The Emotional Toll of Vet Med: Recognizing Burnout and Compassion Fatigue | Episode 59 | Reviving Vet Med

Feeling drained and disconnected from your work? You’re not alone. In this episode, we dive into the emotional challenges that many veterinary professionals face: burnout, compassion fatigue, and empathy fatigue. Though often used interchangeably, each of these issues has its own distinct impact on our well-being. We’ll unpack what sets them apart, how to recognize the signs, and why understanding the differences is key to managing them effectively.

In addition to breaking down these emotional tolls, we share practical strategies to help you navigate them, including setting boundaries, practicing self-compassion, and shifting your focus to protective forms of empathy. Tune in for expert tips on assessing your emotional health and discover actionable solutions to safeguard your wellbeing, so you can continue doing the work you love without burning out.

Resources
Burnout Self-Assessment Tool (MBI): https://revivingvetmed.com/wp-content/uploads/2024/10/LifeLearn-Burnout-Self-Assessment-Tool-Interactive.pdf

ProQOL (self-assessment): https://proqol.org/proqol-1

Is empathy good or bad for veterinary caregivers? (blog): https://revivingvetmed.com/empathy-good-bad-veterinary-caregivers/

Compassion does not fatigue! (article): https://pmc.ncbi.nlm.nih.gov/articles/PMC6005077/

The power of self-compassion in veterinary medicine (blog): https://revivingvetmed.com/the-power-of-self-compassion-in-veterinary-medicine/

Five tips for building better boundaries (blog): https://revivingvetmed.com/five-tips-building-better-boundaries-aka-saving-sanity/

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Transcript

Practical and Evidence-Based Reviving Vet Med Podcast

Episode 59

00:00

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00:58

Hey everyone! Welcome to another episode of Reviving Vet Med. Today we're diving into a topic that is so important for veterinary professionals, the differences between burnout, compassion fatigue and empathy fatigue, and most importantly, how to manage them. As veterinary professionals, we enter this field with a deep compassion and empathy for our patients and clients, but over time, the emotional and physical toll of our work can wear us down. You may have heard terms like burnout and compassion fatigue used interchangeably, but they're actually distinctly different. Understanding these differences can help us develop strategies to protect our well being and continue doing the work we love. So today we're breaking it all down. Let's go ahead and get into the episode. 

01:57

This is the Reviving Vet Med podcast and I'm your host, Dr. Marie Holowaychuk. My mission is to improve the mental health and well being of veterinary professionals around the world.

02:16

So let's start with burnout. I think that burnout is one of the most talked about issues within the veterinary profession today. When it comes to well being, burnout is a state of emotional, physical and mental exhaustion that is the result of prolonged stress. Now by definition this stems from stress in the workplace, and so these are factors like excessive workload, lack of control over work, not feeling appreciated and those sorts of things. Certainly in veterinary medicine there is also a lot of research to support workplace issues like toxicity and poor communication, which are tied with burnout. So this is definitely something that is top of mind for many of us and it's something that we talk a lot about on the podcast.

03:11

Now, one important distinction about burnout, when we differentiate it from other issues that we deal with, is that it's not necessarily tied to patient care. Burnout can happen in any profession. So in veterinary medicine, we find that burnout is often driven by long hours, challenging interactions with clients, the administrative burden of medical record keeping, and this sense of feeling like no matter how hard you work, it's never enough, or that your own personal values are not in alignment with the organization or with the practice that you are working for. So when

burnout sets in, there are different signs that you might notice. We think of, typically signs or symptoms that are defined according to the MASLACH Burnout Inventory.

04:04

And these three symptoms are emotional exhaustion, which is just feeling like you don't have the emotional capacity to deal with your job, or your work cynicism, which is a little bit of detachment from your patients and your clients and your team. You know, feeling like maybe you're just going through the motions and then last but not least, reduce professional efficacy. So this can either look like tasks that once felt manageable now seem very overwhelming, or that even when you find yourself successful at work helping patients, you know, supporting clients, it just doesn't feel like enough. It doesn't feel satisfying. And so for me, I have experienced burnout several times in my veterinary career. And the first time I experienced it was, well, realistically was probably in my internship and residency, but really in my grown up working veterinary life.

05:05

It was when I was on faculty at the Ontario Veterinary College. And at the time I didn't even realize that I was experiencing burnout. I just knew that I felt completely emotionally taxed by the caseload in icu. I was starting to feel like I really was, I don't know, just not so much cynical, but more so just detached or not as connected to my patients and to my team members. And it definitely felt like I was not really doing anything worthwhile. You know that at the end of the day, sure, we were helping some of these patients, but those successes just didn't really feel like enough. And so again, at the time I didn't realize it was burnout.

05:55

I just thought, ugh, I'm just not cut out for this job because it's clear that I just am having all these negative emotions when it comes to this incredible work that I'm doing. And so I think at the time, when I think about factors that played into that, definitely the time that we spent on call as faculty at OVC definitely played a role. And I think that was probably the biggest thing. In addition to the fact that I just really wasn't taking care of myself well outside of work. I was working all the time. Whether or not I was on call and there was very little work life separation and there was very little attention to self care, which are things that we're going to talk about later on in the podcast in terms of strategies. So that is burnout.

06:44

I want to talk next about compassion fatigue. So unlike burnout that really stems from working conditions, compassion fatigue is specifically related to the emotional toll of caring for others. And this is especially common when we witness suffering day after day. And, you know, I think there's a big public misconception around what we do in veterinary medicine. So many people, when they find out I'm a vet, they're like, wow, that's amazing. That's such an awesome job. That must be so fun. I think they imagine that we are playing with animals all day and that it is all fun and cuddles and snuggles. And the reality is that we deal with so much more than that. We treat severe illnesses, we perform euthanasia, we see our clients struggle with financial limitations.

07:36

And all of these things can really drain us when it comes to experiencing care and compassion for our clients and the pets that they have. So signs of compassion fatigue include an emotional numbness or a feeling of disconnection from work. Specifically, the work of caring for others can also show up as increased irritability or anxiety and really a decreased ability to empathize with clients or patients. And this has often been termed the cost of caring because it really is a caregiving syndrome. And it really ultimately ends up in an inability to care. Right? We want to care. We still have that compassion in some regard. But there's a challenge in terms of putting that into action or at least feeling enthusiasm behind that action. And I definitely remember the first time that I experienced compassion fatigue.

08:37

This for me did not happen until I was at the Ontario Veterinary College. And for me, it was really a culmination of a lot of experiences of moral stress. And that moral stress really came from the workload and feeling like I wasn't doing a good job because of how tired and overworked and overwhelmed I was feeling. And so anytime we experience moral stress, we feel a little bit of a tug when it comes to our ethical compass, right? Our ethical values. And I firmly believe that to do good work as veterinary professionals, we need to be well rested and we need to have breaks. And there was a period of time when I was working that I didn't feel rested because of my on-call and because I wasn't enforcing breaks in myself and I wasn't taking care of myself.

09:33

And so ultimately, that led to these situations where I didn't feel like I was giving my best, and I worried that was going to be negatively impacting my patients. There were also some circumstances where we had so many patients and so many really challenging cases that I questioned whether we were doing a good job of managing them. And it's not to say that we weren't. That was just my internal moral compass that felt like, my goodness, you know, am I

providing the best mentorship to my interns and residents? Am I doing the best job teaching my students? And are we serving these patients to the best of our ability? This overwhelming sense of concern and pull emotionally in a caregiving role is ultimately what can lead to this compassion fatigue.

10:27

And so it's interesting that some experts actually argue that what we call compassion fatigue might more appropriately be termed empathy fatigue. And this is really important to recognize. And I will link to an article that a mentor of mine, Dr. Trisha Dowling, who is a pharmacologist at the Western College of Veterinary Medicine, where I went to vet school, she also has a very strong interest in aptitude and mindfulness and for years has run a mindfulness elective for the veterinary students at the WCVM. She wrote an editorial several years ago arguing that as veterinary professionals, we don't actually run out of compassion. You know, with that compassion is ever flowing. What we fatigue with is our empathy, right? And empathy is really that not just recognizing that you care and want to help somebody, but that you feel what that person is experiencing.

11:32

And so empathy fatigue by definition happens when we absorb the emotions and suffering of others to the point where that it depletes us. Okay, so I'm going to take a step back and just discuss the three different types of empathy. So there is cognitive empathy. This is exactly like it sounds. This is the cognition or the understanding of what someone else is feeling. Right? So we can see that a person's face is turning red and their voice is raised and their cheeks are puffing out, and we can recognize that they're feeling angry. Right? That is cognitive empathy. Emotional empathy is when we actually feel someone else's feelings or emotions. Okay? So when we see someone getting angry, we start to get angry. Or when we see a client in distress, we feel distress. This is emotional empathy taking on the emotions of others.

12:36

And if we're not careful, this can happen without or even knowing it. And there's many different reasons why that can happen. But we want to be very careful that, this, when we engage in this emotional empathy repeatedly, that is what becomes depleting. Taking on other people's pain and suffering and sadness and upsetedness especially can and will leave us feeling emotionally drained. So the third type of empathy is empathic concern. This is where we recognize what someone else is feeling and we engage our desire to help and alleviate that suffering. But what we don't do is take on that person's emotions, so we recognize what they're feeling and we tap into that compassion, that desire to help and alleviate suffering without taking it on as our own.

13:36

And this is where shifting from emotional empathy to empathic concern really is crucial for protecting our mental health as veterinary professionals and arguably preventing us from experiencing that emotional drainage, or in some regards, what some people believe is compassion fatigue. So how do you know if you're experiencing burnout, compassion fatigue, or empathy fatigue? Let's break it down. If you feel exhausted emotionally by your work, if you feel disengaged from your work, or like your work has lost meaning, then it's likely that you're experiencing burnout. A lot of people who experience burnout, especially in the early stages, when they take a break from work, when they take a vacation, if they take time off, if they go on sabbatical, they come back feeling great. They've had that break from that and they feel okay outside of work.

14:35

On the other hand, if you feel emotionally drained from taking care of your patients or you feel like you're struggling to connect with and care for your clients, that is probably compassion fatigue. Again, that is that caregiver burden, where it is the inability to care or feeling drained by your caregiving role that is resulting in this compassion fatigue. And then last but not least, if you feel like you are absorbing the suffering of every client and patient and that is leaving you feeling emotionally overloaded, then you're probably experiencing empathy fatigue. Now, there are some scores that you can use other than just self reflection to gauge what your experience is, and I will link to those in the show notes. The most really well known score for gauging burnout is the Maslach Burnout Inventory.

15:33

And then another score that is very commonly used by veterinary professionals and other caregiving professionals is the Professional Quality of Life scale or the Pro QoL. So this scale measures three areas, the first being compassion satisfaction. This is the joy you get from your work. This is the opposite of compassion fatigue. If you have high compassion satisfaction scores, then by definition your compassion fatigue is low. It also measures burnout and it also measures secondary traumatic stress, which is also very closely related to compassion fatigue.  Mentioned earlier that compassion fatigue is often the result of feeling those morally stressful situations, even experiencing moral distress where you feel like you're being prevented from doing the right thing or that something is stopping you from being able to do what you think should be done.

16:30

When I think of moral distress, I think of things like euthanasia that is done for economic reasons or convenience reasons. So these situations on repeat can lead to secondary traumatic stress, because in essence, we're experiencing traumas in those situations. So I'll link to the professional quality of life scale in the show notes. And taking a moment really to assess where you fall on these different scales can be eye opening. And this just enhances our self awareness because when we know ourselves better, we can do better and we can start to make changes in our lives. So now that we know what we're dealing with, let's talk about solutions. I want to take you through some key strategies to protect your mental health and wellbeing in the name of preventing burnout, as well as compassion fatigue and empathy fatigue.

17:27

So we've touched on this already, but it's worth highlighting again. One of the best ways to prevent empathy fatigue is to shift from absorbing emotions to focusing on helping. So instead of internalizing a client's grief or distress, focus on how you can support them and their pet. When I started practicing this shift, I have to say I noticed a huge difference. Instead of taking on every client's pain as if it was my own pain, I focused on being present, being compassionate for them, demonstrating that empathy, naming what their experience was, but reminding myself that this is not my own experience. So I even started using the mantra, this is not my distress, this is not my pain, this is not my suffering. Just to remind my mind and body that I'm here to help.

18:24

But I'm not going to take this on as my own. The second strategy that I want to give you is to be mindful of your boundaries. And boundaries apply in all of these situations. What I just described about focusing on helping rather than experiencing is a boundary. And a lot of us struggle with boundaries, right? We stay late at the end of the day for just one more appointment, or we check our email on our days off, or we take on those extra shifts when we know that we're already feeling at capacity. And all of these things in different ways can lead to compassion fatigue or burnout or empathy fatigue. And so setting boundaries might look like making sure that you've got clear working hours and sticking with them.

19:13

I know one of the reasons for me that I experienced burnout is because there was no clear delineation between work and personal life. It was very rare that I took time off completely from work and used that time off to really take care of myself. So having those boundaries and sticking with them is very important. It's also important to learn to say no and not feel guilty about it. And I know a lot of people ask me, how do I say no without the guilt? And I think if you care, you're gonna feel guilty. That's just the reality. So it's, I guess in essence I should reframe that. It's not so much saying no without guilt, it's saying no despite the guilt. You will feel guilty if you care.

19:58

And the important thing is to push through by reminding yourself, if I don't take care of myself, I am not going to be able to show up for my team, my patients, and my clients. And I think if you're anything like me, and you've been in a situation where you have experienced burnout or compassion fatigue and you've shown up to work as that shell version of yourself, you're really not serving anybody. Those are the times I've shown up to work frustrated, resentful, angry, and I've been very snappy with my team and very, I'm sure, challenging to work with. And nobody wants that. I don't work that, want that either. And so learning to say no so that we can show up as the best version of ourselves. Setting boundaries involves also making sure that we have boundaries around breaks.

20:47

Not working too many shifts in a row, not working too long without taking vacation, not working too many hours without stepping away. Remember, if you struggle with these boundaries, you are not alone. This takes practice, but these really are essential for long term sustainability in our profession. Now, another strategy I want to share from you in this regard is practicing self compassion. If you follow my work, then you know that I am a big proponent of self compassion. And I will link to a blog that talks about the importance of self compassion. We give so much compassion to our patients and our clients, but what about ourselves? I think there are times where if we're feeling burnt out or we're feeling compassion fatigue, not only are we feeling that way, but then we're berating ourselves for feeling that way.

21:42

Self compassion means in these times of struggle, that you are as kind to yourself as you would be to a friend or to a child that was going through a difficult time. So this means recognizing that veterinary medicine is hard and you're not alone in your struggles. In our profession. So allow yourself to recognize that and to be kind to yourself, knowing that if a classmate called you up and said, hey, I'm really struggling, I'm going through this hard time, that you would be kind and compassionate to them in return, that's how you want to treat yourself. And for me, self compassion really has been a game changer. I used to think if I'm soft on myself, I'm going to lose my edge, I'm not going to achieve anything, it's not going to be helpful. And the opposite has been true.

22:36

I know, for me, that sooner that I can be kind to myself, the faster I bounce back. And that has been something that we have seen repeatedly in research studies. There's a study looking at self compassion among veterinary students and what they found is that those students with higher self compassion scores also had higher resilience scores. So they were able to bounce back faster during times of adversity. So if you find yourself feeling burnt out, feeling compassion fatigue, don't be hard on yourself. Be kind to yourself and know that this is a normal part of veterinary practice and that you can take care of yourself and get back to the person who you want to be. Another strategy is to engage in self care and recovery.

23:24

And I want to be clear that self care is not pouring a glass of wine and watching Netflix. Right? This is about building habits that refuel you and boost your health. So these are things that we don't necessarily always enjoy but that are good for us and that allow us to show up once again as the best version of ourself. So things like regularly moving our bodies, engaging in meditation or mindful reflection, engaging in hobbies outside of veterinary medicine, making sure that we're connecting with people who are important to us. Our partners, our loved ones, our roommates, our pets, our family, seeking therapy or professional support, keeping our finances in order, spending time in nature, all of these things are important self care activities and you need to find what works for you and make it a non negotiable part of your routine.

24:26

And then last but not least, it's so important to seek support and to normalize these conversations. I know that when I was feeling both burnout and compassion fatigue, I was really feeling a lot of shame. Along with that, I really thought that there was something wrong with me. I thought, I've got this amazing job, I've really, I've got my dream job and what's wrong with me that I feel this way. Everybody else around me looks like they're thriving and I'm struggling and I think that would have been changed if I would have connected with people, if I would have told people really how I'm feeling.

25:03

So connecting with your colleagues, your classmates, connecting with a coach or a mental health professional, joining a peer support group, all of these different things can make a huge difference in knowing that you're not alone and getting the help you need so that you can recover from what can be very serious experiences among veterinary care providers. Once again, if you're struggling, you are not alone. There is help and there is hope for getting back to the way that you were before. So to sum it all up, burnout is typically a job related exhaustion. It's a job related experience that can be helped by the strategies that I mentioned as well as changing some components of your job. So sometimes that means decreasing your on-call, shifting your schedule, adjusting your work duties, using AI scribe software or something to help mitigate your medical records.

26:05

It's changing your job so that you can reduce your burnout Compassion fatigue is the Emotional cost of Caregiving There really is no way around compassion fatigue other than to make sure that you are equally caring for yourselves. If you feel as though you are dipping into experiences outside of work where you can't turn off your work brain, you're feeling distressed by traumas or stressors that you've witnessed at work, it's really important to seek support for that. You do want to connect with a mental health professional. And then finally, empathy fatigue really comes from absorbing other people's suffering on a deep level. So making sure that you are practicing empathic concern. It's okay to recognize someone's suffering, but you want to hold the distinction that is their suffering, it is not yours. You're here to help, but that doesn't mean taking it on.

27:02

So all of these can be helped by intentional strategies like boundary setting, shifting our perspectives on empathy, and prioritizing self care. So really making sure that you are recognizing these in yourself and in others and taking steps to take good care of yourself. So that's it for this episode of Reviving that meant. If you want to explore the topic of empathy further, I highly recommend the War for Building Empathy in a Fractured World by Jamil Zaki. And if you're looking for additional resources tailored to veterinary professionals around empathy, burnout or compassion fatigue, please visit our website reviving vetmed.com if you found this episode helpful, please take a moment to subscribe or follow the podcast or share this episode with someone who you think would benefit from it. You can also follow us on social media.

28:03

We are on LinkedIn, Instagram and Facebook reviving vet med and we share tips and strategies for well being and mental health in vet medicine. If you have questions about today's episode, suggestions for future topics, or inquiries about sponsorship, please email us podcast@revivingvetmed.com. I'd like to thank the team at Bearbeat Productions for producing this episode and also you for listening to the end. I hope you'll tune in next time. In the meantime, take care of yourself. Bye for now.