This week I received a few messages and texts telling me I needed to watch the SBS Insight episode on mental health in the veterinary profession (the title of this post was my response to my husband when he told me about it). I still haven’t watched the whole episode in one sitting as I honestly think it’ll be a trigger for me and I’m not due back to my psychologist for another four weeks; besides, as a wise fellow oncologist pointed out, I’m not the target audience anyway.
We are our own worst enemy
There are many shocking stories of how badly vets are treated – by clients, by bosses, by colleagues, but for me, the one who treats me the worst is myself. I see this in the people I work with daily. The expectations veterinarians place on themselves is usually unattainable. Never make a mistake, save that animal above all odds, never receive a complaint, have every client like you, don’t piss off the nurses (that’s actually more important than the client!), never get angry, always always know what to do.
Between a rock and a hard place
I'm told being a vet is a bit like being a paediatrician, because our patients can't talk so our clients do on their behalf. As vets we also work in this strange environment: we are medically driven yet in a 'customer service' industry. The client expects a certain service for the amount of money they are paying, however in the medical field, the customer is actually not "always right". Trying to communicate that to clients while saving their pet at the same time and talk about money is incredibly challenging. The average person doesn’t know the actual cost of medical care and that’s not their fault.
So who’s responsibility is it?
The responsibility for the mental health of veterinary professionals doesn’t lie with the client, and quite frankly it’s ok if a client doesn’t like you, or you them – that’s a normal part of life and a professional relationship can still exist.
I hate receiving complaints, mainly because I work so hard to prevent them. When I receive one, I need to be able to cope with that. And boy does it take work to cope!
So the responsibility for the mental health of veterinary professionals lies with the veterinary profession itself. We need strategies to make us more resilient (yes I’m going to use that latest buzz word) so that after a difficult clinical encounter, or a devastating medical error, or a death, we can move through it and not be a rocking mess in the corner. We need strategies so that we can do our jobs, not be defined by them, and not lose ourselves to them when things go wrong. As they inevitably will.
What can the profession do?
Our new vets need training and support before they graduate, which is now happening in many vet schools. Graduated vets need ongoing support and training – just like we upskill in medicine and surgery, non-clinical competencies of communication and mental health are just as important to continue learning in. Eighty percent of my day is spent helping clients cope with the emotional trauma of a sick pet. Zero percent of my veterinary education prepared me for this. I believe compassion fatigue is a significant proponent of the veterinary drop out and suicide rate.
Workplaces can provide and encourage support – and not just a nod or lip service – but live and breathe mental health as a value. I’ve experienced workplaces where bullying was ingrained, and the hierarchal nature of the profession can make this a challenge to change. It’s hard to even take a sick day when you have a schedule of appointments – we seem a far cry from where taking a mental health day would be seen as OK.
When I worked in the USA more of my clients seemed to understand what the costs of vet care were – in fact when I would quote a price for chemotherapy or radiation, they would say ‘WOW, I thought it would be more than that!’ Thats because they'd actually seen the itemised bills for their own human heathcare. In Australia, we take our own healthcare for granted – and there’s little transparency around the cost of procedures. The profession can help educate people around costs in a broad sense, and we could lobby the government to ensure that people know what the real cost of their mother's ‘free’ hip or knee replacement in Australia is.
What can the individual do?
It’s my responsibility to recognise that how a client is reacting is sometimes not about me, it’s about them - to be able to come back from being called a “cold and heartless bitch”, and to be able to receive the thank you card calling me “an angel sent from heaven” (both happened on the same day BTW).
“The standard you walk past is the standard you accept”
It’s my responsibility to stop when I find something unacceptable – and use my voice to for change it for the better.
I’ve wanted to be a vet ever since I was 6 years old. I love animals and luckily, I also love people. For better or worse, being a veterinarian is a vocation, not just a job. I started seeing a psychologist soon after graduating from vet school. They have helped me through job-induced suicidal times in my life, given me the tools and strategies to be resilient, and now I see one regularly. By being aware of my own mental health needs I can stay in this profession I love and be the vet others need me to be.
I also want to show up for my family and be the best I can be – not just the leftover shell that comes home from my workplace.
To my fellow veterinarians and nurses, I see you.
You are not alone. You are not weak. In fact, you have been too strong for too long. It's ok to ask for help.