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10 Things You Should Know About Suicide

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We skirt the cage this tiger circles in. We’ve been taught over decades to walk carefully around this topic and its people like they are in the middle of a mandala and the path is eggshells. I remember being told if we talked about it, then people would do it.  We’d best just keep quiet.

It triggered me even then.  If someone is asking you to keep a secret and it’s not about something fun, something is wrong. Alarm bells should be going off.  Why don’t you want to talk about this?  What makes you so uncomfortable?  I suspect that it’s not having all the answers.  I suspect it’s being afraid of saying the wrong things.  I suspect it’s feeling responsible.  I suspect it’s helplessness and a lack of understanding.  I remember thinking, “Why don’t they want to talk about me?”

What can you do?

You can educate yourself about suicide, about symptoms and signs.  You can have open, non-judgmental conversations with your colleagues and your co-workers about suicide.  You can speak up against the pervasive suicide shaming and misinformation in our culture.

There are plenty of myths that are still pervasive in culture in general about suicide and suicidality.  Let’s debunk them here, not for the first time, and not for the last, but as a solid reminder:

Myth: People who try to kill themselves are mentally ill.

Fact: Mental health, well-being, and balance are topics that are just now being brought to the forefront of conversations about suicide in the veterinary profession. While mental illness may predispose an individual to suicidal thoughts, many suicidal individuals are not struggling with mental illness. They may instead be suffering from extreme distress and emotional pain, which are not necessarily signs of mental illness. The stigma surrounding mental health crisis, suicidality, and depression prevents these individuals from speaking out as openly as we need them to and they need to get help.

Myth: People who talk about suicide don’t do it.

Fact: Most everyone who attempts suicide has given verbal clues.  No matter how casually offhand comments are made, they should be taken seriously.

Myth: If a person has made a plan to kill themselves, nothing is going to stop them.

Fact: Suicide isn’t about dying.  It’s about stopping pain. The impulse to end it all, however overpowering, does not last forever.

Myth: Talking about suicide may give someone the idea.

Fact: You don’t give a suicidal person ideas by talking about suicide. Removing the stigma surrounding the subject of suicide and discussing it openly is one of the most helpful things you can do.

Here are a few things I’d like you to know about suicide:

  1. We work in your clinics.  We are your top performers.  We work in industry. We are world-renowned speakers.  You don’t just act shocked when we take our lives, you are shocked because you didn’t notice.
  2. We have gotten help and yes if we were prescribed medication we are probably taking it. This issue isn’t about getting into counseling or getting onto the right drug regimen.  Those things help, but it’s deeper.  Studies of suicide victims have shown that more than half had sought medical help in the six months prior to their deaths.
  3. Suicide isn’t selfish, but it also isn’t about you.
  4. Suicide isn’t cowardly either. It’s literally a choice someone made and it’s not your place to judge.
  5. Committing to suicide is not a brief process, it takes time, thought, research, and a great deal of soul searching. Suicide is for so many people the choice they are making to escape unbearable pain.
  6. There are warning signs. If you see us exhibiting these behaviors, reach out.  Please let us know that you are concerned about us and why.  Ask how you can help.
  7. Don’t know what to say, that’s okay. Dial the crisis line number and sit next to them while they talk.
  8. Don’t minimize how this feels for us. It’s totally okay to say, “I don’t have any idea what you’re going through” or to ask, “how does this feel” and “what does tomorrow look like?” But telling us “we have so much to live for” isn’t the right tact.
  9. We aren’t contagious. When one of us speaks up, it is a bright light in a dark place and it allows for others to speak up. While we’ve made tremendous roads regarding mental health in veterinary medicine, it’s time that the stigma surrounding suicide fall aside.
  10. Suicidality doesn’t have to define who we are and it absolutely does not have to define who we were.

National Suicide Prevention Lifeline – Suicide prevention telephone hotline funded by the U.S. government. Provides free, 24-hour assistance. 1-800-273-TALK (8255).

Crisis Text Hotline – Text HOME to 741741 from anywhere in the USA, anytime, about any type of crisis.

The views and opinions featured on There, I Said It are those of the authors and do not necessarily reflect the position of the DrAndyRoark.com editorial team.

A Note to the Crying Nurse

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Last week I worked with a freshly-minted veterinary nurse who recently joined our practice. Anna has all the skills she needs and an attitude and work ethic that I admire. I’m thrilled she joined our clinic.

At 5:30 p.m. on Friday, a woman in tears walked into the building. Her dog, Maggie, had been diagnosed with an aggressive cancer months earlier. Surgery at the time had removed the primary tumor and made Maggie feel much better.

Unfortunately, now it was back. I could feel a mass in her abdomen and knew why she had recently given up eating. As Maggie trembled in fits, her owner and I decided to put her to sleep. Anna did skillful and compassionate work in her assistance.

When it was over, I found Anna gathering supplies to make a clay paw impression of Maggie’s foot, noticeably avoiding the rest of the team in the treatment room. She looked up when I asked if she was okay, and I saw the tears. She hurriedly wiped them away.

In that moment, everyone in the room wanted to make her feel better. There was a chorus of encouraging comments like, “It’s okay,” “We’ve all been there,” and “You did a great job.” Finally, one of the senior nurses said, “In no time, you’ll be dead inside like the rest of us.” We all chuckled, even Anna.

It was past closing time by this point, and another nurse who was already staying late shooed Anna out the door with promises of finishing up for her. I know Anna was still upset when she left. I think it was more about embarrassment over showing her grief than the actual grief itself.

I’ve thought about that afternoon a lot since then, and about what it means when young doctors and nurses weep while the veterans work on.

If you’re new to veterinary medicine and you’re worried that the sadness you feel or the emotions you show when animals suffer or die are somehow a signal that you’re not cut out for this work, I’d like to put your mind at ease. Listen: there is nothing wrong with feeling sorrow or crying.

Tears — or lack thereof — have nothing to do with your levels of strength, maturity, toughness, or resilience. Honestly, I might worry about you if you didn’t have these struggles as you enter this career.

The truth is, you will always have cases that bring you to tears. After a whole career in veterinary medicine, you will probably still choke up when you euthanize someone’s especially beloved pet when you see the dying animal that looks just like the pet you loved and lost, or when you say goodbye to pets you’ve known since they were kittens or puppies or foals. We all have our soft spots, and we always will.

When the sorrow comes, I find it helpful not to resist it. Fighting the urge to cry is frustrating and futile. (I do, however, have a general rule about not showing more emotion that the pet owner in front of that pet owner.) Instead, take a few minutes to reflect and understand why you feel so strongly. Facing and acknowledging your pain is the only way to move past it.

It’s perfectly normal to feel the pain of cases that poke into our own vulnerabilities. For example: when I see young families losing a pet, my heart absolutely breaks. I’m not ashamed of that, and I know I feel this way because I remember the pain my own family recently went through when we lost our faithful dog. I also know I’ll get past this pain as my family moves on, and I remind myself that my clients will, too. As I focus on that, these cases will get much easier.

Thankfully, the more time we spend in veterinary medicine, the more we come to understand that death is rarely the worst outcome. When I began in practice, I deeply mourned the passing of every one of my patients. No matter their age and condition, I felt their passing as my own loss.

What changed is that over time I gained a lot of experience with pets who didn’t die. In those cases, I saw what suffering truly looks like. Later, I went through experiences where I prayed every night that a pet would peacefully pass, only to sigh in the morning when I looked into that pet’s lucid, sorrowful eyes. I came to know pets whose quality of life ended many days before they got the peace they were waiting for. You will, unfortunately, know these pets too, and it will change how you see death.

This is why the young doctors and nurses cry while the others keep working. It’s experience, simple as that. We will always hurt when pets pass before they should. We will feel for the families they have left behind, and we will remember pain from our own lives in their loss. These emotions should be celebrated as a mark of our enduring humanity. Blessedly, for most of us, sorrow will eventually become tempered by perspective and familiarity with both death and its alternatives.

I wish for everyone working with pets to feel sorrow because this means they have not run out of compassion. Let us never forget that pets were not meant to be on this earth for very long, and losing the best pet in the world is only sad because we once had the gift of knowing that blessed soul.

Five Things We Have to Stop Doing in Vet Med

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1. Putting ourselves last.

We all care immensely about our jobs. We care for our patients, clients and coworkers. But we often put ourselves last on the list. We must find ways to put ourselves first. Listen to your body. When you feel stressed, anxious or exhausted your body is telling you something is wrong.

Are you putting your physical, emotional and mental health first? Are you leaving work at work when you walk out the clinic door? Are you doing things that you enjoy? We care so much for others that we forget to care for ourselves. This isn’t sustainable. Make yourself a priority! You are worth it!

2. Resisting change.

Back in the old days, we boxed cats down for anesthesia. We used muscle to restrain with the intent of getting the job done. Then we began to see a shift in how we handled cases. We use chemical restraint and practice low-stress techniques to give our patients a better hospital experience.

Change happens. It helps us grow and push forward. It brings innovative ideas and maybe even better ways to do things. We cannot dig our heels into the ground and cling onto how we’ve “always done things”. We must come up with ideas and be willing to let our coworkers feel safe to bring up ideas. Without change there is no growth. We must always be willing to grow.

3. Not speaking up when something seems wrong.

I remember feeling off about a case one day. My gut feeling was this patient wasn’t safe to go under anesthesia. Blood work was normal. There was a heart murmur that had been addressed by the cardiologist. The patient was bright and alert. Something felt wrong and I couldn’t put my finger on it. I asked the doctor what they thought about doing radiographs before anesthesia. They let me go with it.

Turns out the patient had abdominal fluid and needed more than just the elective procedure they came in for that day. I thank my lucky stars that I was willing to say something and that my doctor was willing to listen. Our gut feelings and senses are a mystery on why they work the way they do. And sometimes they are wrong. But by speaking up when something doesn’t sit right, we can continue to be our patient’s advocate.

4. Tolerating bad behavior.

Talking to so many of my colleagues, I have found that many of them have been bullied, spoken down to or made miserable by someone in the clinic. Maybe it’s a boss, coworker or even a client. But many of those who were experiencing this nasty behavior didn’t say or do anything. They put up with it and felt utterly helpless.

I’ve always believed that to make your garden grow, you must remove the weeds. When people are aggressive, abusive or just plain jerks, we must stop putting up with it. By allowing this behavior to happen in clinics or thinking “It’s just part of the field,” we are condoning negative behavior. Make your garden beautiful and don’t put up with those who try and destroy it.

5. Getting lost in our mistakes.

We all want to be right. We are overachievers and a lot of our self-worth comes from being right. We are human beings. We will make mistakes. Those mistakes will haunt us forever. But what we do with those mistakes is crucial to our success. We cannot beat ourselves up over the past.

The best thing we can get from a mistake is to the ability to learn from it. We know that our mistakes can have a huge magnitude. It’s ok to feel guilty or think of what we could have done differently. But don’t live there and don’t let it immobilize you.

This is truly an amazing profession we get to be a part of. We have endless opportunities to learn, grow and evolve into the professional we were meant to be. The most important thing is not to just survive this field, but to be able to provide amazing care for your entire career. When we stop doing these five things, we increase our longevity in this field. I want to see you all do what you do best, for as long as you possibly can. I want to see you happy. You have the power to make it so.

The views and opinions expressed in this article are those of the author and do not necessarily reflect the position of the DrAndyRoark.com editorial team.

Finding Happiness in The Journey That is Veterinary Medicine

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“You will never be happy if you continue to search for what happiness consists of.  You will never live if you are looking for the meaning of life.” Philosopher Albert Camus.

The plan was so clear when I was in my early 20’s and the comfort that came from that certainty was amazing.  I knew exactly where I needed to go and had a very specific detailed “Plan”.  I’m an organizer and I had organized my life to my end goal, or so I thought.

I approached each challenge like a mountain to climb, where each mountain was to lead me to my civilization, a place called happiness.  With my hiking boots on, backpack full of supplies, and walking stick in hand, I started on that clearly mapped trek.  At the summit of each mountain, I knew exactly which mountain to tackle next.

Undergrad, acceptance to vet school, complete first year of vet school, then second year, externships, etc.  With time, more peaks began to rise in front of me providing me with directions to go away from the clearly mapped trek.  At first it was clear the direction to follow, in time the direction became hazy.

Over time the supplies in my backpack dwindled, the stick broke some where back on mountain 8, and there I stood, at the top of yet another mountain with no idea which way civilization was.   In that moment I realized I create civilization, and that meant civilization was where ever I stood on whatever mountain I was on in that moment.

Making camp and holding my own during difficult weather or when drinking water was sparse, was not easy.  But in time I found others to camp with and I realized, I am not alone and the reality is that there is no “plan”.  It is just me and my civilization, that I create as I walk forward.

Don’t get me wrong, I’ll gladly take on a difficult hike up a new mountain and at times I may have to hunker down for a wicked snowstorm.  The difference is today I embrace the struggle, because I know the struggle is the path to my happiness. The “plan” is vague, and that is okay.  Reality is hard and in fact can suck at times, and that is okay too.

I’m content because I have a vision in mind, and this vision is nothing like I’m mindlessly running around a mountain range with no clothes on hoping I don’t die of exposure.  The path is not a “plan” but in fact the one I choose, and now I enjoy civilization along the way.

Another way to look at the mountains is the concept of The Backwards Law noted by philosopher Alan Watts (The Wisdom of Insecurity published in 1951).  The more effort we put into climbing those mountains to find civilization, the farther the civilization is to us.  In other words the harder we work to find happiness, the more unhappy we become. As you dig into this concept Watts shares we can see that pain is a way that can lead us to having a better awareness of a more desirable path, however without the pain we do not know the path to contentment.

Each mountain along the way has both negative and positive aspects.  In order to continue toward the peak of a mountain or relax into a valley, we must embrace them both.  The beautiful open meadow with freshwater is easy to embrace, the agonizing incline scampering over large boulders, not so much.

We value the meadow because of the experience we had with the incredibly intense incline and we welcome the incline away from the meadow knowing that another vista of amazing beauty is to be provided to us at the top of that incline.  We do not stop at the peak, we look for the next meadow to explore and the next incline to tackle.  That is life. We look at the negative as not bad and the positive as good, but that in fact both are part of us that are equally required and without them both, there is no us.

On this journey through the mountains there is a start point (birth) and an endpoint (death) with countless important steps along the way.  Often we make adjustments when we have determined that we started up the wrong mountain or perhaps the valley is too steep.  Each of those steps is valuable and important in working to come to the “endpoint”.  We can’t skip a step, nor linger at one for too long, in the end we keep moving forward, tackling each new mountain.

In addition, the goal is not about the end result, death, it is all the steps along the way.  I mean we are not born only to look forward to death.  We are here to enjoy each of those steps and embrace the uncertainty that comes from the fact that we don’t know what step 10 could hold, while we are involved with step 5.

We know we are moving towards that future step, but it is unclear and uncertain what that looks like.  That is where happiness lies, because happiness is not a “plan” we develop, it is actually the value in each step as they present themselves, some related to positive moments and others negative.  When we accept uncertainty, things become all that more clear and comfortable.

Step 10 is where one maybe today, and step 20 is in the distance, maybe even many mountain ranges away, we work to embrace the uncertainty of its place.   Following core values and passion allows us to have confidence we are on the path we should be on. With each mountain we tackle we work on creating our civilization as we go, embracing both the positive and negative aspects of the path, and we take the next step into the uncertain trek that is our life’s journey.

The views and opinions expressed in this article are those of the author and do not necessarily reflect the position of the DrAndyRoark.com editorial team.

About the Author

Kimberly Pope-Robinson is a veterinarian life coach who started the 1 Life Connected movement, www.1lifecc.com in 2015. She is dedicated to helping the profession connect their career with their life’s passion. 1 Life Connected creates the space to give us each permission to find our unique path towards suitability in the veterinary industry. Dr. Pope authored the book “The Unspoken Life, Recognize your Passion, Embrace Imperfection, and Stay Connected” which provides a framework in helping the veterinary profession find well-being in the lifestyle we call a career.

What Kid Number 2 Taught Me About Vet Med

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A little more than three months ago, my husband and I were blessed to bring another little boy into the world and into our family. While our first son certainly initially turned our world upside down, I thought I had pretty much figured this motherhood thing out. I assumed one kid + one kid = 2 times the work, right?

 

I was sorely mistaken. In my new world, 1 + 1 = 17. Needless to say, I was wildly unprepared for exactly how much a second child would impact our family, our household or my career. Here are five ways the second kid has affected my viewpoint as a veterinarian:

 

1. On Clients

We’ve all heard the statistics of owners retaining only a fraction of what we’re telling them in the exam room. If they have multiple kids with them, then divide that statistical number by 5 and subtract another 7 or 8, because there is just no way they’re getting it.

 

Even if they heard it over the begging for the smartphone from the toddler, the crying from the baby and the clamor of the veterinary clinic as background ambience, they certainly can’t retain it when they’ve also filled their brains with the endless to-do list that accompanies parenthood.

 

My solution? Write. It. Down. I was already a huge fan of report cards before Baby Dos arrived. I try to quickly complete my records while the owner is checking out and present them with a one page summary using our software’s templates by the time they’re done.

 

Now, I’m taking it a step further. In addition to the printed summary, I’m emailing it to them. That way, they don’t have to worry about losing one more piece of paper, can share it quickly with their spouse or partner, and have it easily accessible when they do have an extra few minutes to review it without distraction.

 

2. On Patients

I have a newfound admiration and respect for pets in households with children. How utterly terrifying for them, right?! In our house, the arrival of our first born four years ago brought new noises, smells and schedules. Now, it’s utter chaos most of the day and night. Routine is laughable, sounds ranging from crying babies to Transformer imitations are constant, and no space in the house is sacred. While my dog doesn’t mind, food is frequently dropped.

 

Between the baby swing, bouncer and remote-control vehicles, our house is a real-life pet obstacle course. There are toys everywhere, sometimes actually falling from the ceiling (parents: if your kid asks for a splat ball, offer them literally anything else).

 

I’m lucky that my dog isn’t into chewing on non-edible things and is a low foreign body risk. My cats are currently settling into their new normal with the help of a secluded closet and some strategically placed calming pheromone diffusers. I’m hopeful the producers at NBC will consider a cat-style American Ninja Warrior experience soon.

 

That said, I look at pets in child-filled households with new respect, and new questions:

 

Dogs with GI signs: they could have eaten literally anything. From dropped food to Lego pieces, ingestion of pancreatitis and foreign body-inducing items have been on my floor more times than I care to admit. My dog definitely could have wolfed something down while my back was turned.

 

Cats with urinary issues: Where are their boxes? Do they have privacy? Are they away from the hustle and bustle? Can they get to them without being picked up by a toddler or having to climb over a PJ Masks playhouse? Do they get ANY attention or time with their adult owners? If they’re like my cat Hurricane, she’s completely terrified of coming downstairs when the kids are awake. We see her emerge from her hiding spot only late at night, and if we hadn’t arranged for a new second litterbox location upstairs, I’d be doing even more laundry and cleanup.

 

Pets with possible pain: In a house with kiddos, anything is possible. I am hyper-sensitive to the potential injury of either canine or tiny human in my own house. Despite extensive precautions, it’s still happened on both ends. The behavior of a child and the behavior of a scared or hurt pet are equally unpredictable, and when put in a confined space together, accidents can’t be entirely avoided.

 

In a split second a child could intentionally or unintentionally hurt a pet by picking them up, stepping on them, attempting to love on them and invading their space, or a million other possible scenarios.

 

If pain is potentially on the table, we have to treat it, and we have to prevent it in older pets that may be more sensitive. It’s our job as veterinarians to protect not only animals, but their people and the public as well. Pain control has always been a no-brainer for me, but I now see how quickly and easily these accidents could happen, and how someone, two- or four-legged, could get hurt.

 

3. On colleagues

Man, I love my work family. I have truly been so lucky. I’m back to work after my maternity leave, and my entire team has been exceptionally accommodating to my new schedule as my husband and I are figuring out how to best juggle two jobs, child care and extra-curriculars. Before our second son arrived, if one of us wasn’t able to do daycare pickup, the other was usually free.

 

Now, that person likely has the other kiddo, or is pulling a later work shift to accommodate our new schedules. Between summer camps, daycare, doctor visits, two work schedules and family commitments, I had to break down and buy an actual planner. Now, I’ve got the written planner, a refrigerator calendar, and the most elaborate color-coded, ultra-synced Google calendar you’ve ever seen.

 

How it affects my relationship with my co-workers: I’ve already run late a handful of time and had to switch several shifts with my colleagues to accommodate this new life, and we’re only three months in. My receptionists have been awesome about scheduling me breaks to pump.

 

Several technicians have been kind enough to take on diaper and bottle duty on the occasions when I’ve had to bring the bambino along for some paperwork or meeting. The entire staff has been kind, understanding, and willing to help.

 

The lesson here is that not only do I have a renewed appreciation for these people, but the realization that, if at all possible, I need to be flexible in accommodating their schedules and supportive of their outside lives too. Since my return, I’ve been trying to pick up any shifts or make any schedule trades that I can with my colleagues.

 

In addition to it being common courtesy, it’s clear that the possibility of a kiddo doctor appointment, school event or change in babysitter availability is now doubled, and it’s likely I’ll need to call on them for a favor soon.  I’m hoping that by building up this “schedule karma,” the generosity and patience of my colleagues will continue.

 

4. On Continuing Education

Hi, my name is Caitlin, and I’m a huge nerd. I love continuing education events, from the lunch and learns/dinner lectures to the local specialist lectures to the national conventions. I love learning about new products, new research and ways I can bring better care to my patients. But now…. it’s not as easy for me to justify taking time away from my family.

 

Don’t get me wrong– the interest and the desire to learn is still there. And sure, my husband can handle both boys for a few hours for a dinner lecture. But for an entire three or four days? Truthfully, he totally can, but I don’t want him to have to. And I don’t want to be away from them for that long, at least not right now.

 

For the evening and weekend mini-lectures, these are sometimes still ok, but if my husband has something going on or we’ve had another weeknight activity that has disrupted our routine, I’m gonna be a hard pass on those. Sorry, reps, but babysitters don’t come cheap these days and while I’d love to learn, if I’m paying a sitter I’m going to be somewhere with live music and cold beer.

 

My new solution? I’m still going to conferences, because that’s part of my actual job, and I do love them. But, sometimes the kids and hubby are going to come too, like they did when I recently went to AVMA and a recent state lecture. And online webinars are my new friend…but on the replay. Lately I’ve found myself registering for webinars but missing them at their launch time. Luckily for most of them, I’ve been able to catch the replay after the kiddos are in bed and I could finally relax.

 

5. On Scrubs…

Can we just say how awesome it is to have a profession in which it is perfectly acceptable to essentially wear glorified pajamas to work? I have a new found appreciation for a scrubs-only wardrobe, because, despite the breastfeeding, seemingly endless walk/bouncing of a newborn around my living room and literally climbing a tree after my four-year old, the LB’s  just aren’t falling off like they used to and I need that extra stretchy waistband. #takemymoney #dotheymakesscrubswithspanx

 

Having a second child has definitely affected my viewpoints on many things, including how I view aspects of my job as a veterinarian. I’m taking it day by day and enjoying both the quiet moments and the chaos because I know it won’t last forever. Someday soon I’ll long for the squishy cheeks and the requests to cuddle up and watch Lego Batman (again). So in the meantime, I’ll keep plugging along and work every day to be a little bit better of mom and veterinarian.

 

The views and opinions expressed in this article are those of the author and do not necessarily reflect the position of the DrAndyRoark.com editorial team.

Decision Fatigue: Our Daily Mental Crossfit

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We hear a lot about compassion fatigue these days, and rightly so. We are all more aware of the potential toll our work can have on us and on all aspects of our lives outside work. But we can’t use compassion fatigue as an umbrella encompassing all of our feelings. It’s a wide-reaching issue but only one of many we face.

I’d like to talk about a different type of fatigue – the invisible and often misattributed exhaustion that comes from the constant, pervasive, unrelenting decision-making we vets do. Every. Single. Day. All-day. In physiological terms, if we work a muscle “to fatigue,” it means we work it until it physically cannot do the work anymore, and tasks that would normally be very easy are suddenly much more difficult because of the amount we’ve just asked it to do.

The same happens when we have to make choice after choice until our choice-making apparatus is worn out. Social psychologists call this “decision fatigue.” It’s the mental equivalent of the way you couldn’t sit down on the toilet the morning after you tried Crossfit.

We all know the routine – we take a deep breath, open the hospital door, and before we can put our things down, we have someone waiting to ask us a question, Post-its or faxes on the desk, lists of calls from clients asking for the next step, for a prescription refill, for permission to skip the recheck.

Behind the first exam room door is an anxious owner with a sick pet and little money, asking us to prioritize testing and treatment to minimize cost and maximize results. A simple wellness appointment with a reluctant owner becomes a long conversation about which preventive care is most important. A client calls asking to be fit in and is approved, but then another calls, and another.

Do we see them? Send them? Tell them it can wait? A cat with advanced periodontal disease is asleep on the table and we have to decide on her behalf which teeth are compromised enough to warrant extraction. An oozing vessel mid-spay will probably stop… unless it won’t. Do we go after it? Are those liver values elevated enough to worry? Is it too soon to start steroids? Too late to stop antibiotics?

And on… and on… and on. That’s a tiny fraction of the decisions we make at work in a typical day, and they all matter. To the clients and animals involved in each one, they matter A LOT. Of course we’re tired! But that’s the job, right? That’s what we get paid to do, and doing it earnestly, honestly, openly, and with a smile is what keeps people coming back to us.

We may not be able to control the number or the nature of decisions we need to make every hour, every minute even, with regard to patient care and client satisfaction. But research has shown that ANY decisions we need to make during a given day will sap our resources until we reach a point where we just can’t make decisions reasonably, cheerfully, or rationally anymore. That’s decision fatigue, and in my opinion it’s a HUGE contributor to burnout in this profession.

The solution, according to experts, is to do everything you can to minimize decisions you need to make in situations you CAN control. Something as simple as wearing essentially the same clothes to work every day or eating the same thing for breakfast can make you less edgy, more confident, and more able to concentrate your decision-making energy on things that come up unexpectedly.

I have struggled with decision fatigue for most of my adult life, I think. It just didn’t have a name, or I didn’t know it. I still struggle. What helps one person might be different from what helps another.

These things have really worked for me:

  • Have a “work uniform.” I haven’t stressed about what to wear in the morning since I was in my 20s and worked in an art museum. People notice and judge what you wear in an art museum. Now I wear a white coat over top of the same pants and shirt in different colors every day and no one cares. Win!
  • Meal prep. You don’t have to know about “macros” or be one of those Instagram people who show photos of their 26 Tupperware containers full of quinoa with kale and perfectly cubed sweet potatoes to benefit from a little advance planning. “Meal prep lite” has changed my life. Deciding what to eat takes a huge amount of mental energy.
  • Schedule workouts and errands ahead of time. Write down a time and place. Then be there. No dithering.
  • Make as few decisions in the morning before work as possible. Set the coffee maker on a timer. Put your work clothes out the night before, and also use that time to pack lunch and a bag for whatever you need to do after work.

You can also do small things to reduce daily decision-making you have to do at work. For instance, state number of refills on approved prescription requests. Summarize complex case findings in an alert for yourself if you know you’ll forget the details by the time you get the update you asked for in a month. Take a short break at lunch, if you can, to step away from the barrage of requests for seemingly small decisions that will “just take a minute.” Delegate any decisions you can legally, ethically, and comfortably pass on.

It’s OK not to do it all yourself. Ask your fellow vets, technicians, client care specialists, and supervisors to brainstorm with you on ways to make as much of the daily routine as automatic as possible. The entire team is affected by the short tempers, indecisiveness, and second-guessing that arise from too many judgment calls with too little mental rest.

I’m guilty of letting decision fatigue get the better of me many, many times without realizing what was really going on. Knowing it exists and that we are all susceptible is a huge help. Talking with your team about it means better understanding if you feel overwhelmed, and more empathy from you if it’s one of them who’s starting to snap.

Sometimes all a person needs is to hear, “This is what I would do – what do you think?” or maybe, “I’ll tell her you’ll call back later. You don’t have to decide this now.” By knowing this is a real phenomenon and communicating openly with one another before things get out of hand, we can make everyone’s load just a little bit lighter.

The views and opinions expressed in this article are those of the author and do not necessarily reflect the position of the DrAndyRoark.com editorial team.