Caring for the Caregivers

Initiatives and resources to help veterinarians address burnout and compassion fatigue.

Depression and suicide within the veterinary profession are high. According to the first mental health survey of U.S. veterinarians, one in four have considered suicide.

“There is a problem,” said Heather Kalinowski, program director for MightyVet.

Fortunately, associations, organizations, universities and even individuals are working on resources and education to help the veterinary caregivers receive care for themselves in order to maintain a healthy outlook and lifestyle, while balancing the rigors of a demanding profession.

The following article highlights several of those initiatives that distributor reps can discuss with their veterinary practice customers.

MightyVet

Though the industry recognizes depression and suicide within the veterinary profession, Kalinowski said that much of what has been done to address the problem has been focused on the end of the journey of burnout and compassion fatigue – suicide and suicide prevention.

“We need to focus on the causes of the trend, which include the need for veterinary professionals to take care of their personal wellbeing, but also to address the lack of education early on of the realities of practice, so once these students become veterinary professionals, they are better equipped to deal with the problems that arise,” she said.

MightyVet is an online community intended to tackle the issues veterinarians and veterinary practice team members face in the veterinary profession that they are not prepared for in schools. MightyVet offers free, on-demand continuing education, global mentorship programs, office hours with industry professionals and thought leaders around the world, as well as other resources to help veterinary professionals in their career and wellbeing.

MightyVet’s online platform is built around education. The organization works to identify the areas that lead to burnout, and find experts in the field who can teach around those areas. This is done through educational courses, mentorship, and other resources. MightyVet courses are currently solely webinar-based and offer continuing education credits, which inevitably attracts professionals already working in the field. MightyVet is also in discussion with veterinary universities to be able to test MightyVet curriculum in school to prepare students before they enter the field, Kalinowski said.

There are two goals the CE courses work to address:

1. Get curriculum into schools to prepare veterinary professionals for the realities of practice before they start their first job.

2. Offer Continuing Education for those already in the field who either have yet to be exposed to non-medical curriculum and may be suffering from burnout, compassion fatigue, ethics exhaustion, or suicidal ideations; or those who have taken MightyVet courses in veterinary school and want to continue honing their non-medical skills as they would any medical skill they learned.

“We develop new course topics by listening to the field,” said Kalinowski. “What are the pain points that lead to frustration, uncertainty, or helplessness? That could be anything from a desire to pay off student loan debt to a lack of leadership training. We have current courses around the cost of care, career planning, leadership, culture, compensation, and communication.”

Any member of MightyVet can apply to become a mentor. The application requests the member’s background and resume, and offers several different areas of mentorship, including business, ethics, and career path. They set their own hours and can offer an hour once a week or once a year.

“It’s really up to them,” said Kalinowski. “Once their application is received, we utilize our board members (including our advisory board members) to approve them as a mentor. Once approved, the mentor will be visible on our website and any member can sign up to meet with a mentor. This can be via phone, email, skype, or in person, whichever way they feel more comfortable.”

When a member is going through a difficult situation, they can find a mentor that has experience in that situation. That could be someone who wants to buy into a practice getting advice from someone who recently bought a practice. Or it could be someone who feels like quitting because they just completed their 50th euthanasia meeting with a peer who has been there and made it through the other side. “Often, having a peer to talk to can truly be lifesaving, helping you put your situation in perspective,” said Kalinowski.

Another program, MightyVet Office Hours, is still in the works. “We are working with an outstanding group of people at Coding Dojo who are volunteering their time to help us update and improve our website,” said Kalinowski. “This is a project in their queue. What we expect from this program is similar to the mentorship program, but more of a group-to-one conversation instead of a one-to-one session. A group of people can sign up to meet with a mentor or the dean at a school together. The idea is to facilitate conversation and learn from one another, potentially making connections in the process.”

One of the basic ways distributor reps can help veterinary practices is through acknowledgment and to understand that these challenges don’t just affect veterinarians, said Kalinowski. “All veterinary professionals, from the practice owner to the kennel assistant, are feeling these concerns and a simple ‘thank you’ can really mean a lot,” she said.

Further, introducing the teams to resources like MightyVet and Not One More Vet (NOMV) is important, said Kalinowski. “You never know who might need to hear about them. Free RACE-approved CE can be super helpful to veterinarians and technicians who need CE to renew their license but have trouble paying for it.”

AVMA resources

Last December, the American Veterinary Medical Association (AVMA) announced it had participated with the Centers for Disease Control and Prevention (CDC) in researching suicide among veterinarians in the United States from 1979 through 2015. The study, published in the Journal of the American Veterinary Medical Association, reported female veterinarians were 3.5 times as likely, and male veterinarians were 2.1 times as likely, to die from suicide as the general population. According to a 2016 CDC report, 45,000 Americans, ages 10 or older, died by suicide. Suicide is the 10th leading cause of death in the United States and is on the rise.

The AVMA and partners are creating and developing resources for those in distress and those who wish to help at-risk colleagues.

A key program available to help veterinarians identify and refer at-risk colleagues is QPR (Question, Persuade, Refer) training. The AVMA offers this one-hour, online ‘gatekeeper training’ free of charge to every member and veterinary student. It teaches people without professional mental health backgrounds to recognize the signs that someone may be considering suicide and helps them to establish a dialogue.

“Oftentimes, people may suspect someone is suffering but they don’t know what to say, or they worry that what they say may make the situation worse,” said Dr. Jen Brandt, AVMA’s director of member wellbeing and diversity. “It is my goal to have every veterinarian complete the QPR training. It provides guidance on what to say and ways in which you can enhance a sense of belonging and help alleviate the sense of fear that some may have about being a burden to their friends, family or colleagues.”

Other programs and tools available to tackle specific stressors include:

• Moral/ethical distress: the result of a medical caregiver’s unique relationship with a patient, through which empathy allows the caregiver to “take on the burden” of an ill or dying patient. The AVMA has collected and developed a number of resources to help veterinarians combat moral/ethical distress.
• Financial burdens can also play a part in harming veterinarians’ mental health. With average student debt loads on the rise, veterinarians may be struggling to make ends meet and find it difficult to plan for the future. The AVMA has resources on financial planning – including a personal financial planning tool, salary calculator and tips on student loan repayment – to help veterinarians address these concerns.
• Availability of controlled substances: The potential for drug abuse and addiction is higher in medical professions than in other workplaces because of the increased access to controlled drugs. To address these issues, the AVMA has developed an online wellbeing and peer-assistance toolkit.
• Student debt and other early-career stressors: MyVeterinaryLife.com, a website aimed at students and early career veterinarians geared to helping them navigate wellbeing, finances, and career concerns.
• AVMA’s 100 Healthy Tips to Support a Culture of Wellbeing: this guide offers strategies and practical steps one can take at work and at home to support healthful living and create a positive work environment.
• Peer assistance programs around the country can be found at veterinary peer assistance programs.
• Veterinary Wellbeing Summits: These summits provide veterinary practitioners, as well as those in industry, academia, researchers, and others, an opportunity to discuss what steps should be taken to support enhanced wellbeing throughout the profession.
• Numerous educational efforts through public speaking and webinars aimed at creating cultures of wellbeing are ongoing.
• AVMA is working with the United Kingdom’s (UK) Royal College of Veterinary Surgeons (RCVS) and the World Small Animal Veterinary Association (WSAVA) to improve the health and wellbeing of all those who work on veterinary teams across the globe.

Banfield Launches “ASK”

At its recent Pet Healthcare Industry Summit in Portland, Oregon, Banfield Pet Hospital® announced a new training program, “ASK” (Assess, Support, Know), designed specifically for veterinary professionals to help them recognize and address emotional distress and suicidal thoughts in themselves and others.

Banfield’s ASK training is one of several programs and resources the practice offers its associates to support a holistic health and wellbeing approach, ranging from a Veterinary Student Debt Relief Program to an Associate Assistance Program.

In total, Banfield announced it will invest more than $3 million in mental health resources and tools like ASK by the end of 2020. Banfield also announced plans to do the following by Jan. 6, 2020:

• Close schedules at all 1,000+ Banfield hospitals nationwide for two hours to facilitate interactive mental health and wellbeing training for its more than 19,000 hospital associates.
• Make the ASK training available as a free resource for the entire veterinary profession.
• Share the ASK training as a free resource with all U.S. veterinary colleges.

“At Banfield, delivering high-quality preventive pet care is a top priority, but just as important is extending that same preventive care to our people,” said Brian Garish, president, Banfield Pet Hospital. “As a practice, we are proactively prioritizing mental health and wellbeing resources such as ASK because we take seriously our responsibility to create meaningful change and make a positive impact on society, today and tomorrow.”

Veterinary Social Work Program

The University of Tennessee College of Veterinary Medicine has created a veterinary social work program as part of its outreach to pet owners, as well as the profession (visit VetSocialWork.utk.edu). Services include:

• Access a veterinary social worker: UT Veterinary Medical Center medical team may invite a veterinary social worker to support a pet owner during an animal’s care, or the pet owner can request support directly.
• Grief and bereavement services: These services include support when pet owners must make a difficult treatment decision, euthanasia, and after an animal’s death. UT’s Pet Loss Support Group and Seasonal Pet Memorial Celebrations are free of charge and open to both the community and clients of the University of Tennessee Veterinary Medical Center.
• Mindfulness-Based Stress Reduction: Mindfulness-Based Stress Reduction (MBSR) was founded by John Kabat-Zinn at the University of Massachusetts Medical Center in 1979. The program was designed to help human patients who were not responding to other forms of medical treatment. MBSR has now spread to multiple populations including health professionals and medical and nursing students as well as in multiple settings including workplaces, educational settings and even prisons. UT VSW is the first to offer this class at a veterinary teaching institution.
• Suicide Awareness in Veterinary Education: S.A.V.E. is a memorial to University of Tennessee College of Veterinary Medicine alumnus, Dr. N. Paul Nolen, who lost his life as a result of suicide. S.A.V.E will make mental health education available to veterinary students throughout all four years of the curriculum via classroom and self-paced online content.

Not One More Vet

Not One More Vet is an online veterinary support group founded in 2014 by Dr. Nicole McArthur. NOMV board members speak at conferences, hospitals and schools on a wide range of mental health topics.

NOMV workshops can be tailored to large or small groups, and contain a variety of interactive content, discussions, Q&A, and exercises. They typically run 1 to 2 hours. Workshop content includes “Social Media Boot-Camp for Veterinary Professionals,” “Mental Health Hacks” and “Crisis Intervention 101.”

NOMV lecture topics include:

• Depression, Suicide and Religion. Faith and spirituality is often listed as an important part of self-care – but how do faith, depression, and thoughts about suicide interact? In this lecture, Dr. Melanie Goble talks about views of depression and suicide from various religious viewpoints, as well as how the misuse of religion can injure individuals living with mental health concerns. Dr. Goble draws on her own experiences for this lecture series and will talk about how faith saved her life.
• Finding Your Purpose: An Exploration of Missionary Work as a Veterinarian. Have you ever thought about spending your vacation in remote exotic locales, meeting new and exciting people and helping teach young vets and save animals all at the same time? In this lecture,
  Dr. Goble talks about her work in Mongolia, as well
  as a disaster relief veterinarian.
• How to Help You Help Others. This talk will cover ways to help identify warning signs in others and giving you some tools to help support them. Often we are faced with seeing others struggling and being unsure whether we should step in, and how to do it. After this talk, you will have several steps you can take and more confidence to be able to step in where appropriate.
• “I’m Fine”: The Biggest Lie We Tell Ourselves. When asked how we are doing today, we often lie to others and to ourselves. This talk will go into many things we can do
  to help our own mental health and those around us.

For more information, visit nomv.org.

Photo credit:  istockphoto.com/gpointstudio