Coping with Stress and Burnout as a Veterinarian
Nadine Hamilton
Positive Psych Solutions"As a vet of nearly 20 years experience, I cannot believe the difference that your book has made to the way I see myself, my profession, and my coworkers. I am genuinely enjoying being a vet again.”
"Your book is amazing and is helping me navigate the task of building a wellness foundation for BluePearl's 6,000 plus associates.”Lori Harbert, Director of health & Well-being, Bluepearl
"There are copies of this book at every Greencross Vets clinic as a means to empower vets in their everyday routines. It's a tough conversation to have, but an important one.”Andrew McInerney, Chief Operating Officer, Greencross
The best way to tackle the unique nature of veterinary stress that can lead to anxiety, depression and suicide is to use evidence-based research to create an intervention able to have a scientifically measurable positive impact on wellbeing. That's why psychologist Dr Nadine Hamilton wrote this book after spending over 15 years researching, working with thousands of stressed vets, and consulting with industry associations, practice managers and owners. This unique resource combines reading on mindfulness, positive psychology, wellbeing, and resiliency training with a ‘toolkit’ of practical tasks and tips to teach people how to cope with everyday pressures, so they no longer feel like suicide is the only way out. Its approach has been tested with statistically significant results showing reduced stress, depression, anxiety, and negative affect."I greatly enjoyed reading this book. It is an excellent resource. Every third-year DVM student at our school gets a copy of this book.”Prof. Anna Meredith, Head of Melbourne Veterinary School
Working in the veterinary profession can be a rewarding, challenging and demanding career, requiring a passion for animals, excellent interpersonal skills and a strong work ethic.
It also has a dark and very dangerous side.
The suicide rate for veterinarians as measured across Australia, the US, UK, New Zealand and Canada is almost four times higher than the general population. This suicide risk has been shown to surface at graduation and remain for the rest of a vet’s working life.
The veterinary profession faces a severe mental health issue.
The effects of working long hours, performing euthanasia on animals, emotional pressure, financial issues, unrealistic expectations, and dealing with distressed clients place considerable stress on both the vet themselves and their families at home. Failure to cope with such stress upsets mental wellbeing and can lead to serious emotional, physical, and behavioural issues.
Psychologist Dr Nadine Hamilton is passionate about veterinary suicide prevention, having been touched by the tragic effects of suicide within her own family. A chance encounter early in her psychology career led to her interest in the mental wellbeing of veterinary professionals. She has spent over 15 years in her specialty psychology practice working with thousands of stressed vets as well as consulting to industry associations, practice managers and owners to increase wellbeing, productivity, and retention in the workplace. In support of her aim to create a ‘paradigm shift’ within the veterinary industry, in 2018 she founded love your Pet Love Your Vet, a not-for-profit charity raising awareness about the issues within the veterinary industry and reducing stigma in veterinary professionals seeking help.
Her postgraduate research focussed on how key evidence-based psychological strategies could be used to decrease the risk of psychological ill-health and suicide by vets due to their day-to-day stress levels. What she found was that the best way to tackle the unique nature of veterinary stress was to combine certain psychoeducational elements. That meant specific education on the principles of positive psychology, mindfulness, and ACT along with a ‘toolkit’ of practical tasks from these fields. Combining these elements with supportive strategies such as stress management and communication tips results in a holistic intervention able to have a scientifically measurable positive impact on wellbeing. She uses this approach in her popular Coping and Wellbeing for Veterinary Professionals workshop.
Building on this workshop, she produced Coping With Stress and Burnout as a Veterinarian as a cost-effective highly accessible way to empower vets in their everyday work lives to use psychological knowledge and skills to combat stress, burnout, anxiety, depression and suicide. It is an easy read for individual vets both experienced and freshly minted and sits well with existing veterinary HR approaches as well as supporting face-to-face counselling and industry association mental health programs. It also provides a clear call-to-arms for veterinary industry leaders.
The book is structured in four sections. The first two provide vets with both an understanding and an acknowledgement of the uniqueness of their work and the mental health issues that come with that work. A section on psychology provides a comprehensive overview of several psychological fields that assist wellbeing. The final section includes specially selected strategies along with some references to a vet’s workday.
Together, these elements result in a unique resource able to provide self-help as well as support for existing vet wellbeing programs. Research has shown the importance of reinforcing the immediate-term effects of mental health interventions with take-home resources — something that reminds people of the information they have learnt and is able to be referred back to in difficult times. For some who take it off a practice shelf the book will simply be a confirmation that they or a colleague are not alone in experiencing stress and that their issues are understood, for others they will find practical tools helpful in their working day, for leaders it might help guide their interactions with staff, or it might help someone to seek professional help.
That’s why the book is not only popular with individuals working in local vet practices, it has also been taken up by vet schools, large vet hospitals and across hundreds of practices managed by ‘mega’ practice groups. For these corporate businesses, the book is seen as a major cost-effective mental health investment for the benefit of their staff and a commitment to the global fight against workplace suicide. Indeed, the 2018 Merck Animal Health Veterinary Wellbeing Study recommended that employers educate all team members on the importance of mental health and wellbeing.
Evidence-based and reader-friendly, the book is easy to keep on hand as a reliable staff resource or in support of employee assistance programs (EAP), continuing professional development CPD, or wellbeing support initiatives. In fact, larger veterinary groups and hospitals benefit from special discounts for bulk purchases of the book and options for customised branding with a personalised opening page message."I greatly enjoyed reading this book. It is an excellent resource. Every third-year DVM student at our school now receives a copy of this book.”
Prof. Anna Meredith, Head of Melbourne Veterinary School
"Nadine’s book greatly helps VetPartners meet its vital HR commitment to the wellbeing of all of our staff and our goal as a veterinary employer of choice.”
"UQ School of Veterinary Science strongly endorses' Nadine's book. We have copies available for all students across key areas, including staff year group mentors and key personnel, and have
Prof. Nigel Perkins, Head of University of Queensland School of Veterinary Science
"There are copies of this book at every Greencross vets clinic as a means to empower vets in their everyday routines. It's a tough conversation to have, but an important one — and this book is not a solution, but a start.”
Andrew McInerney, Chief Operating Officer, Greencross
"Highly recommended, a very easy and enjoyable read, this book should be readily available in clinics for all staff. Many of the stressors will be experienced by anyone working in a clinic, and our veterinary nurses and receptionists often bear the brunt of grief and unrealistic client expectations.”
Dr Jenny Weston, Massey University Dean of Veterinary Sciences
"Every veterinary and mental health care professional who works with veterinary staff should read this book with an eye on helping shape a better future for people and animals. ”
Melanie Goble, DVM, Not One More Vet Inc. (NOMV.org)
"The suicide rate among veterinarians is a concern for the WVA and we use Nadine’s book as a reference while working on the issue of stress in the profession.”
"Finally a practical self-help book aimed specifically at the veterinary profession. Easy to read and with lots of practical advice and the tools to traverse the corrugated road of professional life.”
"It is almost an unspoken rule or even a general acceptance that stress and burnout are just a fact of life if you are a veterinarian. It doesn't have to be that way. I believe this book will make a difference, help veterinarians have successful and fulfilling careers and also most importantly save lives of our dear colleagues."
"Thank you Nadine, for recognising and building awareness around such an important issue. I highly recommend this book, it may just save a life one day.”
"As a clinical psychotherapist with over 30 years working with high performer medical professionals, I can say that Dr Nadine Hamilton has a deep understanding of the stresses, conflicts, and unique challenges facing veterinarians today. I highly recommend this book to veterinarians and to the educators and mental health professionals who work with them.”
About the Author
Psychologist Dr Nadine Hamilton is passionate about suicide prevention, having been touched by its tragic effects within her own family. She has also held a love of animals since childhood. A chance encounter early in her psychology career led her to become a proud supporter and advocate for the mental wellbeing veterinary professionals. In her private practice, she helped many vets developReviews
Journal of the American Veterinary Medical Association, December 15, 2019, Vol. 255, No. 12 , Pages 1353-1357
Reviewed by Melanie Noble, DVM, CCFP
Renewed Strength Veterinary Services and Not One More Vet Inc
Coping With Stress and Burnout as a Veterinarian: An Evidence-based Solution to Increase
Review by
Dr Jenny Weston
Dean of Veterinary Sciences
Massey University
Published August 2019 in VetScript, the flagship magazine of the New Zealand Veterinary Association (NZVA)
https://www.nzva.org.nz/page/VetScript1
THIS 173-PAGE BOOK is billed as an evidence-based solution to
The book comes highly recommended by a number of Australian veterinarians who are well-known proponents of veterinary wellbeing, including Brian McErlean and Emeritus Professor Trevor Heath, who writes an insightful foreword. In the introduction, Nadine explains her career path and how her childhood aspirations changed from being a veterinarian
The book is divided into sections, the first being a concise summary of the ‘dark side’ of the profession, including the theories and statistics about veterinarian mental health. Section two covers the reality of working as a clinical veterinarian and how things have changed in the past 30 years. In this section, Nadine eloquently describes the personal, emotional and financial challenges that most of us are aware of. Her insights
Section three discusses the nuances between different forms of psychology that can assist us (or anyone) to thrive. I particularly liked the chapter covering positive psychology, an area I was already reasonably familiar with and which covers the factors that allow optimal human functioning by considering how we view our past, present and the future. Much of this can be affected by how we view events – preferably through a positive lens and with hope and optimism. This doesn’t mean we should all have a naïve, Pollyannaish take on life, but that we keep things in perspective and realise that everyone has challenges in their life at some point. Positive psychology isn’t just about fixing what’s wrong, it also focuses on strategies that support and nurture our physical and mental wellbeing.
The other chapters in this section cover Acceptance and Commitment Therapy (ACT) and Career Construction Theory. The author lost me a little in these chapters when a little more psychological jargon was thrown around, but there were intertwining themes about what makes a life worth living – positive relationships, meaningful work, a sense of achievement, and making a positive difference in the lives of others. All this doesn’t need to be earth-shattering, ‘ save-the-world’ type action – random acts of kindness and being adaptable are all important. The final chapter in section three covers resilience, which was also very interesting.
The perspective that you can bounce back from setbacks as opposed to grinding on with gritted teeth is useful. While there is evidence for a genetic component in resilience, it is good to know that resilience and optimism can be learned.
Section four, titled ‘Intervention’, outlines the seven modules that anyone can work through to improve their coping and wellbeing strategies. These modules come as a combination of information and worksheets that you could photocopy to assist you to work through the exercises. The modules
A comprehensive bibliography is provided at the end of the book. A minor criticism is that I would prefer references to be listed alongside the text to make it easier to read more around a particular subject, rather than just looking at all the articles and books listed in the bibliography and then guessing which ones might have the relevant information.
This is a very easy and enjoyable read, and Nadine is no doubt an expert in the field. her recommendations are based on science and her experience of working with veterinarians. I strongly recommend that this book be readily available in clinics for all staff to browse. Many of the stressors will be experienced by anyone working in a clinic, and our veterinary nurses and receptionists often bear the brunt of grief and unrealistic client expectations. Highly recommended.
Review by
Stress-busting strategies to tackle "dark" work risks
06 March 2019 1:28pm
A new book focusing on stress, burnout and the high suicide rate among veterinarians has outlined a seven-module "coping and wellbeing program", which includes important lessons for all time-poor or socially isolated workers.
in Coping with Stress and Burnout as a Veterinarian(Australian Academic Press), psychologist Dr Nadine Hamilton says there is a "dark side" to the veterinary profession, with workers operating within a "culture of death" (animal slaughter and euthanasia) and struggling with financial issues, despite the often-incorrect belief that they are wealthy due to the high charge-out rates for their treatment of pets.
In some Australian states, the suicide rate for vets is about four times higher than the rate for the general adult population, while UK research shows that vets are more likely to suffer from severe or very severe symptoms of depression, their suicide risk is higher than for medical doctors and dentists, and their access to lethal medication "can translate thoughts of suicide into actual behaviour", she says.
Factors that adversely affect a vet's wellbeing include poor work-life balance and a lower-than-expected income, given the nature of the work and the extensive training required to enter the profession, Hamilton says.
The high costs of setting up, running or maintaining a practice significantly reduce profit margins, while veterinary nurses can have "limited scope for advance once they have already reached practice manager status, placing a ceiling on their earning capacity", she says.
Vets must also deal with "difficult or emotionally distressed" animal owners, perform complex work at a fast pace for long hours, work on their own and in remote locations, and perform euthanasia, which is distressing for multiple reasons, she adds.
The threat of suicidality in vets can be tackled through career counselling and providing a "psychological toolbox of resources they can refer to when required", the book says.
The book includes the " complete coping and wellbeing program for veterinary professionals", with strategies for proactively managing stress and increasing resilience grouped into seven modules: stress management; time management; communication and assertiveness; relaxation; SMART goal setting; acceptance and commitment therapy; and positive psychology.
The first module incorporates a 10-point "stress-busting list" that includes:
- Know your stressors– learn to recognise the things that "get you stressed" and work on strategies for coping with them;
- Recognise your symptoms– try to recognise the signs of stress, like feeling nauseous, being irritable or sweating, so you can "take a more proactive role in combating stress";
- Practice mindfulness– focus on "being in the moment" instead of getting "caught up in the past or future";
- Socialisation– surround yourself with supportive friends and family, and be aware that laughing releases endorphins that help you "de-stress in the long run"; and
- Seek professional help– speak to your GP or psychologist if "you feel like stress has control of you" and "you do not feel like you have appropriate strategies".
Hamilton has spent a decade researching the mental wellbeing
Table of Contents
Acknowledgements
About the Author
Foreword
Introduction
SECTION ONE – THE CHALLENGE
Chapter 1 – The ‘dark side' of the veterinary profession
The Problem
Why do so many vets contemplate suicide?
What do we do to help vets at risk?
The Coping and Wellbeing Program for Veterinary Professionals
SECTION TWO – THE REALITY
Chapter 2 — Being a vet
Impacts on Vet Wellbeing
Students and Fresh Graduates
Major Strengths Supporting Vet Wellbeing
The Next Step
SECTION THREE — WHAT CAN HELP
Chapter 3 — Positive Psychology
Authentic Happiness Theory to Wellbeing Theory
PERMA
Positive Education
The Core Virtues of Positive Psychology
Another Step to Go
Chapter 4 — Acceptance and Commitment Therapy
Psychological Flexibility
Mindfulness
Core Pathological Processes
Overlap Among Pathological Processes
A Further Step Yet
Chapter 5 — Career Construction Theory
Life Themes
Vocational Personality
Career Adaptability
Career Construction Theory in Action
One More Step
Chapter 6 — Resilience
Keys for a Resilient Life
SECTION FOUR — INTERVENTION
The Coping and Wellbeing Program for Veterinary Professionals
Module 1 Stress management
Module 2 Time management
Module 3 Communication and assertiveness
Module 4 Relaxation
Module 5 SMART goal setting
Module 6 Acceptance and Commitment Therapy
Module 7 Positive Psychology
Helpful Contacts
Bibliography