Burnout and depression report hospitalists in the US
A recent report looking at the quality of life in US hospitalists (hospital workers) showed that, while burnout and depression are major worries for the entire medical profession, they were a greater risk for workers treating patients full time in a hospital environment.
We are not, of course, human medical hospitalists. Neither are we in the US. However, being an experienced hospitalist in the veterinary sector in the UK, and listening to my clients in therapy (vets, vet nurses and doctors), I can see that the similarities are striking, and we can learn from this review.

This review (1) questioned hospitalists regarding their efforts towards having a well-rounded life, and how much their employers are helping to address burnout and depression risk.
The good news is that there is definitely a greater awareness in our UK veterinary world of the risks of poor mental health, depression and burnout compared to previous years. I have been working in London for 20 years and we have gone a full 180 from head in the sand, stiff upper lip, to now talking about mental healthiness being something we are all allowed and encouraged to focus on. The concerns I have are that sometimes we don’t know how to ‘do it’. Often, we are given a load of phone numbers pasted to the back of the toilet door as though they are all the resources we need. I know first-hand that that method doesn’t work with the majority of staff suffering with poor mental health.
I also belief (being a positive psychologist) that we would be much better off economically and emotionally if we addressed mental unhealthiness before it becomes a crisis.
It’s a bit like brushing your teeth really well after you’ve been told you need root canal treatment.
Or have you ever examined a dogs teeth to see deep layers of rock-solid calculus present and the owners ask you about whether they should now start to brush their dogs teeth?
Or have you ever shut the stable door after the horse has bolted?

Here’s another thought.
Do you ever look at your carefree happy kids and hope that they’ll keep this sense of joy forever with them despite the inevitable life hurdles they’ll face as they become older? It’s easier to hang onto that ability to enjoy life rather than desperately attempt to scrape ourselves back to that childhood bliss after we’ve let it go in pursuit of greater achievements like status and tangible achievements.

We should be aiming to have a life peppered with joyful moments instead of aiming to get through it intact in spite of our careers.
There will always be challenges for our entire workforce. It was Covid for several years, now it’s the financial pressures and public judgments of our finances, next year it may be something else.
We cannot postpone our happiness to the other side of these challenges.
Here are a few more parallels with us which I found in that study.

Job Stress and Burnout

Women experienced burnout more than men did. (I note that it was split in a binary fashion into men and women; a limiting factor of course).
Ask yourself “What’s your immediate reaction to hearing this?”
When I put this question to my colleagues, the answers were mostly “shame and embarrassment” from the female workers, and “surprise” by the males.

I can’t measure the significance of this and it’s not a double- blinded, placebo-based study. Neither is it looking at the results of veterinary professionals in the UK, nor is it asking other genders their opinions. However, shame is an emotion I often see in my clients: shame when they show vulnerability which they and many others see as a sign of weakness.
Why my male colleagues were surprised is again open to interpretation. I wonder if it’s because females cover up their stress, depression, and burnout more than males because of that shame we feel when we’re not seen as ‘strong enough for the job’.

What stressors at work contribute to Burnout?

If you are a line manager, practice manager or if you are in any way responsible for a clinicians job description, please ask yourself the following questions:

1. Am I giving my clinicians too much admin to do? Is it really necessary to do that much e-learning? Am I sending out too many emails with too many clicks to get to the actual information? Am I scheduling webinars during clinicians work hours as if I don’t realise they’ll be up to their eyes in clinical tasks during that webinar? It can make you look out of touch. Also, those tasks won’t be done, and the webinars will be ignored, perpetuating the divide between ‘people on the shop floor’ and ‘the powers above’.
2. Do you respect your clinical staff? Do you really understand the day-to-day workings of the clinic/s you oversee? If you do understand, do your clinicians believe this?
3. Do your staff feel adequately remunerated for the hours they work? Have you asked them? Would they prefer less hours with less pay? Do you know?
4. When clients disrespect your staff, do you have their back?
5. Do you allow your clinical leads and experienced staff to make decisions they are good at making? Have you decreased their autonomy in any way? If you have, do you know in what way it has affected them?

Duration of Burnout
The results of this study showing that burnout is a long-term state correlates with what I see in my counselling rooms.

When Burnout is primarily due to our job stresses and work environment, it’s not going to change just by going on a nice holiday or having a weekend off.
When we return, the same stressors are likely to still be in place. Burnout isn’t an acute state. It is the result of an accumulation of concerns, many of them embedded in the makeup of the workplace.
I don’t say this to make you throw your hands up in the air and give up. My hope is that we will learn to face the plethora of varying stressors, observe the emotions they bring up in us, and still manage to concurrently enjoy other factors in the workplace, life outside of work and those holidays. Adversity co-existing with happiness.

Personal relationships and Burnout

I suppose this statistic isn’t a shock.
What is surprising is how many people, when struggling with poor mental health, simply cannot see how it is affecting their relationships with their partners, children, parents and friends.
When we become practiced at noticing the small things around us which are ‘okay’ or even ‘good’, then our workplace stressors take up less of our headspace. This takes effort because we are so used to only focusing on problem lists, tasks which need to be completed and things which need to be fixed because they’re broken. It’s the tiny, good things which don’t need our attention that can bring us robust joy in the long run. And yet if we break the habit of a lifetime and make the effort to focus on what’s going well e.g. a game of hide and seek with your kid or a well made shape on the foam of your cappuccino, then, and only then are we giving ourselves a chance to balance the weighing scales a bit where burnout, depression, and exhaustion are on one end of the scales and joy is on the other.

How about your Employer?

I do feel very hopeful about this one as regards the veterinary sector in the UK.
All the large veterinary conferences are hosting wellbeing streams now. As these are growing in popularity and size, I have moved from speaking on positive psychology in a lecture area separated from the loud PA system by a crimson curtain, to pop-up lecture pods and now to decently sized lecture theatres.
I see most of the corporates looking for new and effective ways to promote Positive Psychology throughout their workforces, focusing on new graduate vets and nurses, managers and everyone in between.
‘Your employer’ is a human too. Many people along the chain of management and command are struggling with their own issues including job stress, depression, and burnout. Many others are having the time of their lives, and of course there are so many others in between.
At any given moment there are numerous reasons to be sad and numerous reasons to be happy. When we each take a moment to see where our focus is and try to shift it slightly towards the tiny reasons to feel happy, we are not only helping ourselves but also helping those below us and above us in the chain of command.
There’s an increasing awareness among executives in healthcare that wellbeing is a leading quality indicator, if not the indicator of favourable outcomes in patient care, staff turnover and other areas. I’m very optimistic that someday the veterinary world may lead the way on this.

What are your Coping Mechanisms?

This is what I see us do too to combat or attempt to combat the effects of the negative influences on our wellbeing.
What’s important here is to try to remain non-judgmental. For example, if you go for a run in the fresh air to help with your wellbeing and then have a few beers that evening to also help with your wellbeing, neither has to be judged as ‘good’ or ‘bad’.
I can meditate for an hour before dawn and still have a takeaway that evening. The Pad Thai does not undo the loving-kindness meditation.
I can choose to be completely alone, and I can then spend the night at a crowded gig. Both can be good for my mental wellbeing in different ways.
Even though it may seem more extreme, and therefore prone to be classed as ‘bad’, some intravenous drug users meditate effectively, and some alcoholics do amazing voluntary work.
So, listening to yourself actively, and being ‘responsibly selfish’ i.e. making the effort to balance your work with your wellbeing in whatever ways are genuinely effective for you, are life skills. Regularly checking in with yourself after partaking in activities which you expect will improve your wellbeing, and trying to honestly and accurately assess their beneficial or detrimental effects takes time and effort.

Do you talk about it?

Here’s an interesting one: Why might you not tell anyone about your poor mental wellbeing or depression?
We still see poor mental health as a weakness. We are terrified of shame. And I know for sure that sadly, many people do judge those who say they have mental health struggles as unfit for the job.
Can we change this common misperception?, I think it’s happening albeit at a very slow rate. Maybe those of us who feel content and happy at present can be advocates for those who don’t. Speaking out loud about Positive Psychology methodology is the easiest way to do this. The narrative around burnout and depression is nothing new (here I am writing about it again). The narrative around Positive Psychology is current and exciting and yet I believe we don’t shout about it enough.
Mental Wellbeing and Positive Psychology for Veterinary Professionals is a book that has been available for 6 months now. It contains chapters on Stress, Depression and Burnout of course. It also has a large section full of chapters on Positive Psychology and is written specifically for our Veterinary Professions.
Sprinkling 3 or more copies in the practice breakroom for staff to flip open takes such little effort, and yet it opens up conversations around positive psychology immediately. And it benefits VetLife and Veterinary Nurses in crisis who receive all the royalties from its sale.