Veterinary Wellbeing and Self Care
Introduction
The mission of MentorVet “leveraging evidence-based approaches to empower veterinary professionals, transforming veterinary medicine into a healthy profession for individuals and communities”. As part of fulfilling its mission MentorVet has a staff that includes mental health and financial coaches as well as mentors. The mentors are practicing veterinarians who serve as coaches to help early-career veterinarians learn to cope with the stressors of practice.
Several articles have been posted by MentorVet that address burnout, moral distress, depression, substance use, grief, compassion fatigue, and anxiety. In the Prevention and Resource Section of each article we list organizations or strategies that address veterinary wellbeing. Today’s article, Veterinary Wellbeing and Self-care, we will expand on the importance of self-care by reviewing some of the latest research on its benefits, dimensions of wellness, as well as resources that are available to help veterinarians.
Prevalence of Mental Health Issues in Veterinary Medicine
Issues of mental health and the wellbeing of healthcare providers is a relatively new phenomenon that came about in the 1980’s as a result of nurses reporting being “fatigued” when providing patient care. The term fatigue has been replaced with compassion fatigue, secondary traumatic stress, empathic distress, mental distress, depression, and burnout to reflect a more accurate description of what is occurring. Current figures for “substantial burnout” in the U.S. for nurses and physicians are between 35-45%, while for medical students and residents is between 45-60%.[1] Costs associated with healthcare provider burnout include occupational injury, mental illness, substance and alcohol misuse, and suicide.
Unfortunately, veterinary medicine is not immune from burnout and the mental health problems experienced by their counterparts in human medicine. In the Merck Animal Health Veterinary Wellbeing Study, researchers were asked to assess the mental health and wellbeing of over 3,500 U.S. veterinarians. In this study, wellbeing was defined as as, “How satisfied an individual is with his or her life and how they believe their life compares to the best possible or worst possible life for them.”[2] They found:
Nearly 80% of respondents reported feelings of depression, compassion fatigue, or anxiety/panic attacks with the past 12 months
Over 5% experienced serious psychological distress within the past 30 days
Approximately 25% thought about suicide during their lifetime
Approximately 1.5% reported having attempted suicide during their lifetime
Younger veterinarians scored lower in wellbeing as compared to older veterinarians
Male veterinarians scored higher in wellbeing as compared to female veterinarians
What is Self-care?
Previous MentorVet articles address how veterinary practices can address burnout, compassion fatigue and moral distress from an organization level. However, with the prevalence of mental health challenges and lower wellbeing rates facing veterinarians, using self-care techniques is another approach to increase wellbeing.
Having a working definition for self-care is needed and the National Institute of Mental Health provides a clear and concise definition. They define self-care as “taking the time to do things that help you live well and improve both your physical health and mental health.” [3]
But for those of us who are challenged with the numerous demands of working in a caregiving profession, self-care is often at the bottom of our “to-do” list. The next section will explain the consequences of a lack of self-care and the importance of attending to one’s wellbeing through self-care.
Problems Associated with a Lack of Self-care in Veterinary Medicine
Numerous articles, books, and healthcare organizations have written about the problems of burnout and mental health challenges within human medicine. In veterinary medicine however, the research into burnout has only recently been addressed in a few large-scale studies and therefore those results are limited.
However, the recommendations made to ameliorate its effects in veterinary medicine are similar to those made in human medicine as it relates to burnout and wellbeing. Therefore, we will be reporting from both human and veterinary medicine research on burnout and mental illness.
Both the personal negative consequences as well as the economic consequences of burnout in the workplace will be discussed. Some of the personal consequences of a lack of self-care include:
Higher levels of depression
Higher levels of anxiety
Higher levels of stress
Higher levels of burnout [4]
The negative economic consequences of burnout in the workplace include:
Multifaceted costs associated with turnover
Lost revenue associated with decreased productivity
Threats to the organization’s long-term viability
Lower quality of care
Decreased patient satisfaction
Patient safety [5]
How to Address Self-Care in Veterinary Medicine
Organizational changes that include workplace accommodations have been discussed in other MentorVet articles and serve as an important component of workplace wellness. However, personal changes that include self-care play a vital role in personal wellness.
Self-care is seen by the mental health community as essential to one’s overall health and wellbeing. In one review of the effects of self-care (or therapeutic lifestyle changes), Walsh found that exercise, nutrition and diet (food selection), good relationships, and stress management (self-management skills) improved one’s wellbeing. [6]
In her book, Creating Wellbeing and Building Resilience in the Veterinary Profession, Sonja Olson, DVM, provides a comprehensive overview of the complex challenges facing the veterinary profession as well as how to prepare for the occupational hazards associated with veterinary medicine through self-care.[7]
Dr. Olson includes a chapter on developing one’s own “toolbox” for self-care and recommends incorporating the Eight Dimensions of Wellness to help in creating balance in our lives. Each dimension influences the others and therefore are seen as interdependent, they include:
Physical Wellness—includes nutrition, exercise, sleep, and appropriate health choices
Intellectual Wellness—engaging in brain exercises to keep one’s mind sharp, and broadening one’s
perspective
Financial Wellness—understanding one’s financial situation and taking action to improve it
Environmental Wellness—access to clean air, food, water; spending time outdoors; declutter the home
Spiritual Wellness—having meaning and purpose in one’s life; having balance or activities that achieve balance
Social Wellness—having healthy relationships with family, friends, and the community where one lives and works
Occupational Wellness—participating in activities that provide meaning and purpose and reflect your personal values
Emotional Wellness—ability to express feelings and cope with life’s stressors[8]
As part of a self-care plan, Dr. Olson recommends an assessment of each of the Eight Dimensions of Wellness in terms of what is missing and what you have that is supporting your wellness. The Resource section of this article offers some links that can help in assessing one’s wellbeing and corrective actions to take.
The Professional Quality of Life Health Measure
Another resource, the Professional Quality of Life Health Measure, or ProQOL Health was developed for healthcare professionals, including veterinarians, to improve their self-care and overall well-being. While not a diagnostic assessment, the ProQOL Health measures:
Burnout
Compassion Fatigue
Compassion Satisfaction
Moral Distress
Perceived Support
Secondary Traumatic Stress [9]
The ProQOL website and manual offers self-care handouts for healthcare workers that include:
Better Sleep
Boundaries
Breathing
Intentional Avoidance and Focus
Grounding Techniques
Intrusive Thoughts and Flashbacks
Mindfulness
Nightmares
Progressive Muscle Relaxation
Stretching
Visualization [10]
Conclusion
The concept of self-care while relatively new is now recognized as vital to increase worker productivity, employee retention, overall wellness by healthcare organizations. This article highlighted some of the negative outcomes associated with burnout and empathic distress as well as ways to increase one’s wellbeing through therapeutic lifestyle changes (self-care). We also discussed the Eight Dimensions of Wellness as one way to build your own toolbox of self-care.
Lastly, we provided information on the ProQOL Health Measure as a way to ascertain if someone is experiencing burnout, compassion fatigue, moral distress, or secondary traumatic stress. The ProQOL website has additional handouts specific to improving or developing a toolbox for self-care. Additional resources that include the AVMA website for additional resources as well as other organizations specific to veterinary medicine are available.
Additional Resources
Veterinary-specific Resources
AVMA Reading List: Work-life Balance
This link can direct veterinarians to resources that can help establish and maintain a good work-life balance.
AVMA—Stress Management for Veterinarians
This link provides strategies for coping with stress as well as additional links on tips to help manage stress and the negative health effects of stress.
AVMA—Work and Compassion Fatigue
This link offers a short but comprehensive look at compassion fatigue in veterinary medicine and includes what symptoms to be aware of; how to address compassion fatigue; and, steps to take to address it.
Compassion Fatigue in the Animal-Care Community
Written by Charles R. Figley, PhD, and Robert G. Roop, PhD, this book examines the causes of compassion fatigue and offers help for fighting it.
Compassion Fatigue Workshops for Veterinary HR Teams and Managers
Katherine Dobbs, RVT, CVPM, PHR, speaks at veterinary conferences in addition to providing consulting work and workshops on compassion fatigue for the veterinary team.
Creating Wellbeing and Building Resilience in the Veterinary Profession: A Call to Life
From the publisher: This book combines shared experiences (personal stories) with academic research into the contributing factors of compassion fatigue and how to counter these. Normalizing the conversation in the profession, it provides a wide array of possible solutions to build resilience and to shape a culture of collaboration and support where caregivers can flourish.
The ProQOL is free and is translated into many languages for healthcare providers
University of Tennessee Veterinary Social Work Program
The University of Tennessee Veterinary Social Work program provides resources and insights on grief and pet loss, animal assisted interactions, the link between human and animal violence, and compassion fatigue and conflict management.
When Helping Hurts: Compassion Fatigue in the Veterinary Profession
This book, published by the American Animal Hospital Association, offers veterinarians and their teams tips for recognizing compassion fatigue and provides strategies for how to deal with it.
An on-line veterinary continuing education (RACE approved) that also offers podcasts on wellness and some of the practice challenges encountered by veterinary on wellness and from VetGirl discusses the growing concern of suicide in veterinary medicine.
National Associations
American Foundation for Suicide Prevention (AFSP)
The AFSP is made up of scientists, survivors of suicide loss, people with mental disorders and their families, and a network of business and community members dedicated to understanding and preventing suicide through education, research and advocacy.
National Suicide Prevention Lifeline 1-800-273-TALK (8255) and as of July 16, 2022: 988
The National Suicide Prevention Lifeline is a 24/7, confidential, toll-free suicide prevention hotline for anyone in emotional distress or suicidal crisis. They work with a network of more than 150 local crisis centers that provide mental health referrals and counseling day and night. The Lifeline site provides crisis center locations and information about getting help.
References
[1] National Academies of Sciences, Engineering, and Medicine 2019. Taking Action Against Clinician Burnout: A Systems Approach to Professional Wellbeing. Washington, DC: The National Academies Press. https://doi.org/10/17226/25521.
[2] Volk JO, Schimmack, U, Strand EB, Lord LK, Siren CW. Executive summary of the Merck Animal Health veterinary wellbeing study. Journal of the American Veterinary Medicine Association. 2018;252(10):1231-1238.
[3] National Institute of Mental Health. Caring for your mental health. 2021
https://www.nimh.nih.gov/health/topics/caring-for-your-mental-health. Accessed June 21, 2022
[4] Hatch PH, Winefeld HR, Christie BA, Lievarrt JJ. Workplace stress, mental health, and burnout of veterinarians in Australia. Australian Veterinarian Journal. 2011;89(11). doi: 10.1111/j.1751-0813.2011.00833.x
[5] Shanafelt T, Goh J, Sinsky C. The business case for investing in physician well-being. JAMA Internal Medicine. 2017;117(12):1826-1832. doi:10.1001/jamainternmed.2017.4340
[6] Walsh, R. Lifestyle and mental health. American Psychologist. 2011;66(7):579-592. doi: 10.1037/a0021769
[7] Olson SA. Creating Wellbeing and Building Resilience in the Veterinary Profession: A Call to Life. Boca Raton, FL: CRC Press; 2022
[8] U.S. Department of Health and Human Services Administration, Substance Abuse and Mental Health Services Administration. Creating a healthier life: A step-by-step guide to wellness. https://store.samhsa.gov/sites/default/files/d7/priv/sma16-4958.pdf. Accessed June 23, 2022.
[9] Center for Victims of Torture. The ProQOL Health Manual. https://img1.wsimg.com/blobby/go/dfc1e1a0-a1db-4456-9391-18746725179b/Manual%20-%20ProQOL%20Health_11.26.21.pdf. Accessed June 23, 2022.
[10] Center for Victims of Torture. ProQOL Health.https://proqol.org/proqol-health-1. Accessed June 23, 2022.