In veterinary care, compassion fatigue stands out as an emotional toll often hidden from view.
Not One More Vet, an organization dedicated to addressing the issues of mental wellness in the veterinary profession, calls compassion fatigue one of the career’s “hidden dangers.”
Here’s why compassion fatigue occurs, what it looks like, as well as what veterinarians can do about it.
What is Compassion Fatigue in Veterinary Medicine?
So what exactly is compassion fatigue? When people in caregiving roles have to constantly expose themselves to suffering, trauma, and stress, their natural tendency toward empathy and compassion can become strained over time. They tend to feel depleted and exhausted, and may find it difficult to feel compassion—even though compassion is a central tenant to their profession.
“When vets have been exposed to constant, extreme emotional experiences, not only in ourselves but in our patients and our clients and our animals, we lose that ability to nurture,” explains IndeVets veterinary social worker Dave Shuey.
A Range in Symptoms
It can be difficult for veterinarians to recognize the signs of compassion fatigue: the nature of the job often means vets are moving quickly through the day, without taking stock of their stress levels or emotional bandwidth.
Veterinarians suffering from compassion fatigue might feel overwhelmed and anxious—they might also feel detached and grow numb to patient suffering.
Compassion fatigue symptoms tend to fall within three categories. “One is exhaustion: physically, mentally, emotionally, spiritually, and socially,” notes Shuey. “And then cynicism, which is that kind of loss of the human connection that we’ve got between ourselves and those we care for. And the third category is the loss of professional efficacy. So that’s not feeling like we make a difference.”
It’s important for veterinarians to know the symptoms of compassion fatigue so that they can address the issue when it happens—before it has a negative impact on their mental well-being or on their practice of veterinary care.
Moral injury and trauma exposure are two of the lead causes of compassion fatigue.
What Leads to Compassion Fatigue: Moral Injury
In veterinary care, compassion fatigue can result from a vet’s deeply held beliefs and ethics being at odds with situational realities. While a vet’s primary goal and desire is to put the patient first and take care of the patient, the patient’s client may not always agree on the recommended course of action—or they might be unable to afford it.
Vets may have to stand by and watch as an animal suffers.
“On my large animal rotation in vet school, we had a pregnant mare that went septic—and the owner declined to do a c-section and treat the colic. This horse was dying in my arms,” recalls IndeVets Veterinarian Dr. Marissa Brunetti. “We used every single pain medication in both the small and large animal clinic to make sure this horse didn’t suffer, but the owner wouldn’t euthanize—and you see events like that even very early in your career.”
Similarly, a vet working in a budget-restrained shelter may intake puppies suffering from parvo, but can’t dedicate the extensive resources and attention necessary to give them the best chance of survival.
The conflict between knowing what the proper treatment plan should be, yet not being able to help the animal is known as moral injury—and it can be a traumatic experience for vets.
What Leads to Compassion Fatigue: Trauma Exposure
The practice of veterinary medicine will inevitably expose practitioners to trauma. Dealing with the pain and distress of clients inherently leads to compassion stress, which is a typical precursor to compassion fatigue. “The longer you practice, the more trauma that you see,” notes VETgirl Dr. Justine Lee.
And the human brain is wired in a way that can make compartmentalizing these experiences difficult.
“We have FMRI data that says the human brain cannot tell the difference between whether something is actually happening to us or whether we are just hearing about it,” notes Shuey. “The same structures, like the anterior cingulate, lights up when we see a picture of someone getting poked with a pin or whether we see a dog with its paw in a bear trap.”
In other words, hearing about trauma and seeing trauma in a veterinary setting are ultimately both still traumatic events.
How to Deal With Veterinary Compassion Fatigue: Creating Compassion Resilience
Once someone recognizes that they’re showing signs of compassion fatigue, it’s important to take proactive steps. Psychologist Amy M. Williams has recommended following the well-known flight attendant mantra when dealing with compassion fatigue: “Put on your own oxygen mask on before helping others.”
In other words, veterinarians give the best care to their patients when they’re able to bring their best selves to the clinic. Here are the steps experts recommend taking.
1) Enforce a Manageable Schedule
Being overworked can lead to compassion fatigue because vets have less opportunity to emotionally replenish themselves, and less time to devote to self-care activities that tend to keep compassion fatigue at bay.
“Stop working. Take your PTO. You’ve earned it. Use it like currency and be very, very serious about just getting out of the environment,” advises Shuey. “That’s the simplest thing. Set aside time to be unreachable as veterinary professionals.”
It may be difficult for veterinarians to advocate for themselves in a field that is notorious for overtime requests and overworking, but firm boundaries are necessary if they want to prevent compassion fatigue—and prioritize their mental health.
Ultimately, if veterinarians can’t get the support and resources they need at their current job, it could be worth exploring other career options. Many IndeVets vets, for example, realized that relief work was a better fit for maintaining their work/life balance and keeping their love for the profession alive.
2) Stop Victim Blaming
Victim blaming is one of the reasons veterinarians may be reluctant to address their compassion fatigue: they blame themselves for their own lack of resilience, lack of wisdom, or for struggling with work/life balance.
“Why am I burnt out? Why do I have all this fatigue? Because we are perfectionists, we turn it inward and it almost becomes ‘why can’t I get out of this?’ It can become this cycle where you can’t get out of it because you make it more personal,” observes Dr. Brunetti.
Victim blaming happens when the focus is on what is wrong with the person, rather than on what happened to the person. Reframing the conversation to “what happened to you” rather than “what you did wrong” in one’s practice can help reduce the self-blame that creates stress and fatigue.
3) Open the Conversation
Feeling isolated as a caregiver can lead to compassion fatigue—it’s daunting for veterinarians to feel like they are operating alone in a silo. Opening the conversation and creating a support network in the workplace helps people feel like they’re part of a team, rather than a one-man operation.
Dr. Brunetti notes that it helps to discuss what’s happened so that people can vocalize what they’re going through, rather than bury it.
“Do more huddles pre- and post-shift: where you’re saying if there was a trauma experienced, or a client that could not pay, or euthanasia that may happen that maybe we could have treated, but the owner could not do that. I would bring that out, and I would talk about that as something that happened to the staff, not something that we did,” she recommends. “Bringing it out into the light is really helpful.”
4) Build a Peer Network
Whatever veterinarians are going through, they’re likely going through it together: a study of Australian veterinary students found that 21% were already dealing with compassion fatigue. Discussing what’s happening with other veterinarians can create a bedrock of support and resilience, enabling them to better care for their animal patients—and themselves.
“I think it should be more common that we talk about these things. Whether it’s through text or Zoom calls or group face times. So we are reaching out and saying, ‘Have you had any traumatic cases lately?’ Let’s be a support network together and talk about those things—they’re real, and it happened to you, right? It isn’t you, it happened to you,” recommends Dr. Brunetti.
Shuey notes that it’s the discussion that’s key, rather than necessarily being able to connect with another veterinary expert—so your support network can go beyond other veterinarians.
“I think companions are more important than experts. When we’ve been through that tough case, we don’t necessarily need an expert to come into it, analyze it, and tell us what to do. We just need that other human being there with what’s going on,” he explains.
Veterinary Compassion Fatigue: Moving Toward Resilience
Ultimately, building up compassion resilience will help veterinarians manage their caseloads without feeling emotionally disconnected, numb, or powerless.
Dr. Brunetti emphasizes that solutions need to be holistic, and not just focused on relieving a single symptom—such as stress.
“I love yoga and meditation, but [combating compassion fatigue] is more than just that. And I think when people hear some of these self-care things, that’s another form of victim blaming. Someone might think, ‘Oh, if I just do yoga, you know, all of this moral injury will go away.’ But it can’t be the whole plan, right? It is more about discussion and community support.”
For vets who want additional guidance on how to redesign their lifestyle and embrace healthier coping mechanisms, Veterinary Compassion Fatigue Certification for Caregivers—such as this program offered by EverGreen Certifications—can be a great resource.