Monday, December 5, 2016

Why vets, nurses and other health care professionals need to go to the doctor

Sometimes vets need to go to the doctor.

I used to think that the well-being of people who care for others (human and veterinary health professionals) was a side issue. But when you look at the stats, it’s a major One Health issue with potential to impact us all – so worth doing something about. 

One thing I think every veterinarian and veterinary student could do to help is to get themselves to the dentist, GP, psychologist, physiotherapist, skin cancer clinic, optometrist or whichever health professional meets their needs as early and as regularly as possible.

According to figures compiled by the Association of American Medical Colleges (and this is just one source), health professionals have high rates of stress, 
burnout and suicide.

In one US study, 45.4% of physicians had symptoms of burnout in 2011, increasing to 54.4%in 2014. 15 per cent of medical students were suffering moderate to severe depression. Only 2 in 5 with suicidal ideation sought care. The prevalence of depression in medicine residents varied from 21-43% (you can read more and check out the AAMC’s resources here). 

Physicians are twice as likely to commit suicide than members of the general population. Veterinarians are four times as likely to do so. When our mental health is impacted, the welfare of those around us – including animals and the environment – is impacted. In one study, one third of physicians had no regular health care. This is not a side issue. If health professionals aren’t engaging in health care, how can we expect the general population to do so? What message does that send about our beliefs about the importance of health care?

Sure, making appointments that fit in with our schedule can be a drag. Welcome to the world of our clients!

What if there’s nothing wrong? Establishing a relationship with a health professional or two is helpful, for when things really go wrong. Of course they might never, but it’s hard to plan in advance for health crises.

I’m not a fan of going to the dentist. But I’ve found one who can understand that anxiety and work with it. Knowing we can have a laugh is an incentive to attend check-ups. He also discovers binary asteroids on the side which doesn’t necessarily impact my oral health but it’s cool to know he’s a well-rounded human being with an awesome hobby. He also doesn't mind when I sing him the Little Shop of Horrors song. I digress.

Going to visit health professionals is a way of taking care of ourselves and of learning what it is like being in the client’s shoes. If you’ve put off that appointment all year, consider clearing a block in your schedule.

If you aren’t convinced that your own health is worthwhile (which it is!) treat it as an exercise in professional practice. What can you learn from the bedside manner of your fellow professionals?

The advice of veterinarian and counsellor David Foote is “don’t say you’re okay and everything isn’t. You can read his article here.

In other news, we’re approaching the deadline for the Vet Cook Book. This is a well-being initiative which involves sharing food, sharing a story and submitting it for others to read.

Today we’re sharing Gwen’s Awesome Pick-Me-Up Banana Cake, submitted by Gwen Shirlow in Canberra. If you’d like to share a recipe, please email vetcookbook[at]gmail.com for instructions and we will send them your way.

Gwen's awesome pick-me-up banana cake.

I was gifted this recipe (minus a few modifications I have since made) by a vet nurse I worked with as a new graduate vet in a busy rural mixed practice. It came after a weekend on-call that had started out well only to descend into back-to-back calvings, colics and stitch-ups which kept me occupied late into each night. Come Monday morning I was struggling on another busy workday when one of the lovely older nurses put a slice of this banana cake in my hand with a smile. I will be forever grateful to her. I now make this cake regularly for the nurses and vets at work and it never sits in the staff room for very long!

Ingredients:
  1. 125g unsalted butter
  2. 1.5 cups caster sugar (can substitute ¼ cup brown sugar)
  3. 2 eggs
  4. 1 cup mashed banana
  5. Vanilla essence
  6. 1/8 tsp ground allspice (if you don’t have allspice you can make it up with whatever you have – I often use ground ginger, clove, garamasala, cumin etc)
  7. ½ tsp salt
  8. ½ tsp ground cinnamon
  9. 250g plain flour
  10. ½ cup buttermilk ( or you can use regular milk with a squeeze of lemon juice)
  11. 1 tsp bicarb soda
 Topping ingredients:
  1. 3 tablespoons coarsely chopped walnuts
  2. 1.5 tsp ground cinnamon
  3. 100g butter
  4. 3 tablespoons brown sugar
Instructions
  1. Butter and flour a 20cm square (or round) tin and line with baking paper (I often leave out the paper)
  2. Preheat oven to 180 degrees
  3. Soften but don’t melt 125g unsalted butter plus 1.5cups sugar.
  4. Cream until pale and fluffy
  5. Beat in 2 eggs, 1 cup of mashed banana and a few drops of vanilla
  6. In another bowl sift together 250g plain flour, 1 tsp bicarb soda, ½ tsp salt, ½ tsp ground cinnamon and 1/8tsp ground allspice
  7. Add dry ingredients to butter mix, alternating with ½ cup buttermilk (or the regular milk with a squeeze of lemon in it)
 Topping:
  1. Combine 3 Tablespoons coarsely chopped walnuts, 1.5 cups ground cinnamon, 100g soften butter and 3 tsp brown sugar
  2. Scatter over uncooked cake and bake
  3. Bake for 45min or until clean
  4. Often need to cover with foil after 40min in oven or will burn the topping
Topping quantity can be doubled per cake if desired



Follow the VetCookBook on facebook here https://www.facebook.com/vetcookbook 

Wednesday, November 30, 2016

Do dogs synchronise their behaviour with humans?

So that's how dogs work...

What’s the legacy of your companion animals? Phil and I have engaged in a lot of citizen science to try to improve general understanding of dogs, human, and the whole dog-human relationship.

You can do it too! Our mates at Do You Believe in Dog? Are helping PhD student Charlotte Duranton at the University Aix-Marseille Laboratory of Cognitive Psychology to recruit human participants for a citizen science project.

The project is about behavioural synchrony – i.e. whether dogs synchronise their behaviour to humans. (You can read more about the project here - with a bit more of an explanation of the science behind this question).

Charlotte needs participants who are dog owners AND she needs NON-dog owners too. That seems to account for everyone on the planet.

It takes about 10-15 minutes and requires you to view some videos and provide responses. (I completed the study while Phil slept in – he loves citizen science).

In other news, one of our readers shared this photo essay about dogs in bags on the New York subway. 

Monday, November 28, 2016

Great advice for vets and other news

Dixie does her best to blend in to the rug.

Our colleague Dr Jim Euclid runs Vetx.com, a fantastic free blog/vlog/forum for veterinarians. Recently we’ve been watching his fantastic interviews, including with Professor Richard Malik and Dr Charles Kuntz. These contain advice for recent and experienced graduates that is definitely worth a look, as well as fascinating insights into veterinary career trajectories. Registration is free. Find it here.

If you’re in Melbourne and interested in health (human or non-human), consider coming along to the Future Health Leaders dinner on Saturday night. Aside from great food and great company, there will be a great talk (I hope so – I’m the speaker) about the importance of One Health. Tickets are very reasonably priced and available online.

We’re still working hard on the Vet Cook Book. In the interests of gender balance, we are hoping a few more blokes share the culinary skills we know they have! Check out our facebook page at https://www.facebook.com/vetcookbook

Friday, November 25, 2016

How do you deal with stress when you have a stressful job?

Skye has no trouble amplifying pleasure. She's pictured having a massage on the deck, getting her relaxed face on.

How do you deal with stress when you have a stressful job? It’s a commonly asked question but it was a topic of discussion in a session lead by psychologist Emily Scanlan at the Australian Veterinary Association’s regional conference in Coff’s Habour recently. Dr Scanlan covered a lot of ground but for me there were some standout points.

  1. Regarding burnout, “most of us have a bit of it going on.” It is part of being stretched and challenged. Dr Scanlan argued that veterinarians and nurses have made a conscious decision to pursue a meaningful career. Meaning can’t be taken from us, but burnout can be associated with falling out of touch with that meaning. “It steals the zest for living.” Thus burnout is not just the absence of happiness but a bit of an existential crisis, e.g. what is the point? Why am I doing this? It brings a negative bias to thinking, reduces energy levels, limits creative thinking, limits compassion and causes irritability and so on. Getting back in touch with why we do what we do is important in tackling burnout.
  2. When we think about animals with behaviour problems, we often address these in terms of biology, training and environment. The same approach can be used with people when we are trying to change our lives. We can work on the biological (getting more sleep, improving nutrition, removing or reducing alcohol intake), environmental (seeking support, reducing working hours) and psychological (challenging types of thinking, working through unprocessed grief).
  3. We need to separate our work from our personal selves. As Dr Scanlan said, “You are NOT your job but vets find it difficult to separate work from who they are.” She recommends having some sort of ritual, even if it’s just having a shower and changing clothes (usually not negotiable when you’re a vet coming home from work – at least if you live with other Homo sapiens!), to delineate the working self from the home self.
  4. Pleasure amplification is a skill. Knowing what brings positive feelings and amplifying these is a skill that often needs deliberate cultivation. This reminded me of a conversation I had with a workaholic friend a few weeks ago who was giving herself gradual exposure to unstructured time. It actually takes training to enjoy this time. Dogs and cats seem to be much better at it than we are.                 


Wednesday, November 23, 2016

Pathology-themed mocktails from The Vet Cook Book

The Vet Cook Book, pathology, mocktail, medical themed drink
Wait - these aren't what you think! They're healthy mocktails!

Earlier this year SAT teamed up with Dr Deepa Gopinath and Asti May to compile The Vet Cook Book. The idea is to promote collegiality in a profession in which many feel isolated. We set up a facebook page and since then entries have been dribbling in.

If you’ve not heard here is how it works: any vet, nurse, technician or person associated with the profession can submit a recipe or recipes.

BUT you also need to make it and send us a photo or two – of the ingredients, the recipe, people enjoying the recipe, something related to the recipe or just your budgie if you need to.

We’re also after a bit of a story. It can be short, long or in between but something our readers can learn about how a colleague helped you through a tough time, or good advice you’ve been given, or the ways you deal with the challenges of working in this profession.

We’ve had a lot of entries but keen to have a few more, especially in the lunches, main meals and vet-themed snacks departments. If you need more info, please email us at vetcookbook[at]gmail.com

Pathology-themed healthy mocktails

The making of...
These beverages are not for everyone. I tend to cope better with reality when I know the gory details and with a dose of gallows humour. When I acquired a Nutribullet juicer I realised that many of the juices I made resembled fluids I was sending to the lab. It didn’t take a lot of tweaking to invent these mocktails, which have the dual benefit of appearing disgusting AND being healthy. Certain friends love these, certain friends run a mile from them. They’re definitely a talking point.

Mocktail name à
Ingredients
Biliary peritonitis
Chylothorax
UTI with uroliths
Haematuria
1 Banana
X
X


1 tablespoon cashews
X
X


2 teaspoons agave nectar
X
X


1 cup loose-leaf spinach
X



1 cup water
X

X
X
2 tablespoons ground flaxseeds




1 cup almond milk

X


2 teaspoons white chia seeds


X
X
1 apple (peeled)


X
X
1 pear


X
X
1 handful raspberries



X

medical milkshake, vet cook book
The ingredients for the chylothorax cocktail.

Chyle, chylothorax, mocktail
The end product.
Instructions:
  • 1.   Put the ingredients in a juicer and flick the switch.
  • 2.   Serve chilled.

Serving suggestion: for the full effect, serve in sterile urine jars. But if you do this be absolutely certain to ensure these are not left in the work place or they may be confused with actual samples.

To follow The Vet Cook Book, check out our facebook page https://www.facebook.com/vetcookbook/

Sunday, November 20, 2016

Survival tips for new and recent graduates

I graduated a while ago now, but I am pretty sure if I came across these girls in my waiting room I'd feel like a new graduate (also, pretty perplexed as to how they got in).

About to graduate with a veterinary degree? Are you a new graduate? Are you a recent graduate? A recent graduate, according to organisations like the 
Australian Veterinary Association and the Centre for Veterinary Education, is someone who graduated within the last three years.

The reality is I felt like a recent graduate for a bit longer than that! It’s all relative, I suppose. One of my colleagues says it takes a good five years to find your feet in practice.  It would be interesting to survey veterinarians as to their own definitions of new/recent/not-so-new/what do you call vets at the other end of the spectrum vets. No doubt there are people with decades of practice under their belts who feel, in some ways, like new graduates.

The Centre for Veterinary Education is hosting its annual Recent Graduate Survival Seminar this week. It’s a very reasonably priced 1.5 day seminar which reviews key areas you need to be across to survive – and thrive - in practice. This includes ophthalmology, surgery, dermatology, medicine, anaesthesia, pathology, avian patients and veterinary ethics (I’ll be opening the latter can of worms).

They haven’t paid us* – nor even asked us – to mention that there are spots remaining, but here at SAT we’re big supporters of initiatives that support junior colleagues. For more info, click here.

*Smallanimaltalk does not undertake any paid advertising. 


Friday, November 18, 2016

What do veterinarians and astronauts have in common?

The universe works in mysterious ways. I was thinking about this post over lunch when the pathology courier turned up in this car featuring a feline astronaut. Major Tom???
“Imagine you're in your living room, intently reading a book, and then you look up casually and you're face to face with a tiger. No warning, no sound or smell, just suddenly, that feral presence.”
That is Col. Chris Hadfield's description of taking a break from a technical task on a spacewalk and looking behind him at the entire universe. 

The highlight of this week was seeing another astronaut, Terry Virts, give a talk on perspective, having spent over 200 days in space. The talk was hosted by the School of Life.

I need a car like this!
Sure, vets have stressful days at work, but few of us have ever space walked, where a millimetre-thin visor and awkward, bulky space suit are the only things between us and instant death. (I say few of us because I know of and have spoken to at least one veterinarian astronaut – RichardLinnehan).

Astronauts have a unique perspective on the world. They get an overview of the wonders of nature, as well as anthropogenic environmental damage (according to Col Virts, you can see – among other things – deforestation of the Amazon and smog from space). They see how finite a resource the planet is – a perspective that many of us struggle to empathise with, making behaviour change difficult to motivate.

So what did I learn? Not much about being a vet (except I am glad I didn’t have to be a test pilot first), but a couple of things.
  1. It takes a few months to master the art of floating. Gravity is a lifelong habit that is hard to throw off. Virts reckoned it took him two months to learn how to float well – and use his hands to move while carrying things with his feet.
  2. There’s no weather in space. The astronauts missed this a lot and he talked about one weekend getting all the laptops together and playing the sounds of rain. Something we whinge about so much on planet earth.
  3. Being an astronaut isn’t all rocket launches and space-walking. The same way that being a vet isn’t about cuddling puppies and kittens. In fact, Col. Virts mentioned that it was around 8 years from when he got accepted into NASA’s program to when he went to space. He said something to the effect that it was fun for the first five years, but after that it was a bit of a downer when everyone said “oh, so you’re an astronaut? What’s it like in space???”. When they ARE up there it’s all about work – it seems that, just like on planet earth, there’s no escaping emails, errands, mundane tasks. They would be worn out and then at the end of the day tuck themselves into their wall mounted (so they don’t float away and impale themselves on equipment) sleeping bags. For those who wanted to, they could velcro themselves to the wall.

Something I learned from Chris Hadfield's book is that worst-case scenario thinking is actually useful – and can have a positive impact on mental health. They simulate everything – multiple times – from fires in space to computer failure (I wonder if they are cursed by ill-timed Windows updates?) to their own deaths.
“While play-acting grim scenarios day in and day out may sound like a good recipe for clinical depression, its actually weirdly uplifting. Rehearsing for catastrophe has made me positive that I have the problem -solving skills to deal with tough situations and come out the other side smiling. For me, this has greatly reduced the mental and emotional clutter that unchecked worrying produces, those random thoughts that hijack your brain at three o'clock in the morning.”
This has made me realise two things. First, I am definitely sure I don't wish to become an astronaut (in awe of them though I am). Second, astronauts and veterinarians have a lot more in common than I thought.
“An astronaut is someone who's able to make good decisions quickly, with incomplete information, when the consequences really matter.”
And we don’t have to wait sometimes a decade between missions!

Reference

Hadfield, C (2013) An Astronaut's Guide to Life On Earth: Life Lessons From Space. Pan Books.