Cultivating resilience in veterinary medicine

2019-10-18
Hilal Dogan, BVSc, CCTP

Rising above adversity in the middle of a stressful day in the veterinary clinic is not easy. Yet there are key factors in becoming more resilient, and its not nearly as impossible as youd think.

Look inward. You may be more resilient than you think. (Image: zenzaetr/adobestock.com)If you've attended any wellbeing lectures, listened to podcasts or read articles about compassion fatigue or burnout in veterinary medicine, you've probably seen the word “resilience” bandied about.

In its most basic definition, resilience is the capacity to recover quickly from difficulties. In its colloquial use, resilience is seen as a quality of someone succeeding against all odds, overcoming adversity and having the grit to rise above negative forces in life.

It's probably clear if you work in veterinary medicine that there is a high degree of variation in how individuals respond to stress. The stress of a veterinary technician who can't run to the bathroom because doing so would compromise the care of her patients looks different than that of an associate prepping for surgery for the first time since she lost her last patient.

What if we thought of resilience in the same manner? As research in genetics, psychology and neurobiology advance, the idea of individualized resilience is gaining ground.

 

Vicarious resilience: Seeing is believing

Just as there is secondary trauma, there is also vicarious, or secondary, resilience.

The other day was another insanely busy Sunday at the emergency hospital where I work. I was juggling a few critical patients at the same time, literally running between a crashing parvo puppy in the isolation ward and a cat with a urinary obstruction. I was attempting to place a urinary catheter to unblock the obstruction while also making sure my parvo puppy wasn't about to have a seizure from hypoglycemia. It was a difficult day. I was barely keeping things under control.

I then accidentally cut the urinary catheter in half while trying to cut the suture material I was using to tie it in. In that moment, I just wanted to cry. I knew I was going to have to start all over again with what was already a difficult catheter placement. My mind was on the puppy in isolation as well, and the bloodwork had just come back showing that he had almost zero white blood cells.

My usual tactics for self-management were starting to fail me. I could feel myself about to lose it. Tears were about to burst out of me, and I was feeling like I wanted to give up. I knew the technician working with me was equally at the end of her rope. I told her, “I am about to cry, but I know I need to keep it together and just get this done.”

She responded by saying simply: “I know, me too, but we need to ‘woosah.'” In that moment that word sounded so funny I managed to smile and feel my stress start to stabilize. She had me take a deep breath and exhale out while saying the word “woosah”-like they do in the movie Bad Boys 2. We laughed and I placed the catheter in like a breeze and tied the sutures. I felt grateful for her resilience in that moment, because I was able to lean on her.

Key factors in resilience

How can a person become more resilient? According to Andrew Shatté, PhD, a professor at the University of Arizona, it's best to start by breaking resilience down into an aggregation of clearly defined inner strengths. “This way, we can pinpoint employees' strengths and help them work on their weaknesses,” he says.

He outlines seven key factors of resilience, to help people adopt healthy behavior for life:

1. Emotion control: The ability to control feelings in the midst of adversity.

2. Impulse control: The ability to shut out distraction and urges and to restrain reaction.

3. Problem-solving: The ability to identify the causes of a problem and what can or can't be controlled.

4. Realistic optimism: The belief that things can change for the better, that you can control your life's direction while being aware of the challenges.

5. Self-confidence: A sense of mastery and belief in one's abilities.

6. Empathy: The ability to read and react to others' social and emotional cues.

7. Reaching out: The ability to seek out new challenges and relationships.

“Individuals can have some of these traits and not others, or lean on a specific strength when the others are weak,” Shatté says. “For example, an employee who can seemingly power through the most taxing and time-intensive projects at work without breaking a sweat probably possesses a high degree of ‘problem-solving.' But that same employee might have an extreme reaction to harsh feedback, thus lacking ‘emotion control,' another factor of resilience.”

I'm working on building my own resilience through indoor rock climbing (yes, really!). When I first started, I couldn't trust my partner, fearing he or she would let me fall. I clung to the wall like a wild cat, eyes wide, adrenaline pumping through my body. The higher I climbed the more panicked I became. Yet I was determined. I kept telling myself that I was safe. The friends down below would shout up, encouraging me. I've reached a point where I'm able to climb with ease, and a big part was learning how to ask for help when I am struggling.

Veterinary medicine is a profession filled with proverbial mountains to climb, and building resilience is certainly no easy task. But next time you're panicking from stress, you can always “woosah” … and see what happens.

Dr. Hilal Dogan is a certified clinical trauma professional and frequent Fetch dvm360 speaker who is a veterinary relief practitioner in Denver, Colorado. She started the Veterinary Confessionals Project (dvm360.com/vetconfessions) as a senior veterinary student at Massey University in New Zealand.