Ways to manage and prevent moral distress and moral injury for veterinary professionals
Part 1 explained the basic concepts of moral distress and moral injury within the veterinary profession and some of the common symptoms with each of these issues may manifest. In Part 2, I’ll share suggestions on how the veterinary community can deal with moral distress and moral injury.
Education and training
As stated earlier, one of the most important ways to deal with moral distress and moral injury is through education and training. Providing animal care professionals with comprehensive training in ethics, communication skills, and coping strategies in the early stages of veterinary/animal care education could help them be more prepared and aligned with the challenges they may face in their careers. Continuing education programs related to ethical issues, conflicts, resilience building, and coping mechanisms should be offered to all professionals working in the animal care industry.
Such programs could include moral resilience building, which helps a person focus on the positive aspects of addressing moral distress/injury and the ethical issues they may face at work. This training would help professionals to strengthen their integrity even when challenged by moral complexities, distress, and adversities.
Training on how to reprogram the mind to be more resilient and changing one’s perception of work events could also help professionals cope with challenging situations.
Open communication and moral community support
Having a support group of professionals who have experienced or are experiencing similar ethical issues, challenges, and difficulties can foster a culture of open, nonjudgmental, and fear-free discussions about moral topics.
Independent organisations could create such groups without any connection to the work environment or by private companies/clinics/NGOs to support their employees in navigating such challenges.
Providing debriefing sessions in the work environment after challenging cases to discuss technical issues, moral challenges, and the emotional burden that a professional may be carrying can be an effective way to prevent moral distress and moral injury.
Work environments must adopt a culture of safety and support, where it is customary to process emotions and seek support when needed. This would help professionals develop their moral agency, voice their beliefs and values, and protect their integrity without fearing negative repercussions. The animal care professional needs to feel a sense of support and encouragement in the workplace to deal with moral challenges more resiliently.
Being part of a moral support community can significantly impact people’s lives and prevent them from developing more serious mental issues, dissatisfaction with the workplace, and abandonment of an animal care career.
Ethics committees and mentorship programs
Another way to prevent and manage moral distress and moral injury within the animal care community is to adopt similar ethics committees used in research settings. Veterinary practices, clinics, and vet hospitals could establish such committees to help address and resolve ethical concerns related to specific cases. However, it would be important to structure these committees to ensure professionals’ accessibility to meetings and discussions, allowing them to seek compassionate guidance and support when facing moral distress.
Another way to deal with moral distress would be to develop mentorship programs within private organisations or independent companies. The idea is to create a support alliance between experienced veterinarians and newer professionals, for example, to provide a supportive environment for mentees to discuss moral challenges and seek guidance from their mentors on how to deal with ethical issues during difficult situations.
Patient-centred care and systemic changes:
Employers have a duty of care for the professionals they employ to care for animals. They must understand that promoting animal/patient-centred care services starts by emphasising the positive impact professionals have on the well-being of animals.
Supporting professionals with a safe environment for debriefings, non-judgemental discussion related to challenging topics, training, and education, and respecting professionals’ boundaries and personal time, among many others, must be the top priority for vet clinics, hospitals or similar organisations that provide animal healthcare.
All professionals involved in animal care must recognise the importance of providing compassionate care while respecting ethical boundaries. These boundaries include those involving pet owners, clients, etc., to avoid inflicting more stress and emotional burden on animal care professionals.
Veterinary associations and related organisations should be involved and encourage systemic changes within veterinary settings to address issues that contribute to moral distress and other mental health issues. Supportive initiatives that improve working conditions, mental health and well-being discussions, workload management, and ethical standards within the profession should be the top priority of such organisations to avoid the increasing number of professionals leaving the animal care industry.
Self-care strategies:
Finally, animal care professionals must understand the importance of prioritising their health and well-being before they can take care of animals.
To provide excellence at work, veterinary professionals must see themselves as an essential part of the puzzle. If the caregiver is not mentally or physically well, they cannot perform their job at the highest standard for the animals under their care. Professionals should be educated on effective self-care strategies to manage stress and prevent emotional fatigue and burnout.
Organisations and veterinary associations must promote events and training related to work-life harmony and empower professionals to recognise their value and their worth when caring for animals. In this process, nine self-care areas should be included:
- Physical,
- Mental,
- Emotional,
- Spiritual,
- Intellectual,
- Environmental,
- Social,
- Financial, and
- Time management.
While some may not look like part of self-care, each plays a role in a veterinary professional’s professional, personal, and mental well-being. Self-care is a necessary part of an animal healthcare career. Animal care professionals must learn to care for themselves the same way they care for animals so their job outcomes and satisfaction can continue to be the same or even better than when they started. All animals will thank you if you do!
References:
Ammar, A., & Shoka, A. (2022). Moral Injury and Education Trauma! Moral Injury Seriously Hinders the Education and Career Development. In A. Ammar (Ed.), Learning and Career Development in Neurosurgery. Springer, Cham. https://doi.org/10.1007/978-3-031-02078-0_17
Čartolovni, A., Stolt, M., Scott, P. A., & Suhonen, R. (2021). Moral injury in healthcare professionals: A scoping review and discussion. Nursing Ethics, 28(5), 590-602. https://doi.org/10.1177/0969733020966776
Nett, R. J., Witte, T., Spitzer, E. G., Edwards, N., & Fowler, K. A. (2019). Suicide Risk for Veterinarians and Veterinary Technicians. Posted by Randall J. Nett, MD, MPH; Tracy Witte, PhD; Elizabeth G. Spitzer, MA; Nicole Edwards, MS; and Katherine A. Fowler, PhD. Available at: https://blogs.cdc.gov/niosh-science-blog/2019/09/04/veterinary-suicide/. Accessed Jan 21, 2024.
Paton, M. W., Kalemtzaki, E., Stoewen, D., Hameedunisha, T., Yang, H., Donlin, J., & Endenburg, N. (2024). WSAVA professional wellness guidelines. The Journal of Small Animal Practice. Advance online publication. https://doi.org/10.1111/jsap.13689
Rushton, C. H. (2016). Moral Resilience: A Capacity for Navigating Moral Distress in Critical Care. AACN Advanced Critical Care, 27(1), 111–119. https://doi.org/10.4037/aacnacc2016275
Tomasi, S. E., Fechter-Leggett, E. D., Edwards, N. T., Reddish, A. D., Crosby, A. E., & Nett, R. J. (2019). Suicide among veterinarians in the United States from 1979 through 2015. Journal of the American Veterinary Medical Association, 254(1), 104-112. https://doi.org/10.2460/javma.254.1.104
Witte, T. K., Spitzer, E. G., Edwards, N., Fowler, K. A., & Nett, R. J. (2019). Suicides and deaths of undetermined intent among veterinary professionals from 2003 through 2014. Journal of the American Veterinary Medical Association, 255(5), 595-608. https://doi.org/10.2460/javma.255.5.595
