Burnout:

The secret to unlocking the stress cycle

Emily Nagoski, PhD, Amelia Nagoski, DMA

I believe this book needs no introduction to explain why this is a useful topic for veterinarians to be aware of! This was an outstanding look at the subject, offering information on recognizing and managing the experience of burnout. And to the author’s credit, the answer isn’t just quit and move on! I found quite a bit of useful knowledge, wonderful nuggets of thought (BONUS!! Star Trek and Star Wars references!) and helpful applications. It is definitely slanted towards women, with a strong but compassionate feminist perspective- but I’d expect all humans to find value in it!

The concept of burnout is generally recognized as having three components: 

Emotional exhaustion

Bingo! I think there is a rare veterinarian that doesn’t feel and recognize emotional exhaustion at various stages of their career. Nagoski(x2) describe emotions as tunnels- “if you go all the way through them, you get to the light at the end.” Emotional exhaustion occurs when you become stuck in an emotion. After five euthanasias in one shift, who hasn’t been stuck in sadness and grief?! We rarely maintain schedules that allow us to process these emotions during our shift, and it just keeps building! Care-givers are going to be at high risk for emotional burnout, and women are at even higher risk (Purvanova et al; Gender Differences in Burnout). Nagoski(x2) also describe another feature eerily predominate in veterinary medicine: The Human Giver Syndrome. Human Givers are expected by society (and themselves) to pass on any resource or power they happen to possess (jobs, time, affection, attention, emotion, compensation) to others.

Depersonalization

Depersonalization would be characterized as the depletion of empathy, caring and compassion. Super easy to plummet into in veterinary medicine. After managing the tenth Parvo puppy in a month due to errant and deadly misinformation by opinionated, uneducated authoritative personalities, who preach that vaccines are bad for puppies and they know better than the money-grubbing, big-pharma purchased veterinary industry, show me the human that hasn’t found their reserves of empathy deeply in the red. Another strike! 

Decreased Sense of Accomplishment

I quote: “an unconquerable sense of futility: feeling that nothing you do makes any difference”. We’ve all had shifts/rotations/weeks/…. that felt like this. Every human has really. But how frequently are you experiencing this? Is it a transient state of mind? Or is it a struggle to remember the last time you DIDN’T feel like this? 

Bluntly, these components are unavoidable in veterinary medicine. We may be able to minimize them by carefully selecting work environment, clientele, boundaries, activities outside work and your support system. But you will be guaranteed to experience these components, multiple times. 

Stress Cycle

The stress cycle is the process of coping with a stressor AND the stress it has caused! Most of us are very experienced at coping with stressors (regardless of whether it is a healthy means or not), but our system/society doesn’t have a prevelant habit of also dealing with the stress. These are two separate actions, and most of us are either unable to resolve the stressor (due to chronicity or social inapprotiateness or fear), or resolve it and quickly find ourselves managing additional stressors, preventing the management of the stress itself. Managing the stress itself is obviously a very highly individualized process, but don’t worry- there have been studies to try to pinpoint the most effective strategies! 

Completing the stress cycle: 

1. Physical activity! 

            The clearest winner! 20-60 minutes of moving your body per day. 

2. Breathing 

            Deep, controlled breaths. Good for minor stress, or as a quick, short-term solution in the moment. 

3. Positive Social Interaction

            This doesn’t mean you need to schedule a date with your bestie to accomplish this option. Casual, friendly conversation and gestures with whomever is standing right in front of you works! 

4. Laughter

            We are talking deep belly laughs- your favorite comedian or movie laughter, not the polite socially obligated laugh when some random stranger cracks a dad joke. 

5. Affection

            This requires a trusted and loved individual for reciprocal physical or emotional connection- do NOT try this one with just anyone standing right in front of you! You may create a new stressor to deal with! 

There is much more value in reading the book, than merely relying on this summary, as there is quite a bit I had to leave out. They have a lot of good discussion points on how to strengthen yourself to become better equipped for future stresses, many of which are past or future Book Rounds topics. However, you now have the building blocks for completing the stress cycle! 
What’s your preferred strategy? Do you have a major strategy they didn’t touch on?