Stay essential by protecting selves, others

Presenters at AABP meeting say veterinarians need to address personal needs
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Jen Brandt, PhD, said being essential to clients can be exhilarating and draining.

Dr. Brandt, member well-being and diversity initiatives director for the AVMA, told cattle veterinarians at an American Association of Bovine Practitioners meeting that veterinarians need to care for themselves. At the group's annual meeting Sept. 13-15 in Phoenix, a series of lecturers described ways veterinarians can become indispensable to clients (see story).

Dr. Brandt was among several speakers who described ways veterinarians can keep themselves fit for work, protect others who work on client farms, and avoid bringing pathogens home.

Citing the Merck Animal Health Veterinary Wellbeing Study, the executive summary of which JAVMA published in its May 15 issue, Dr. Brandt noted that food animal veterinarians who responded to the survey were among groups that reported higher-than-average well-being.

"The prevalence of serious psychological distress was generally consistent across practice types, except that it was low to nonexistent for respondents in food animal practice," the article states (J Am Vet Med Assoc 2018;252:1231-1238).

But Dr. Brandt said the study does not indicate those veterinarians are without stress.

She described the benefits of focusing on the control veterinarians have over their own lives, the influence of lack of sleep on work and relationships, and a misconception that self-care is easy. In addition to addressing physical needs such as nutrition and hydration, veterinarians can care for mental needs by making clients call the office rather than their personal phone or keeping a journal of things that make them grateful.

Scott J. Uhlenhake, a physical therapist from Ohio who has worked with cattle veterinarians, got attendees out of their chairs to stand, stretch, and think about their posture and movements. He described the best relationship between shoulder and arm positions while working, the risks from outstretched arms during work, the need to minimize or break up repetitive tasks, the ways people can put stress on joints while carrying heavy objects, and the help given by supportive shoes and good sleeping positions.

Even a few minutes of stretching outside a truck between calls can help, he said.

Caring for others

Dr. Noa Roman-Muniz, an associate professor in the Department of Animal Sciences and extension dairy specialist at Colorado State University, said farms are getting bigger and hiring more workers.

They come from various countries and often speak Spanish or K'iche' as their first language, she said.

"We were not taught how to be experts in teaching, and now the farm managers are counting on us to teach," she said.

She recommends that veterinarians, when talking with farm workers, listen, watch body language, encourage questions and stories, have humility, and emphasize that they share the goal of raising healthy and productive cows.

"At the end of the day, we all smell like manure," Dr. Roman-Muniz said, quoting a friend.

We cannot forget about the social aspect or the people aspect of farming.

Michelle Calvo-Lorenzo, PhD, a technical consultant for Elanco Animal Health and presenter at the AABP annual meeting

By knowing what others go through on farms, veterinarians know what needs to change.

Michelle Calvo-Lorenzo, PhD, a technical consultant for Elanco Animal Health, said the welfare of workers on farms and ranches is tied to the welfare of cattle.

"We cannot forget about the social aspect or the people aspect of farming," she said.

Attitudes influence people's behavior, which influences fear and stress levels in animals, affecting production.

The feedlot industry has low worker retention rates that may improve if employees are treated as professionals whose work contributes to a larger mission, she said. Give them meaningful work, help minimize stress, and build a culture with positive attitudes toward animals, she said.

Workers need training toward long-term career opportunities, Dr. Calvo-Lorenzo said. They also need to feel safe.

Data from the Bureau of Labor Statistics indicate that, in 2016, people working in cattle ranching and farming reported about five injuries for every 100 workers, whereas the mean for all industries was three per 100 workers. The rate is about even between dairy and beef production.

The veterinary profession—including veterinarians, veterinary technicians, and office staff—had a rate of 12 injuries for every 100 workers that year (see JAVMA, Nov. 1, 2018).

Protecting selves, clients, families

Dr. Danelle A. Bickett-Weddle, associate director of the Center for Food Security and Public Health at Iowa State University, recommends finding out what disease risks keep clients up at night. Ask questions, listen, and address those needs first.

Dr. Bickett-Weddle
Dr. Danelle A. Bickett-Weddle talks about disease risk during the American Association of Bovine Practitioners meeting, held this past September in Phoenix. (Photo by Greg Cima)

She also encouraged meeting attendees to think about how often clients bring in new animals, what tests are performed, and what the veterinarian and client do with that information. Disease risk can be managed but not eliminated, she said.

She noted the hierarchy of a hazard control system that ranks risk-reduction methods from most to least effective: elimination, substitution, engineering controls, administrative controls, and personal protective equipment. Eliminating or substituting for a lesser risk is impractical for preventing Salmonella infection, for example, but people add engineering controls that improve food handling and preparation and administrative ones such as procedures for cleaning and disinfecting areas where animals live, in addition to using PPE such as face shields and gloves.

She also cautioned that fomites can spread disease to vulnerable people. She knows of a veterinarian whose son was hospitalized with hemolytic uremic syndrome as a result of infection with Escherichia coli likely brought home from a client's farm.

Dr. Bickett-Weddle said dissolvable laundry bags, designed for travelers, could help. So could designating areas of a truck as clean or dirty and making sure items that risk spreading contamination stay, for example, in the back.

Dr. Bickett-Weddle also recommended consulting information from the Center for Food Security and Public Health and compendia from the National Association of Public Health Veterinarians.

Biosecurity is difficult, and it tends to be unnoticed when it is working, she said.

Related JAVMA content:

Hurt at work (Nov. 1, 2018)

CSU launches certificate in Spanish for animal health and care (Sept. 1, 2018)

Mental health, well-being problem serious, not dire: study (Feb. 15, 2018)