Compassion fatigue in the veterinary profession

Most of us became vets and nurses out of a love of animals and a desire to help them.

But a love of humans was not listed as a prerequisite for our career choice. Sometimes we love them, sometimes we’re stressed by them, sometimes we shut ourselves off from their emotions as an act of self-preservation.

Nevertheless, the more we “love” the people who are tethered to our patients, the more job satisfaction we are likely to have.

If we can celebrate with the owners of our patients, then it’s all good, right?

The downside to having a close emotional bond with our clients is that, without good self-awareness and self-regulation, we can feel their emotions a bit too intensely. We can “become” their emotions of fear when investigations are being discussed, and grief and sadness when things aren’t going well.

This, in turn, saps our strength and leaves nothing in the tank for actually doing what the client wants us to do: diagnose and treat.

Our capacity for compassion, on top of the insanely busy days and other emotional strains, even without a global pandemic added to the mix, can lead to emotional exhaustion and compassion fatigue.

So, shutting off from others is the solution? No. This only serves to increase our vulnerability. This is because being a rock and an island is only ever a temporary “fix”. Humans need positive relationships in order to thrive.

There is an abundance of literature showing that people who are socially integrated, and who experience more supportive and rewarding relationships with others, have better mental health, higher levels of subjective well-being and lower rates of morbidity and mortality compared to others (see reference list below). Even more interestingly, a 2012 meta-analysis showed that being socially integrated in a network of meaningful relationships, or not, predicts mortality more strongly than many lifestyle behaviours such as smoking or physical activity (Holt-Lunstad and Smith, 2012), indicating that the better the relationships, the lower the mortality rate in middle age.

What are the symptoms of compassion fatigue?

Compassion fatigue and PTSD have many symptoms in common:

• Depersonalisation (isolation from others, feeling like a zombie or an onlooker onto your own life)
• Difficulty falling asleep or staying asleep
• Feeling like you’re never refreshed when you wake up
• Irritability
• Hopeless attitude towards your job
• Feeling like you have to just “get through” each day
• Difficulty in leaving work at the end of the day
• Thinking about cases when not at work
• Dreaming about cases
• Awfulising about cases (an irrational and dramatic thought pattern, characterised by the tendency to overestimate the potential bad outcomes of a case)
• Predicting the most catastrophic outcome

How do I prevent or recover from compassion fatigue?

1. Awareness of the symptoms and early recognition are crucial. Using mindfulness to enhance self-awareness will alert us to the difference between having good empathy with a client and having “too much” empathy with them
2. Self-regulation. Knowing when the drain on your emotional resources is more than what is being replenished as it’s happening in the consult room or on the phone, and being able to stop yourself from travelling down that emotional spiral with your distressed client in order to stay strong
3. Taking time off doesn’t necessarily bring relief for many of us, either because we’re thinking about work and checking our emails while we’re off, or because we return to the workplace having done little to no self-care while away. A holiday can still be a holiday even if we’re getting the “chore” of self-compassion done Self-care and self-compassion ideally shouldn’t be at the bottom of our “to do list”, only to be ignored when we’ve finished work because we’re exhausted. Making time for short mindful meditations each and every day provides a structure for psychological self-care. Make that 10 minutes or half hour non-negotiable with your self-neglecting self.
4. Good nutrition, good sleep and exercise. We all know that these are helpful, but I don’t know any vet or nurse who’s nailed this. Maybe this could be adjusted for each of us to make it realistic and achievable. For example, no screens just before bedtime and walking some of the way to work. Whatever plan you make, stick to it. Because if it’s your own plan, it’s a great deal more valid than a plan a therapist has made for you
5. Positive relationships. Invest in and nurture them with more than just text messages and Facebook posts. Spend time with these people who feed your soul and who genuinely care about you. Put your phone on silent somewhere else when you’re with them if you can
6. Spend less time with the negative influences in your life

Unrecognised and untreated compassion fatigue causes vets and nurses to leave the profession, hit the bottle or, in all too many cases, become self-destructive or suicidal.

Recognising the symptoms in ourselves and our colleagues benefits everyone: those with emotional exhaustion, those trying to avoid it and the clients we see.