In recent years, it’s been recognised that the veterinary profession suffers disproportionately from stress-related issues with a high incidence of alcohol dependence, depression and suicide. The job includes many types of stress, with after-hours work, poor work-life balance and the high level of personal responsibility for individual cases playing a part. But as a vet in practice, there’s one part of my daily job that brings more immediate stress than any other: euthanasing pets.
There are three main reasons why I find Euthanasia so stressful.
First, the huge significance of the act itself. I’m a vet because I care for animals, and I want to help them. Yet here I am, deliberately killing the animal in front of me. This often causes a type of cognitive dissonance that I blank from my mind with justifications, such as the following:
the animal is old, sick and suffering (or about to suffer)
the dog has just bitten a child badly and so cannot fit into our society anymore
the cat is badly injured and the owner cannot afford the expensive surgery needed, so euthanasia is the “least worst” option.
Despite these mental gymnastics to allow me to carry out the act of killing, at some level, I sometimes feel discomfort with what I am doing. The animal gazes into my eyes as they die, and something inside me feels crestfallen. For me, killing an animal always involves some level of personal angst, and this is certain to inflict stress on me, whether or not I am conscious of it at the time.
Second, the witnessing of client grief. A classic example happened to me last week: the sixteen-year-old terrier, who had clearly reached the end of his life, was being hugged by his twenty-year-old female owner. She was devastated, sobbing hysterically, and her parents were crying quietly on either side of her. It is impossible to be involved in such situations without being emotionally moved or even disturbed. There is nothing easy about it, and I feel the immediate stress in a physically palpable way, with sweaty palms and racing heart. Very few other human beings need to witness this level of human grief every day as part of their job.
Third, the way that we schedule euthanasia into our daily work routine creates the need for vets to portray a seesaw of public faces. We might welcome a new puppy or kitten to our practice, ooo-ing and ahh-ing over the young animal, enthusing about its loveliness and joining in with the general glow of contentment. Then one minute later, we ask our next client into the consulting room, and it’s the euthanasia of a pet who has been a part of the family for over a decade. The smiling, cheerful public face is gone, and we now have to wear a mask of sympathetic understanding and serious professional care. This flip-flopping of public facing image happens naturally, but it carries an inherent stress.
So how can the stress of euthanasia be ameliorated for vets in practice? Here are four simple tips:
Schedule euthanasia appointments appropriately. Allow plenty of time for the procedure, and try to schedule a break for the vet immediately afterward, rather than further appointments.
Carry out euthanasia in as planned a manner as possible so that the event happens smoothly and professionally. The use of an intravenous catheter, set up behind the scenes in the few minutes prior to the act itself, can help by removing the risk of being unable to find a vein. Judicious use of sedation can also make the event more predictable.
Write a note or card to the client immediately after the euthanasia; as well as providing good service which is much appreciated by the client, this can help the vet achieve some sort of emotional closure to a challenging episode.
If you find euthanasia unduly distressing, review your overall work-life balance. Do you have enough “me-time”? Do you take regular exercise? It can be difficult to do this when working in a busy practice, but it’s an important way of achieving emotional resilience.
You need to remember that euthanasia is often the best answer for animals under your care. Remember, ‘You are not alone’ – we all know how it feels to do this. I respect any vet who has to carry out euthanasia: it is not easy.
We will be providing further helpful advice on dealing with different types of stress within a practice, so be sure to keep checking out our blog for our latest topics!
Dr Pete Wedderburn BVM&S CertVR MRCVS