Our new study, published in the Journal of Veterinary Medical Education, confirms veterinary work can be a rewarding yet stressful profession. This study has important implications for staff wellbeing programs and retention.

Current reports suggest that vets are leaving the profession in droves and clinics are struggling to fill roles in their practice. The high risk of compassion fatigue is often being cited as an additional challenge in the industry. With these concerns in mind, I conducted a study together with Rebekah Scotney (University of Queensland), Holly Monaghan, and Pauleen Bennett at La Trobe University, to address two key challenges facing the veterinary profession – compassion fatigue and staff turnover.

We did this by exploring factors predicting professional quality of life and intentions to leave in a sample of 141 veterinary nurses and veterinarians residing in Australia.

What is professional quality of life (ProQOL)?

No job is perfect and there are always positive and negative aspects associated with the work we do. ProQOL refers to the positive and negative ways we feel about our work in the context of helping others (Stamm, 2010).

The negative aspects we explored were compassion fatigue which, in the research literature consists of both burnout and secondary traumatic stress (STS). STS typically occurs from providing care to those who have suffered or are suffering trauma. Symptoms include intrusive thoughts, avoidance of reminders, and preoccupation with clients or patients (Figley, 1995; Stamm, 2010). Burnout is thought to occur from continuous exposure to workplace stressors. Signs include feeling overwhelmed, disconnected, and exhausted (Stamm, 2010).

The positive aspects relate to compassion satisfaction (CS). CS describes a sense of fulfillment or meaning one received from their work (Stamm, 2010). Not only is CS good to have simply because it feels nice, the research shows it is also linked with lower levels of compassion fatigue. In this sense, CS, the good stuff, is what makes it all worth it.

What did we find?

Prevalence of ProQOL

Veterinary professionals report positive and negative aspects associated with the work, but they are at risk of compassion fatigue, and some report low levels of compassion satisfaction (CS).

A quarter of the sample reported high levels of compassion fatigue with 23.5% reporting high levels of STS and 24.4% reporting high levels of burnout. We also found that a quarter of the sample (25.7%) reported high levels of CS and 27.2% reported low levels of CS.

Predictors of intentions to leave.

ProQOL contributed to intentions to leave the current role and the profession altogether.

Compassion satisfaction and burnout predicted intentions to leave the current role. This shows that regardless of the possibility of indirect trauma if compassion satisfaction is high and burnout is low, retention in the current role may be more likely. Burnout also predicted intentions to leave the profession, and this highlights just how important it is to manage burnout if we want the profession to thrive.

Predictors of ProQOL.

Aspects about the person and the workplace both contributed to compassion fatigue and compassion satisfaction. This means that simply hiring more resilient people or simply redesigning jobs will not entirely address the issue if done in isolation.   

We provide a list of important factors predicting ProQOL and suggest ways to promote wellbeing and retention.

Person-related factors

Behavioural disengagement predicted compassion fatigue, secondary traumatic stress, and burnout. 

In the short term, stepping away to recharge or simmer down from a stressful situation or from conflict can be useful. In the long term, however, this research suggests that giving up trying to cope with, or avoiding a stressful situation, is linked with greater levels of stress and can, therefore, lead to bigger issues.

Veterinary professionals must be encouraged to talk through difficulties openly with management and have other avenues of support such as peer support, mentor programs, and counselling as ways to address workplace issues. Further, if you do notice someone is not themselves and appears disengaged, then this may be a sign that they are not be feeling their best. Check-in with them and ask if they are ok.

Optimism and positive reframing predicted compassion satisfaction. This shows that positively reappraising a situation may be linked with more meaningful and satisfying experiences at work. Optimism refers to a tendency to expect that things will ultimately turn out for the best. Of course, in veterinary situations, one must prepare for the worst-case scenario. If you get a call that someone is coming in with a dog that has been hit by a car, we of course must prepare for the worst and not think that everything will be ok. Being prepared is important (Sweeny, Carroll, & Shepperd, 2006) and in clinical practice, it can save a life.

Optimism is not about expecting a positive outcome all the time as this would be unrealistic. Optimism is also not about minimising or denying negative experiences and events either. It is more about having a positive outlook and finding silver linings when we can. It turns out that some people are more likely to be optimistic than others. The good news is that optimism can be learned and there are many ways we can promote optimism in our work lives.

Positively reframing situations can promote optimism. For example, in palliative care situations, one may not be able to save a life but focusing on being able to provide comfort and preserve quality of life can be ways to positively reappraise the situation. Practicing gratitude, reflecting on positive cases, focusing on effort and lessons learned when outcomes are not positive, can also promote optimism. Cognitive behaviour therapy (CBT) with a trained counsellor can help to identify unhelpful thinking patterns and replace them with more helpful thoughts has also been shown to promote optimism (Gillham & Reivich, 2004).

Work-related factors.

Opportunities for development predicted burnout and compassion satisfaction. This indicates that workplaces that encourage staff to develop their strengths and learn new skills and processes can significantly lower risks of burnout and increase job satisfaction. Management may, therefore, wish to discuss with employees their strengths and goals and work through ways to achieve these through training, work design, or other means.

Emotional demands, hassles, and indirect exposure to euthanasia predicted secondary traumatic stress (STS) in veterinary professionals. Veterinary work draws very much on emotional resources. Working with traumatised and grieving clients, as well as suffering animals, are just some of the emotionally demanding tasks faced by veterinary professionals, and many report these facets of the job are the most challenging. Unfortunately, very little formal training has been traditionally offered on how to manage these difficulties. These “soft skills” like emotional intelligence, communication skills, empathy, conflict management, and relationship skills are all important facets of veterinary work. Emotional demands can’t be completely eliminated from the job, but training in how to competently manage these demands certainly can help.

It is interesting that indirect exposure to euthanasia predicted STS which suggests that simply hearing that animals staff have cared for have been euthanased, can be associated with trauma.

Feedback also predicted STS. This suggests that regular, timely, and sufficient feedback and debriefs reduce the risk of trauma. Since indirect exposure to euthanasia is linked to STS, all who were involved in the care of patients and clients might best be involved in these discussions.

Putting it all together.

This research shows that veterinary professionals are at risk of compassion fatigue and a proportion of those experience low compassion satisfaction. Both predict intentions to leave.

Wellbeing and retention programs must take a comprehensive approach and address both personal and workplace factors. For more information on training, debriefs, wellbeing program design, or a full copy of the paper, contact Dr. Vanessa Rohlf: virohlf@gmail.com

Note: This is a summary of Rohlf, V. I., Scotney, R., Monaghan, H., & Bennett, P. (2021). Predictors of professional quality of life in veterinary professionals. Journal of Veterinary Medical Education, DOI: 10.3138/jvme-2020-0144

References

Figley, C. (1995). Compassion Fatigue: Coping with Secondary Traumatic Stress Disorder in Those Who Treat the Traumatized. London, UNITED KINGDOM: Routledge.

Gillham, J., & Reivich, K. (2004). Cultivating optimism in childhood and adolescence. The Annals of the American Academy of Political and Social Science, 591(1), 146-163.

Stamm, B. (2010). The concise manual for the professional quality of life scale. 2nd. Retrieved from https://www.proqol.org/ProQOl_Test_Manuals.html

Sweeny, K., Carroll, P. J., & Shepperd, J. A. (2006). Is Optimism Always Best? Future Outlooks and Preparedness. Current Directions in Psychological Science, 15(6), 302-306. doi:10.1111/j.1467-8721.2006.00457.x