Managing grief associated with euthanasia

1. Managing grief associated with euthanasia Dianne Gardner Paper presented at the ANZCCART Conference, Auckland, June 2008 With thanks to Kerry Gibson, Centre for Psychology, Massey University, Albany, Auckland

2. Is it a problem? • Mostly studied in animal shelter workers and veterinarians. • Affinity for animals part of choice of occupation. • “Normal” reactions may include sadness, fear, guilt, irritability, depression, anger, helplessness or hopelessness. • Can feel threatened or simply philosophically uncomfortable • Can be a major source of stress • Stress can be related to work-family conflict, health, job satisfaction, intentions to leave. • “Moral stress”: when people are required to perform actions they have difficulty justifying on moral grounds Not everyone Not all the time

3. Who might be susceptible? • Gender • Attachment to animals • Seeing euthanasia as performed for human convenience. • Inexperience • Exposure to stressors can be cumulative BUT • Experience (of successsfully managing stressors) can lead to resilience (the stress inoculation hypothesis) • Lack of training • Lack of social support (more on that later)

4. Other factors that affect susceptibility • Species (even differences b/w dogs vs. cats in shelters) • Practices (reasons, methods) • Employee workload, feelings of support, rates of euthanasia, reasons for it. • Evaluation of euthanasia as necessary and acceptable.

5. Coping with work stressors Task focused coping • Active coping: deliberate efforts to solve the problem • Planning: working out steps to put things right. Reappraisal of the situation • Reframing: Trying to see the problem positively. • Acceptance. • Humour. Social support • Emotional support: comfort and understanding from someone • Instrumental support: practical help from someone Avoidance • Self-distraction: attempts to take your mind off it. • Denial: thinking it isn’t real/hasn’t happened. • Behavioural disengagement: doing something else. • Self-blame. • Venting: expressing negative feelings. • Substance use.

6. Coping with euthanasia: the research • A major coping strategy was to emotionally separate from situations encountered. • “I'm not cold, but I am detached” • Can still lead to stress and emotional exhaustion • The ability to detach and desensitise is learned. • Humor • reduces tension by acknowledging death as part of the setting but also minimising for the moment tragedy and finality • Placing blame – tends to be unhelpful.

7. Managing meaning. • Rationalising: paid to do it, do it or someone else will… • Technical proficiency: becoming skilled, gaining confidence that the euthanasia was done well • Thinking of euthanasia as a humane act • “Maintaining a perspective that your work matters and is part of a larger effort by thousands of people who deeply care about animals” • “there is no conflict between caring about animals and working in research once an individual is committed to the inevitability of the invasive use of animals and has accepted a role as an animal advocate. Persons in such a position are all that stand in the way of animals being treated solely as tools.” (Rollin).

8. Social support • Can be hard to find people who can listen without judging. • Source of support, perception of the existence of support and, most importantly, satisfaction with support • Sources: • peers • companion animals • management

9. Other individual strategies that may work. • Good self-care • Leisure, having fun, hobbies, time in nature • Finding a relaxation technique that works for you; • Knowing when to ask for help – everyone experiences frustration or weariness. • Supportive peer supervision - examine stressful and often emotionally demanding situations in a safe and confidential environment. • Mentors • If you decide to seek help, identify a counsellor or psychologist who understands compassion fatigue and is familiar with your profession.

10. The danger of focusing only on what individuals do… • Increasing interest in healthy work. • The legal context puts responsibility on workplaces to manage psychological harm resulting from work-related stress (HSEAA, 2003) • Rules protect the animals not the staff??

11. Organisational factors can help • Larger organisations may have more social and financial resources to help employees. • Importance of good HR practices in staff selection: structured interviews, work samples, realistic previews. • Training: easing new employees in is recommended.

12. Organisational culture Some damaging cultures (i.e. sets of values, norms) found in organisations that deal with traumatic work. • A culture of denial (emotional numbing) • A culture of helplessness (‘a drop in the ocean’) • A culture of suspicion (mistrust, overly concerned with rights) • A culture of bonding (people band together - but against a real or perceived external enemy) • A culture of disintegration (loss of focus, conflict) • How about: • A culture of scientific inquiry? Of learning? Of…

13. Other important factors • Management supportiveness • Counselling (available if required) • Job rotation • Assistance or more help, breaks and time off • Skills-based training • Stress and coping seminars • Employee appreciation and morale-boosting initiatives.

14. Communication… • Feelings about euthanasia should be discussed openly. • Informal support groups canbe helpful. • It may be appropriate to take a few minutes out to share thoughts and feelings. Talking can help relieve stress and perhaps vent feelings. • Allowing time at staff meetings for exchange of ideas and feelings on the topic of euthanasia can be helpful. • Some organisations use ritual (University of Guelph, Canada - memorial service to acknowledge the use of animals and their contributions to excellence in research and teaching; Buddhist rituals at Japanese animal research facilities).

15. Other ideas • allowing requests for more time for specific animals • working in pairs when euthanizing • having a choice about whether to be in the euthanasia room with a specific animal • a Euthanasia Journal in the staff room • a prayer posted beside the crematorium • a periodic memorial service • displaying photographs to acknowledge animals that have been there

16. So what’s really happening? • Small groups • In your experience what do INDIVIDUALS do to manage euthanasia-related stress that works? • In your experience what do ORGANISATIONS do to manage euthanasia-related stress that works?

17. Personal daily debriefing(Huggard & Huggard) • Leave your professional role at work at the end of each day • Check that tasks are finished and documentation completed. • Outstanding issues: either Complete OR Delegate or Write down to do tomorrow. • Formally acknowledge that the work day is completed. • Remember what went well in the day and what didn't, focus on the positives. • Acknowledge you did your best with the resources available to you. • Say your goodbyes. • Take off your name badge or develop other personal “rituals” that signify that work is now completed. • Try hard to not take work home but if you must, create a specific space and only use it for this purpose.

18. Thank you!

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