Compassion Fatigue and its Consequences

Monique Craig, EponaMind

 

Recently a few depressing events made me reflect on the potentiality of my own compassion fatigue and its consequences not just for me personally but for equine health care professionals. I am specifically referring to hoof care providers and equine veterinarians. A few weeks ago, seven horses came to EponaMind for hoof care services. Out of these horses, four were laminitic broodmares. Out of the four laminitic ones, two are long term chronic laminitic cases. At this stage, it is only a question of time until these broodmares need to be euthanized.  (All the clinical cases are under veterinarian supervision and are referred by veterinarians). For educational purposes for others here at EponaMind, I brought up a case study I worked on 23 years ago. That mare was eventually euthanized after 5 years plus of trimming and shoeing. I also displayed her dissection. It was a sad eye opener for everyone present when I displayed her harvested pedal bones.

The top image shows a reasonably good pedal bone, and the lower image shows the ravages to the pedal bone due to chronic laminitis.

 

Thankfully some comic relief ensued when someone in the room mentioned that he was 2 months old in 2002. We all chuckled! Time flies and how it flies depends on what one experiences. Repetitive dramatic experience will eventually mar one’s consciousness.  That same day, I found out that my neighbor Gene Armstrong had passed. Gene was a hall of fame farrier, an outstanding horseman and a humble person. He was an acquaintance of mine, and it was honor to have him attending some of our EponaMind seminars. I had also the pleasure of interviewing him about his views on hoof care and horsemanship. The sadness went beyond his passing.  I felt sad because people like Gene represent a soon-to-be-missed breed of horse people. These people have wisdom, not just knowledge.

 

Knowledge, Wisdom, and Social Media

I don’t believe that wisdom can be truly explained but it seems to me that wisdom is the integration of participatory knowledge, common sense, and respect for nature. Knowledge refers to organized information about a subject, it is selective and theoretical. In most countries, knowledge is readily available via education (personal or academic). Knowledge without conscience and grounding in nature admits the possibility for a dissociative reality – especially since the advent of social media. Social media is not necessarily all bad, but the constant barrage of information flung on social media can become overwhelming, confusing and at times dishonest.  The human brain has limits on how much information it can process at one time. Spending vast amounts of time on social media has negative effects on mental health – such as increased cognitive overload and anxiety.  Social media has also introduced new stressors in terms of having to sieve through manipulative misinformation.  By nature, humans have a tendency towards what psychologists refer to as “the mere exposure effect”. This phenomenon is a cognitive bias where humans seem to prefer ideas or things which they are familiar with. In other words, the more we encounter something, the more we tend to prefer it. Our preferences or choices are not always based on critical thinking but rather based on familiarity. Professionals must navigate through unreliable information not only at a personal level but also with erroneous information spewed on social media to their clients. Finally, there is added stress from chat boards where horse owners tend to vent their frustration at professionals.

 

Burnout, Compassion Fatigue and Physical Stress

Although stress and compassion fatigue are slightly different, their symptoms present similar outcomes such as physical and mental distress, and even suicide. Incidentally, the rate of suicide among veterinarians is twice the medical profession and four times the rate of the general population. I have no data on the suicide rate for hoof care providers, but I have the vague suspicion that it might be as high as that of the veterinarians.  These professionals also must deal with added stressors such as danger and repetitive physical strain. Handling horses when in pain or hurt can be hazardous to even to the most tactful and seasoned professionals – many of which end up getting hurt at some point in their careers.

 

These images show a compilation of different injuries (one veterinarian and two farriers) which occurred while treating and shoeing horses.

 

Even barring accidents, the mere physicality of the profession takes a toll on human bodies.  Many seasoned professionals end up with chronic physical issues due to repetitive work. Chronic pain affects mental health such as heightened risks of sleep deprivation, anxiety and depression.

 

Recommendation to Horse Owners

There is a lot of good (and bad) information about horsemanship. However, most of the horsemanship gurus rarely or ever go under horses – such as trimming and shoeing and rarely must handle hurt horses – which is what many veterinarians are often faced with. I am a strong advocate of being thoughtful with horses, but horses are not always well behaved, especially when owners (and unseasoned trainers) are not confident handlers and make excuses for the bad behavior of their horses. Horses are not stupid and know instinctively what they can get away with. Horse owners should be honest with their capabilities to handle horses and seek help from capable trainers. Capable trainers are horse people not social media experts. This is crucial for the safety of everyone. Horse owners should not have unrealistic expectations concerning treatments. Horses get hurt or die even with the best veterinary care.  Horses go lame even with the best trimming and shoeing care. Horses are always half a foot away from death! Most professionals are caring people and try their best to help horses. So don’t put them in danger and stop the blame game. It is tremendously stressful for them.  Horse owners should try to put themselves in the shoes of the professionals. Also please don’t vent your frustration about a particular professional on social media when you have a bad hair day. Drama on social media is almost required to draw attention to a particular post, especially when the post content has little new information. Cyberbullying is unfair and depressing to professionals. The equine world does not have enough veterinarians and hoof care providers. Why discourage them! Think before you spew on social media.

 

On a personal level, I have faced my own sense of burnout and discouragement over the years of providing training and shoeing care. It is often difficult not to bring your work home. I always think about what I could do better to improve a certain outcome or question myself whether I missed something. Added stress is often caused by the owners and not the horses. Some owners are wonderful, some are difficult and many just don’t care. I have always tried to help the horses first but with time I have learnt to steer away from the psychologically challenged or uncaring owners. In some instances, it is not always easy to tell what one gets into with a particular client.  Although occasionally I get nailed by an unsavory client – it just happened to me recently. Does it bother me? Yes, it does especially when I have spent years helping the client. I get resentful about my wasted time but never about helping horses. I have re-homed many horses, adopted many and improved the lives of many during 30 years in this business. This is what keeps me going, the horses!

 

References on Social Media

Luca Braghieri, Ro’ee Levy, and Alexey Makarin, Social Media and Mental Health, American Economic Review 2022, 112(11): 3660–3693

674298. Schodt, S. Quiroz, B. Wheeler B, D. Hall, and Y. Silva, Cyberbullying and Mental Health in Adults: The Moderating Role of Social Media Use and Gender, Front. Psychiatry 12:674298., 2021.

 

References on Veterinarian/Farrier Burn-Out

Amber Foote, Moral distress, compassion fatigue and burn-out in veterinary practice, The Veterinary Nurse, September 2020, Volume 11 No 7

Kirsten Blokland, PhD, Jason B. Coe, DVM, PhD, Mary Beth Spitznagel, PhD, Veterinary team members experiencing high levels of burden transfer are more likely to report burnout and a less optimal psychosocial work environment, JAVMA, March 2024, Vol 262, No. 3.

Carina Rodrigues da Silva, Alexandre Coutinho Antonelli, Ana Amélia Domingues Gomes, Rafael Felipe da Costa Vieira, Thaís Rabelo dos Santos-Doni, and Alexandre Redson Soares da Silva, Suicide in veterinary medicine: A literature review, Veterinary World, EISSN: 2231-0916, June 2023.

American Farriers Journal, Compassion Fatigue Survey, https://www.americanfarriers.com/articles/12216-tips-for-identifying-and-managing-compassion-fatigue

 

References on Information Overload

2023. Arnold, M. Goldschmitt, and T. Rigotti, Dealing with information overload: a comprehensive review, Front. Psychol. 14:1122200, 2023.

Richard L. Byyny, MD,  Information and cognitive overload: How much is too much?, The Pharos/Autumn 2016.

Merit Bruckmaier, Ilias Tachtsidis, Phong Phan, and Nilli Lavie, Attention and Capacity Limits in Perception: A Cellular Metabolism Account, The Journal of Neuroscience, August 26, 2020

 

References on Physical Dangers

T D H Parkin, J Brown, E B Macdonald, Occupational risks of working with horses: A questionnaire survey of equine veterinary surgeons, Equine Vet Educ. April 2018;30(4):200–205.

Forge Magazine, Injury Survey,  https://www.forgeandfarrier.co.uk/wp-content/uploads/2022/02/Forge_March_21_HR.pdf