Many of you not in the veterinary profession may not be aware, but there has been an ongoing discussion about mental health, compassion fatigue, and depression in the veterinary profession. Compassion fatigue has long been an epidemic in our profession, but every time a prominent veterinarian commits suicide, the discussion resurfaces over and over again. What many don’t realize or fail to acknowledge is that new or recent graduates are far more prone or at risk of compassion fatigue, depression, burnout, and suicidal thoughts. The cause of this is largely unknown and likely multifactorial, but after an in-depth discussion with my colleagues and people who are far more insightful than I on the subject, I will be discussing some possible causes and solutions to this growing problem in veterinary medicine. I don’t want to leave anything out that may help someone, so I will divide this topic into a few blogs in the hopes that my readers can take away bits, one blog at a time, and hopefully work on any problem they see in themselves. I want this to be a helpful tool. In this post, I will give some background and go over a couple of problems that veterinarians face. I’m not a psychologist and this problem is WAY above my pay grade, but my hope is this may raise a bit more awareness and possibly spark more discussion. What is compassion fatigue and burnout? This is a condition that is relatively common in many of the medical professions. Compassion fatigue is a result of caring very much and working very hard, but not recognizing your own needs. In many ways, the veterinary profession is the perfect breeding ground for this condition. Our job entails a fair amount of moral stress. Many professionals may find themselves in situations where they are quite aware of the ethical principles at stake, but external factors prevent them from making a decision that would reduce the conflict. This could be anything from a client that can’t or refuses to pay for care for their pet, apathy of leadership in the workplace, or simply feeling like you don’t have the skills or resources to cope with stressors in the workplace. It’s important to know that while burnout and compassion fatigue can produce similar symptoms, they are quite different. People who are “burned out” lose the ability to empathize. People with compassion fatigue want to help and empathize with the clients they serve, but they’re overwhelmed by their feelings to do so. We’re going to discuss some of the external factors that may prevent new or recent graduates from coping, solving problems, and reducing conflict in the workplace, leading to compassion fatigue, depression, and burnout. The James Herriot Syndrome While attending a talk on compassion fatigue at a leadership convention, a psychiatrist described a syndrome in new graduates as The James Herriot Syndrome. Most young people knew from a very young age they wanted to be a veterinarian. Many of my friends started shadowing a vet as young as the age of twelve. We also grew up idolizing veterinarians. Many may have grown up reading the infamous book series written by James Herriot. We viewed veterinarians as superheroes and pillars of the community. Many of us have a strong passion for the profession and did whatever it took to become a veterinarian. Once we obtained this momentous and challenging goal, we believed we would go out and save every animal we could. We would save the world! Graduating veterinary school was/is a huge accomplishment that puts you on cloud nine. Shortly after entering veterinary practice, the stressors and overwhelming aspects of the job can pull you back down to reality. You might not know as much as you thought. You might not feel prepared for the fast pace and long hours of private practice. Sure, you’re helping pets, but are you helping pets to the extent that you would like? Are you saving the world? Probably not. It can easily make you feel like you’re falling from grace. Without a strong support network and good coping skills, it can be easy to slip into feelings of helplessness or even depression. What helped me with this more than anything was having hobbies outside of the profession. When your whole life is being a veterinarian, it can make those rough weeks at work much harder. Taking time away to do other things can make you feel more like a whole person. Vet med can't come close to fulfilling every need in your life. As a profession, we also need to stop holding ourselves to such ridiculous expectations and standards. As Dr. Dean Scott pointed out in his article on the subject, we’re not superheroes. We’re veterinarians and human beings doing a job. Veterinary medicine is certainly a calling, a passion, and an important career, but it’s also a job that comes with its own stresses and disadvantages. Maybe romanticizing the life of a veterinarian can help us cope with the hard work and challenges we face in veterinary school, but it can make the realities of real world veterinary practice difficult to swallow. Generational Component? In discussing the challenges of depression and burnout in new graduates with my colleagues, many of us (mostly Millennials ourselves) had to wonder if there was a generational component. Is it possible that Baby Boomers (our parents) failed to teach or allow learning of coping skills? While I’m no expert on generational studies, I have heard many experts speak on this topic. Boomers learned the skill of outworking the competition at an early age because there were more people in the workforce. They had to fight tooth and nail to become successful. When Boomers became parents, they adopted a parenting philosophy of wanting to make the lives of their children easier than it was for them. For the most part, that parenting philosophy has come back to haunt them and all of us, really. As a generation of parents, were Boomers too eager to fix things and therefore disabled this generation from developing adult skills and emotional IQ? I’m not saying this is true for everyone, but it could be a possibility. I am also not blaming Boomers for our problems. If we are, as a generation, lacking coping skills, we have many other benefits that our parents never had, so don’t head home for a visit and start blaming them for all your problems at work. They might smash your smartphone, hand you a map, and tell you to find the nearest emergency room for what Red Forman liked to call a foot in the a$@. Baby Boomers did what every generation does, learns from their upbringing and reacts. Having the opportunity to make mistakes, experience failures, deal with stress, solve problems, and face bullies are all skills that are (should) be ingrained in early childhood. Those experiences are part of making a functional adult. Many in the Millennial generation were protected from those experiences to make our lives easier, so it’s no surprise that the newer generation of veterinarians may not have the skills or resources to cope with a high-stress, fast-paced job. The question is: Is it too late for our generation to learn these skills? My initial gut response to that question was sadly yes. However, the more I think about it and research, there is, in fact, hope for our youngest generation of veterinarians. It requires work, diligence, and motivation in each individual. Younger veterinarians may require more mentorship in the workplace. Some practice owners are willing to pick up this “burden” of teaching these young professionals these vital skills, and some are not. Some might argue why is it their responsibility to mentor young practitioners and teach them skills that their parents and instructors have failed to teach. That’s a fair enough assessment, but if we want our young veterinarians to be more functional in the workplace and cope with the challenges that arrive there, mentorship is vital. Another question many of us have is the constant inflow of information from social media preventing us from unplugging and relaxing in a healthy way? Many in my generation are also big fans of Netflix, Hulu, or other streaming websites. I like to refer to these streaming websites as the crack of television. It has been found that when someone spends long periods of time on social media or binge-watching shows, it can be a trigger or root of unhealthy emotions. Spending long periods of time on the Internet can start a negative cycle, taking time away from activities that may improve emotional health like exercising, spending time with friends and family, or engaging in other activities and hobbies that provide pleasure. Look, I get it. I myself spend WAY too much time on Facebook. We also just finished the newest season of Orange Is The New Black, and now I don’t know what to do with my life. That’s a bit of an over-exaggeration as running a business, getting ready for a baby, and preparing to build a house is more than enough to keep me busy, but there is something to be said for the general feeling of emptiness when you finish binge watching a show. The older I get, the more I recognize the value of unplugging and dealing with stress in a healthy way. I hate to say it, but TV and wine can’t solve ALL of your problems. Lastly, another generational component that could be contributing to more depression and burnout in new graduates is different standards of quality of life. Many older veterinarians accepted a 60+ hour work week and expected to see emergencies on nights and weekends. New veterinarians expect to have more of a work/life balance. Many veterinarians in the younger generation find their identities outside the workplace, which is a stark difference from the older generation. A colleague of mine puts it this way, “I love being a veterinarian, but it’s not who I am.” Coming from someone who regularly puts in 60+ hour work weeks, I know from experience that our need for balance in our life doesn’t always match up with the demands of our jobs. Being a practice owner now, I’m working harder to incorporate the “work smart, not hard” philosophy into my practice. Doing so in a practice where previous veterinarians devoted their entire lives to the profession and never demanded or wanted as much balance in their lives can be quite challenging. Our generation is having to change the attitudes and the face of the profession. Progress in our profession, like with anything, can be slow which is very frustrating. Change is hard for your clients and maybe even your staff to accept, but practice owners have to continue to fight for quality of life for themselves and their staff. They are responsible for creating a culture for growth and healthy lifestyles. Some traditions are honorable and exist for a reason. However, you might also come to certain realizations after looking at a practice through fresh eyes. The other thing about tradition is this: Just because you’ve always done it that way, doesn’t mean it’s not incredibly stupid, such as Presidential pardons for a turkey or the running of the bulls. Furthermore, policies and business structure that were set up 50 years ago might not fit so well with today’s business demands. There’s nothing wrong with trying new things and mixing things up, especially when the only reason NOT to change something is, “we’ve always done it this way.” Overcoming a generational gap is challenging, but here are a few tips to sum up what you can do to help yourself if you feel you fall into this category: 1.) Ask for help. You might need a cheerleader, a mentor, a sounding board, or just someone to tell you to suck it up, but you may not get that enforcement unless you ask. 2.) Unplug, especially if you’re not feeling that great about work. Binging on television or social media or anything really is not going to help. 3.) Make a change. It may be small, but try something. Just like with the lottery, you can’t win unless you buy a ticket. 4.) Do something for yourself! Run, read, cook, craft, play the piano, train to be the next American Ninja Warrior, anything, but make sure it has nothing to do with your work. Try to make this completely separate to get back some focus. Next week I’ll talk about the isolation, financial burden, and changing gender makeup of veterinary medicine. Hopefully you can take something away to either help yourself or a colleague. He's either training for American Ninja Warrior or he's dancing. I can't tell, but either way, he looks cool!
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Jessica Stroupe, DVM
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August 2017
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