Veterinary medicine attracts people with a drive to help others, as well as high levels of compassion, a deep awareness of suffering of another, coupled with a wish to relieve that suffering. While this trait enables veterinary care providers to experience compassion satisfaction that is a joy or sense of achievement in helping others and providing high quality patient care, this can take its toll personally and professionally over time. With repeated exposure to traumatic events such as animal abuse, diagnosis of serious illnesses, or euthanasia, as well as moral dilemmas, and occupational demands, compassion fatigue and burnout can occur. However, while the two phrases are often used interchangeably and elicit some of the same signs, they are not the same.
Burnout describes the physical and emotional exhaustion that occurs when veterinary care providers have low job satisfaction and feel powerless and overwhelmed at work. This results from a combination of exposure to environmental and internal stressors, as well as inadequate coping and adaptive skills. Some examples of work-related causes of burnout include feeling like you have little to no control over your work (e.g., working emergency shifts and never knowing what cases might walk through the door), lack of recognition or rewards for good work, unclear or overly demanding job expectations, doing work that is monotonous or not challenging (e.g., technician only doing reception duties), and working in a chaotic or high-pressure environment (i.e., most shifts in veterinary practice!). Lifestyle causes of burnout include working long hours, feeling over-extended or overwhelmed, not getting enough sleep, and lacking an adequate social support system. Personality traits can also contribute to burnout including perfectionism, pessimism, the need to be in control, and being a high achiever.
Signs of burnout include feeling overwhelmed, being unable to meet work demands or deadlines, losing interest or motivation, developing reduced productivity, having low energy, and feeling helpless, hopeless, cynical, resentful, or depleted. Other signs can include drug abuse, excessive sleep, procrastination, avoidance behavior, over- or under-eating, excessive alcohol intake, withdrawing from friends, family, or activities, and angry or emotional outbursts. Often times a co-worker that seems more grouchy or withdrawn than normal is actually suffering from burnout.
Compassion fatigue results from the veterinary care provider’s unique relationship with sick or dying patients and the empathy they feel for the owners or clients. It is a profound emotional and physical loss that occurs when veterinary care providers are unable to refuel and regenerate. Compassion fatigue can manifest as negative behaviors such as detachment or avoidance, emotional exhaustion, reduced sense of personal accomplishment or meaning in work, mental exhaustion, denial, apathy, or decreased interactions with others (isolation). Physical illness, substance abuse, compulsive behavior, and detrimental workplace conduct including interpersonal conflict or absenteeism can also occur. Most concernedly, compassion fatigue can establish a negative feedback cycle that can erode a veterinary care provider’s strong human-animal bond, thus reducing the feelings of compassion and empathy for patients and clients.
The important difference that must be recognized is that whereas burnout can often be resolved by changing jobs or adjusting duties at work, compassion fatigue cumulates over time and will follow you no matter what job you have. As such, it is imperative that positive coping strategies such as regular exercise, mindfulness and meditation, and self-care are fostered in order to increase resilience and ameliorate compassion fatigue. Likewise, as veterinary care providers we must learn to recognize signs of compassion fatigue and burnout in ourselves and others, as well as normalizing feelings related to stressful events or moral stressors. Just like many of our clients need validation that the grief they are feeling over the difficult decision to euthanize their pet is normal, as veterinary professionals, we too need validation that the feelings of burnout and compassion fatigue are more common than we think and nothing to feel ashamed of.
If you would like to complete a self-assessment to determine where you stand on the scale of compassion satisfaction, burnout, and compassion fatigue, the ProQOL (Professional Quality of Life) scoring system is commonly used and available for anyone to download online. Visit www.proqol.org for more information.
Marie K. Holowaychuk, DVM, DACVECC is a small animal emergency and critical care specialist and certified yoga and meditation teacher who also has an invested interest in the health and well-being of veterinary professionals. She organizes Veterinary Wellness Workshops & Retreats for veterinarians, technicians, and other veterinary care providers. To sign up for newsletters containing information regarding these events and veterinary wellness topics, please click here. More information can be found at www.criticalcarevet.ca/wellness.
Excellent review contrasting and comparing burnout and compassion fatigue. I found a nice phone application (Provider Resilience) that gives me an ongoing evaluation of how I'm doing with both of those conditions. It was designed to help caregivers of veterans, but most of the tools transfer nicely to veterinarians. For a brief review and link to the Provider Resilience website, check out the Helpful Apps section at the bottom of my website's resources page.
Tad B. Coles, DVM, MRSS-P, CCFP
Compassion Fatigue Coach
Helping helpers continue compassionate careers they love!