Editor's note: This article is brought to you by Boehringer Ingelheim.
Our work involves dealing with clients and their horses on a daily basis, often under conditions of strain. Inevitably, there is a problem to be solved or investigated that requires us to use our creativity, intelligence and persistence to solve. In thinking about the work we do, much of it is selfless work. We work tirelessly for the betterment of other people’s horses, for a reward significantly less than our human counterparts with increased risk of harm to ourselves. This selflessness is to be applauded to a certain extent. However, it can contribute to burnout because we believe that we must continue to meet the needs of others before ourselves. If we are not meeting our own needs, the only ones we are harming are ourselves. This is categorically untrue when we are experiencing burnout.
Burnout is a syndrome that is defined by three facets – emotional exhaustion, depersonalization, and low personal accomplishment. Emotional exhaustion results from the use of oneself as a tool in solving the problems of the client. The state of emotional exhaustion leads to the diminished ability to connect with clients on an emotional level. Depersonalization is best described as the dehumanization of clients, when our attitudes towards and perceptions of them are cynical and unfeeling. Depersonalization tends to develop alongside or as a consequence of emotional exhaustion. Lastly, reduced personal accomplishment is the belief that one’s work does not have a positive impact or is without meaning. One way to think about why burnout occurs is from a resource standpoint.
Research in other health care professions, such as nurses and physicians, has demonstrated the serious consequences of burnout on patient-related outcomes. It is likely that the same types of decreased client- and patient-related outcomes are occurring in veterinary medicine. One of the most significant outcomes that is compromised when practitioners experience burnout is quality of patient care. Further, there are likely to be costs to the practice as well; burnout has been associated with increased job turnover, absenteeism and low morale. There are also consequences for our lives outside of work, including exhaustion, poor sleep, inappropriate use of drugs and alcohol, as well as marriage and family problems.
Understanding the multifaceted consequences of burnout is valuable because it can help us put our selflessness into perspective, and hopefully support our ability to effect positive changes that support our wellness and ultimately the wellness of our families, friends, clients and patients.
Here are some skills, ideas, and actions that can support wellness and decrease the risk of burnout.
Research has shown that individuals experiencing burnout often have low empathy scores; empathy being the ability to recognize another’s experience and reflect their experience back to them. It might seem counter intuitive that an improved ability to relate to and engage compassionately with clients and patients would decrease feelings of burnout. It is theorized that empathy is protective because it helps us continue to see the humanity and desire to care about our clients. This can also contribute to stronger relationships with our clients, which in itself is rewarding and supports positive client and patient outcomes.
The premise of all mindfulness practices is increased awareness and attention to one’s current experience and thoughts, while remaining nonjudgmental of them. Often, mindfulness practices consist of a meditation, however, there are others, including mindful eating, mindful walking and so on. When we are more grounded in our surroundings, and what is happening, we can decrease anxiety, which often stems from worrying about things that might happen. Similarly, there is a decrease in ruminating over things that have happened in the past that we are unable to change. Encouraging a nonjudgmental stance can help us be more accepting of our clients, can facilitate feelings of empathy, and allow for stronger relationships.
Boundaries are rules that we create about how we are willing to be treated by others. When we don’t set boundaries, we allow others to set them for us. Boundaries relate to burnout because they relate to how we engage with the world. They are also a critical component of how much we work and the time we reserve for our lives outside of work. We can spend time being angry and frustrated over clients who text us at 10 p.m. on a weeknight, or 8 a.m. on a Sunday to ask about scheduling a routine appointment. Or we can know that our boundary states that we don’t respond to these messages, we choose not to get angry and we don't give it any of our precious time and energy. This does involve accepting the potential consequences of an upset client; this can be turned around as an opportunity to stand up for ourselves and what we need, which can be very powerful, and, in simply doing so, support our wellness.
Gratitude has been shown to improve our mood and increase our satisfaction with our life. How does it do this? Through helping us to see the positive in everyday life. The discipline of positive psychology helps us to understand this. All of us have a built-in negativity bias, which is to say, we see the negative more than we see the positive. This is a sound approach from an evolutionary standpoint; seeing the negative or the threat has helped us to stay alive through successfully handling the threat. However, research also tells us that positive things happen more than negative. Gratitude is a practice that supports looking for and focusing on the many positive things that happen each day, instead of the negative which naturally float to the surface. Specifically, when applied to practice, gratitude involves seeing our ability to be a part of our clients' and patients' lives as valuable.
Meaning and Purpose
Lastly, having a strong idea of our meaning and purpose in life is protective against burnout. This is true of both how we make meaning out of the work we do, and of how we view our purpose or meaning in our personal lives. A colleague I was privileged to work with defined her purpose this way: ‘to support students learning how to successfully interact with clients.’ For her, she could use her purpose as an acid test for each day. If she did work that contributed to her purpose, then she was satisfied. If there were things that occurred in that day that dragged her down, such as challenges with a coworker or getting buried in paperwork, she would return to her purpose, and if it was achieved, she was happy and able to let the other stuff slide. It can be hard to remember what we love about practice or why we became veterinarians in the first place when clients are angry or cases are going south. But connecting with these things can help increase feelings of satisfaction and decrease feelings of burnout.
It can be hard to prioritize self-care, or to create the mental space to change your perspective, but doing so is likely to have ripple out rewards and be protective against burnout!
1. Maslach, C.; Leiter, M.P.; Jackson, S.E. Maslach burnout inventory manual. 1996. Palo Alto, California.
2. Turgoose, D.; Glover, N.; Barker, C., et al. Empathy, compassion fatigue, and burnout in police officers working with rape victims. Traumatology. 2017.
3. Suttie, J. Can compassion training help physicians avoid burnout? Greater Good website, 2017. Accessed August 2017.