adaptive coping strategies are a key component of a health
promotion strategy. A problem-focused strategy involves tack-
ling problems that give rise to stress, and an emotion-focused
strategy works on normalizing feelings that arise from stress (9).
For example, emotion-focused strategies that Brenda frequently
uses are to listen to music, burn incense, enjoy coffee/tea, turn
on area lighting, stroke our pets, and walk outdoors, all of which
stimulate the senses and help to minimize harmful stress.
Some of the key points of this article were discussed at The
4th Annual International Conference on Communication in
Veterinary Medicine, Banff, Alberta, November 13–16, 2008.
References
1. Lawrence C. Shock central: Veterinarian suicides. 2009 Corralonline.
com Available from: http://www.corralonline.com/articles/article
080310152649.htm Last accessed June 12, 2013.
2. Carr GD. Veterinarians and potentially impairing illness. Insight
Magazine Sept./Oct. 2012. Available from: http://digital.turn-page.
com/i/80739/13:12-13 Last accessed June 12, 2013.
3. Lee RT, Lovell BL, Brotheridge CM. Tenderness and steadiness: Relating
job and interpersonal demands and resources with burnout and physi-
cal symptoms of stress among Canadian physicians. J Appl Soc Psychol
2010;40:2319–2342.
Independent wellness consultant, 1 Glengarry Drive, Winnipeg,
Manitoba R3T 2J5 (Lovell); Department of Business
Administration, University of Manitoba, Winnipeg, Manitoba
R3T 5V4 (Lee).
Address all correspondence to Brenda Lovell; e-mail:
brendalee.lovell@yahoo.ca
Use of this article is limited to a single copy for personal study.
Anyone interested in obtaining reprints should contact the
CVMA office (hbroughton@cvma-acmv.org) for additional
copies or permission to use this material elsewhere.
CVJ / VOL 54 / AUGUST 2013 791
VETERI NARY WELLNESS
4. Williams S, Davis H. Stressors in the veterinary profession. 2002. Board
Talk; Issue 12:12–13. Available from: http://www.vpb.nsw.gov.au/
Boardtalk/2002/aug2002/August2002_9.htm Last accessed June 12,
2013.
5. Dawson S, Fowler J, Ormerod E, Sheridan L. New perspectives on bond-
ing. The SCAS Journal; 2007:2–5. Available from: http://www.pat.org.za/
files/documents/New%20perspectives%20on%20bonding.pdf Last
accessed June 12, 2013.
6. Lue T, Pantenburg DP, Crawford PM. Impact of the owner-pet and
client-veterinarian bond on the care that pets receive. Vet Med Today:
Special Report 2008;232:531–540.
7. Cohen SP. Compassion fatigue and the veterinary health team. Vet Clin
North Am Small Anim Pract 2007;37:123–134.
8. Huggard PK, Huggard EJ. When the caring gets tough: Compassion
fatigue and veterinary care. Vet Script 2008:14–16.
9. Bartram D, Gardner D. Coping with stress. In Practice 2008;30:228–231.
... Moreover, apart from the financial and ethical dimensions of the conflict, there is also a conflict of interest that can be different for the animal and the client who pays for the treatment [5,14,31,32]. Undeniably, managing people and emotions in such complex circumstances requires practice, time and patience all at once [20]. Actions to resolve the conflicts peacefully are necessary, not only to satisfy the conflicting parties but also to prospectively avoid mental health disorders and related consequences. ...
... In addition, further research is required and more data must be collected to characterize and authenticate the root cause of the issue, i.e. the lack of training of the graduate. Thus, if the Veterinary School does not provide a curriculum corresponding to current demands, then there is a role for organizations that should provide resources such as lifelong learning and continuing professional development workshops in verbal and nonverbal communication and the maintenance of mental, spiritual and emotional balance of veterinarians [20]. ...
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Background The problems of burnout and the moral and ethical distress resulting from various kinds of conflict have been raised in the veterinary profession. However, their sources and inter-relationships have not been thoroughly recognized mainly due to the multidimensional nature of human interactions related to animal breeding, farming, welfare, prophylaxis and therapy. For the first time in Poland, an analysis of conflict and conflict-causing factors in veterinary practice has been conducted with the participation of veterinarians of various specialties and the owners of different animal species. Results Conflict in the course of work is most often experienced by young veterinarians. The problems associated with communication between veterinarians and animal owners and unforeseen random situations are the general causes of conflict. Approved Veterinarians were identified by animal owners as the most common professional group associated with the conflict experienced . Conclusions There is a lack of professional preparation by veterinary surgeons to cope with unpredicted stressful situations at work, resulting from an absence of appropriate educational input in this area. The animal owners do not understand the role and duties of Approved Veterinarians.
... 21,[24][25][26] There is also an influence on professional identity formation. 8,23,27 Closely integrated with these aspects, affect plays a key role in mental well-being and health; both the human and veterinary healthcare literature have identified concerns relating to stress and burnout in the profession, 21,24,[28][29][30][31][32][33] and the emotional consequences of errors. 9,34,35 In response to this, there is an emerging literature focussing on the development of resilience and strategies for emotional well-being. ...
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... 29 30 Not being able to comfort an owner may result in stress for the FLP and contribute to psychological problems, unfortunately often reported in the veterinary profession. 31 Communication skills are necessary to be able to cope with these stressors. Confidence in being able to comfort owners was investigated in this study, to get some idea on whether veterinarians can be expected to be 'at risk' of stress relating to this matter. ...
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... There is an extensive body of literature documenting the serious emotional impacts of conducting or being associated with euthanasia among veterinarians, animal shelter staff, and animal rescue workers. Working in these fields, where euthanasia is performed frequently and may be seen as an unavoidable necessity, can erode the mental and physical well-being of staff, leading to compassion fatigue, burnout, and overall stress (Baran et al., 2009;Figley & Roop, 2006;Lovell & Lee, 2013;Scotney, McLaughlin, & Keates, 2015). While the average pet owner does not, of course, deal with euthanasia on the same scale as veterinarians or shelter staff, the ethical issues associated with making the decision to end the life of a companion animal remain. ...
Helping Clients Cope with Grief Associated with Euthanasia for Behavior Problems
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... Indeed, having to face ethical challenges increases stress and burnout in veterinary surgeons and support staff. 35,36 These professionals, whose studies are oriented towards the care of animals, are continually faced with animal suffering, which is often underestimated on a social level. In fact, veterinarians can suffer more easily from severe compassion fatigue than physicians because they are not only responsible for animal care and end-of-life decisions, but they also have the power to perform euthanasia. ...
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... 9 In veterinary medicine, women report more work-related stress, anxiety, depression, and burnout than men. [23][24][25][26] This observation is of particular importance, given that a recent study 29 revealed a higher incidence of psychological distress, including suicidal ideation and depression, in female versus male veterinarians. One of the most commonly reported stressors in that study was demands of practice, which could be interpreted to include involvement in AEs and NMs. ...
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This study examined the extent to which job and interpersonal demands and resources are associated with burnout and physical symptoms of stress among Canadian physicians. Using the job demands-resources (JD-R) model, we predicted that demands would be more strongly related to emotional exhaustion and physical symptoms, whereas resources would be more strongly related to personal accomplishment and decreased depersonalization. The findings reveal that communication skills and emotional labor contributed to the explained variances beyond workload and work–life conflict (as job demands), as well as autonomy, predictability, and understanding (as job resources). The predictors were differentially associated with the outcome variables in a manner that is consistent with the JD-R model. Implications for physician well-being and improved patient outcomes are discussed.
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Impact of the owner-pet and client-veterinarian bond on the care that pets receive
Article
Shock central: Veterinarian suicides
  • Jun 2009
  • C Lawrence
Lawrence C. Shock central: Veterinarian suicides. 2009 Corralonline. com Available from: http://www.corralonline.com/articles/article 080310152649.htm Last accessed June 12, 2013.
Veterinarians and potentially impairing illness Available from: http://digital.turn-page. com/i
  • Nov 2012
  • 12-13
  • Gd Carr
Carr GD. Veterinarians and potentially impairing illness. Insight Magazine Sept./Oct. 2012. Available from: http://digital.turn-page. com/i/80739/13:12-13 Last accessed June 12, 2013.
New perspectives on bonding . The SCAS Journal Available from
  • Jul 2013
  • 2-5
  • S Dawson
  • J Fowler
  • E Ormerod
  • L Sheridan
Dawson S, Fowler J, Ormerod E, Sheridan L. New perspectives on bonding. The SCAS Journal; 2007:2–5. Available from: http://www.pat.org.za/ files/documents/New%20perspectives%20on%20bonding.pdf Last accessed June 12, 2013.
Stressors in the veterinary profession Board Talk Available from: http://www.vpb.nsw.gov
  • Jul 2002
  • 12-13
  • S Williams
  • H Davis
Williams S, Davis H. Stressors in the veterinary profession. 2002. Board Talk; Issue 12:12–13. Available from: http://www.vpb.nsw.gov.au/ Boardtalk/2002/aug2002/August2002_9.htm Last accessed June 12, 2013.
Veterinarians and potentially impairing illness
  • Oct 2012
  • 12-13
  • G D Carr
Carr GD. Veterinarians and potentially impairing illness. Insight Magazine Sept./Oct. 2012. Available from: http://digital.turn-page. com/i/80739/13:12-13 Last accessed June 12, 2013.