Work-life balance is essential to reducing burnout, improving well-being.

OBJECTIVE: To assess levels of burnout, well-being, and mental health of veterinarians and compare them to those of nonveterinarians by use of validated instruments, and to identify the predictive values of techniques individuals can use to help reduce burnout and/or improve well-being and mental health. SAMPLE: An online survey of 4,636 veterinarians from a random sample of 40,000 US veterinarians provided by the AVMA. METHODS: The study was fielded from September 11 to October 9, 2023. RESULTS: Burnout and well-being of veterinarians were generally consistent with that of employed US adults. Serious psychological distress was more common among veterinarians than in the general population. Veterinarians on average were more likely to score higher in neuroticism than nonveterinarians, and neuroticism was a predictor of low well-being, poor mental health, and burnout. Work-life balance, an effective coping mechanism for stress, and working in a positive clinic culture were among the significant factors that predicted good well-being and mental health and reduced burnout. CLINICAL RELEVANCE: The higher percentage than the norm of veterinarians with serious psychological distress was a concern. Focusing on maintaining a good work-life balance and adopting a reliable coping mechanism can potentially help reduce distress. Veterinary medicine is an inherently stressful profession. The purpose of this study was to identify key factors that contribute to burnout, well-being, and mental health and to determine what behaviors and management techniques help reduce stress and burnout and contribute to well-being and mental health, thus improving job satisfaction and personal fulfillment.

Psychological implications of humane endings on the veterinary profession.

The veterinary profession has a unique responsibility to animals during the final stages of their lives. The veterinarian's obligations extend to humane endings, involving all species of animals in a range of circumstances including, but not limited to, euthanasia of individually owned animals, euthanasia of animals for research purposes, depopulation of animals during emergencies, and slaughter of animals raised for food. The veterinary profession continues to improve animal welfare through advances in end-of-life decision-making and humane killing techniques,1-3 but the psychological impacts on veterinarians have not received the same level of consideration. Building on the influential AVMA Humane Endings Guideline, the AVMA recognizes that support for the mental health of veterinarians engaged in such activities needs to be a priority. This article aims to provide the foundation and rationale for improved preparation and establishment of sustainable mental health resources and to offer recommendations on pragmatic solutions to support and prepare veterinary professionals as leaders impacted by participation in humane endings-related activities. While end-of-life decision-making and implementation may present mental health challenges to veterinarians, it is crucial to recognize that there are stressors specific to each situation and that every individual's experience is valid. Addressing the mental health issues surrounding the decision-making process and implementation of humane endings activities start with a comprehensive understanding of each activity's unique context and the veterinarian's leadership role. Therefore, this article highlights the psychological impact of depopulation and its similarities and exclusive challenges compared with euthanasia and humane slaughter.

Emotive Themes from Tennessee Cattle Producers Regarding Responsible Antibiotic Use.

To improve judicious antimicrobial use (AMU) in food animals in the United States, all feed additives that were medically important antimicrobials were moved from over the counter to Veterinary Feed Directive in 2017. This action required a change in behavior of producers' AMU practices. Because emotions are important aspects of behavior, several behavioral interventions have targeted people's emotions as means of effecting change. Hence, understanding and incorporating the emotional experiences of producers towards current AMU practices can be a starting point to making future behavioral changes that could reduce the emergence of antimicrobial resistance challenge. Between June 2017 and March 2018, seven focus group meetings of Tennessee (TN) beef and dairy cattle producers were conducted to evaluate producers' emotional views regarding responsible AMU in TN cattle. Sixty-two TN cattle producers participated and emotively expressed the following: (1) deep connections to animals in ways that improve animal and public health; (2) pride in their quality of products; (3) distress that consumers misconceive their AMU practices as indiscriminate; and (4) recommended that producers be more transparent about their AMU practices and the public improve their awareness for detecting marketers' deceptive product labels that take advantage of public ignorance. Knowledge of these producers' emotions would help educators target more successful behavioral change campaigns, improving stewardship in AMU practices among producers.

Executive summary of the Merck Animal Health Veterinarian Wellbeing Study III and Veterinary Support Staff Study.

OBJECTIVE: Merck Animal Health Veterinarian Wellbeing Study III was conducted to continue to monitor mental health and well being within the veterinary profession in the US and to identify factors associated with high levels of wellbeing and lack of serious psychological distress. METHODS: A questionnaire consisting of several instruments and questions for measurement of mental health and wellbeing was completed by 2,495 veterinarians and 448 veterinary support staff. Results for veterinarians were weighted to the US AVMA membership. RESULTS: This study revealed that wellbeing and mental health of some veterinarians declined over the past 2 years, driven in part by the COVID-19 pandemic and extreme labor shortages. Burnout remained at a high level, but there was no increase in suicide ideation. A new companion survey of veterinary support staff demonstrated that staff scored lower in wellbeing and mental health, and higher in burnout than veterinarians. CLINICAL RELEVANCE: Importantly, these studies identified techniques that both individuals and employers may find useful in fostering wellbeing and good mental health. A healthy method for coping with stress and good work-life balance was important, as was engaging a financial adviser for those with student debt or other financial stresses. Employers should create safe environments where employees feel comfortable seeking help, reducing the stigma associated with mental health issues. In addition, employers can provide Employee Assistance Programs and health insurance that covers mental health treatment. Fostering a healthy work culture was also important, one with good communication, teamwork, trust, and adequate time allotted to provide quality patient care.

Pet Ownership and Quality of Life: A Systematic Review of the Literature.

Pet ownership is the most common form of human-animal interaction, and anecdotally, pet ownership can lead to improved physical and mental health for owners. However, scant research is available validating these claims. This study aimed to review the recent peer reviewed literature to better describe the body of knowledge surrounding the relationship between pet ownership and mental health. A literature search was conducted in May 2020 using two databases to identify articles that met inclusion/exclusion criteria. After title review, abstract review, and then full article review, 54 articles were included in the final analysis. Of the 54 studies, 18 were conducted in the general population, 15 were conducted in an older adult population, eight were conducted in children and adolescents, nine focused on people with chronic disease, and four examined a specific unique population. Forty-one of the studies were cross-sectional, 11 were prospective longitudinal cohorts, and two were other study designs. For each of the articles, the impact of pet ownership on the mental health of owners was divided into four categories: positive impact (n = 17), mixed impact (n = 19), no impact (n = 13), and negative impact (n = 5). Among the reviewed articles, there was much variation in population studied and study design, and these differences make direct comparison challenging. However, when focusing on the impact of pet ownership on mental health, the results were variable and not wholly supportive of the benefit of pets on mental health. Future research should use more consistent methods across broader populations and the development of a pet-ownership survey module for use in broad, population surveys would afford a better description of the true relationship of pet ownership and mental health.

Are They Ready? Trials, Tribulations, and Professional Skills Vital for New Veterinary Graduate Success.

Stress and burnout levels are high among young veterinarians with the transition to practice being particularly challenging. This qualitative study aimed to capture and document the new graduate veterinary experience within the United States and which professional skills are most important for success during the transition to practice. The researchers sought to better understand this challenging transition period and provide insight for veterinary educators who are tasked with preparing new veterinary graduates for day 1 practice readiness. To gain a deeper understanding of the new graduate experience, a focus group was conducted with six veterinarians who recently graduated from four different U.S. veterinary colleges. Several themes arose regarding their experiences in the transition to practice including setbacks and adaptations, self-sufficiency and self-doubt, changing clientele and ethical dilemmas, leadership and conflict, and good vs. bad mentorship. Self-care, conflict management, and client communication were perceived as the most important professional skills for success in the transition to practice. New graduate veterinarians reported that they were least prepared for working with clients with financial constraints and managing conflict. Drawing from this qualitative data, the researchers propose several topics that could be incorporated into professional skills curriculum to further enhance day 1 preparedness of new veterinary graduates to promote well-being in the transition to practice.

A survey of antimicrobial use practices of Tennessee beef producers.

BACKGROUND: Inappropriate antimicrobial use (AMU) is a key modifiable factor that leads to the development of antimicrobial resistance (AMR). The objectives of this study were to determine the following among Tennessee beef cattle producers: (1) the opinions on factors driving AMU (2) opinions on alternatives to antimicrobials, (3) the knowledge and perceptions regarding AMU and AMR, and (4) the preferred avenues for receiving information on prudent AMU. A survey questionnaire was made available to participants both in print and online from January 26, 2018 through May 11, 2018. The questions targeted the producers' demographics and their AMU practices; factors driving producer's choice of antimicrobials; perceptions, opinions and concerns about AMU and AMR in cattle production. Ordinal logistic regression was used to test for associations between the captured demographic information and producers' degree of concern about AMR. RESULTS: Overall, 231 beef producers responded to all or some of the survey questions. More than 60% of the participants mentioned that they kept up-to-date written records on antimicrobial purchases and AMU. Regarding extra-label use, 169 (84.1%) of the 201 respondents did not practice extra-label AMU. Profitability of the beef operation was a key factor influencing the decisions of many producers to use antimicrobials for disease management and prevention on their farms. Of the 228 producers who completed the question on the rating of their degree of concern about AMR, 50 (21.9%) reported that they were very concerned about AMR, 133 (58.3%) were moderately concerned, and 36 (15.8%) reported that they were not concerned about AMR. Nine producers (4%) did not rate their degree of concern about AMR because they were not familiar with what antimicrobial resistance meant. The inferential analyses suggested that younger beef producers were significantly less concerned about AMR when compared to the older ones (P = 0.019). Regarding avenues for receiving information on prudent AMU, no single medium was most preferred by all the respondents. CONCLUSIONS: There is a need to promote the use of written antimicrobial treatment protocols among beef producers in Tennessee. Continued training for beef producers on infection prevention and control and prudent AMU is needed.

Perceptions of Tennessee cattle producers regarding the Veterinary Feed Directive.

Since January 1, 2017, the United States Food and Drug Administration (FDA) has fully implemented the Veterinary Feed Directive (VFD) final rule aimed at facilitating the judicious use of medically important antimicrobials in food-producing animals. The objective of this study was to identify the common perceptions of Tennessee (TN) cattle producers regarding the VFD. We used a combination of focus groups and survey questionnaires to explore TN cattle producers' perceptions regarding the VFD. Preliminary findings from seven focus groups of 62 producers were used in the development of the questionnaire sent both online and in-print to rest of cattle producers in TN. The beef focus group participants perceived the VFD: to be a top-down policy; to have led to unregulated access to in-feed antimicrobials; a regulation that has limited the producers' ability to prevent disease and leading to economic losses; to negatively affect small producers; and to be affected by challenges related to prescription writing and disposal of un-used medicines. The dairy focus group participants perceived the VFD as unnecessary and burdensome, to have affected small producers, and introduced additional costs. Among the survey questionnaire respondents, 35 (15.4%) beef producers and 6 (13.6%) dairy producers respectively were not familiar at all with the VFD. Forty-eight (21.1%) beef producers and 11 (25%) dairy producers were slightly familiar with VFD. Gender was significantly associated (P = 0.02) with the beef producers' belief in the usefulness of the VFD. Similarly, for dairy producers, herd size was significantly associated (P = 0.002) with their perceptions regarding the usefulness of the VFD. The findings of this study could inform future VFD policy review processes. More awareness regarding the VFD and its benefits is needed among both beef and dairy producers in TN.

Brain Awareness and Conflict in Veterinary Medical Practice: What Happens and How to Deal with It.

Conflict resolution is a technical skill required in medical environments. This article explores interpersonal conflicts through a brain awareness lens and offers tools for increasing the ability to manage conflict in veterinary medical practice.

Drivers, alternatives, knowledge, and perceptions towards antimicrobial use among Tennessee beef cattle producers: a qualitative study.

BACKGROUND: In recent years, there has been an increased awareness of antimicrobial resistance in both animals and humans, which has triggered concerns over non-judicious antimicrobial use. In the United States, antimicrobial use in food-producing animals for growth promotion or improved feed efficiency is perceived as non-judicious. To facilitate judicious antimicrobial use, the United States Food and Drug Administration implemented the Veterinary Feed Directive, effective from January 1, 2017. Interventions, such as the VFD, designed to ensure the judicious use of antimicrobials among cattle producers may be more effective if the factors that inform and influence producer AMU practices are addressed. The specific objectives of this study were to determine the following among Tennessee beef cattle producers: (1) the most common drivers for using antimicrobials, (2) the perceived alternatives to antimicrobials, (3) the knowledge and perceptions regarding antimicrobial resistance, and (4) the preferred avenues for receiving information on prudent antimicrobial use. A total of 5 focus group meetings with beef producers were conducted in East, Middle, and West Tennessee. Each focus group was video recorded and thematic analysis was performed using NVivo. RESULTS: The factors that producers considered to drive antimicrobial use were the type of cattle operation, disease and animal welfare, economic factors, veterinarian consultation, producer's experience and peer support, Veterinary Feed Directive, and perceived drug efficacy. Vaccination, proper nutrition, and other good management practices were considered alternatives to antimicrobial use. To encourage vaccine use among small producers, participants suggested packaging vaccines into smaller quantities. Antimicrobial resistance was perceived to be a problem affecting animal and public health. Participants suggested additional education for cattle producers on the prudent use of antimicrobials as a measure for improving antimicrobial use. The veterinarian, producer associations and meetings, and county extension agents emerged as trusted avenues for channeling information on prudent antimicrobial use to cattle producers. CONCLUSIONS: Several factors drive antimicrobial use among cattle producers in Tennessee. Participants generally perceived their antimicrobial use to be discreet and only when necessary. More awareness of drivers for the development of antimicrobial resistance and continuing education on prudent antimicrobial use is needed for Tennessee beef producers.

Drivers of Antimicrobial Use Practices among Tennessee Dairy Cattle Producers.

Nonjudicious antimicrobial use (AMU) and inadequate antimicrobial stewardship are known modifiable factors driving the occurrence of antimicrobial resistance (AMR). A mixed methods approach using a combination of focus groups and survey questionnaires was used to explore the AMU practices of Tennessee (TN) dairy cattle producers. Specifically, the objectives of the study were to determine the following: (1) the most common drivers for using antimicrobials, (2) perceived alternatives to antimicrobials, (3) knowledge of and perceptions regarding AMR, (4) and the appropriate avenues for receiving information on prudent AMU. Two focus groups were conducted, one in July 2017 and the other in March 2018. The questionnaire was simultaneously made available to participants both in print form and online from January 26, 2018, through May 11, 2018. Twenty-three dairy producers participated in the focus groups and 45 responded to the survey. Eight (18.6%) producers never used bacterial culture and sensitivity testing (C/S) to select antimicrobials, more than half (25 producers (58.1%)) sometimes used C/S, four (9.3%) used C/S about half the time, five (11.6%) most of the time, and one (2.3%) always used C/S. The most common drivers for using antimicrobials were disease and animal welfare, pathogen surveillance, economic factors, veterinarian recommendation, producer's experience and judgment, drug attributes, and the Veterinary Feed Directive. Good management practices, vaccination, use of immunomodulatory products, and use of appropriate technology for early disease detection were considered alternatives to AMU. Four (9.1%) dairy producers were very concerned about AMR, 27 (61.4%) moderately concerned, and 10 (22.7%) not concerned. The veterinarian was considered to be a trusted source of information on prudent AMU. Use of C/S test results for antimicrobial selection is widespread among TN dairy producers. There is a need to popularize/promote selective dry cow therapy among TN dairy producers.

Adverse Childhood Experiences among Veterinary Medical Students: A Multi-Site Study.

This research explores Adverse Childhood Experiences (ACEs) among veterinary medical students across six academic institutions of veterinary medicine, and their relationship with depression, stress, and desire to become a veterinarian. Between April 1, 2016, and May 23, 2016, 1,118 veterinary medical students in all 4 years of the curriculum (39% response rate) completed an anonymous web-based questionnaire about ACEs, depression using the Center for Epidemiological Studies Depression scale (CESD), stress using the Perceived Stress Scale (PSS), and the age at which they wanted to become a veterinarian. Sixty-one percent (677) of respondents reported having at least one ACE. The most prevalent ACE reported was living with a household member with a mental illness (31%). Students who had experienced four or more ACEs had an approximately threefold increase in signs of clinical depression and higher than average stress when compared to students who had experienced no ACEs. The number of ACEs showed an overall graded relationship to signs of clinical depression and higher than average stress. There was no statistically significant relationship between age at which a student wanted to become a veterinarian and exposure to ACEs. Veterinary students report being exposed to ACEs before age 18 at a rate similar to that of other population-based studies. These findings do not suggest that veterinary students enter the veterinary medical education system more at risk for poor mental health due to ACEs than the general population.

Mindful Mates: A Pilot Study of the Relational Effects of Mindfulness-Based Stress Reduction on Participants and Their Partners.

Very little is currently known about how increases in dispositional mindfulness through mindfulness training affect the quality of participants' romantic relationships, and no previous studies have examined how increases in specific facets of mindfulness differentially contribute to relationship health. Additionally, even less is known about how an individual's development of mindfulness skills affects the relationship satisfaction of his or her romantic partner. Thus, the purpose of this pilot study was to examine associations between changes in facets of mindfulness and relationship satisfaction among participants enrolled in a Mindfulness-Based Stress Reduction (MBSR) course and their nonenrolled romantic partners. Twenty MBSR participants and their nonenrolled partners (n = 40) completed measures of mindfulness and relationship satisfaction pre- and post-enrolled partners' completion of an MBSR course. Results indicated that enrolled participants significantly improved on all facets of mindfulness and relationship satisfaction, while nonenrolled partners did not significantly increase on any facet of mindfulness or relationship satisfaction. Moreover, enrolled participants' increases in Acting with Awareness were positively associated with increases in their own and their nonenrolled partners' relationship satisfaction, whereas increases in enrolled participants' Nonreactivity were positively associated with increases in their nonenrolled partners' (but not their own) relationship satisfaction. These results suggest that increasing levels of mindfulness (particularly specific aspects of mindfulness) may have positive effects on couples' relationship satisfaction and highlight mindfulness training as a promising tool for education and intervention efforts aimed at promoting relational health.

Peer-assisted communication training: veterinary students as simulated clients and communication skills trainers.

Mounting research supports the use of peer-assisted learning (PAL) as a teaching method in human and veterinary medicine. PAL can be a cost-efficient educational tool, saving both financial resources and faculty time. This article reviews a PAL model for teaching communication skills to veterinary medical students. In this model, junior veterinary students served as simulated clients for sophomore veterinary students. Details regarding methods of program delivery as well as evaluation data are presented. Differences between two student cohorts who participated in the PAL educational model and their subsequent evaluation results are discussed. Overall, veterinary medical students reported that this approach was beneficial and that the topic was critical to their success as veterinarians. Students also showed improvement in communication knowledge and reported that peer feedback was a strength of the program. Finally, future directions to assess and strengthen the use of PAL for communication training in veterinary medical education are proposed.

Homeless people who are animal caretakers: a comparative study.

Data from a Homeless Management Information System (HMIS) were used to compare homeless people who report caring for animals with homeless people who do not report caring for animals, based on demographic variables and stated reasons for homelessness. Among homeless clients (N = 4,100; M age = 39 yr., SD 13.2), 5.5% reported animal caretaking; demographic differences between caretaking and not caretaking homeless clients and life factors related to homelessness were most often associated with animal caretaking. 41% of participants (n = 1,664) were female, and 59% (n = 2,436) were male. Findings suggest that first-time homeless, Euro-American women who were homeless due to domestic violence were the most likely to say they were caring for animals. The use of such an information system could aid in identifying this subpopulation and coordinating services for animal care.

Enhanced communication by developing a non-anxious presence: a key attribute for the successful veterinarian.

In the recent past much has been written about non-technical skills in veterinary medical education. This dialogue has focused extensively on competence in behaviorally based communication skills for successful veterinary practice. Other relationship-based communication skills are also useful in communication, such as self-awareness, flexibility, non-judgment (compassion), and being present. All of these relationally based skills are present in the concept of non-anxious presence. This article will review the history of the term ''non-anxious presence'' (NAP), discuss a proposed model of NAP for the veterinary medical environment, and review some methods useful in teaching NAP in veterinary medical education.

Quality of life and stress factors for veterinary medical students.

Psychological distress has been shown to affect the academic success, health, emotional well-being, and dropout rates of medical students. Although it can be assumed that stress has similar effects on veterinary students, there is a paucity of research pertaining to the psychological stressors and coping strategies of this group. This article focuses on selected non-academic areas (as identified through a survey of currently enrolled students) that can create significant stressors for veterinary students. Also assessed and discussed here are poor coping strategies (e.g., substance abuse) and gender differences in perceived stressors and coping strategies that emerged from the survey. Results suggest the need for veterinary programs to integrate academic and professional skills instruction with personal life balance training and access to psychological services.

To leave or to stay?: Battered women's concern for vulnerable pets.

Consistent with previous research, almost half of a sample of 41 pet-owning battered women reported that their partners had threatened or actually harmed their pets, and over a fourth reported that concern for their pets had affected their decisions about leaving or staying with the batterer. Differences between rural and urban women were not significant, although higher proportions of rural than urban women reported that their partners had threatened or harmed their pets and that concern for their pets had affected their decisions. For the sample as a whole, logistic regression analyses showed that women whose pets had been threatened or harmed were significantly more likely to report that concern for their pets had affected their decisions about leaving or staying. The findings suggest that service providers should inquire about battered women's concern for their pets and should include arrangements for animals in safety planning.