As the veterinary profession struggles with how to define and cope with the emotional aspects of the work we do, we have recently identified two concepts: burnout and compassion fatigue. Burnout is simply defined as the stresses caused by our interaction with the work environment. Among the list of causes are the feeling of having no control over the quality of care provided and a conflict between individual values and organizational goals and demands. Compassion fatigue is defined as the stresses caused by our relationship with our patients and clients. The majority of the stress in these relationships comes from the fact that in healthcare, we are expected to be technically proficient, emotionally available, straightforward, clear and compassionate … all at the same time!
So what happens when we see corners being cut, perhaps resulting in providing services below our own personal opinion of “standard medical care,” and we feel powerless to change the system? What happens when we have to be straightforward, yet hide substandard quality of services? What happens when we have to demonstrate compassion and be emotionally available when we feel we are asked to act in an immoral way? This is the dangerous zone of “Moral Distress.”
We’ve all likely heard the phrase “to sell your soul,” and we understand what it means to say that money can’t buy our soul. No matter how much we get paid, we have the right to stand up for what we believe is the moral or ethical thing to do. This is when money doesn’t matter, and in fact, money didn’t matter much when we began in veterinary medicine. This job is more than a career; it’s a calling. We feel called to, or compelled to, help those animals that are suffering and, in turn, those people who love those animals. This compassion is the foundation of what we are all about, and we must be vigilant to watch this line and avoid crossing boundaries that steer us away from this compassionate calling. It helps to remember or acknowledge the positive and uplifting feelings that drew us to veterinary medicine.
If we are experiencing negative feelings now—whether it be called burnout, compassion fatigue or something else unnamed—another factor that adds to our negative feelings is a realization that we did not start out feeling the way we may feel now. We began with noble ideas of helping animals and the good way that sense of purpose would make us feel. In her book, “The Joy of Burnout” (2003), Dina Glouberman discusses these first feelings as what “fueled our fires” in the beginning, and they include a time when:
- We felt challenged and could meet those challenges.
- We had the power to effect change.
- We were proud of our own abilities and performance, sometimes to the point of feeling omnipotent.
- We felt appreciated materially and/or emotionally for our contribution.
- We had a positive connection to, or sense of community with, the people we were working with, for, or on behalf of.
- We enjoyed the process of doing what we were doing and could be playful while working hard.
These are feelings we need to remember and reconnect with, particularly if we are feeling an urge to change jobs, or especially, change professions. Try this exercise: Take 15 minutes of quiet “me time,” and reflect on why you entered the veterinary profession in the first place. Have you thought of leaving the profession since then? Do you feel that way now? What goals did you set for yourself or what picture did you see on the horizon when you began your work as an animal caregiver? Have you reached those goals, painted that picture? Have your goals changed over time?
Now write down what those goals included and whether you have met or not met each one. This list helps you to prioritize the sense of purpose that you are searching for right now. You do have a choice; veterinary medicine is not the only field in which you can work. In fact, many of our medical support staff have jumped over to human medicine … but what would your goals look like over there? Are they similar to the goals you had when you started caring for animals? Recognize that we all have choices, but try to be mindful of the big picture when making those choices.
Next time, we’ll look at what we can do when we feel our morals are being distressed, before it leads to Ethics Exhaustion.