Saturday, April 2, 2011

At the risk of alienating my readers...

I am rapidly approaching a burnt out point. This scares me, as I've only been practicing 3 years. Granted, it's been an intense 3 years - with the internship from hell and now, working ER. On top of that the economy has taken such a huge nosedive that clients' financial situations are just getting worse and worse. Veterinarians are really bearing the brunt of many of these financial situations, and nowhere is worse than ER. It's exhausting and demoralizing to spend the majority of the day seeing critically ill and injured animals only to turn around and euthanize them. By the end of today, my head was pounding, my heart was sore and bitter, and I just wanted to quit veterinary medicine forever.

It's not the cases that I can't fix for any amount of money - those don't eat at me so much. It's the ones that I CAN fix and that have a great prognosis that break my heart. My first one of the day was a blocked cat. He'd been blocked for at least a couple of days, given his condition - but he would have responded well to treatment. The owners came with $100 (our exam fee is $92). They both sobbed as I euthanized him.

Then, the small dog that was picked up and ripped to shreds by a CANE CORSO - a whopping 36 hours before the owners decided to bring him in. He was covered with rotting wounds, couldn't walk, and was likely septic. Had the owners brought him in when it happened - a day and a half prior - than I might have been able to fix him for a reasonable cost. Now, he was trying to die and needed serious intervention to the tune of at least $1500-3000. No can do, said the owner.

I know that pregnancy hormones are worsening my feelings, but it doesn't help. I feel so bad right now that going to work is a chore. Leaving the house is a chore. I want to hide somewhere. Facing these owners, in this economic climate, with their animals that need medical care, I am starting to FEEL like a moneygrubber. I hate going into a room and telling someone that we cannot continue care for their pet because the care will cost $1500 or more. LOATHE it. I would fix them all for free with my expertise if I could, but I have to eat too and feed my family. Just like everyone, we have a mortgage, electricity bills, phone bills. Yet still, lately, the guilt is overwhelming. The blocked cat was especially hard because it was one of the rare cases where the owners did nothing wrong. The cat was vaccinated, indoors, and well-loved. Fate dealt him a crappy, crappy hand.

On top of the stress of my job in general, there is the financial stress. We are trying to carefully save for my unpaid maternity leave, but I am paid on production. And our numbers have been way, way off compared to last year. My pay has dived down about $2200/month, adding stress to the burn out. At this point, I'm looking at doing relief shifts to help build up the savings for baby Homeless Parrot. My husband has offered to find a job, but his thesis is finally in the writing stages and may be undergoing defense THIS SUMMER, so I want nothing to interrupt his continued work. Once he's finished, a massive amount of stress will magically be lifted.

Sorry for the tirade...but it's one reason I blog. Therapy. Catharsis. Release.

11 comments:

Anonymous said...

Look, I've been there. It's taken me more than three years to climb out of the burnout hole, and I live for the day when I find another job and can close my practice forever. Unfortunately, many other veterinarians have the same idea right now, so there is more competition for non-practice jobs.

You're at a turning point: re-trench, talk to mentors, and learn effective coping skills, or make a plan and get out forever.

Don't allow your job to suck the joy out of you, especially not while you're on the threshold of a happy new chapter of your life. Veterinary medicine isn't worth it.

LetMeTellYouATale said...

I don't know how the vet stress feels, but the financial stress I understand completely. I can't even fathom going through both and being pregnant too. I'll be thinking about you and I hope things get better for you soon.

Anonymous said...

Oh gosh, I am sorry to hear of your burnout. It definitely sucks when you know you can help an animal but the owners can't (or won't) pay for it. I think being in the ER is the worst for that, since so many people simply don't plan for or recognize an emergency, and then it's too late. It probably doesn't help, but I read human ER blogs too and it's pretty much the same situation with burnout--medicaideurs abusing the system for pregnancy tests, addicts trying to scam for narcotics, very few actual "emergencies" and more abuse from patients than thanks.

Any way you could fill in every so often at a general practice somewhere? Just for the sake of being able to do wellness exams, puppies and kittens, and basic vomiting/diarrhea stuff? I've only been reading your blog for a little while, so I don't know if it's an option, but it's much more gratifying seeing regular patients with the occasional "OMG!!" emergency than seeing ALL "OMG!!" emergencies.

I dunno if any of that helps. I'm sorry about your frustration (and congrats on the baby Parrot!). I'm one of those possibly naive hopefuls (someday...) thinking about vet school, but coming up against my poor undergrad grades in stuff like, oh, I dunno, organic chem. So to hear about the "other side" of the profession, while saddening, is also helpful.

Can you get a massage and take a nap? That's all I can come up with for being helpful. :)

Pamela said...

You have a tough job. Try to be as kind to yourself as you are to your patients.

thelearningvet said...

I suspect many of your readers follow you because you are so human--I know I do. My hope is that you will not give up on veterinary medicine. I hope that when you come back from maternity leave, you find yourself a well-managed general practice and give it a try. I believe in starting with AAHA-accredited hospitals. That's how I landed at my job--and I've been there ever since I graduated 7 years ago! I really, really love it, and wish everyone could experience the positive side of veterinary medicine.

Anonymous said...

it is all rather bleak right now, isn't it? the hormones are part of it, the upcoming arrival of baby and all the accompanying role shifts for you and your husband are a HUGE stress. any kind of emergency work where life and death decisions are involved is stressful, too. so, it makes sense that your stressors are off the chart and the choices seems so limited. you'll get through it, we all do. just look at one bit at a time and don't fret too much about the stuff you can't change. babies don't require much stuff, no matter what the advertisers tell you! rest as much as you can, get some sunshine every day, and realize that it won't always feel this way.

Lise said...

I can totally see how this is dispiriting. It almost seems like ER should be done by vets in a rotation of maybe one month a couple of times a year, so nobody would have to deal with the stress nonstop.

Sending you good thoughts, virtual tea, and smiles for the baby Parakeet. *G*

C. Todd Dolen, DVM said...

If it helps to know it, I did the same thing during my 3rd year of practice. I left that practice during the 4th year. I was convinced that I had chosen the wrong career and would have to scramble to find something else to do with my degree. My saving grace was relief work. It enabled me to visit MANY different practices and observe MANY different ways of handling patients, clients, new drugs/protocols, etc. And the beauty of it was....at the end of the day, I walked away. I had a paycheck in my hand and though curious of outcomes, remained free of interhospital problems and dramas. I had only to enforce each hospital's policy and say...I'm sorry, I'm filling in and these are the rules I must follow.
This is also a GREAT way to shop around for your next more permanent job...as you find out a LOT from the staff of each and other surrounding hospitals.
I started relief four years ago and fell back in love with veterinary medicine. Perhaps this could be the answer for you and give you the flexible schedule that a parent needs?

The Nurse said...

Dr. Parrot,

I'm sorry to hear of your stress and discouragement regarding your current job. I've been a nurse for a long time and suffered from various episodes of burnout. I have a "calling" to be a nurse since a very young age, and fortunately, there are lots of options as a nurse and I've been able to change jobs to keep my sanity and my current position is perfect. I also do volunteer mission work to keep things in perspective. But I never tell nurse-hopefuls to pick another profession and it is disheartening to hear the advice Anonymous 1 gave you. Of course you must do what's best for you and your family but know there are lots of people who admire and appreciate what you (Dr. Parrot and "you" veterinarians in general) do for our beloved pets. Perhaps some GP days of healthy puppies and kittens is what you need. Or working with students... I find youthful enthusiasm for one's profession is always an "upper".

So how can we, veterinary clients help keep our vets happy in their work? Besides taking good care of our pets, taking the advice of trained veterinary professionals, saying "thank you" and paying our bills? A good vet to work "with" in the care of my dogs is priceless and I hate to think he's also feeling discouraged....

Elizabeth said...

Find a way to deal with the stress before it swallows you.
Last week my Vet who I dearly love left the practice after 20 yrs. It is a large general practice that does their own ER 24/7. She just had enough and needs a change in her life. I am going to miss her but I wish only the best for her.

VetVoyeur said...

I've been away and am just catching up on the blogs I follow . . . I'm sorry you're feeling burned out, it's a huge hazard for anyone dealing with constant crises and the powerful emotions of others. I hope you're able to find some time for yourself and try out the good advice of those who care about you. However, remember that you DO make a difference and clients like me and my pets need doctors like you. VV