Cara Wright, DVM, MS, IVCA, tackled the important topic of on-call stress and ways to mitigate it during her presentation at the 2023 AAEP Convention in San Diego, California. Emergency on-call duty is a necessary part of equine veterinary medicine, she stated, but the responsibility can be overwhelming.
On-Call Stress for Equine Veterinarians
One stressful aspect of being on call is the frequent need to travel to patients in all weather and at all hours. Adding to the stress is the lack of dedicated emergency practices for horses. Many practitioners experience anxiety about the unknown when they are on call, which can manifest as paralysis.
“They may not feel that they can run errands or cook dinner due to being on call,” Wright explained. Veterinarians are often stressed by their perceived lack of control while on call; the doctor does not have control over who will call, when they will call, and what the problem will be.
In a 2017 survey published in Frontiers of Veterinary Science, over half of the more than 1,900 veterinarian respondents of various species focus said they agreed or strongly agreed they experience significant anxiety while on call, regardless of whether they get called in, Wright reported. Almost 70% said they cannot relax while on call, and eight out of 10 routinely worked the following day. Another study showed moods are lower and cortisol levels are higher the morning after veterinarians are on call, regardless of whether they attended an emergency. The researchers said they believe readiness to respond makes it harder to recover from work and does not count as true rest. In addition, veterinarians on call take longer to fall asleep and have decreased sleep quality. However, Wright suggested “a mindset shift can help you live your life.”
On-Call Stress Mitigation Strategies
Tangible changes can make a big difference in coping with on-call stress, Wright said. “Coping mechanisms are actions or thought processes used to modify one’s reaction to stressful or unpleasant situations,” she explained.
Control What You Can
Because much of a veterinarian’s work life is out of their control, managing the parts of their life they can control can help decrease stress. Veterinarians rarely need to return phone calls about emergent issues immediately; instead, Wright suggested allowing yourself a 20-minute period to finish eating dinner or complete an errand or urgent task. Wright also noted veterinarians might experience a visceral reaction to a ringtone that signifies an emergency call. She suggested having a different ringtone for routine calls to reduce the number of adrenaline rushes or to change your ringtone to something fun. It can also help to have all calls go to voicemail so you can listen to the client’s message and prepare before returning the call.
Prepare Ahead of Time
“Sometimes, on-call stress is due to worry about cases that may be outside of our comfort zone,” said Wright. She recommended asking yourself how often a case is actually beyond your ability to handle. One way to deal with these anxieties is by preparing ahead of time for those cases you lack confidence in seeing. She also advised becoming familiar with your referral center doctors and calling them for guidance if you feel overwhelmed. Wright said recent data show just 2.6% of equine emergency calls occur between midnight and 6 a.m., which can help veterinarians shift their mindset. Other suggestions included being paid 100% of the emergency fees, which “allows reframing the experience,” and making personal time adaptations—such as cycling or running a repetitive 2-mile loop rather than a 10-mile loop—so you can attend an emergency if necessary without sacrificing your training session entirely.
Change Your Mindset
For more abstract coping, Wright cited a discussion with Jamie Goldstein, Psy.D, a licensed clinical psychologist who suggested taking control of and reframing your thoughts is a great tool for building resiliency and changing your mindset. She recommended recognizing your thoughts and creating space to express them through journaling.
“Self-reflect about what it actually means to you to be on call. Do you see it as a chance to serve your clients or just as a barrier to your freedom? Defining this for yourself is the first step in reframing your thoughts,” Wright said. Training yourself to set firm boundaries around your time away from work can help you rest and recover fully, she added. Finally, if necessary, “schedule worry time,” rather than letting it invade every moment.
Final Thoughts
In conclusion, Wright said making tangible changes and committing to a mindset shift are essential for reducing the stress and increasing the health of practitioners providing emergency on-call services.
