As mentioned in the recent article Supporting clients during euthanasia, the death of a patient in a veterinary clinic has a ripple effect. It can affect everyone from the pet’s owner to the veterinarian and any staff member who had ever interacted with that pet or client. Anticipating the emotional fallout and its consequences are key to supporting staff.
Now let’s examine the effect of an animal’s death on clinic staff members, whether planned euthanasia or death while in the clinic.
The high incidence of death the veterinary staff faces every day is significant. Veterinarians often deal with death more frequently than human hospice workers due to the comparatively short life span of dogs and cats. And it is probably the only profession where death is scheduled on a regular basis. While the veterinary oath states that veterinarians are “to prevent and relieve animal suffering,” participating in euthanasia day after day can take a toll on everyone in the clinic. The realization that “Mia” won’t be in for her monthly bloodwork or “Smoky” won’t need his weekly injection anymore reminds everyone of life’s brevity. It also causes emotional distress knowing that that our companion animals love us unconditionally and rely on us to care and make decisions for them, while they have no knowledge of their own mortality.
Certain staff members who have had regular contact with the animal may grieve loss more than others—that’s burden enough. These same staff members may also share the grief of the pet owners, which only adds to their own pain. This is called secondary or vicarious trauma. It is the pain felt by witnessing the pain of others. On a repeated basis, this can contribute to compassion fatigue and possibly burnout.
Staff shortages became rampant during the pandemic and pose an additional hurdle many clinics continue to face. Incorporating the knowledge below into clinic operations may help retain valuable staff members:
• Monitor how many euthanasia’s staff members are assisting with and consider adjusting the schedule to ensure members participating in more euthanasia’s get a break from the additional burden.
• Learn to recognize the signs of compassion fatigue in your staff and in yourself. It’s important to address the causative issues before we find a resignation letter on the desk. For additional resources on compassion fatigue from AVMA visit: https://www.avma.org/resources-tools/wellbeing/work-and-compassion-fatigue
Guilt also contributes to grief, especially for the veterinarian. “What if I had made the diagnosis sooner?” “Should I have chosen a different treatment plan?” “Could I have done more?” While veterinarians are usually great examples of compassion, they are often the last to show themselves any mercy. The entire veterinary staff often judge themselves harshly and hold themselves to superhuman standards. These thoughts become toxic and, once combined with the other traumas of life, can take a toll on anyone’s mental wellness.
The feelings mentioned above are intensified when an unexpected death* occurs in the clinic: A standard poodle suffers bloat while boarding, or a surgical patient stops breathing on the table. While the first thought may be concern for the owner, very few realize the staff should also be considered.
The staff is referred to as secondary victims in such cases. Unexplained deaths are traumatic for everyone, especially staff members who find joy in helping and caring for animals. Again, guilt can play a major role here through mistakes in medications, miscommunication about procedures, mislabeling prescriptions, etc. As humans we need to understand what happened and to rationalize to make sense of it all. Again, we tend to judge ourselves more harshly than others do. All this is good reason for a process called debriefing. According to Bonnie Gatson, DVM, DACVAA, VIN/NAVAS Rounds: “Coping with Anesthetic Adverse Events: What to Do When Things Go Wrong”, the purpose of debriefing is to provide emotional guidance for staff after a traumatic event occurs in the workplace. The idea is to focus on the emotional needs of personnel while gently trying to identify sources of potential error that can be controlled to prevent future problems. An effective debriefing is going to describe the problem, try to analyze why we think those problems occurred in the first place, and how we can incorporate learning points from the incident into practice to prevent future incidences from occurring.
For major traumatic events in the clinic, reaching out to trained professionals for a debriefing may be helpful. Otherwise, clinic management may be able to conduct their own debriefing. All staff involved in the event should attend, but ideally, they will not be responsible for running the debriefing, to avoid added stress and responsibility.
In order to retain talented individuals in the field of veterinary medicine, including veterinarians and staff members, we need to learn to deal with the range of emotions we experience—from the joy of puppy breath to the death of an innocent animal. The veterinary community is a devoted group of caregivers. Besides caring for our companion animals, we need to care for ourselves and our colleagues. We need to be aware of all the circumstances that challenge our mental wellness. Being alert to changes in our own emotions as well as other coworkers can help make the veterinary clinic a rewarding place to work.
Do you encourage self-care to staff members as well as yourself? Do you have access to a mental wellness professional or an employee assistance program you can utilize to help struggling staff members? Below are additional resources for yourself and your staff.
For a list of compassion fatigue symptons from AVMA visit: https://www.avma.org/resources-tools/wellbeing/work-and-compassion-fatigue
*Because of the sensitive nature of pet owner conversations in an unexpected death and the ever-present possibility of litigation, those topics will not be covered in this article. For more information refer to avmaplit.com
