Can caregivers care too much?

Traditionally veterinarians have enjoyed an enduring reputation as the most caring of professions, but many are paying a price personally for that care, experts say.

Tracy Zaparanick

An emerging trend is escalating where a growing number of animal caregivers, negatively wrought by emotional events at work, fall victim to a condition known as compassion fatigue.

What isn't known yet is just how many people are affected.

That missing link inspired Tracy Zaparanick, licensed clinical social worker at the University of Tennessee, to collaborate with colleagues on the first-ever multi-faceted series of studies to establish the frequency of compassion fatigue in veterinary and shelter medicine and then develop resiliency skills to cope.

"In the animal care world and human health, we're trying to get people to be empathetic with the person or animal but not to the extent where they become entwined in that person's or being's world," Zaparanick says.

Compassion fatigue, according to Zaparanick, is the synergistic effects of primary traumatic stress, secondary traumatic stress and burnout.

Defining the condition is only the first step, says Zaparanick, who suspects the incidence of compassion fatigue within the veterinary profession is "a significant problem." For evidence, she points to the human healthcare profession.

"In the human healthcare profession, we see emergency room personnel, psychologists, social workers, police officers placed in situations where they are subjected to trauma," she says. "In talking with these folks, we found that animal care professionals are being exposed as much as human healthcare professionals."

Eric Gentry

Launched in 2001, the first study is gathering quantitative and qualitative information from a veterinary oncology clinic and two humane shelters. Researchers are supplementing their data with a recently launched online survey (www.compassionfatigue.net) to collect additional input from veterinary clinics and shelters nationwide. Zaparanick expects to finalize Web results by October.

In detail

"What we hope to do is answer the question: what is the prevalence rate for veterinarians with compassion fatigue?" asks Zaparanick.

Zaparanick says the project got wings from her conversations with a veterinary oncologist, Dr. Kathy Mitchener, who has since co-authored a paper entitled "Understanding Compassion Fatigue: Keys for the Caring Veterinary Healthcare Team" with Gregory Ogilvie, DVM, dipl. ACVIM. It was published in 2002 in the Journal of the American Animal Hospital Association. Mitchener was unavailable for comment at press time.

Project born

Eric Gentry, social worker at the University of South Florida, has extensively studied compassion fatigue in human health caregivers and has treated caregivers in recent tragedies including the Oklahoma City bombing and events of 9/11. Compassion fatigue, whether afflicting human or animal caregivers, is comprised of two components: secondary traumatic stress and burnout, Gentry says.

Recognizing symptoms

Secondary traumatic stress includes intrusive and avoidance symptoms. "The intrusive aspect of work experiences comes unbidden into consciousness as a person is trying to live their life especially outside of work," says Gentry.

"People may feel very anxious, may perceive danger, think about a particular animal or experience of cruelty unconsciously," he explains.

Avoidance symptoms are expressed when people begin to numb themselves, withdraw from activity that was previously pleasurable, shut down or face troubled relationships. Such symptoms can lead to greater anxiety and can cause physical ailments (i.e., gastrointestinal or chronic pain, fatigue).

Burnout can cause fatigue and exhaustion, even depersonalization.

"The work loses its meaning and worth and that capacity to excite us. It becomes a sentence and people become victims of their jobs," he says.

Zaparanick agrees, "In the case of veterinarians, I've heard they will drop out of a private clinic as a direct veterinarian with companion animals and work in a job that doesn't require a lot of public interaction to avoid any kind of traumatic stress. They are wounded caregivers."

How a caregiver processes the act of euthanasia can significantly impact the risk for compassion fatigue, according to experts.

Contributing factor

Gentry says, "Some people have processed it in a way that it is doing service to the animals with technical efficiency, so it's not harming or scaring the animals. Those people are less affected. It causes them great sadness, but they're not collecting symptoms from that."

Coinciding with the first study, Zaparanick, Gentry and the Humane Society University (a training branch of the Humane Society of the United States) are collaborating on a secondary project to assess ways to boost resiliency of animal caregivers and decrease the chances of them experiencing compassion fatigue.

Secondary project

As part of the project, Gentry has developed a treatment and training program applicable to animal caregivers. The two-day workshops are scheduled to begin this summer.

"For anybody who comes into the field with wide-eyed idealism, to sustain that joy in work, we have to grow some skills to become resilient and hardy without growing hard and cynical," he says of the training.

The project also features an interactive Web site, where people can complete tools to capture their levels of stress and resiliency to compassion fatigue.