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Thursday, January 8, 2015

Veterinary Burnout, PTSD, And Life Balance

Recently I received a very interesting email from Tim.
 
I ran across your blog when I did a research for my own blog post on veterinarians and depression/PTSD. I had a recent conversation with a woman who used to be a vet tech and had to give it up because of too much exposure to sick and suffering animals.
 
I started thinking about the veterinary industry and how it may be a segment of the population that may suffer from PTSD due to occupational exposure. PTSD is an important topic to me because this past year I have been treated for the same due to my 20+ year career as a firefighter/medic. Do you know of any studies or resources that discuss PTSD and veterinarians?
The blog I write is called Self Care and Fitness Education where I discussed my own experiences as well as holistic means to return to a more balanced life. I want to raise social awareness about your profession and PTSD, as well as give my readers food for thought.
 
I'm not a psychologist and will have to defer to official definitions of Post-Traumatic Stress Disorder (PTSD).  I'll also admit that I'd never really given much thought to experiences in my profession as leading to PTSD.  When I think of that disorder I think of military, police, and other first-responders who frequently end up in sudden and violent situations.  I've never applied it to veterinary medicine.
 
Depression and emotional burnout is most certainly an issue in this job.  I've faced it myself many times.  Emotional fatigue hits us from time to time since daily we deal with often emotionally charged situations.  One of my most popular recent blog posts was on the emotional toll of the job, and I have been very surprised at that particular post being read 4-5 times as much as my average ones.  It's obvious that this topic resonates with people.
 
Personally I wouldn't think of this job as creating PTSD, but someone more familiar with the disorder may define it more broadly than myself.  Is there emotional and psychological trauma in veterinary medicine?  Absolutely.  Virtually every day I am faced with pets that need to be muzzled or sedated due to aggression.  Recently my hospital manager was bit severely by one of our patients and had to have her hand bandaged and put in a brace.  People outside of the profession can develop fear of animals due to the experiences of being attacked, which probably falls within a spectrum of PTSD.  I personally think that most of us in the field learn how to handle that since we face it so frequently, just like not every soldier or police officer is going to have true PTSD.  But is it possible?  Sure, especially if the attack is severe.  I know that the times I've been badly injured I'm more nervous than normal around aggressive pets.  If I was mauled, I'd probably be downright terrified by the idea of another vicious dog.
 
Burnout and depression is much easier for me to understand, having faced both issues over my career.  Think about our situation.  We make a fraction of what our human colleagues do, and have at least as much training and work the same weekly hours, if not longer.  It's tough for many vets to make ends meet, especially newer graduates.  We have the highest debt-to-income ratio of any medical profession.  Every day we have to almost bargain with clients to let them allow us to treat their pets.  Daily we face situations where we know what to do to diagnose and treat problems, but the owner can't or won't pay for the necessary tests and medications.  We are often physically attacked by our patients, and sometimes yelled at by their owners for things that are beyond our control or because we didn't fix the problem the first time (and those people never seem to understand that they keep denying our treatment plan).  We are in this job because we love animals, especially pets, and often become emotionally attached to our patients and clients.  This attachment helps us do our job, but it can make it especially hard on us when despite our best efforts we can't figure out a problem and lose the pet.  We are physically stressed, often working long days, sometimes coming in after hours, rarely getting full lunch breaks, and are having to get up and down off the floor after restraining and sometimes "wrestling" with pets (my large animal colleagues have even greater physical challenges).
 
To summarize....long hours, comparatively low pay, daily risk of physical injury, emotional roller-coasters, not being able to freely do what we were trained for....
 
Yes, depression and burnout are a concern.
 
It's also difficult to balance our work and home life.  I can't tell you how many times I've driven my wife crazy because I fret over a case for days, especially if it went poorly.  My worry over the clinic's revenues sometimes dominate my thoughts on my days off, affecting my interactions with my family.  I don't do emergency work anymore, but when I did my planned evening could be ruined by a sudden after-hours call.  It can also be hard for me to participate in plays and other outside activities because I can't say that I'll leave exactly at closing time every day.  Balancing personal and professional lives is a huge concern among veterinarians, and one that we're likely doing a poor job handling.
 
Tim, I'm not aware of any specific studies on these issues in veterinary medicine.  I may have seen an article or two on depression and burnout, but I can't remember where or when so I can't give you a specific reference.  In writing this I'm hoping that some of my readers will know of specific studies and can direct you to them by writting in the comments.  If there haven't been many studies, there certainly should be, as my personal experience is that these are common issues.  But more important than simply knowing the extent, we need to have good solutions on how to handle the problems.
 
And I have no magic answers on how to do so.
 

3 comments:

  1. When I read this, I immediately thought rather of livestock veterinarians. And more particularly during major disease outbreaks in Britain like BSE in 1996 or foot and mouth disease in 2001. There people were really pushed to the edge, having to kill millions of healthy animals to stop the spread of the disease. There were a lot of suicides (mainly among farmers) after the foot and mouth outbreak, but also government veterinary personnel were severely distressed about what they had to do. At the moment they are thinking of bringing back vaccination for such outbreaks. Also in other countries with smaller outbreaks, stress levels are very high in those communities, compared to the general public.
    And as more women practice veterinary medicine, and some specialize in livestock, they suffer a lot at farmers not wanting to accept women in the job, the pure physicality of the job (animals weighing half a ton), working outside sometimes in freezing weather.
    I wonder if this is not where Tim should go searching for information - livestock veterinarians but also farmers?

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  2. I thought I'd share the link to the blog entry of the person who started the discussion on this topic. http://abalancedlifeselfcare.blogspot.com/2015/01/ptsd-and-forgotten-segment-of-population.html

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  3. http://barkpost.com/compassion-fatigue-animal-workers/ Another article on this as well

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