Most of us are veterinarians, vet techs or vet nurses not only because we like the challenge that the world of medicine presents us, but also because we are “natural caregivers”. The combination of emotional skills and scientific knowledge is what clients value most about the care received in veterinary clinics and hospitals. However, veterinarians and VTAs are sometimes unaware of the dangers of emotionally supporting others, especially when it comes to the death of patients. If they don’t take care of themselves, they run a high risk of emotional exhaustion, i.e. Compassion Fatigue.
In the veterinary profession, we constantly walk the fine line between life and death. Battles are not always won and this presents a great emotional burden, especially for the veterinarian, who may come to blame themselves for the loss.
Not surprisingly, veterinarians often struggle with mental health problems related to the deaths of patients, especially with their prominent role in euthanasia. These feelings can be exacerbated when the relationship with the patient has existed for many years. The professional who’s watched a pet grow from its first vaccination as a puppy to adulthood and has seen the ailments of old age set in, inevitably loses a cherished relationship and loved one.
The degree of attachment the owner has with the pet also exacerbates the management of the situation. Several studies have established the high degree of emotional connection that pets have within families. For many people, a dog or cat is like a small child and this places the vet professional on the emotional level of paediatrics.
The dichotomy between the veterinary profession and emotions
Although medical training protects you to some extent from getting lost in your emotions with a barrier of objectivity, rigour and rationality, the reality is that as a veterinarian you must manage others’ grief while also managing your own.
At one level, you may feel that you need to be “strong for the owner” and consequently not express your emotions. Indeed, this is very important in the doctor-patient relationship, and especially in the critical moments surrounding the death of a patient.
Our primary role here as veterinarians is to reassure the client throughout the entire process, from the time the option of euthanasia is being considered to the later stages of grief itself. It would be inappropriate to be overly emotional or to lose objectivity.
But at the same time, as a professional you must be honest with yourself and your feelings, maybe not in the presence of the owners but at the end of the day. No matter how much you try to distance yourself from what happens in the euthanasia room, you are only human. And that’s okay.
How bereavement unfolds and how to cope with it
Every time a companion animal that we cared for dies or is euthanised, it should be considered a critical moment in terms of Compassion Fatigue. These incidents have a cumulative impact that can be compounded if not managed in some way.
As a veterinarian or technician, you must be aware of this emotional burden in order to detect how much you are affected. Manifestations of this emotional burden may include crying, difficulty sleeping, loss of appetite, emotional distancing from similar cases, denial, confusion, inability to concentrate, needing to re-live the loss, sadness, anger, depression, withdrawal, feeling overwhelmed, rejection or even self-doubt.
Bereavement can affect various members of the team in different ways.
It’s important that you all have the opportunity to share these feelings together and recognise that you are truly grieving.
The deeper the bond between the guardian and their pet and the guardian and the clinical team, the greater the need for emotional support from staff. These emotionally charged interactions day in and day out can leave the team drained.
What can you personally do to minimise the emotional impact of death and euthanasia?
Come to terms with the reality that as a veterinarian and vet assistant you cannot be compassionate without being emotionally affected. This is not a weakness, but a very human reality. But constant giving can leave you empty. Therefore, you must adopt a plan that replenishes your emotional reserves.
Find a trusted partner who you can talk to about these feelings and share your pain with. Take turns listening to each other and support each other during difficult cases.
Establish an atmosphere in the workplace that accepts the impact that patient death and euthanasia can have on all of the staff. Encourage each other to respect this fact and to be supportive of each other.
Set realistic boundaries in your work to ensure that you have time to retreat and recuperate. Socialising, hobbies or sports are very beneficial for unwinding.
Loss, sadness, grief and doubt are part of the life of a compassionate vet professional.
Developing a lifestyle and a supportive environment at the clinic that buffers the impact of these emotions is key to a healthy professional and personal life.
Try yoga exercises by Cris Pestana, veterinarian and yoga expert, specifically designed to help you cope with the emotional impact of loss and grief. You can find them here: Loss and Grief.
What actions can be taken in the clinic to help the team stay emotionally strong?
When euthanasia is considered for a terminally ill patient, a number of actions can be taken to alleviate the emotional stress on the team.
- See euthanasia as synonymous with giving the animal a more dignified death and not as a failure.
- Have a euthanasia protocol that minimises the negative memories associated with euthanasia and is as respectful and empathetic as possible for the animal, its carers and also for the staff.
- Inform all staff involved in the animal’s care that euthanasia is being considered.
- Provide the opportunity to staff who wish to bid farewell to the animal to do so, this includes the opportunity to comfort the family in any way they see appropriate.
- Allow staff to prepare cards of condolence to the family or let them prepare a memento for the animal’s caregiver.
- Discuss the whole case afterwards with the team, reflecting together on what was done well and what could have been improved. Support each other without judging each other’s reactions.
- Accept that everyone may have different reactions: sadness, relief or anger.
- Praise all staff for their efforts in caring for the patient and client involved.
- Reflect as a team on the lessons learned from the case and the specialness of the relationship with that client and their pet, if applicable.
Compassion Fatigue can be one of the triggers of Burnout and is often under-diagnosed. In the article Compassion Fatigue in Vets and Vet Nurses: identify the symptoms and learn how to protect yourself you will find all the information about the aspects of emotional distress that have led many professionals to leave the profession.
For managers of veterinary centres, we’ve created the Compassion Fatigue test – a critical tool for evaluating the degree of physical and mental exhaustion in your staff. We encourage you to read the article “Compassion Fatigue Syndrome Assessment Tools for Veterinary Centre Managers” . Download this valuable resource and take action to improve the mental health of your team. It’s available in English, French, German, Italian, Polish and Spanish.
