Keep compassion fatigue at bay
In a recent Fetch dvm360 session, Bree Montana, DVM, creator of Vets4Vets, a confidential support group for veterinary professionals through the VIN Foundation, spoke on ways to combat compassion fatigue and burnout in the veterinary world.
“Some compassion fatigue and burnout is still going to happen,” she said in her session, “but the sooner we can recognize it, the sooner we can manage it.”
Dr. Montana’s first key instrument for fighting these stressors? Self-regulation.
“Self-regulation is a little complicated, but at the same time it’s super-simple,” Dr. Montana says. “It’s the ability to shift from sympathetic to parasympathetic dominance, while remaining fully engaged in the activities of daily living.”
In other words, you have two modes you can switch into in a stressful situation. Sympathetic triggers your fight-or-flight response, while parasympathetic triggers your rest-and-digest response.
“Let’s say a patient comes in, the patient’s crashing, and you expect this patient to be in an Addisonian crisis because it’s a little white dog that’s had vomiting and diarrhea off and on its whole life and it looks like crap on a cracker,” Dr. Montana says. “So you’re looking at the bloodwork and the math doesn’t make sense—the math doesn’t say Addisonian crisis.”
This is when your body begins to build a response to the situation. Dr. Montana says the biggest mistake you can make here is thinking in a behavioral tunnel. Behavioral tunneling is when you fall back onto a default response to a situation and then instinctually follow that default response from then on.
“The bloodwork says everything’s normal, but you’re in sympathetic mode, so you’re fight-or-flight—your body says it’s got to be an Addisonian crisis and you need to start fluids and do some steroids,” she says. “If you were in your parasympathetic mode, you’d be able to say, ‘Well, I guess not every little white dog coming in looking like crap on a cracker is an Addisonian dog, so let’s look a little deeper, go back and repeat the history.’”
Behavioral tunneling can happen with any stressful situations that regularly occur. Take, for instance, that deep-chested fat spay—you know, the one that keeps you up at night?
“We’ll start to melt down,” Dr. Montana says. “And if we stay in meltdown mode—even if we get through the spay, the dog goes home and everything goes wonderfully—our brain is going to go back there, because our brains like what they’re familiar with. So the more time you spend in sympathetic mode, the more time you’re going to be doing damage to your adrenals.”
This means that instead of taking a seat in the director’s chair for a project, you’re stuck down in the mud trying to see clearly from that vantage point.
“We need to recognize when we’re in our sympathetic mode and allow ourselves to go into parasympathetic mode,” Dr. Montana says. Though it may seem difficult to dig yourself out of the trap of the sympathetic mode, Dr. Montana says all it takes is a simple body scan.
Your how-to for a quick body scan
Here’s a step-by-step rundown for a body scan when you’re feeling trapped in sympathetic mode in a stressful situation. Follow these steps and feel yourself relax in real time.
> Close your eyes.
> Notice your breathing.
> Relax your eyes and body and allow your breathing to get deeper.
> Breathe in for three counts and breathe out for four.
> Breathe in for four counts and breathe out for six.
> Put your hand on your tummy and keep breathing in and out for twice as long, and just let your breathing flow.
> Bring your attention down to your feet and see if they’re tense. If they are, relax them. Then go to your calves, then thighs, and keep going up, relaxing each part of your body from bottom to top.
Repeat as needed during stressful scenarios.
Two minutes to a clearer mind
Leading the class in a group body scan during her Fetch dvm360 session, Dr. Montana proved that it takes less than two minutes to do.
“When you find yourself in a tricky situation, take a moment and do a whole body scan,” she said. “Nobody can see me doing it if I relax my eyes rather than close them, but when I relax, the whole room relaxes—the team, the clients, the dogs and cats, everyone becomes calmer with me.”
Dr. Montana’s challenge for veterinary professionals? Identify two things that make you absolutely crazy at work, then commit to doing a full body scan during those moments for two weeks: “For me, it’s courtesy progress exams that don’t show up—15 minutes of my life I’ll never get back!”