Updated: Oct 23
We've talked a lot already about burnout in veterinary care and the steps you can take to watch your mental health and avoid reaching the stages of burnout that require intervention. There's a related condition called compassion fatigue, however, and while they may present similarly, they have different roots and need to be handled differently.
If you've looked at the burnout resources and decided that wasn't what you're feeling, but you still feel like your mental health is suffering, it may be compassion fatigue.
What is Compassion Fatigue?
Compassion fatigue is the colloquial name for a cognitive and behavioral condition scientifically known as Secondary Traumatic Stress. It affects people in roles related to caring for others, both people and animals, which means it's very common in nursing, healthcare of various sorts, and, of course, veterinary medicine. Vets, vet techs, veterinary nurses, and even your front-line office staff can all experience it.
The term compassion fatigue was originally coined by Carla Joinson (the nurse, not the author) in 1992, who described it in relation to nurses. Since then, the condition has been identified in all sorts of individuals working in careers where they are exposed to the trauma of others, such as vets, child protective services, clergy, teachers, librarians, social workers, firefighters, and more.
Compassion fatigue can also crop up in people who are exposed to the trauma of others in their personal lives rather than their professional lives. Whether it's individuals volunteering in the aftermath of a disaster, friends and relatives helping others go through their traumatic situations, or people with finely-tuned empathy who are frequently helping others in their social circles, all of these individuals can experience compassion fatigue.
How Does Compassion Fatigue Compare to Burnout?
Compassion fatigue can be a contributing factor to burnout. Similarly, burnout can make one more susceptible to compassion fatigue. In many ways, the two are connected, and they often have similar sets of symptoms. There are, however, significant differences between the two.
The primary difference between the two is where they come from. Compassion fatigue comes from working, largely directly, with traumatic situations. Vets who typically perform routine examinations are less likely to experience it than vets who work in oncology or critical care, where emergent and traumatic situations are much more common.
Note: This is not to say that a vet who handles day-to-day exams and the like can't experience compassion fatigue. Anyone can experience it; it's just much more common the closer they are to traumatic situations and the more frequently those situations occur.
In contrast, burnout typically comes from poor working conditions. Long hours, dense workdays, combative coworkers, stress in the environment and in the work, difficult clients, and a host of other factors all contribute to burnout.
Compassion fatigue also tends to be more rapid-onset; it comes up after exposure to trauma and can often be dealt with and set aside in relatively short order as well. Burnout, meanwhile, takes longer to manifest but is also much harder to deal with.
Some people are also much more resilient to either burnout, compassion fatigue, or both. Some people are naturally able to segment off some of their compassion and empathy while working to avoid major stresses; others are able to compartmentalize workplace stresses. It varies from individual to individual, and sometimes it relates to coping strategies, including unhealthy coping mechanisms.
Both compassion fatigue and burnout are serious issues in veterinary mental health and should be treated with the weight they deserve.
What Are the Signs of Compassion Fatigue?
How do you know whether or not you may be experiencing compassion fatigue? Unfortunately, many of the symptoms tend to be at least partially shared with a variety of cognitive issues, including burnout, depression, and anxiety.
Key symptoms, however, include:
Physical symptoms, such as headaches, fatigue, or a weakened immune system, leading to more common illnesses, which, of course, add to other sources of stress and can contribute to burnout.
Emotional symptoms, including feeling helpless or powerless, as well as general anxiety about the state of the world, the career, or the individual patients.
Behavioral symptoms, including appetite and sleep changes, hypervigilance, exclusionary focus leading to easy startling, and irritability.
Cognitive symptoms such as having a more difficult time concentrating, being more pessimistic, general inattentiveness, and intrusive thoughts.
Relational symptoms like isolation and distrust from friends and family.
Spiritual symptoms such as questioning the value and worth of the world and of society.
When a vet experiences compassion fatigue, the atmosphere and attitude they bring to work can also affect the workplace, though usually not to the same extent as burnout. This can lead to lower morale, decreased performance, loss of interest in the job, disconnection, and irresponsibility.
Additionally, organizational compassion fatigue – compassion fatigue that affects more than just one or two people, but many of the people within the clinic or office – can present with high absenteeism, changing and degrading relationships between coworkers, inability to meet deadlines and complete tasks, disengagement, rampant rumor and gossip spreading, and similar toxic work environment characteristics.
Are There Tests You Can Take to Identify Compassion Fatigue?
Introspection and self-assessment can be difficult because there's an inherent drive to minimize the negatives we experience, and it can be challenging to be honest and admit to ourselves when something is wrong. As the aphorism goes, "The first step to solving a problem is admitting there's a problem." As such, it can be valuable to take a more objective assessment to get an outside view of whether or not you are experiencing compassion fatigue.
Several assessments have been developed over the years to check for and identify the symptoms of compassion fatigue. Options include:
The Compassion Satisfaction / Fatigue Self-Test for Helpers is a short worksheet for self-assessment of compassion fatigue. It was designed for use in child protection but can be used by anyone in a role where they are both a care provider and a professional. That is, it's less suitable for personal life compassion fatigue.
ProQOL, the Professional Quality Of Life Scale, is an iterated assessment that helps you evaluate the past 30 days of your life and behavior to check for signs of compassion fatigue. It's very similar to the first item on this list but with a bit more robust descriptions of the meaning of each result.
The Secondary Traumatic Stress Scale Assessment is an early version of the above tests and can provide a simple analysis to identify the risk of compassion fatigue in recent behavior.
The Life Stress and Empath Tests are a pair of tests provided by the Compassion Fatigue Awareness Project, along with their own version of the ProQOL assessment. The Life Stress test analyzes day-to-day stresses and coping skills, while the empath test helps analyze the risk of experiencing compassion fatigue and your susceptibility to it.
In addition, if you believe you may be experiencing compassion fatigue, you can consider talking with a therapist. In addition to our veterinary outsourcing and consultation services, we also offer vet mental health consultations and presentations; talking to a mental health coach or therapist can help both with identifying and developing coping skills to handle potential compassion fatigue.
What Steps Can You Take to Minimize Compassion Fatigue?
The first step is to recognize if you're experiencing compassion fatigue and, more importantly, to recognize that it's both normal and common to do so. This is not a struggle that you need to face alone, or that is by any means unique to you; studies show that as many as 86% of healthcare workers – including vets – will experience compassion fatigue at some point.
Fortunately, unlike burnout, compassion fatigue is both shorter-lived and easier to cope with. There are many effective coping strategies to help your mind recover from vicarious trauma and heal.
Find time and opportunities to spend some quiet time alone, away from the constant press of news, social obligations, and work. Mindfulness, meditation, and even just leisure activities for a short time each day can help the mind ground itself and recover from trauma, including secondary trauma.
Take steps to relieve physical stress. Making sure to get better sleep by maintaining proper sleep hygiene and focusing on a healthier diet can help a lot. When the body isn't struggling under poor nutrition or poor sleep, it has more energy and capacity to function without adding more stress to a stressful situation.
Similarly, regular exercise can be very helpful, both as a way to help express pent-up energy and frustration, as a way to cycle energy to build healthier bodily function, and as part of mindfulness habits. You don't necessarily need to embark on marathon training or powerlifting, but simple exercise each day can go a long way.
Consider taking a vacation. Even taking a long weekend can be helpful, but a solid week off to recharge, relax, step away from traumatic situations, and rebuild a cognitive buffer can help immensely.
One of the biggest challenges of compassion fatigue is handling it without making rash decisions that can have long-lasting consequences. All too often, vets suffering from compassion fatigue, feeling trapped and in a hostile environment they can't handle, throw their hands up and quit the practice entirely.
"Don't make big decisions. We advise our compassion-fatigued clients not to make any major life decisions until they've recovered physically, emotionally, and spiritually. This is perhaps the most important advice we can give. Don't quit your job, get a divorce, have an affair, or spend your money on a lavish trip or a new sports car. It may feel great at the time, but a few days or weeks later you'll find yourself waking up to the same set of problems." - AAFP.
While this will certainly remove you from one traumatic situation, it leads to a cascade of other life changes, which themselves can be traumatic in their own ways. As such, it's a good idea to postpone any major decisions until you've had time to rest and heal from compassion fatigue and can avoid letting it color your choices.
Sometimes, being exposed to trauma regularly isn't healthy, and you don't have the coping mechanisms to handle it; in these cases, it's entirely possible that it might be worthwhile to step away from the career, either to a less critical care form of veterinary care, to research, to administration, or even just on a temporary sabbatical. There's no shame in adjusting your career, if necessary; just don't make the leap without proper consideration.
One thing that can help here is taking on a temporary relief veterinarian, who can help you by easing the burden and taking some of your caseload to give you more time to process and recover from traumatic situations.
Another significant risk of both compassion fatigue and advanced burnout (and even more so with the two combined) is the "quick fix" of substance abuse. Drugs, alcohol, and a variety of addictive behaviors can all offer temporary, fleeting relief, but they lead to further personal pain and a spiral that can be both incredibly self-destructive and, in some cases, even deadly.
There's no quick fix for compassion fatigue, but understanding the condition and practicing healthier, more mindful habits can help to both fight it in the moment and insulate you from future bouts of fatigue.
Getting the Help You Deserve
If you find yourself facing an oppressive workload, the symptoms of burnout, or the symptoms of compassion fatigue, there's a good chance we can help.
At Hope Vet, we specialize in providing second opinions and consultations for a variety of purposes. Our specialties include Oncology, Neurology, Dermatology, critical care, internal medicine, and more. From this angle, we can help lighten the load and guide you toward making the right decisions and feeling confident that you are indeed making the right choices. Moreover, we also help with consultations for veterinary mental health. We understand the unique challenges and pressures you face because we're vets, too. Our social worker can help ease the burden and offer coping strategies to assist you along the way.
If you're interested in learning more about any of our services or would like to request a consultation, simply reach out; we're always ready to help.