• The Pandemic’s Impact on Veterinary Medicine’s Most Sacred Responsibility

    The Pandemic’s Impact on Veterinary Medicine’s Most Sacred Responsibility

    Aug 16 2021

    Dr. Holly Sawyer, DVM During the most heinous rotation of my senior year in veterinary school, my horse developed laminitis in all four hooves. It is an acutely painful condition with an extremely poor prognosis. Emmy was 32, beloved beyond words, and I agonized over the decision before me. Four sleepless nights later, I chose to end her suffering. Truly, I was not certain I would be okay without her. Little did I comprehend, Emmy, who had taught me so much during her life, would mold me into the veterinarian I became the day she died. Euthanasia became hallowed ground for me. While most of my colleagues treat these appointments as jarringly sad interludes in an otherwise busy day of saving or improving lives, I view them as the highest purpose of my training and the most significant act I could ever perform for the family. Why? Because euthanasia would only ever happen once in the animal’s lifetime, and nothing intensifies the preciousness of the human-animal bond like imminent separation. I was present during the worst days of my clients’ lives—and humbled to have seen so many at their very best. For me, this realization occurred before the term “human-animal bond” officially entered the veterinary vernacular, before hospice gained popularity, and well before COVID turned this most sacred responsibility of the veterinary profession into a minefield of client anxiety and unmet expectations. I am out of private practice now—partly due to my refusal to erect a barrier between myself and the raw grief of clients—but in my current position with a veterinary triage provider, I still witness the chaos reigning in our profession over this very issue. Whether euthanasia results from financial constraint, grave prognosis, or the tender knowledge the joy has gone out of an animal’s life, clients asking for this service are typically driven by one overriding emotion and, thus, have one supreme need the veterinary team must address. Euthanasia, distilled Illness and death slam all of us with the realization we do not have full control over life (we never did, of course, but this is a topic for philosophy class). Lack of control breeds fear: fear of what to expect with the euthanasia itself. Fear the pet will be scared, will suffer, or will struggle. Fear of taking a pet’s life away too early (or too late). Fear of not knowing how we will cope with the loss of this animal. Fear of not knowing if mornings or evenings will be worse. A young boy’s fear over how he will grieve his first and best friend. An elderly widow’s fear she might not survive the loss of her constant companion. Fear is the emotion behind every thought and the engine driving every client’s euthanasia experience. When the veterinary team meets a client’s fear with compassion, effective communication, and predictable action, the pet owner’s emotion transforms into gratitude. If any of these components are missing, if the complex dance of describing the euthanasia process, responding to the client’s body language, modifying tone and posture, and showing affection for the animal at the center of the visit falls apart, client fear easily escalates to fury. Why? Because in a tangible or intangible way, the client feels abandoned—and this is the single and absolute unforgivable sin of our profession. COVID’s unintended consequences Curbside care converted face-to-face heart-to-hearts into constrained phone conversations, which could easily degrade into a listing of facts delivered with thinly veiled impatience. This hardly happens on purpose, but each day’s flood of patient cases dictates less time on each pet. Compassion suffers at the hands of expediency. Without compassion, rapport evaporates, trust crumbles, and communication falters. Additionally, in most cases, clients could not be present during the euthanasia itself due to social distancing. This introduces a level of unpredictability in this emotional procedure, heretofore unimagined by most pet parents. Veterinary professionals do their best to slow down and treat euthanasia with the kindness and respect it deserves, whether the client is with the pet or not; all the client sees, however, is a crammed parking lot, a wait time defying logic, and a clinic too busy to answer exhaustive questions. Many pet parents feel their final and greatest responsibility is to be with their four-legged friend to the very end, to pour out the kind of love only they can give when the pet needs it most. Curbside care wrenched the inviolable duty away from them. As mask mandates subside and clinics return to more normal workflows, our profession is still grappling with unmanageable patient loads. To mitigate burnout, many practitioners who were once on-call for afterhours care now refer all clients to emergency clinics. In some cases, the nearest emergency facility is three hours away, and we all know the wait times for emergency care have skyrocketed. Clients calling in the middle of the night expecting their veterinarian to be available are stunned to find themselves sent to a distant stranger instead. During regular business hours, same-day euthanasia requests are either worked in at the cost of staff sanity or are scheduled out to a different, hopefully less busy, day. We all know this is not always the case. Clients told they must delay euthanasia wonder how to trust a practice, which, to their thinking, is making their pet suffer needlessly. Mobile veterinarians are now answering nonstop calls from new clients requesting same-day euthanasia, while dealing with limited staff support and impractical driving distances. The way forward The veterinary profession’s ability to end suffering humanely and peacefully is at the heart of what makes us different from every other medical profession. It is a heavy and delicate responsibility, which can determine if the heart of veterinary medicine is noble or tarnished. As we emerge from the strictures of the pandemic, let us own that client trust in our profession has decreased. Meet this challenge by renewing your commitment to compassion. Put yourself in the client’s shoes. Even a brief glimpse of life through their eyes can reset your emotional temperature. Effectively communicate any changes in your after-hours services to pet owners through social media, pet portal announcements, invoice notes, hold time messaging, and, most importantly, in-person interactions. Go out of your way to acknowledge client fear and explain what to expect throughout the euthanasia process. Never let a client feel abandoned. Your extra effort will not only rebuild client trust, but enhance team satisfaction, magnify the human-animal bond, and restore the beating heart of this most honorable profession. Holly Sawyer, DVM, Human-Animal Bond certified, is a 1999 graduate of UC Davis School of Veterinary Medicine. After 19 years in private practice, she became a regional director for GuardianVets, a veterinary communication company that helps practices streamline access to patient care, strengthen client bonding, and alleviate professional burnout through live, 24-hour triage service, call overflow support, and user-friendly telemedicine access. https://www.veterinarypracticenews.com/the-pandemics-impact-on-veterinary-medicines-most-sacred-responsibility/

  • Understanding Veterinary Burnout Using the Job Demand-Control Model

    Understanding Veterinary Burnout Using the Job Demand-Control Model

    Jul 26 2021

    Dr. Holly Sawyer, DVM We’ve all been touched by the reality of veterinary burnout in our work lives. Burnout has been studied extensively in human medicine for more than a decade. Thankfully, more literature is coming out now to unravel why burnout has become so prominent in the veterinary realm as well. First, we must understand some terms. Compassion fatigue is the emotional burden felt when caring for those who are suffering. To speak metaphorically, if each contact with suffering is a spritz of water on a cloth, the compassion-fatigued worker is a water-logged towel that cannot hold another drop of moisture. Burnout, in contrast, is defined as severe physical and emotional depletion due to prolonged work stress. Where compassion fatigue produces a sopping wet mess, burnout results in a crispy, bone-dry cloth that can no longer bend to fulfill its original purpose. What is it about modern-day veterinary medicine in particular that is leading to so much burnout in our colleagues? Industry articles propose a variety of causes: Student debt outstripping the rate of projected salary increases Compassion fatigue in the face of constant exposure to suffering Frustration over effective treatments that clients cannot afford Work overload due to unprecedented patient demand What do all of these explanations have in common? Modern veterinary professionals do not feel they can control their own destinies. In 1979, sociologist Robert Karasek observed that workers, regardless of how demanding their jobs were, experienced improved mental and physical health when given increased control over their work environments. In contrast, workers in low demand jobs with rigid work parameters became passive and bored, while workers in high demand jobs given no opportunity to influence their work space were prone to psychological strain and physical illness. Karasek named these tendencies the Job Demand-Control Model.[1] Every job position in a veterinary clinic requires maximal effort from each team member to provide safe, consistent, and compassionate care to patients whose lives are on the line. This is the definition of a high demand job. According to the Job Demand-Control Model (JDCM), workers in high demand jobs who lack autonomy over their work environments are at extreme risk for prolonged work stress. That sounds like a top-of-the-list differential diagnosis for the burnout that ails our profession. The JDCM not only explains this major cause of work stress, but also elucidates areas of potential intervention. Work environments can be modified to decrease the likelihood of workers reaching burnout and leaving their jobs altogether. The first step is to give veterinary staff, from the CSR to the associate DVM, more control over their immediate environment and the systems that govern it. The model advocates managers to grant this “decision latitude”[2] to mitigate work stress and improve professional longevity in individuals and teams at large. Model Behavior Increasing a worker’s sense of self-determination within a broader work environment requires concerted effort on the part of hospital managers to ask for and implement suggestions from the team. Whether this happens at staff meetings or during individual employee reviews, it is imperative for the leadership to ask, “What can we do better?” and then to show how suggestions are being incorporated into the daily workflow. Individual autonomy can also be enhanced by giving each team member a certain amount of freedom over work schedules while maintaining standard of care and proper patient flow. This could take the form of increased job sharing and part-time positions. adjusted work hours to facilitate childcare needs, and establishing a culture of affirmation when hardworking individuals request needed time off. Lastly, it is worthwhile to note the Job Demand-Control Model also goes by the name of the Demand-Control-Support Model. This nomenclature emphasizes the importance of support from supervisors and colleagues in raising the overall health of the workers. This again speaks to practice culture and how concerted effort by management can facilitate the kind of mutual respect and camaraderie that can only be found in well-managed troops in the trenches together. The Now and Future Worker It has been said compassion fatigue results from WHAT we do, but veterinary burnout results from WHERE we work.[3] To decrease staff burnout, hospital managers must take a step back and look at the practice through fresh eyes. Would your workers characterize your management style as collaborative or authoritarian? Proactive or reactive? Open or closed? By giving CSRs, veterinary technicians, and associate DVMs a voice in how the practice can improve, you will give your team ownership over its own success, and enhance team loyalty and retention along the way. GuardianVets partners with veterinary practices to decrease the demands on today’s clinic staff at three major pain points. For the daytime practice: the licensed veterinary professionals at GuardianVets help answer phones during high call volume. For the hectic emergency practice: GuardianVets professionals triage patients over the phone to ensure the most critical cases get the fastest intervention while shunting those that can wait back to their regular DVMs. For the on-call DVM: GuardianVets triagers filter calls based on emergent status and contact the on-call doctor only when after-hours intervention is necessary. GuardianVets steps in as an ally in the trenches to ease your veterinary team’s stress and decrease the risk of veterinary burnout. [1]https://www.toolshero.com/human-resources/job-demand-control-model/ [2]https://www.ckju.net/en/dossier/job-demand-control-support-model-what-it-and-why-it-matters-cope-workplace-stress [3]https://vetidealist.com/burnout-veterinary-medicine/

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