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Is a Burden Shared a Burden Doubled?

Caregiving is a labor of love. Regardless of whether you provide care for a relative or a pet, it is possible to give until it hurts. Our past work showed just how true that is when we found that pet owners providing care for a dog or cat with a serious illness experienced twice as much caregiver burden compared to those with a healthy pet. That burden can be emotional, like feelings of guilt or fear of the future, or tangible like feeling stretched for money or time. We also found that caregiver burden was strongly related to stress and anxiety, lower quality of life, and clinical levels of depressive symptoms. Pet caregiver burden is very real, and affects many pet owners

But does our burden also affect our veterinarians?

For the animal lover who does not work in veterinary medicine, the job might seem like heaven--days filled with wagging tails, furry head-bonks, and sandpaper-lick kisses. But on-the-job stress is on the rise in veterinarians, with high levels of psychological distress reported in the field. Nearly one third of veterinarians report having experienced at least one depressive episode since graduating from school, nearly 20% describe being in current treatment for mental health reasons, and 1 in 6 describe having considered suicide. Many issues contribute to occupational stress for the veterinarian, including long hours, compassion fatigue (exhaustion from caring too much for too long), moral stress encountered when pet owners ask for a service that may not be in that pet’s best interest, and even cyber-bullying.

That purr-fect job no longer seems like a walk in the park!

It is easy to understand how overwork, being bullied, or having clients ask you to euthanize a healthy animal might take a toll. But what about the day-to-day interactions of working with pet owners who are themselves distressed?

We wanted to find out if the caregiver burden experienced by pet owners in turn affects veterinarians—if we could trace a “burden transfer.” We know that symptoms of depression can manifest as anger. And people with higher levels of distress are also more likely to use health care resources. Could pet owners who are feeling burdened with caregiving use veterinary services more than expected for medical reasons, due to needing support for their stress? Might they be more likely to lash out in anger, or make complaints about their veterinarian?

We've just published two studies in the Journal of the American Veterinary Medical Association examining these questions.

 

The first study focused on how pet owners use veterinary services, like bringing their pet in for an exam or procedure, or calling their veterinarian to report concerns or ask for more information. We asked clients of a general veterinary hospital about experiences related to burden--Do they feel stretched beyond capacity, like there isn’t enough time in the day? Do they feel like they don’t do enough for their pet? Do they not have the money to continue taking care of their pet? Then we looked at how often their pets came in for an exam or procedure, and how often their owners called for support.

Not everyone with a sick pet experienced caregiver burden, so we compared pet owners who described high levels of burden to those with lower burden. There was no difference in how often they brought their pets in, suggesting the groups were similar in disease severity. But those with high levels of burden were calling about twice as often! It makes sense if pet owners who feel burdened reach out, seeking more support. However, if we add up those extra phone calls, and the veterinarian’s long hours become longer. In this way, the burdened pet owner may be sharing (or transferring) some of their burden to the veterinarian.

 

To continue looking at the idea of burden transfer, in our second study we compiled a list of situations that might occur when a pet owner is experiencing burden while caregiving for a sick pet. What might pet owners do when they are feeling stressed out, exhausted, financially strapped, and frustrated?

We included a long list of situations, including the pet owner making a decision to change their pet's care plan (for example, introducing new supplements or medications) without consulting the veterinarian, declining a recommended treatment, feeling or expressing anger at veterinary personnel, even making a public complaint about their veterinarian. In a sample of nearly 400 pet owners with a sick cat or dog, those who described greater levels of caregiver burden indeed reported significantly more of these behaviors and interactions. Experiencing pet caregiver burden seems to bring out the Mama (or Papa) Bear in a lot of us!

We then turned to a group of over 1,000 veterinarians, and asked them to tell us how often they had encountered these types of interactions with clients in recent weeks. They also rated their own levels of stress and burnout. Veterinarians who experienced more situations of this nature reported higher levels of distress. That is--greater interaction with burdened pet owners predicted higher stress for veterinarians. Findings again supported the idea that Burden Transfer is occurring—a burden shared just might be a burden doubled.

That’s not where the story ends, because the veterinarians’ own reaction to these situations, meaning how bothered they felt by these types of interactions, was more related to their overall stress and burnout than how often the situations occurred. In addition to making an effort to reduce caregiver burden in the pet owner, we need to find ways to help veterinarians regulate their own reaction in these situations.

 

When a sick pet is involved, both the client and the veterinarian are likely to experience stress.

Veterinarians: The stress of your job goes beyond compassion fatigue and moral distress--Burden Transfer is real. Keep in mind that an angry pet owner or frequent caller is likely feeling frustrated, sad, or afraid of what the future holds for their beloved pet. Examine your own reaction to these situations. Can you find the space to understand your client's point of view? Could this be an opportunity to practice patience? Take time to remind yourself why you chose this job and what you value most about it. Subscribe to our blog to stay tuned for more from our research team--we are working on ways to reduce burden transfer!

Pet owners: If you are feeling angry or upset about your pet's treatment, know that you are not alone--many pet caregivers feel this way at times. The stress of caregiving can stir up emotional turmoil. Take a moment to look at how much of that frustration is due to your worries and fears about your pet. Know that your worry could actually be an indicator of just how dedicated you are to your pet. Forgive yourself for being imperfect. And keep in mind that shouldering this burden with you can take a very real toll on your veterinarian.

We are all in it together for the sake of those furry creatures. Understanding one another’s perspective might lighten everyone’s burden a little.~

The information offered on this website does not constitute psychological or veterinary medical advice. Please consult with an appropriate professional who can make recommendations for your specific situation.

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