BETTERINARY CARE:
Caring About the Caregivers Heidi Hulon | DVM, CCFP, MHFA
“The expectation that we can be immersed in suffering and loss daily and not be touched by it is as unrealistic as expecting to walk through water without getting wet. This sort of denial is no small matter. The way we deal with loss shapes our capacity to be present in life more than anything else. The way we protect ourselves from loss may be the way in which we distance ourselves from life. We burn out not because we don’t care but because we don’t grieve. We burn out because we’ve allowed our hearts to become so filled with loss that we have no room left to care.” This is what happens to those of us within the veterinary profession. We care a great deal – that is why we are in this profession. The problem is that we do not grieve. We do not acknowledge our feelings in the moment. We go from appointment to appointment to appointment every day. All the negative, sad, difficult emotions/interactions from each appointment are held onto – “I will deal with that later.” They become our negative emotions. That is why we burn out – because our hearts become so filled with loss/stress/anxiety/ fear, that we have no room left to care about anything. This is empathetic exhaustion. We go into this profession for purpose. Our purpose is to help and to save lives. We are trained to alleviate the suffering in our patients. However, we are not taught how to alleviate the suffering and loss that we will see in humans – clients and self. It is not just what we see, but what we feel as a result of our interactions. We care. We care a great deal – it is in our job description. What we do not do is grieve or allow ourselves to process what we are emotionally and mentally exposed to. These feelings build up and then weigh us down. Our ability to care is diminished and damaged as a result. This can affect anyone within the profession – “All of us who 28 | FVMA Advocate
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Self-care
attempt to heal the wounds of others will ourselves be wounded; it is, after all, inherent in the relationship.” To care for someone in pain requires you to be vulnerable, to walk through that water and get wet. We have to be careful not to drown in the suffering of others. Emotions are brief experiences that last for micro-moments. Emotions are like waves that rise up on an ocean and then dissipate. Emotions are typically triggered by the perception of our current circumstances. While short-lived, they initiate cascades of other emotions – upward or downward spirals. Positive emotions – these tiny fleeting emotions – drive us towards both flourishing mental and emotional health.
“We must grieve to process what we feel. We grieve that which we love.”
1. Feelings of energy depletion or exhaustion 2. Increased mental distance from one's job 3. Feelings of negativism or cynicism related to one's job
The status of the “water” changes, but do we? Are we adequately prepared to handle what we face daily in our jobs? “A smooth sea never made a skilled sailor.” – Franklin D. Roosevelt Why then do we do this? Do you ask yourself that question? You need to be able to answer that question: “I do this because…” Knowing your meaning and purpose in life is the single most predictive factor for well-being. What is your why? What gives meaning and purpose to your life? Empathy is at the core of who we are as caregivers. It is both an innate quality and a learned skill. Empathy is the capacity to see things from another’s point of view and feel what that person is feeling. This applies to both positive and negative feelings. Empathy can go one of two ways – empathetic distress or empathetic concern. When we only focus on the other and forget our own feelings, empathetic distress occurs. Empathy is what we emotionally receive from another. Empathy can trigger the pain center in our brain. Once empathy is established, that leads to compassion. Compassion is the deep awareness of the suffering of another coupled with the desire to relieve it. It is both emotion and action. It is being present in an energetic way for someone who is hurt or suffering. It is in our job description. Compassion triggers the reward center in our brain. We feel better when we show compassion to others and to ourselves.
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Burnout is a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed. The World Health Organization characterizes it in three dimensions:
Empathetic exhaustion is defined as ‘the cost of caring.’ The price paid by the caregiver in doing their job. A price that includes our emotional, physical, psychological health, and, sometimes, the ultimate price: a life. Why are we so willing to pay so much to do what we want to do? The components of empathetic exhaustion are burnout +/traumatic stress (primary and secondary).
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How can you avoid burnout? Here are some ways: • Work with purpose • Perform a job analysis and eliminate or delegate unnecessary work • Give to others • Take control and actively manage your time • Get more exercise • Learn how to manage stress Traumatic stress is a more significant factor for us. The resulting clinical signs from both look the same. It is the causes that are different. Primary traumatic stress is a trauma, injury, or challenge that occurs to you. Secondary traumatic stress is what you witness/hear about a trauma (the drama of someone else’s trauma). This is what we encounter every day with our patients and clients. You witness their pain, fear, anxiety, stress, regret, and anger. We are “infected” with this secondary traumatic stress.
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