An Evaluation of Compassion Fatigue in Wildlife Rehabilitation
Abstract
Professionals in the fields of animal care face particular challenges in caring for their own mental health. Many face a caring-killing paradox that deteriorates their mental state and leads to suicide in some fields (Andrukonis et al., 2020). Compassion fatigue is a psychological condition that is experienced by caregivers of animals and humans alike when they are exposed to the continued suffering of their patients. Compassion fatigue not only deteriorates the caregiver, but the patient’s quality of care (Tremoleda, & Kerton, 2020). In wildlife rehabilitation, individuals operate on a small scale with no option to distribute work to staff and often face minimal success rates (Kwok et al., 2021). Veterinarians experience suicide rates two times higher than that of the national average because of their work-life (Stayner, 2019). The study described in this paper focuses on compassion fatigue in wildlife rehabilitation and veterinary medicine. This study found that veterinarians experienced more compassion fatigue and reported higher exposure to euthanasia. In contrast, wildlife rehabilitators felt less successful in their jobs and maintained poor relationships with coworkers. In a further study, different results may be found with a broader sample and continued survey over a year’s time. This may be because samples were collected during a less active period of time for the rehabilitators (Long et al., 2020). With continued study, we may see that rehabilitators cycle through compassion fatigue, whereas veterinarians may stay relatively consistent.
Introduction
Working in the field of health care, whether with animals or humans, come at the cost of exposure to a multitude of mental health tolls. Being in any care-related field comes with moral challenges, as people provide care for those who frequently maintain a poor prognosis. This creates a perplexing dynamic for those seeking to utilize their compassion and finding that their job is more psychologically demanding due to their predisposed caring nature. This mental struggle has been documented among professionals in the fields of human health care such as doctors, nurses, and other caregivers; however, animal caregivers experience alarming levels of mental health plights. Animal control officers experience the highest workplace suicide rate, not including military-related fields, at 5.3 per 1 million people (Andrukonis et al., 2020). Veterinarians are more likely to be exposed to death than human caregivers and also suffer a high suicide rate as a consequence (Stayner, 2019). Individuals who work in an animal shelter regularly undergo severe moral stress when faced with the caring-killing paradox that happens in many shelters (Andrukonis et al., 2020). This happens when workers are asked to euthanize the same healthy animals they care for on a daily basis, sometimes multiple animals at once (Andrukonis et al., 2020). In the lab, scientists can also face moral predicaments when they are required by an experimental procedure to euthanize their subjects (Tremoleda, & Kerton, 2020).
While there is comparatively little known about the mental health of professionals within general animal care as opposed to human healthcare, there is a startlingly insufficient collection of mental health data in the field of wildlife rehabilitation. As it is a novel field of animal care and remains a small niche working environment, this comes as no surprise. Wildlife rehabilitators often specialize in certain areas of wildlife (i.e., songbirds, mammals, raptors, deer, etc.), while others take in a broad range of animals. The primary cause of patient intake has been attributed to young animals being abandoned or orphaned (Kwok et al., 2021). In such cases, the rehabilitator must make extreme efforts to care for and nurture these offspring on a continuous basis until they become self-sufficient. This could mean feeding them every thirty minutes to every two hours, sometimes for weeks on end. Many rehabilitators must operate out of their homes instead of a facility with staff. Living and working in the same areas can create a stressful environment where separating work from home life is nearly impossible. In many cases, the ultimate release of a patient is not likely. Results from a study in New South Wales, Australia reported that only 37.1% of some 364,461 patients were reported as “released” (Kwok et al., 2021). In the same study, 54.8% were reported as “dead”, “died”, or “euthanized” (Kwok et al., 2021). The psychological stress, though unknown, caused by this work-success ratio is undoubtedly high.
In contrast to wildlife rehabilitation, there is a more sufficient understanding of mental health within the profession of veterinary medicine. Small animal practices often have to provide care for not only their client’s pets, but also their clients, staff, and themselves. Many veterinarians report working forty or more hours during the week (Leffler, 2019). Most veterinarians develop a connection to their patients as they care for them throughout their entire lives. With that in mind, the daily conditions of a vet clinic fluctuate on an hour-by-hour basis. In a single day, a veterinarian can see a new puppy or kitten patient, existing patients that may be deteriorating, a client that has decided to euthanize their pet, and so on. The emotional and mental capacity that veterinarians require to handle this broad range of situations is extensive and often draining. These kinds of conditions are what often lead veterinarians to burnout, compassion fatigue, depression, and other states of debilitated mental health. Pet owners scored veterinarians as first in compassion when compared to seven other professions, including physicians, lawyers, and accountants (Mitchener, & Ogilvie, 2002).
Compassion fatigue is a condition, often confused with burnout, that results from the exhaustion of one’s emotional bank (Mitchener, & Ogilvie, 2002). Its onset is usually marked when an individual is being attentive to the emotional well-being of others for a prolonged period of time (Mitchener, & Ogilvie, 2002). When doing this, an individual often puts themselves in the shoes of the other person and usually makes an attempt to lessen the burden of the suffering individual. In contrast, burnout is the procedural response to mental distress (Mitchener, & Ogilvie, 2002). Burnout is considered a catalyst for compassion fatigue (Mitchener, & Ogilvie, 2002). When a condition goes untreated, the worsening is what is considered burnout. Compassion fatigue is most prominent in those who provide care for others (Stamm, 2010). Psychologists, therapists, doctors, veterinarians, social workers, nurses, lab researchers, and animal shelter employees are all careers that are susceptible to compassion fatigue. These jobs require that an individual provide attentive care to others and often attract those who display high levels of empathy and compassion. Compassion fatigue can impact anyone who delivers prolonged care (Stamm, 2010). Suffering from compassion fatigue has been documented to impact not only the individual, but the recipients of the individual’s care (Tremoleda, & Kerton, 2020). There is a noted decrease in care quality among those who are experiencing compassion fatigue (Tremoleda, & Kerton, 2020).
I performed a survey analysis of compassion fatigue within wildlife rehabilitation and veterinary practice to determine which field faces higher levels of compassion fatigue. Based on existing data, I would predict that wildlife rehabilitation faces higher levels of compassion fatigue. Contributing factors that put wildlife rehabilitators at greater risk of experiencing compassion fatigue include poor prognoses of patients within the field, little work-life balance, and patients’ needs for constant care.
Methods
For my study, I sent a short survey to wildlife rehabilitators and veterinarians in small animal practices within the local vicinity of western North Carolina. My wildlife rehabilitation sample largely consisted of those who work in the May Wildlife Rehabilitation Center. Veterinarians who took my survey practice around Banner Elk, NC. I sent an online version to rehabilitators, whereas an email and online version were sent to veterinarians. This was to make the survey easier to complete for both groups.
Demographic information such as age, experience in their field, hours worked, and exposure to euthanasia was recorded by each survey participant. This information was taken to document any correlations with survey scores and additional factors that could influence how questions are answered. The survey used was compiled using existing questions from multiple compassion fatigue surveys. Surveys used to create the questionnaire include the Professional Quality of Life Scale (ProQOL) version 5 and Compassion Fatigue/Satisfaction Self-Test (CFS) (Stamm, 2009; Figley & Stamm, 1995). I chose most of my questions from the ProQOL, as it has reputable reliability and validity (Bride, et al., 2007). In addition, the ProQOL is a more current and widely used measure of compassion fatigue (Bride et al., 2007). Questions from the CFS were chosen because they address issues that could be faced in the animal care fields I surveyed. The ProQOL and CFS were intended for those who work with humans instead of animals.
While the ProQOL made efforts to provide flexible questions, alterations were needed for the purposes of this survey. When selecting questions, I chose those that are general, yet still, have an application to animal caregiving (Table 2). In some cases, I reworded questions to gear them towards animal caregiving as opposed to human care. The survey contains 10 items from the ProQOL and 5 from the CFS, however; some items overlap between the surveys.
Individuals provided an answer according to a 1-5 Likert scale. A Mann-Whitney U test was performed to compare scores between rehabilitators and veterinarians on individual questions. Z-scores and P-values were then used to measure any significant difference between group answers. If a significant difference was found, scores were examined further in graphs. Demographic differences were also considered to provide a reasonable explanation for distinctions between scores. In addition, overall survey scores between the two groups were compared (Figure 3). To score the survey, answers to questions 1, 2, 6, 7, 9, 11, 12, 13, 14, and 15 were reversed because they were related to signs of low compassion fatigue. For example, an answer of 1 became 5 when scores were tallied. This meant that the lowest score possible is 15 and the highest score is 75.
Results
Surveys from 16 wildlife rehabilitators and 6 veterinarians were returned for the study. Most veterinarians did not complete or return surveys before the deadline. Both wildlife rehabilitators and veterinarians overwhelmingly preferred the online version of the survey.
The Mann-Whitney U test revealed that there was a statistical difference between wildlife rehabilitator and veterinarian scores on questions 13 (Z = -2.359, N = 22, P= 0.018) and question 14 (Z = -2.064, N = 22, P= 0.039) (Table 1, Figures 1 & 2). Question 13, “I have thoughts that I am a ‘success’ as a caregiver.”, relates to the job success outlook of the individual. Veterinarians, on average gave higher scores to this statement (Figure 1). Question 14, “I enjoy my coworkers.”, relates to trust in coworkers and willingness to share the burden of the job. Veterinarians also gave higher scores to this statement than wildlife rehabilitators (Figure 2).
Survey scores revealed that veterinarians had, on average, higher scores than wildlife rehabilitators (Figure 3). The majority of wildlife rehabilitator’s scores fell between 31-45 (Figure 3). In contrast, most veterinarians scored between 46-60 (Figure 3). The veterinarian sample reported having higher participation in euthanasia than wildlife rehabilitators, which may play a role in some survey scores (Figure 4).
Discussion
The study concluded that veterinarians scored higher on the compassion fatigue survey and therefore experience compassion fatigue at a greater level than their counterparts in wildlife rehabilitation. However, wildlife rehabilitators were less likely to maintain a positive attitude towards their work in terms of successful outcomes for their patients (Figure 2). This coincides with the previously discussed idea that wildlife rehabilitators often face a low success rate (Kwok et al., 2021). Wildlife rehabilitators were also less likely to enjoy working with their coworkers (Figure 3). This can create a more difficult working environment and may make a rehabilitator less likely to have a good support system with their coworkers that provides a collaborative work environment as well as a safety net of emotional support.
With veterinarians reporting higher exposure to euthanasia, this can explain why their levels of compassion fatigue were higher than those in wildlife rehabilitation. Previous studies have attested that euthanasia participation increases feelings of compassion fatigue (Tremoleda, & Kerton, 2020). To further evaluate this within the study, protocol within the May Wildlife Rehabilitation Center permits only a select few individuals to make euthanasia decisions. While others can participate in the discussion and process, the decision is not up to most of those in the wildlife rehabilitation sample. Because the veterinarian sample work in multiple practices, they follow slightly different rules and disperse responsibility differently than those within the wildlife rehabilitation sample.
Another factor to account for is the timing of the study. With surveys being collected in the months of August through November, rehabilitators were not taking care of as many patients as they would during summer months when orphaned/abandoned intakes are higher (Young, et al., 2020). To gather a more well-rounded picture of compassion fatigue in both fields, a study conducted in multiple facilities over the course of a year would provide sufficient data as both fields progress through patient fluctuations. Compassion fatigue among rehabilitators might be higher in months when facilities take in many babies, whereas veterinarians might stay consistent because they work with a patient throughout their entire life.
Works Cited
Andrukonis, A., Hall, J. N., & Protopopova, A. (2020). The impacts of caring and killing on physiological and psychometric measures of stress in animal shelter employees: A pilot study.
International Journal of Environmental Research and Public Health, 17(24), https://doi.org/10.3390/ijerph17249196
Kwok, A. B. C., Hearing, R., Travers, S. K., Stathis, P. (2021). Trends in wildlife rehabilitation rescues and animal fate across a six-year period in New South Wales, Australia. PLOS ONE,
16(9), https://doi.org/10.1371/journal.pone.0257209
Mitchener, L. K., & Ogilvie, K. G. (2002). Understanding compassion fatigue: Keys for the caring veterinary healthcare team. Journal of the American Animal Hospital Association, 38, DOI:
10.5326/0380307
Bride, B. E., Radey, M., Figley, C. R. (2007). Measuring compassion fatigue. Springer Science and Business Media, 35, DOI: 10.1007/s10615-007-0091-7
Stamm, H. B. (2010). The concise ProQOL manual [PDF file]. Retrieved from https://proqol.org/proqol-manual
Stamm, H. B. (2009). Professional quality of life: Compassion Satisfaction and Fatigue version 5. Retrieved from https://proqol.org/proqol-measure
Leffler, D. (2019). Suicides among veterinarians has become a growing problem: Debt, nonstop stress and social media attacks are the main reasons some take their own lives. The
Washington Post. DOI: 2168678348
Tremoleda, L. J., & Kerton, A. (2020) Creating space to build emotional resilience in the animal research community. Lab Animal 49, 275-277, DOI:
https://doi.org/10.1038/s41684-020-0637-7
Figley, C.R., Stamm, H. B. (1995). Compassion fatigue/satisfaction self test (CFS) [PDF file]. Retrieved from
https://nwdrugtaskforce.ie/wp-content/uploads/2013/01/Compassion-Fatigue-Handout-6.pdf
Stayner, W. (2019, Aug 9). Suicide and veterinarians. Columbian Publishing Company. Retrieved from
Long, B. R., Krumlauf, K., & Young, M. A. (2020) Characterizing trends in human-wildlife conflicts in the American Midwest using wildlife rehabilitation records. PLOS ONE, 15(9),
