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Lost your compassion? Learn how to care without hurting yourself

Article

If you're like most people in the veterinary profession, you were drawn to your job because you love animals and people.

It was a typical Saturday at Columbus Animal Hospital in Columbus, Neb. Team members were busy catching up on paperwork, cleaning cages, and waiting for the weekend to start. No one expected the boy and his father who visited with their beloved Husky would affect team members so deeply.

The dog was clearly distressed. Every breath required enormous effort. To determine the cause of the dyspnea, Jim Kramer, DVM, CVPM, took radiographs, which indicated massive tumors in the Husky's lungs. "He had a hopeless case of neoplasia," Dr. Kramer says.

As the father shared the family's story, the team quickly realized the decision to euthanize the dog was a complicated and heart-wrenching one. The son wasn't a boy. He was a college graduate who suffered from cystic fibrosis, a disease that may cause delayed growth. The young man had spent his life battling a chronic lung disease and had recently suffered through a double-lung transplant.

"It was one of the deepest moments of my long career," Dr. Kramer says. "I stood across the small room from a young man who had fought for breath every day of his life and from his father who had endured every painful breath with his son as only a parent can."

The father and son decided that ending the beloved dog's life was necessary, justified, and right. The dog had been with the son through all those painful days and frightening nights. Now illness plagued the dog's lungs, and euthanasia was the solution. "In the end, it was the right thing to do, but it was difficult," Dr. Kramer says.

Figure 1

Emotional cases like this can hurt the mood of the team. "Sometimes we reign in or bottle up our feelings, which prevents us from moving to acceptance," Dr. Kramer says. "If we allow our work experiences to move us and share the experience openly with our team members and clients, everyone feels comforted and more connected."

And you want to experience these events with your team so you can walk through them hand-in-hand. Because the team members who burn out are the ones who deny their emotions or pretend the tragic event isn't happening, Dr. Kramer says. You must express those emotions to grieve.

"People pay to experience a range of emotion, from laughter and tears to resolution, through movies, books, and music—and they're disappointed when they aren't moved," Dr. Kramer says. "Veterinary professionals have the wonderful opportunity to feel these emotions every day, but we must allow ourselves to do so. We miss the benefit by seeing the sad experiences as negative, rather than seeing them as part of the range of emotion that gives life depth and purpose."

When caring hurts

Perhaps you've experienced a similar situation. After all, a career in animal care can be an emotionally and physically demanding occupation.

Figure 2

"Compassion is one of the traits we look for when we hire our team members," says Sharon DeNayer, a Firstline Editorial Advisory Board member and the clinic manager at Windsor Veterinary Clinic in Windsor, Colo. "Since we've owned the clinic for 17 years, we've seen many patients throughout their lives. It's particularly difficult to euthanize those patients."

While caring for patients with terminal illnesses and participating in the euthanasia process contribute to compassion fatigue, DeNayer says she doesn't think those factors alone usually cause it. Instead, it's when those intense situations are compounded by other stressful circumstances, such as difficulties getting along with team members, caregiving for an ill family member, or experiencing a financial crisis, that compassion fatigue may occur, she says.

But what happens when deaths occur more frequently than we can bear? When owner apathy and neglect leads to a pet's needless suffering? And when the heartache and feelings of helplessness become too much?

Recognize the symptoms

Sometimes the compassion required to properly care for animals can leave you feeling empty, drained of energy both physically and emotionally. Compassion fatigue occurs when you exert so much effort caring for others that you're unable to care yourself. And anytime you become emotionally attached to an animal or person, you're at risk.

"Every person needs so much from you," says Norma Gottstein, DVM, an associate at Gentle Care Animal Hospital in Lawrence, Kan. "We don't just treat animals. We have to answer questions from the owners, talk through treatment options, and comfort adults and children when the prognosis isn't good. It can be overwhelming," she says.

Figure 3

Dr. Gottstein recalls her own experience with compassion fatigue. "I felt physically exhausted and emotionally drained, and I wanted to isolate myself," she says. "I had to force myself to focus on the positive elements in my career and personal life and accept that, despite my best efforts, some things just weren't going to work out the way I wanted them to. And that's not an easy thing to learn."

Those who suffer from compassion fatigue can lack energy and motivation to return to work. "Why would you want to return to the fire?" asks Christiane Holbrook, a life and wellness coach in Pasadena, Calif. "There's a physiological reaction to caring too much, and those suffering from compassion fatigue often experience exhaustion, a loss of appetite, and detachment from others."

DeNayer has observed her team members when they're under this particular kind of stress. "They tend to be more quiet and introverted," she says. "And sometimes they're less tolerant and can be short with one another."

To help team members cope, it's important to plan debriefing sessions after a stressful situation occurs, DeNayer says. "At our practice, everyone gets a chance to share, and soon we all realize our feelings aren't so isolated," she says. If a team member struggles to deal with the situation, DeNayer invites the person to talk with her or another team member. She also recommends time off or professional counseling when it's appropriate.

Often taking time to refocus benefits the whole team, Holbrook says. "When you're stressed in veterinary practice, you can't take your frustration out on a dying pet or a grieving owner, so you may take it out on co-workers," she says. "You may be testy and can snap at the smallest thing. Or you can also withdraw from your surroundings and detach from those around you."

How to protect yourself

To guard against compassion fatigue, Holbrook recommends maintaining a healthy life balance. "Compassion fatigue is an issue of boundaries," Holbrook says. "It's an inability to set limits. So one important thing people can do is accept there's a giver and a taker within each of us. Those who work in helping professions, such as in veterinary practice, often overvalue the giving aspect of themselves but not the other half. We tend to judge the giving part of ourselves as good and the taker within each of us as bad. We have to recognize and honor both sides to achieve balance."

To create a healthy balance, Holbrook suggests learning to take care of the three aspects of wellness: the physical, the emotional, and the occupational. "We've all been told how to take care of ourselves physically. We need to exercise regularly, eat plenty of fresh fruits and vegetables, and get enough sleep," she says.

In addition to those traditional strategies, Holbrook suggests going on mini-retreats. "Get away from your environment for a little while," she says. "Sit on the grass and watch the birds. Take a walk. Whatever you need to do to vacate the situation for a while."

For emotional health, Holbrook recommends examining how you react to stress. "When a negative event occurs, it isn't the event that causes our stress, but the meaning attached to it that determines our emotional response."

The idea, according to mental health professionals, is to realize that most events of this world are out of your control, and you can only control your response. This gives you the chance to make a choice about how you want to feel.

To address the occupational aspect of good health, Holbrook asks her clients to take an inventory. "Ask yourself some key questions," she says. The answers will help assess whether your work fulfills your need for professional satisfaction.

While the thought of euthanizing the beloved Husky still brings tears to Dr. Kramer's eyes, he and his team members know the care and compassion they demonstrated that day mattered. "People and animals are well served because of what we do," Dr. Kramer says. "And while all of our treatments aren't always successful and all of our judgments may not turn out to be correct in every case, it's not for lack of trying. Our intentions are good, our efforts Herculean, and we can bask in the warm glow of our daily accomplishments.

"At the end of every day, I thank our team members for the work they did and acknowledge that it mattered. This offers us closure, and we're lucky to have that in veterinary practice. It's a powerful force for good and for emotional well-being."

Margie carr is a freelance writer in Lawrence, Kan. Please send questions or comments to firstline@advanstar.com

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