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A practitioner ponders

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In the peer-reviewed literature it is well-established that being a veterinarian is associated with high levels of stress. Non-veterinarians often perceive dealing with messy emergencies and euthanasia as the most stressful aspects of practice. ‘I could never do what you do,’ they say; ‘It must be so upsetting.’

Upsetting, perhaps. Challenging, often. But are they the biggest stressors in practice? Not by a mile. Euthanasia is a means to end pain and suffering and, when performed well, can be very satisfying as one can make an immediate difference to an animal. Emergencies can be stressful at the time, but the truth is that they are often a source of excitement in practice; they are a chance to make a difference, to save a life, to use skills and techniques not necessarily used every day.

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In my own experience, the bigger source of stress is the ‘death by a thousand cuts’. An accumulation of minor, even predictable, disappointments, such as disillusionment in clinical outcomes, missed diagnoses, my skill set, relationships with colleagues, lack of courtesy from some clients, and poor compliance from clients with recommended treatments. Let's not forget empathy with clients' and colleagues' own disappointments. The list goes on.

Disappointment is ubiquitous, yet often so subtle that you sometimes don't immediately perceive its presence. As a new graduate, describing yet another disappointing experience to a mentor, I was constantly irritated by his stock response: ‘Life is full of disappointments’. A comment that was inevitably followed by uproarious laughter on his part.

It wasn't until I stumbled on a journal article, entitled ‘Addressing disappointment in veterinary practice’, which promised to help vets reduce the ‘frequency and intensity’ of disappointments, that the very word, disappointment, actually resonated (O'Connell and Bonvicini 2007). At once I felt I had a legitimate handle for the major source of personal and professional stress in my life.

The article itself was client-focused, instructing veterinarians to ensure that clients have realistic expectations ‘and understand the uncertainties of diagnosis and treatment’. Yet, while we might complain to colleagues about clients with unrealistic expectations, we don't always subject our own expectations to the analysis they deserve. As veterinarians, we need to do this for ourselves. A recent German study found that over 17 per cent of vets are almost always or frequently dissatisfied with themselves, and that over 15 per cent almost never feel proud of what they do (Harling and others 2009). The enemy, disappointment, has infiltrated the profession, taking a significant toll on our mental health and wellbeing.

Our training is woefully inadequate in equipping us to detect and deal with disappointment. For one thing, we are rewarded with excellent grades for producing excellent academic work. Yet, some of my best work in practice goes unrewarded – unacknowledged by the client, unremarked upon by colleagues, and occasionally unpaid. The expectation that things should be different only increased my disappointment.

Disappointment occurs when outcomes fail to meet expectations. Realising that I had certain expectations was the first step to dismantling them. I've since determined other parameters with which to measure my own performance and I don't immediately expect feedback for my work. When I do get it I value it much more. I've learned that I need to devote as much energy to managing my own expectations as I dedicate to managing those of clients. In doing so, life has become less full of disappointments.

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