What is it? A practical view

Photo: digitalista/Bigstock Are you feeling burned out and emotionally exhausted? You are not alone. It is 9 a.m. on Monday morning and you just got to work. The schedule is completely booked, and clients keep calling to see if you can “squeeze them in” even though you don’t have any empty appointment slots until next week. The owner of the hospital keeps saying yes to everything, and you feel overwhelmed and defeated even though your shift just started. Does this sound familiar? Our field is experiencing an unprecedented increase in the need for veterinary services, and it is taking a toll on veterinary professionals. Even before the increase in the need for veterinary care, it was very common to see words like “compassion fatigue” and “burnout” being used to describe what some veterinary professionals were feeling. What is it? A practical view What is burnout? “Burnout is a depletion or exhaustion of a person’s mental and physical resources attributed to his or her prolonged, yet, unsuccessful striving toward unrealistic expectations, internally or externally derived.”1 I think the key words in the definition are “unrealistic expectations” and “internally or externally derived.” It is important to understand burnout happens when someone repeatedly experiences the same negative effects without the ability to change them. When I spoke with Allyne Moon, RVT, CCFP, based in Cypress, CA, I asked her why she thought team members feel burnout in our field. She said many times “team members are given unrealistic expectations of what they should be doing at any given time.” Front office team members may be expected to answer the phones, check in clients for their appointments, check the clinic emails, respond to the text messages, follow up on call backs, and check out clients, all at the same time. Unless you are a super receptionist it is very difficult to do all these things at once, but this is a common expectation amongst veterinary hospitals. Technicians and assistants experience similar unrealistic expectations, as well. Those are the external pressures that affect us; later I will address internal pressures. I also spoke with Rhonda Bell, CVPM, CCFP, CDMP, owner of Dog Days Consulting based in San Antonio, who is a veteran hospital manager with over 15 years of veterinary experience. I asked her how she dealt with burnout, and she said, “I physically worked until my body shut down. I had a heart attack at 38.” “I didn’t’ know I was burning out or the effects it was physically having on my body and spirit.” After discovering she also had an autoimmune disease that prevented her from working full-time as a practice manager, she had to reinvent herself and change directions with her career. She stayed in the veterinary field by opening her own business focusing on digital media for veterinary hospitals, but sometimes she misses working in a hospital. Moon said she knew she was experiencing burnout, when she realized that she had done over 5,000 euthanasias at the shelter. “I got into shelter medicine hoping I could make a difference; it took a long time for that to happen.” Burnout can affect every aspect of the veterinary industry whether you work at a general practice, an emergency hospital, or an animal shelter. It can also affect everyone who works there, whether you are a team member, a manager, a veterinarian, or even the practice owner. If you work somewhere long enough and feel like you can’t change the situation or make a difference, it begins to affect you. The scholarly view The Maslach Burnout Inventory2 describes three aspects of burnout:. Emotional exhaustion (“I feel emotionally drained by my work”) Depersonalization (“I worry that my job is hardening me emotionally”) Reduced personal accomplishment (“I don’t feel that I’m positively influencing other people’s lives through my work”)1 The Burnout Measure3 measures the following: Physical exhaustion (feeling tired or rundown) Emotional exhaustion (feeling depressed or hopeless) Mental exhaustion (feeling disillusioned or resentful) 1 Overall, burnout is a feeling of emotional, mental, and physical exhaustion. Many times, it manifests as a feeling of dread toward work. You might find you need to drag yourself out of bed, or even give yourself a “pep talk” just to get started. Do you find yourself getting irritable toward your co-workers or clients? Do you lack the ability to focus or concentrate? Both these feelings can be a sign of burnout. Compassion fatigue – an offshoot of burnout Another common problem in our industry is compassion fatigue. While experiencing burnout can lead to compassion fatigue, one of the biggest differences is the emotional toll compassion fatigue takes on a veterinary professional. “Compassion fatigue can be characterized by emotional and physical exhaustion leading to a diminished ability to empathize or feel compassion for others, often described as the negative cost of caring.” 1 Compassion fatigue is a combination of burnout and “secondary traumatic stress.” Secondary traumatic stress is the “negative effects associated with witnessing people who are suffering or traumatized, knowing you do not need to survive trauma to become traumatized; you just need to witness it.” 1 Veterinary professionals experience secondary traumatic stress differently that our human medicine counterparts. We are not always absorbing trauma from the client’s experiences, but from the pets directly. Working in emergency medicine for the past five years I can say there are things “you can’t unsee,” and that can be very traumatizing. Elizabeth Baird, of Sacramento, CA, who has been in the veterinary field for several years, says, “There are three kinds of people: the young eager ones, the grizzled veterans who are exhausted, just trying to get through the day, and the experienced, yet, realistic ones who have a balanced mindset.” Over time the “young eager ones” start to change the way they feel and how they deal with things. They may start to take on a negative mindset, and we need to figure out ways to prevent this. We also need to find ways to help the “veterans” who are already feeling the effects of burnout. We need to learn from the realistic ones who have a balanced mindset. We all got into this field because we love animals, and the feeling of burnout and compassion fatigue affects our ability to find joy in our work. So, what can we do about it? Resources to assist you There are many tools that can help you deal with burnout. Use the “Maslach burnout inventory”2 and the “burnout measure”3 to help you identify if you are experiencing those feelings. And answer the following questions: Are you tired every day? Do you feel disillusioned about your job? Do you lack satisfaction from your achievements? Do you experience headaches, stomach or bowel issues, or other medical issues that might be a sign of burnout? Are you consuming more alcohol, food, or other drugs to simply “not feel?” The first step in making improvements is understanding you are experiencing burnout. Once you know you are, what can you do about it? The Mayo Clinic has great information on burnout and what to do about it. 4 Whenever possible, talk to your supervisor or manager. Sometimes you think the leadership team is aware of your feelings, or they don’t care about them, but that is not always true. I have been a practice manager for over 16 years and there have been many times I didn’t know how much someone was struggling until they spoke with me about it. Whenever it has been possible, I have tried to make the adjustments needed to help team members feel better. I believe in having open communication with my team so we can work together to find a solution. I understand this is not always an option, if you work for a corporation, you might not be able to speak with the right person, or sometimes you have received a negative response when you have spoken with them. That does make it more challenging if you are not able to influence the negative affects you are experiencing. Dog-tired is one thing – burnout is totally different. Failing to recognize and treat it can result in mental and physical conditions that eventually can’t be ignored. Photo: EA Lopez This is where I ask leaders to put themselves in touch with what their team members are dealing with daily. Put yourself in your employee’s mind to see if there is something that can be done to help. It costs a lot more to hire a new employee then keep one you already have. What else can you do? Ask for help. Patricia Smith, CFAP, and founder of the Compassion Fatigue Awareness Project - Home 5 recognized the need for resources for veterinary professionals to cope with compassion fatigue and burnout. While it is common to speak with your co-workers about your problems, this is not always productive. Many times, we feel the comradery of “suffering” together, but that doesn’t mean we are going to feel better later. Try seeking professional help; many companies have employee assistance programs to help you get professional help that will give you long term relief. Let’s all work at getting rid of the “mental health stigma.” If you had a broken leg, wouldn’t you go to the hospital to get it fixed? The same thing needs to be said about your mental health. Helping curb those internal pressures Unfortunately, you cannot always change the external pressures at work, but you can influence the internal ones. Do you make time for yourself to relax? Do you make time for yourself at all? One common denominator in burnout is we don’t make time for ourselves. You need to take some “me” time. Whether that is reading a book for 30 minutes, painting, or going outside for a walk, you need to do something that will recharge you and take you away from the frustrations of work. You also need to do this regularly. We talk about “self-care,” but many times we approach it like it is something you do once a month, or sporadically. I have heard people say their self-care is getting a massage every few months, or getting their nails done every two weeks. While these are great examples of taking time for yourself, they need to be done regularly to be effective. Sometimes self-care is spending five minutes watching something that makes you laugh or taking a bath at the end of a long day. Whatever you find enjoyable, try doing it more. And stop telling yourself that you are not worth it, because you are! Many times, we lack the ability to set boundaries. We say yes every time we are asked to take on an additional shift, and managers answer every call or text received from the team (even when there is another manager working). We are taught working longer and harder is like a badge of honor and “martyrdom” is something to strive for. I am here to tell you it isn’t. Many of the ways we approach our jobs internally causes burnout just like the external pressures do. We need to learn to say no sometimes and not feel guilty about it. This includes the leaders in the hospital: the managers, supervisors, veterinarians, and practice owners. When I managed my first hospital, I felt like I had to stay longer and work more hours than my team so I didn’t feel guilty when I wasn’t in the office. One pay period I had over 126 hours in an 80-hour work week. I was exhausted and burning out. I had to learn how to delegate and give my team the resources to handle things on their own to give myself a better work-life balance. This mindset is not easy to change, and for many years, veterinary professionals have championed the idea this is “how it’s done,” even when it was to the detriment to the team or themselves. The experiences of the pandemic have changed our lives, and many practice managers and practice owners have realized the need to for time off and a better balance. Bloomfield Animal Hospital in Lakewood, CA, started closing one Saturday a month to give their team a weekend to recuperate. Their manager, Melissa Garcia, BS, CVT, believes giving the team this additional time helps them perform better when they come back to work. “Everyone is more rested, and we start our Monday feeling more positive,” she says. Sometimes burnout can be so overwhelming you might need a change. Baird says, “I’ve experienced burnout, compassion fatigue, and depression, and many times I was able to bounce back after taking a break or moving to a different job.” She also knows what to do to relieve stress before it becomes unmanageable. Unfortunately, sometimes leaving a job is the only way to get out from under the feeling of burnout. The feelings of burnout and compassion fatigue can affect us all. Many times, we get so immersed in those feelings we forget how to be happy, or that we are even allowed to feel happiness. A few years ago, I made a change in my own career direction, feeling extremely burned out I had to decide what I wanted in life and take control of it. Becoming a veterinary management consultant and opening my own business was the best thing I could have ever done. I have been able to help so many people in our field, and see other people succeed and make changes that have made their lives better. Ultimately, even though we work with animals in veterinary medicine, it is the people who make the biggest difference. Melissa Tompkins, BS, CVPM, PHRca, CCFP has worked in the veterinary field for over 18 years. She earned her BS in Animal Science from Cal Poly Pomona. She managed multiple hospitals, including general practice, specialty, and emergency before opening her own veterinary management consulting business in 2018. She is a certified veterinary practice manager, a professional in human tesources for the State of California, as well as a certified compassion fatigue professional. She was the 2018 SCVMA’s Paraprofessional of the Year. She is also an active speaker and published author. References M Teater, MA, LMFT, LPC, LCAS and J Ludgate, PhD. Overcoming Compassion Fatigue, A Practical Resilience Workbook. 2014. PESI Publishing & Media C Maslach, SE Jackson. The Maslach Burnout Inventory. J of Organizational Behavior. 1981; Consulting Psychologists Press. Pines, A. M., & Aronson, E. Burnout Measure. 1978. https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/burnout/art-20046642 http://compassionfatigue.org/index.html

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Are you burned out?

Tips for veterinary professionals to recognize and reduce this emotional state

What is it? A practical view